Dealing with the heat

[happyname]

Hello All,
I am new to the forum and recently read a post about heat.  I was diagnosed with MS 3 years ago which was exactly a year after a round of rabies shots given to me after a cat bite.  Fortunately, mine has been pretty easy to cope with except for 2-3 major episodes per year that require IV steroid treatment.  My symptoms are always the same starting with left sided weakness in the arm and leg, loss of peripheral vision and extreme headaches.  As time goes on I lose the feeling in my face and mouth and begin to feel like I can't find the correct words.  Usually after treatment and a week of rest I am back on track.

This past month the weather was nice so I decided to sit outside with my teenage daughters and read with a mister spraying water on me to keep nice and cool.  I have never had any reaction to heat in the past so I thought nothing of it...after all this is Texas and summers have always been hot.  Within two days of this I was in the worst shape of my life.  I called my doctor who was on vacation and his partner immediately started five days of steroids via IV.  I thought I was following the normal path of progression but on the seventh day I could not lift my head.  I manage a physician's office and had no one to cover me for the month end paperwork etc.  I went into work and had to sleep on a stretcher until the mail came so I could get our last deposit ready.  I worked short days for the next three days and then bedded down completely from Thurs to Monday over the July 4th weekend.  Now it is the 19th and I am still not better.  I had another MRI last Thursday and lab work showed elevated liver enzymes one week and normal the next.  Now, I can be fine and the minute I get in my hot car I am feeling fatigued before the air even cools it.  I am afraid that this is my new life and it makes me a little sad.  I am 38 with two daughters in high school band which we faithfully go to watch and another starting college.  I am curious if anyone else has had this type of relapse and gone back to normal.

Thanks...

[Quixotic1]

Your anme makes me happy, too!  Welcome to our home.  I'm so glad you joined us.  I am Quix, one of the local medical people.  You bring up a very good point.  Can a relapse caused by heat be permanent?

I have a couple medical answers to this, but I hope that people jump in offer their experiences.  The first is that you should be able to rebound some from this relapse just like all prior ones.  There is nothing about getting overheated that should make it more permanent, unless you became severely overheated.  I also come unravelled almost immediately upon entering a hot environment.

People without MS who developed severe heat exhaustion (or even heat stroke if they service it) often report an intolerance to heat that they never had before.  I have heard from patients that it was years before they returned to their prior state of being able to tolerate high temps.  Those with actual heat stroke (shut down of sweating and many body systems, temps to 107 degrees and higher) often have permanent neuro damage.

I would highly (read that HIGHLY) recommend that you get an active cooling vest, neck wrap and one of the evaporative cooling hats that are recommended by the MS Society.  These can help keep the body cooler.  Also, research is showing that actively cooling the body down before any type of exercise allows the person to do more.  So a cool shower before going out would be helpful.  If there is anyway that someone else could start your car and run it until it is cooler, it would be highly advisable.  Everytime you get overheated you slow down your recovery.  So it is possible that you won't be able to heal until the hot weather passes

Back before the invention of the MRI, one of the diagnostic tests for MS was the "Hot Bath Test."  If a patient's symptoms could be brought on (specifically visual problems) by being heated in a bath, then it was a positive test pointing toward MS.  However, in a well publicized (in the med journals) incident, one patient became paralyzed by the test, but did not recover when cooled off.  This damped the enthusiasm for this test.

As for the rabies shots.  It is well known that MS may "present" after an infection or immunization, it is very clear that such things do not cause MS.  The cause of MS lies years before in a combination of genetic susceptibility, prior infections, andprobable Vit D status.  If an inmmunization or shot is going to precipitate the onset of MS it will happen only in the month to 6 weeks after the shots.  This is because of the way that such shots affect the immune system.  A year later this immune process would not still be happening, so I would reassure you that the rabies shots had nothing to do with bringing on the MS.  My post doctoral work work was in Immunology and I can say this with confidence.  

Mostly I would strongly encourage you to get the cooling garments and see if that will help you enjoy the things that matter so matter to you.

Again, Welcome to the forum!

Quix