MS Symptoms and being sick

[sunshine8]

Dr. Kantor,

I am a newly diagnosed (RRMS) 34 year young physically active female. I won’t go into all the details, but my lesions were discovered by accident on a CT scan in the ER following a fall while running. Everyone suspected MS from the start, but after a year of tests to rule out mimics, multiple MRI’s that showed changes along the way and ultimately a bought of optic neuritis, I was diagnosed RRMS. I hadn’t noticed symptoms before the CT, but my clinical Neuro exams have shown abnormalities (reflex, balance issues, tremors, etc.) and thinking back, I had two distinct bought’s of fatigue with coordination issues that were thought to be viruses a few years ago.

I am new to all of this “MS” stuff and have found that I end up with muscle weakness/shakiness upon aerobic type exercise and when my body temperature elevates. Over this past winter I had a sinus infection and separately, an upper respiratory infection. It seems that I have a “mini-flare” whenever I have something else affecting my immune system, like being sick. Symptoms were similar to over-exertions with weakness, fatigue and shakiness, but I also find when I was sick that my balance was worse, my tremors were worse, etc. Is this normal? The “mini-flare” always seems to go away with the other illness, but is there anything that can help in the meantime? I know they think that MS is an autoimmune disease, but is there a correlation between MS and other immune issues?

I also wanted to thank you for monitoring the expert forum and responding to all of our questions. The MS community here at Medhelp has really helped me, especially when I have a new symptom that I have no idea what it is, like parenthesis a while back. (I could have sworn someone was holding a hair dryer to my leg!)

Thanks!

-Amy

[Dr. Daniel Kantor, MD]

You ask and a terrific question -- you are describing classic Uhthoff's phenomenon.

When you get overheated (external like warm weather or hot bath  or internal like a virus or stress) it may "uncover" your older MS symptoms and signs.

In fact in the 1950s they used a "hot bath" test and they put patients in a warm bath and if they came out all noodley, then they had MS!

The same is true for older patients who have had a stroke in the past, and urinary tract infection (UTI) can be mistaken for a new stroke.

Everyone has a heat threshold -- overheat anyone enough and they will succumb to heat stroke.

You wrote: "I could have sworn someone was holding a hair dryer to my leg!" -- I hope since that time you are on an appropriate disease modifying agent (the only proven way to change the course of MS).

A person with MS is likely to have family members with other autoimmune diagnoses, such as lupus, childhood diabetes, rheumatoid arthritis, Crohn's disease etc. We do not understand yet why the body of one person attacks the nerves and in other it attacks the pancreas etc.

[rubybunce]

Hi Doctor Kantor,

I was diagnosed with RRMS Dec 08 after my MRI showed lesions and I had an episode of optic neuritis. The ON started Aug 08 (I had odd days of not being able to see properly) and developed fully Nov 08. I am still sufferring with blurred vision and light sensitivity.  In addition to this I feel the cold. I am always cold but think the ON was brought on fully by the use of central heating as the weather changed and it was very cold here so I turned the heating up.

I've noticed when i am tired I get worse and my vision decreases, I see cartoon cars outside, the floor moves waving around and the light hurts my right eye, but the ON was seen in my left eye by the opthalmologist it is my right eye that has the enlarged pupil. Is it unusual for the condition to last this long and will I ever recover my vision fully? Does ON jump from one eye to the other?

I have 3 sisters with MS, 2 at RRMS stage and 1 with SPMS. The one with SPMS has Typre 1 diabetes and so do I. One of my sisters has psoriais and has done since childhood.  So I can see the connection when you say auto immune conditions.

The consultant has put me on copaxone but I am finding these very difficult to cope with the stinging, the painful lumps and the actual injection is hard, not like the isnusin ones, they are very easy after 32 years.

1) To get back to my original statement do people with Uhthoff's phenomenon feel the cold? or do they feel hot? I am always cold and sit and shiver here often needing the heating on and the fire on.

2)  Is it unusual for 4 siblings to be diagnoesd with MS within 2 years of each other? My Doctor said it could but due to childhood infection such as glandular fever but I dont remember having that.

I would appreciate any input you may have. Please excuse my tardy typing, regards Ruby

[sunshine8]

My official diagnosis came from an MS specialist in October 2008, but after the optic neuritis in August 2008, my General Neuro wanted to start DMD's. The problem is that I was newly married in June 2008, and we immediately started to try to have a child. I have discussed it up and down with my general neuro, the MS specialist and my Gynecologist. We all agreed to give it 6 months and then re-evaluate. Well, we are at the re-evaluate point and we are having some tests done this week and next to see if there are any problems. I know that it is a decision that we might have to make and soon, but I am also not willing to give up the dream of having a child quite yet. The parasthesias came in November and went in December. Nothng else has changed or worsened on my clinical Neuro exams and my one bought of optic neuritis was very mild. Still, it has been a very hard decision to try to have a child while postponing treatment with DMD's. In the end, I weighed what the experts have said and decided that because they think I am in the early stages of RRMS, my "regular" symptoms are very mild and don't really effect day to day living, that I am otherwise healthy and very active, that I have a good support system, that I am young (34 years old) if talking to the Neuro or old if talking to the gyno, and that I agreed to be closely monitored for changes while we are trying, that I really wanted to go ahead with trying to have a child. That is a whole different discussion of itself that I could go on forever about. I have done a lot of research in the last 6 months and it is a hard decision to make.

I just wanted to clarify your answer though. Uhtoff's can also happen with stress or sickness because those things would elevate your internal body temperature. It is because it would elevate your internal temperature and not just the impact of stress or sickness on your immune system. Is that a correct?

Thank you,

-Amy