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I have been told recently that I either have fibromyalgia or MS by my doctor, but I lost my insurance a few months ago, and haven't been able to get my MRI to get my final diagnosis. I am on Cymbalta for fibromyalgia treatment, but it's only helping my depression, if I'm honest. My symptoms are daily and worsening, to the point that my body gets so weak that I'm stuck in bed, barely able to move (like right now). My question is a two-parter: Should I expect an MS diagnosis, and is there anything I can do while I wait on insurance? Answer: It is impossible for me to say, based on the information provided, if there is a possibility of MS in your case. While it is true that people with MS can have symptoms consistent with fibromyalgia, these symptoms are not characteristic or defining for MS. We hope you get some answers and feel better soon. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego
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My feet started swelling and are very cold and painful. I cannot walk long or without assistance. My neurologist suggested I may have a spinal injury but the MRI did not show anything. Is there anything else that could reverse my mobility issues or another approach I need to take? Nerve conduction or GI specialist? Answer: It is relatively common for people with spinal cord disease from any cause, including those with severe multiple sclerosis, to develop dependent swelling of both feet, if both legs are weak, or just one foot, if only one leg is week. The affected foot or feet will often feel cold and painful. The feet may also appear reddish or even purple. This is generally due to inactivity (sitting in a chair most of the day). Getting up and about more, if possible, passive range of motion exercises and massage can all help. A neurologist can determine if a spinal cord problem is causing these symptoms. Neurologists will take a thorough history and exam and usually obtain an MRI scan of all or just part of your spinal cord. Additional testing may also be required. Peripheral neuropathies (not a spinal cord problem) can cause similar symptoms and are usually evaluated by interview, examination and nerve conduction studies with electromyography. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego #multiplesclerosis #spinalinjury Here is My Question:
What is the incidence of patients having both MS and Type 1 DM? If MS flares develop in a person in this circumstance- how do you go about treatment- as IV steroid use is very difficult to manage. I have had multiple consults with MS Specialists over the years and there does not seem to be an understanding of how to manage with steroids. I have been told if you have an insulin pump/cgm- we would just administer the IV steroid in the office. An insulin pump cannot handle controlling glucose levels on IV steroids. The lack of understanding on treatment of T1DM with MS is frightening. Answer: There is not an increased world-wide co-occurrence of Type I diabetes and MS despite similarities in environmental and genetic risk factors and immune pathogenesis. Perhaps one reason is that common genetic susceptibility risk factors differ between the two disorders. It is true that management of MS relapses can be difficult in people with both type I and type II diabetes because of the effect of steroids on glycemic control. The best approach is to use high active DMTs to dramatically lower the risk of relapses, make sure worsening function is not caused by an infection and, if so, treat appropriately, use only short courses (3 days) of high dose corticosteroids (500 to 1000 mg per day equivalent methylprednisolone dose), avoid tapering prednisone courses following the high dose treatment, and frequent blood sugar checks with sliding scale insulin coverage. In practice we usually admit people for 3 days during their steroid treatment to monitor and control blood sugars. Hope this helps. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego #multiplesclerosis #diabetes #diabetesandmultiplesclerosis Here is My Question:
Very unusual symptoms following my third infusion of Ocrevus. Feel like limbs are swelling. Answer: If your legs are not actually swelling, then you are experiencing a common sensory illusion (macrosomia) frequently reported by people with MS. It is akin to the sensation that occurs when the dentist numbs your mouth with lidocaine and your lip feels swollen. If your legs are actually swollen this could be dependent edema or another problem. For this contact your PCP. Hope this information helps Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego #legswelling #multiplesclerosis #Ocrevus Here is My Question:
Can you donate blood if your are taking Kesimpta injections for MS? What about if you are on pain medication? Answer: You cannot donate blood when taking monoclonal antibody therapies. I doubt they allow you to donate if you are taking controlled substances Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego #kesimpta #blooddonation #multiplesclerosis |
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