Sunday 18 December 2016

More than just a pain in the butt! Pain and MS.

Pain and multiple sclerosis, really is a bit of a pain in the head wondering how to put this forward (just to mention metaphorically speaking!). Like many things in MS they sound like things normal, average, healthy, living being thing would go through but with MS there always is that little extra bit of spice.

Like all the symptoms there are different avenues to their cause and they vary in severity but all are due to damaged nerves, pain in MS can be in different ways and forms which will be discussed below. But to start, a few ways in which an MSer may describe the pain they feel: Squeezing or crushing, Cold,Hot or burning, Sharp, Dull, Like ants under my skin or ‘creepy crawlies’, Like a build up of pressure, Stabbing, Creeping, Like an electric shock, Aching, Pins and needles. Those are the few that are noted down!

Optic neuritis again for starters; when the optic nerve or any nerve in that matter is damaged it is known to be 'inflamed'. Due to this symptom, an MSer may not even realise a vision loss but they will most definetely complain of the pain, especially immediately after damage episode starts. Simply put when we move an eye to change direction or look at something else or in some cases look to your far left or right/ up or down, there is an extreme burning like feeling like your eye is being pulled out by a hook from the side.

Next being trigeminal neuralgia pain,the trigeminal nerve is the nerve that is responsible for the sensation your face. If this nerve is inflamed it can leave a sharp stabbing pain on your face, it has been described as one of the worst types of pain a human can face. Damage to the brain stem can also result in this symptom, this type of pain can lead to an MSer thinking there's something wrong with their teeth or jaw and in my case being a bit of a yo-yo between the dentist and the GP.

Then there's the 'MS hug', it is everything but as nice as your normal hug. A feeling of being crushed or squeezed due to damage in the spinal cord, a lesion on the spine leading to a painful band around the chest. At first an MSer may get very worried thinking it's due to issues with their heart and thus get sent for ECG scans to make sure their heart is beating properly! Especially being of an Asian heritage known for our food fancies and heart issues it can be even more worrying!

Lhermitte's pain, Lhermitte being a European guy that is dead. But the Lhermittes phenomenon is something that is seen in MS and related spinal injuries. This is when an MSer were to move their neck, to look up, left or right and a quick zip ( electric shock type) from the neck down to the toes, so people who may have this symptom may do whatever it takes to keep their neck straight and not move it.

Burning limb pain; not a specific pain but due to damage anywhere on the sensory pathways, it can lead to abnormal weird, ' ouchy' feeling. Something that is hard to describe, sometimes best describe as a leg not feeling right and being really painful.

Only few more to go! With the recently mentioned spasticity symptom when the muscles may be almost at war with each other  ( one part wanting to relax and the other contract) it can lead to a type of pain. To put things in context if anyone ever wanted to get an idea of this type of pain and had 5 hours or so to spare, clinch a fist for 5 hours and try to open your hand or click your fingers and a similar type of pain can be felt, this would also cause painful cramps in an MSer but it is somewhat a normal thing for an MSer with this symptom.

Almost done now! Due to the nerve damage in the brain, it can cause random migraine like pain and this may be the only type in which the 'cure for all conditions' for people of the subcontinent (stereo typically!) may be helpful for, yes Paracetamol!

More secondary pain may be knock on effects of other symptoms, like bruises or cuts on the body from falling over or a limp in the walking pattern ( due to symptoms like foot drop or 'gait' issues [still to be mentioned don't be frightened!]) resulting in pain in joints due to an abnormal 'rubbing' on the knees or hips whilst walking ( see for video for example below).

This would probably sum up the pain related symptoms of MS: Neuropathic pain is caused by MS nerve damage in the brain and spinal cord. Nerve damage might cause a range of sensations, from minor irritations to intense sharp or burning pains.
Musculoskeletal pain is the pain in muscles and joints that comes from living with the stresses and strains MS places on the body. For example, difficulties with balance, fatigue or muscle weakness could lead to problems with posture, putting a strain on joints, ligaments or other muscles.

 Lastly, I promise! The drugs used for these symptom can have very severe side effects, though I won't go into too much depth now but for neuropathic pain which can be anywhere there is damage, a very common and vouched for 'homeopathic' or complementary treatment that is used is marijuana, I was approached by a 'dealer who somehow heard of me and MS and told me he had a lot of customers with MS and offered me his details. I will be unfortunately or fortunately have to be a  a killjoy so marijuana, drugs and MS will be saved for a sunny day hopefully! I apologise if this does hurt to read, but this is multiple sclerosis!

https://www.youtube.com/watch?v=CuuNtaLvwA8

Sunday 11 December 2016

Fatigue and sleep.

Why are you tired, you didn't do anything today? What do you mean you're tired, it's not like you go to work or anything? Just a few statements me and perhaps others with MS receive on a regular basis when we are trying to deal with life under fatigue because of MS!

You may think tiredness yes but fatigue is something far from just basic tiredness. One may think all that is needed to deal with tiredness would be a good nights sleep right? Anything but when it comes to MS.

Getting more into things, fatigue can be described as an overwhelming sense of tiredness with no obvious cause. This may have a mental, cognitive or physical exacerbation of symptoms for a period of time that the fatigue is lingering. This could be heavy limbs, balance or sight issues or concentration problems. Fatigue can also leave an MSer having a nice long and fruitful 8 hour sleep only to wake up feeling as gruggy as you did beforehand. And along with other symptoms fatigue can help slow down the process of waking up in the mornings, so for example the mind being fresh but the legs forever taking whatever means to wake up a bit later.

