Here is My Question:
Thank you for the opportunity; I do not currently have a primary care physician. At a very young age (3-4 I believe) I contracted a very serious case of meningitis. I know that I was close to death and had to be taken from Nor Cal to Anaheim. Without a background in medicine Google is a troubling source for self diagnosis. I do have a BA in Journalism and am at least able to filter BS. In short, my symptoms of left hemisphere weakening, numbness, spasticity, gait, etc sure sound like MS is slowly setting in over the past 8 years or so. I know my fever was extremely high when I was young. In short, am I likely correct (I know you can’t do much more than say ‘see a damn doctor already man!’ that the damage to demyelination from my 30 year old illness is a contributing factor to this motor control deterioration? I’ve tried yoga, Thai chi, etc abs still jog daily....Yet engaging/firing the correct muscles to support athletic and daily movement has become near impossible. It was therapeutic just to share that; so thanks. I have no health insurance and I hear constantly about early diagnosis abs therapy. I don’t want charity and I understand the pharmaceutical world more than most. Is there anything I can do (nutrition, supplements, style of exercise) to help slow my symptoms (assuming it is MS). Thank you! Ryan in Portland

Answer:
You’re right, Dr. Google isn’t an adequate substitute for the actual specialist. The assumption of MS is a big one and I remain unconvinced based on symptoms with a history of meningitis presented. However, I’ll play ball and simply say that in the case of confirmed MS—and in addition to a disease modifying therapy, a healthy/well-balanced diet, exercise, and potentially supplementing with vitamin D3 5,000 IU daily, may be helpful. Patients with MS are not exempt from other health issues that come with age. High blood pressure, diabetes, cholesterol problems, etc can also injure the nervous system and increase the rate of disability.  

Ultimately, however, a proper evaluation with an MS specialist is in order. Please be kind in response to this post. My knowledge and command of the English language is likely not up to par with a journalist.

A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente

Here is My Question:
What diet will help those with MS who are unable to take the medication?

Answer:
There have been many proposed MS diets over the years and many claim anecdotal evidence as proof of efficacy.  The fact is that there is no high level scientific evidence for these diets.

​Many have been packaged as “anti-inflammatory” diets which is a testable hypothesis for a well designed clinical trial.  It remains a challenge to carry out such a study because people, by nature, cheat on their diets (which make it difficult to confirm actual benefit).  You can certainly trial a diet yourself and gauge your response.  Of course, it would be best to review the selected diet with your PCP to ensure no contraindications to the diet based on your other health factors.

It remains advisable to follow recommendations for a general well-balanced diet.  Food choice affects other areas of health that MS patients are not excluded from.  For instance, high salt, carbohydrate, fatty, etc diets can accelerate cardiovascular disease that can also injure the nervous system.

As far as the inability to take an MS therapy, I have to question that statement.  There are so many available (and different) MS therapies that it would be hard to believe that ALL are contraindicated in one person.  Even if there was a religious or other exception of conscious to a specific type of therapy, there remains a variety of medication class/type/mechanism to find a suitable therapy for everyone who would otherwise qualify for a disease modifying therapy.

Use of one of these therapies is better than nothing for MS patients who remain in the inflammatory phase of their MS.

​A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente

Here is My Question:
Which part of the spine should be considered to check for lesion in MS? Is the C and D spine enough or should we consider the L spine as well?

Answer:
Your physician should know the appropriate nervous system regions to evaluate you for MS using MR imaging. Remember, MS only affects the optic nerves (which is part of the central nervous system), brain and spinal cord. The spinal cord ends at the L2 vertebral body level, so imaging of the cervical and thoracic spinal cord usually covers the entire spinal cord region.

Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego