In an Instagram post in October 2018, actress Selma Blair courageously went public with her diagnosis of multiple sclerosis (MS). In the post, which has received more than 115,000 likes, she wrote “I am a forthcoming person and I want my life to be full somehow. I want to play with my son again. I want to walk down the street and ride my horse. I have MS and I am ok.”
Since her diagnosis, Blair, 46, has brought to light the emotional journey of living with MS, and her hopeful spirit. To help us better understand what Blair is going through and MS, we spoke with Alendia Hartshorn, MD, a neurologist with Mission Neurology.
Understanding multiple sclerosis
Multiple sclerosis is an inflammatory disease that attacks the central nervous system. MS typically attacks the myelin in the brain, which is a fatty-like substance responsible for insulating and protecting nerve cell axons. The insulation of the nerve cell axons allows for electrical signals to quickly carry information from one nerve cell to another.
In other words, MS hinders the process of passing on command signals from the brain to other parts of the body. This can be particularly detrimental to a person’s ability to stand, walk or perform other basic bodily functions.
Scientists and medical experts do not fully understand what causes MS.
How MS impacts the body
Typically, the onset of MS occurs between 20 and 30 years of age, however, anyone can develop the disease – including children. Symptoms of MS can differ on a case-by-case basis depending on what part of the brain or spine is being impacted by the disease. “Common symptoms of MS include numbness or tingling, vision changes, fatigue and dizziness, but there is a wide range of symptoms and every patient is different,” says Dr. Hartshorn.
Blair explained in a televised interview how MS has impacted her body and speech with spasmodic dysphonia, causing spasms of her vocal chords.
Outside of the physical issues that MS sufferers may experience are the emotional struggles, which Blair has freely opened up about, describing the neurodegenerative brain disease as “uncomfortable” and a “stadium of uncontrollable anxiety at times.” It can be expected that patients will feel distraught and somber after the initial diagnosis, and their decreasing ability to carry out daily functions can add to their high level of frustration.
The damage done to nerve fibers by MS can also alter an individual’s emotional patterns.
What MS “flare-ups” look like and how to manage them
The best way to prevent triggering MS symptoms is to minimize situations that might cause your symptoms to worsen. One significant way to avoid an MS flare-up is to exercise. Activities like yoga and running can help prevent or delay several health symptoms related to MS. Just make sure to consult with your doctor before engaging in any strenuous activity.
Sleep deprivation can significantly trigger symptoms for those with MS so getting enough sleep (7-9 hours for adults) is critical for their wellbeing.
The frequency and length of MS flare-ups can vary. While some individuals only have one or two flare-ups over the course of their entire lifespan, others can experience the development of new symptoms, despite taking the most effective medication. Dr. Hartshorn says that the earlier treatment begins, the less likely new symptoms are to develop.
When initially discussing MS with your neurologist, he or she will likely start by asking questions about your medical history. Neurologists use several exams to assess coordination, motor strength and sensation. If the neurologist suspects a possibility of MS, he or she will order an MRI, or blood or spinal fluid tests. The more flare-ups that occur, the easier it is for neurologists to diagnose. Early diagnosis can also be life-changing in a person’s journey or progression of MS.
An MS diagnosis does not mean quality of life is guaranteed to decrease. In fact, the majority of patients still continue to have a full, normal life after diagnosis. “I love my life and I am succeeding,” Blair said.
You may need to make some adjustments. Changes usually include making sure that the patient gets an increase in their daily vitamin D intake, gets sufficient sleep and maintains a healthy diet.
The three-step treatment approach
There is a three-step approach to treat MS and its symptoms. Step one is taking disease-modifying drugs or using IV infusions to thwart the threat of new symptoms and new inflammation.
The second step is symptom management. Fatigue, muscle spasms, soreness, tingling and pain are MS symptoms that can be treated medically and non-medically – consult with your doctor to find the best treatment method for you.
The third step involves modifying eating habits, quitting smoking, exercising and possibly losing weight. An increase in vitamin D, and omega 3 and omega 6 fatty acids can also help moderate symptoms when recommended by your doctor.
Finding strength after diagnosis
Blair has expressed that her life is not about suffering. “One important thing to know is that a majority of patients with multiple sclerosis live a very full, normal life,” Dr. Hartshorn says.
Dr. Hartshorn explains that most patients will have bloodwork done once or twice a year and regular visits with their neurologist. She notes that you may tire more quickly than you used to and may need to be more conscious of warmer or cooler weather, since overexposure to extreme heat or cold can cause sufferers to grow tired at a faster rate. “There may be some alterations in lifestyle, for example, making sure you eat well, take vitamin D and get enough rest. Most will continue working, taking care of their family and enjoying activities they love,” Dr. Hartshorn says.
Blair even seemed to find a sense of empowerment in her diagnosis. “I cried,” Blair recalls. “They weren’t tears of panic. They were tears of knowing I now had to give in to a body that had loss of control and there was some relief in that.”
Alendia Hartshorn, MD, is a neurologist with Mission Neurology. Learn more about how Mission Neurology can help you at missionhealth.org/neurology. If you have concerns or believe you be impacted by MS, talk to your doctor.