Fatigue affects people in different ways, and it may change from week to week, day to day, or hour to hour. The reason for fatigue in MS is still fairly unknown but there are a few slightly proven theories ( proven by scientific study but not completely identifying a certain cause). Primarily a result of damage caused by MS, a thought that damage to certain areas of the brain are associated with fatigue in MS. Another being that fatigue is caused by the way in which the brain adapts to the damage, simply put the way I saw and thought of it, the extra work required to send signals over damaged pathways leading to fatigue. MRI scans have shown MSers who suffer from fatigue ( the majority just to note) that larger areas of the brain are used for carrying out  activities than people who don't suffer with this symptom.

Fatigue like all MS symptoms vary from person to person, some are exhausted (in the MS sense!) by going to the shop, some by preparing something to eat and some by merely standing up. Fatigue is a symptom that isn't very tangible, many times I am asked by people if I feel fatigued, but usually the fatigue would result in a difficulty giving a yes or no answer! Past the usual comments I would receive like I shouldn't have slept/ woken up so late or should've completed my meal, a lot of the time fatigue can halt or cause problems in carrying out small 'normal' and 'basic' actions. To add further, after I tiresome day of doing 'nothing' sometimes, fatigue can stop an MSer from falling asleep properly! It can induce other symptoms like pain, spasms, bladder issues, spasticity or heat intolerance ( ignore the ones not yet discussed!) and thus leave a pretty double sided sword if anything, and to mention further; psychological impacts also affecting the sleep and fatigue, things like depression or anxiety which could be another thing caused by MS in more abnormal ways ( still to be discussed and I do look forward to it!) that could result in feeling more fatigue and not being able to fall asleep. 

I know for many, sleep is the best part of the day ( or night) along with the above mentioned things that affect sleep, there are further symptoms that may disrupt the quiet time we get in our days, everything but checking Facebook or Twitter before bed! Restless leg syndrome being an overwhelming, irresistible urge to move the legs ( or arms in some cases), this due to the short circuit effect because of damage, this isn't restricted to the night but it obvioisly would make sleeping harder.Lastly sleep apnea, where the regular breathing pattern of a human is 'off chord' whilst asleep, this affects the amount of oxygen that enters the blood, this may wake a person up mid sleep with a choke feeling to get the airways working again or occur without notice, but it can have an effect on the person the following day, the accomplished sleep feeling isn't felt due this symptom.

I think I've went on a bit too long today, would try lie down but I don't think I'd fall asleep so easily, but honestly, as fatigue can impact the whole bodily systems working, it has made me forget the more entertaining parts of my blog but hey, just one of the joys of MS!


Sleep apnea: https://www.youtube.com/watch?v=TgC_S09Xea4

RLS: https://www.youtube.com/watch?v=Pqke9lRn1h8

Sunday 4 December 2016

Muscle spasticity/ stiffness and spasms

Before we start, a video explaining MS in a few seconds I forgot to add in a long time ago ( If videos don't play see the links below):


I'm sure you would know by now especially it is far from beng a monkey scrotum! Muscles, muscles, muscles. What would we do without them? Or what if they didn't work as we plan to use them? The final more specific muscle related symptoms to be discussed, though just like our nerves, muscles are involved in most things in life and another part of the body that is an avenue to the long list of symptoms associated with MS!

Muscle spasticity/ neuro spasticity being an increased tone (resistance or tension in the muscle) due to the damaged or dead nerves along the signal pathway(s) to area involved. But simply meaning when the muscles are used, there is more resistance to the movement and the muscles feel more rigid.

Stiffness being pretty much a similar thing where due to muscle resistance they are slower to relax so simply put it can make fine movements more difficult to perform, like lifting your leg up to get in or out of a car or straightening your legs to stand up from a chair. Other more explicit movements like walking can also be affected by the stiffness, as you can probably imagine it would lead to walking a bit like a robot in the sense that the muscles would keep straight and not follow a normal walking pattern.

To give more of a understandable example; if a healthy person were to lift their fist towards their shoulder almost like to show off your muscles, the muscles on the front of the arm will tighten and the ones on the back would relax. However a person suffering with spasticity did the same when this is done the muscle in the whole arm would tighten and the same time, so the muscle thus is very 'rigid'.

Another example to show the effects of this symptom, if a person where to stretch for a training session, when stretching the tendon ( the muscle on the other side of the shin [the back] they would be able to feel a stretch happening so to speak, but with this symptom the motion can be carried out but there be no feeling of any changes at all.



Spasms being random jerks in uncontrollable ways, somewhat similar to tremors however a different bodily function involved and more random than that of the tremors. These can be minor like a constant tapping of the foot which is known as 'clonus' or quite major where the whole limb or two may suddenly jerk resulting in a bit of pain and embarrassment if around other people! Though me being me, I have warned a few of my close friends that if they do frustrate me, I'd give them a good slap and blame it on the spasm effect!

Clonus:



Though thankfully I do not suffer so severely this symptom but recalling a discussion in a meet up group of MSers, where a gentleman with SPMS and his wife, told us their stories of the wife waking him up at 3am in the morning to tell him off for giving her a hurtful kick whilst fast asleep!

Spasm examples: 



A lot more extreme example. watch with caution: