The start of the confusing journey! The types and disease progression.

If it hasn't been highlighted till now, Multiple Sclerosis is a very very confusing condition, there are several forms of the condition and they all affect each individual MSER in their own special way (yes, literally speaking). There are four main known forms and they are; relapsing remitting, benign, secondary progressive and primary progressive.

On diagnosis, you are probably told that it's multiple sclerosis and if you're lucky given a whole load of scriptures and websites to get more information about the disease. If and when you read the doctor's write up of your case, there usually is a mention of one of the above names of the condition.

Most people are diagnosed with relapsing remitting multiple sclerosis, this is literally as the name suggests, something happens, there is an improvement to a certain degree, either full or partial then it happens again and that's the dirty cycle it follows over and over again. The repairing of the myelin sheath (the insulating layer of nerve cells) of the nerve cells are done by cells called oligodendrocytes ( when you figure out how to pronounce it, it makes you feel intelligent!) so in the remitting stage this continues to occur with repair being complete at a similar rate to a dodgy plumber fixing your bathroom i.e. it never gets 'better' completely, so obviously over time disabilities can be a lasting effect because of the damage with symptoms lingering on after the immediate symptom phase. An example for this would be, after an episode of loss of sensation, although complete sensation may return the strength in the area effected may not return.

After a certain period of disease occurrence the oligodendrocytes pack up their bags and pretty much retire, now after the damage there's nothing that tries to repair the nerves. The condition is then termed secondary progressive MS and it pretty much is downhill from there at a rate that is different to each and every person. Majority of people who start with relapsing remitting will go on to the secondary stage of the condition. Even though it sounds terrifying it actually really doesn't have a stereotypical pathway, I met a guy in a MS gym class who had SPMS (trust me the letters make life easier!) who was doing more exercise and was more able than me!

Benign MS is as the name suggests, you have a small amount of relapses which is followed by a complete recovery. Usually this can only be diagnosed after 10-15 years after initial disease activity.

Primary progressive has this name because from the first (primary) symptoms it is progressive. Symptoms gradually get worse over time, rather than appearing as sudden attacks (relapses).

MS in children: Although ms is usually developed in early adulthood it can happen in teenagers or even kids but the likelihood of this is fairly rare and there are only a few 'special' folk ( like me) that join the crew early on.

Disease progression is thought to occur through the occurrence of the relapses and also in 'invisible' manner which is how Multiple Sclerosis seems to work in it's mysterious ways, if I didn't already mention, MS is a very very confusing condition!