Living With Multiple Sclerosis

Vitamin and Mineral Supplements

Unless there is a specific vitamin deficiency found by your doctor there is no scientific proof that supplementary doses of vitamins or minerals, alone or in combination, favorably affect the course of the disease. Be careful not to take excessive doses of vitamin B6 because excessive doses of this vitamin can produce sensory symptoms similar to those seen in MS. High doses of vitamin A and D are toxic.

Oleic and Linoleic Acids

These fatty acids have been reported to be deficient in MS patients. There is an unconfirmed suggestion that supplementary feeding of these fatty acids may slightly reduce the frequency of MS attacks. These fatty acids are contained in sunflower seed oil and primrose oil. The former is much cheaper and readily available in grocery stores. Two tablespoons of sunflower seed oil each day will provide you with these fatty acids and give you the added benefit of a laxative.

Skin Care

If you have problems with mobility, muscle contractures or are confined to a wheelchair, you should check your skin regularly for sores, pressure spots, infections and abrasions. Regular skin care will minimize the chances of skin breakdown and help you to avoid complications such as a decubitus ulcer. Be sure to check the pressure points on your body including your heels, knees, hips, buttocks and elbows. Remember to protect against skin cancer by wearing sunscreen and protective clothing when outdoors, whether it is sunny or not. Get familiar with your skin and examine it frequently.

Urinary Tract Infections

Vitamin C helps to acidify the urine and prevent the growth of bacteria. Orange juice or vitamin C tablets are both useful. Cranberry juice also will acidify the urine and is available as a sugar free juice for those who count calories. If you develop new urinary frequency, burning when you urinate or have difficulty passing your urine, you should call your doctor and be seen for the possibility of a urinary tract infection.

Vaccinations

There has traditionally been a concern that immunizations could worsen MS by stimulating the immune system. With the exception of transient worsening associated with fever or rare neurological complications known to be associated with certain vaccines, there is no convincing evidence that immunizations make MS patients worse. If immunizations are recommended by a doctor, they can probably be undertaken safely. In general, immunizations should be delayed if the person is experiencing an acute MS attack. However, in some circumstances, such as when urgent vaccinations for tetanus or rabies are required, immunizations should be given immediately. If questions arise, you should discuss them further with your neurologist.

Physical Therapy

Physical Therapy (PT) focuses on ways to preserve or improve safety and independence with functional mobility. This may be accomplished through a variety of approaches including:

• Mobility technique training
• Home exercise programs
• Caregiver training
• Effective use of adaptive equipment

The following are examples of PT therapeutic strategies that help everyday management of mobility-related symptoms.

Exercise Categories

You and a physical therapist should develop an individualized exercise program that is based on your current needs and future goals. This may include yoga, exercises in a gym, tai chi or Feldenkrais, as well as traditional forms of exercise such as running, walking, biking, swimming or water aerobics. In some cases, exercises can be carried out independently, with or without modification. In other instances, certain more challenging exercises may require some assistance.

Stretching

Frequently, persons with MS have spasticity, especially in their lower extremities. This can cause the legs to stiffen if a regular stretching program is not incorporated into the daily routine of activities. Stretching exercises help to maintain or improve muscle length to allow greater flexibility.

Coordination

Coordination exercises are done to improve balance and ease of purposeful movement. The degree of skill required to perform the exercises varies. An appropriate program will be discussed with the individual MS patient.

Strengthening

Strengthening exercises are designed to build weakened muscles to aid in moving and walking. While being beneficial, discretion is advised when carrying out a strengthening program. For instance, if one has undergone a vigorous session of exercising but is too tired to prepare dinner or do chores that ordinarily can be done without difficulty, it may be necessary to modify the program or space the activity more evenly throughout the day.

Upper Body Exercises

These simple exercises are designed to promote flexibility and muscle balance as well as to enhance upper extremity function. If done correctly, they are appropriate for all stages of MS. Stretches are to be done slowly, generally being held for approximately five to 10 seconds. These exercises can be performed either seated or lying on your back. Repeat each exercise five to 10 times on each side as tolerated. You can do one side at a time or both sides at the same time.