Question re: UTI and MS relapse, and update

Question

I'm wondering if at the first signs of a possible relapse, you are routinely tested for UTI? My previous neuro never did so. My current neuro has suggested twice, for my relapse of last summer and again for the current one that I'm experiencing. I didn't follow through either time. Last year as the relapse was mild and short lived. This time as I didn't have time to do so before I left for Italy, wasn't feeling too badly, and my symptoms seemed to be improving. 

However.....I'm clearly in a full blown relapse....symptoms seem to be worsening and no I didn't overdo it travelling....I took it very easy, napped every day, didn't have late nights, and the weather was not too hot, just perfect actually.  Had some jet lag first couple of says back but back to normal now in that regard. But I am needing more and more sleep, the face itchiness has evolved into that Novocain numbness covering the whole right side of my head - face, scalp, ear, down my neck and part of upper back. The back of my skull is where it's especially pronounced and definitely worse every day. Most disheartening is the creepy feeling in my right hand and forearm.....the same creepy feeling I've had for years in the left hand. It's also getting more uncomfortable each day. 

I already have my annual neuro appt so I haven't bothered to call the clinic. I doubt they would recommend IVSM.....I wouldn't want it anyway, it's never helped me much for these kinds of symptoms.

Anyway just wondering if you'd typically have a UTI test in these circumstances and if so and if positive, does treating the infection have any effect on symptoms of relapse.

As for my DMD dilemma, this latest relapse seems to solidify my need to move from Copaxone to something else, especially given all my new lesions discovered earlier this year. Based on discussion with the nurse, it seems Gilenya is the only one they'd support. She said Tysabri would be more of a last resort due to risk of PML. Neuro wouldn't even order JCV test for me. GP did, and I'm negative. Therefore risk of PML is nil I think. So I'm not getting the logic there. Anyway, doing lots of research to prep for my appt and to challenge him on the Tysabri issue. So far from what I've read I think I'd prefer to try it over Gilenya....I think.......I don't know....my brain is feeling muddled by all of this.

doublevision1 · Answer

ok I get it, a UTI test makes sense. I will get a req for one at my appt tomorrow. There is a nurse at the clinic that deals only with bladder symptoms, all day, every day (interesting job, lol?) I met with her once last year. She does the bladder ultrasound that PeninaD mentioned, so perhaps I ought to do this to see if there's a chronic problem. 

As for this relapse, I'm feeling so sluggish and numb and uncomfortable, I would ask for IVSM if I thought it would help but my last time on them was not a good experience and didn't help at all with the sensory discomfort. Just have to ride this out I guess. Bleh.

essdipity · Answer

\I have heard that many doctors feel that infections can trigger pseudo-relapses, but if that's what yours thinks is happening, that can't be right.

In the case of pseudos, though, a quick intervention by way of antibiotics for a UTI might stop other symptoms cold. I've never had this situation myself.

But for regular MS relapses, maybe he's thinking of going the IV route but wants to make sure first you don't have an infection, urinary tract being the most common one for MSers. If you did, steroids would be a bad move.

My doctors have never brought up this issue when I'm in a relapse. But them again, my relapses start extremely slowly so it's weeks before I put two and two together.

Whatever, I hope you get some relief and fast, deebs.

ess

karryon55 · Answer

Hi DV,

My Neuro does the same as well & as was I getting fair few UTI's in the past. He also runs a blood panel checking for infection such as high CRP or white blood cells etc. My Neuro had a conversation with me about the importance of keeping track of my UTI's because I tend to be a bit slack with checking until I start to get pretty sick & by then my MS & RA are having party time.

He has been on the money with me before & I had a UTI which had exacerbated my MS.

I hope you are feeling better soon.

Take care,

Karry.

PeninaD · Answer

And it can be a viscous cycle, as MS patients can have neurogenic bladder issues, such as inability to completely void...that residual "pool" of urine in the bladder becomes a chronic source of UTI. So, if your doc thinks UTI, he/she should probably refer you for other testing, such as bladder ultrasound, to ensure inefficient emptying isn't an issue for you.

PeninaD · Answer

Actually, that was precisely what our daughter's doc did at the start of her last relapse/hospitalization. She explained that infection, very often UTIs can trigger a relapse, so she wanted to rule that out from the get go. (she did not have a UTI, btw)