Don’t neglect your annual physical exam
Multiple sclerosis can be like a problem child: attracting all of your energy and attention to the neglect of everyone else in the family. But MS is only one aspect of your overall health, just as living with MS is but one aspect of your daily life.
Most people don’t suffer from other medical conditions when they are first told they have MS. A recent study in France found that 95% of people with MS had no other chronic illnesses at the time of their diagnosis (Fromont and colleagues. J Neurol 2013; epublished August 2, 2013). So despite MS itself, most people are generally healthy – but this good health needs to be maintained through the years of living with MS. Much of your focus will be on relapses and other symptoms, but this can distract you from the larger picture. MS provides no protection against other medical conditions. So while it’s important to keep your appointments at the MS clinic, it’s equally important to keep seeing your family doctor for an annual physical examination.
As in the general population, a key health problem in people with MS is heart disease. Common problems are high blood pressure and high cholesterol levels (Marrie & Hanwell. Continuum [Minneap Minn] 2013;19:1046-1057). A recent study found that people with MS are slightly more prone to develop heart disease (Wens and colleagues. Mult Scler 2013; epublished September 18, 2013). This is probably not due to the MS disease process but is an indirect effect. If it’s harder to be physically active, there’s a greater tendency to obesity, high blood pressure and diabetes, which in turn are risk factors for heart disease.
Some medical conditions are linked to MS. Two common problems in people with MS are migraine and bowel symptoms, such as irritable bowel syndrome (IBS) (Marrie and colleagues. Neuroepidemiology 2013;40:85-92). IBS symptoms can include bloating, abdominal pain, constipation or diarrhea, or changes in your bowel habits. Your neurologist can prescribe medications if you suffer from migraines or frequent headaches. Bowel symptoms can be treated by your family doctor or your MS clinic team. A referral to a gastroenterologist may be needed to treat IBS and to rule out other conditions that may be causing your symptoms.
Impairments in mobility can contribute to a host of problems. In addition to heart disease, a particular concern is osteoporosis. This is made worse by low vitamin D levels – a common situation in people with MS – and may be helped by vitamin D and calcium supplements. Osteoporosis is a particular concern because MS is associated with a higher risk of falling down due to MS symptoms such as impaired vision, altered gait and balance problems. Osteoporosis treatments coupled with exercise (to strengthen and stabilize muscles) can help guard against fractures and other complications.
Perhaps the greatest challenges of living with MS are not physical: they are psychological. The daily battles can wear on your optimism and outlook, and symptoms of depression are a common problem. Depression is more than just a psychological condition. It also has a physical side, with symptoms such as fatigue, difficulty sleeping, and changes in appetite or weight (either increased or decreased appetite/weight). Depression will have an impact on your overall physical health and is one of the most important contributors to early death (Chruzander and colleagues. J Neurol Sci 2013;332:121-127). So if you’re suffering from symptoms of depression, it’s important not to downplay or ignore them. There are many health professionals in your community – your family doctor, neurologist, MS nurse or psychologist – who can help you with counselling, coping strategies or medications.
An annual physical exam is a contract you make with yourself to take care of your whole person. Booking an appointment is a simple step in your commitment to maintaining your overall health, and to staying strong in your ongoing battle with MS.
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