Tuesday, September 20, 2005

Neurorehabilitation and MS

Here's the deal: if you're like me, your MS treatment has two components: 1) disease-modifying drugs (interferons, Copaxone) and 2) symptom management. My symptom-management component is aimed at 6 issues:
1. pain (Neurontin)
2. bladder (Flomax, Oxytrol)
3. fatigue (Provigil)
4. spasticity (Baclofen)
5. depression (nefazodone)
6. um, "intimacy" (papavirin)

For me, symptom management has basically meant a new drug for each new symptom, with plenty of adjustments for the side-effects that tag along with each new symptom. Granted, I also try to do stuff like exercise, stretch, yoga, meditate, and whatnot, some of it at a doc's recommmendation. But there's a growing body of evidence that supports individualized non-drug rehabilitative approaches to managing MS symptoms. A new Lancet article is on-point:
[S]ymptomatic therapies have benefits, [but] their use is limited by possible side-effects. Moreover, many common disabling symptoms, such as weakness, are not amenable to drug treatment. However, neurorehabilitation has been shown to ease the burden of these symptoms by improving self-performance and independence. Second, we discuss comprehensive multidisciplinary rehabilitation and specific treatment options. Even though rehabilitation has no direct influence on disease progression, studies to date have shown that this type of intervention improves personal activities and ability to participate in social activities, thereby improving quality of life. Treatment should be adapted depending on: the individual patient's needs, demands of their surrounding environment, type and degree of disability, and treatment goals. Improvement commonly persists for several months beyond the treatment period, mostly as a result of reconditioning and adaptation and appropriate use of medical and social support at home. These findings suggest that quality of life is determined by disability and handicap more than by functional deficits and disease progression.

Link to the abstract at Pub Med.
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2 comments:

Kim said...

Hye, I've read about bladder problems being treated by catheterizing in combo with the drugs. Any thoughts?

Doug Lee-Knowles said...

Yeah: ow.

Seriously, tho, at present retention isn't a big problem for me, so a cath seems unnecessary. Mostly, it's the urgency caused by spasms in the muscles that cause the bladder to contract.