Multiple sclerosis is a progressive neurological disorder caused when the myelin – the insulating sheath of nerves – is destroyed by inflammation from an as-yet unknown cause. Without myelin, the nerves cannot operate properly, which causes many symptoms. The symptoms vary depending on where the nerve damage is, and can appear and disappear. It’s not an easy diagnosis to make, and not one that should be made hastily. It is also a diagnosis that needs to be made early, because early intervention can minimize the damage.
I was diagnosed with multiple sclerosis about 15 years ago. At least the company doctor I was seeing claimed that I had the symptoms of multiple sclerosis and wanted me to go through some expensive and painful diagnostic testing to confirm or rule out his opinion. What did I want? I wanted a short-term workman’s comp certificate so my boss would assign me to work that was not so painful to my wrists and hands. And here’s some guy in a white coat telling me I have a serious neurological disease that’s slowly destroying my nervous system, starting with my hands!
He didn’t want to send for my medical records, he didn’t want to accept my explanation that I knew what was wrong because it had happened before … in fact he was happy to hear that it was a “relapse” because recurring symptoms are part of multiple sclerosis. If I had multiple sclerosis, I didn’t qualify for workman’s compensation, and that would make the employer happy.
I left his office and headed straight for the orthopedic surgeon I had seen during an earlier episode of painful hand and arm problems. I wanted a second opinion from a physician who was not getting paid to keep workman’s comp claims low. The surgeon did some quick in-office functional tests, asked me a few questions, then recommended that I find another line of work because my job was (again) damaging my body. I told the orthopod about the other physician insisting that I needed to be tested for multiple sclerosis and asked if it might be a possibility. He said, “Possible, yes, but it’s about number 143 on my list of suspected conditions. We already know that your wrists are screwed up. Your tendons are scarred and you have nerve damage from over-use. That’s enough to explain every symptom you have.”
My symptoms, to be sure, are seen in multiple sclerosis. Clumsy hands, tingling fingers, pain, and tendency to drop things with no warning are symptoms of multiple sclerosis. However, multiple sclerosis has a long list of symptoms, but none of them are diagnostic. We’ve all had or have one or more of them.
He went on to say that he did not see any of the typical symptoms of multiple sclerosis that would make him refer me to a neurologist to start running tests: no vision problems, balance problems, bladder problems, wide-spread sensory nerve problems, speech problems, abnormal walking gait, or muscle spasms. As the diagnostic proverb says; “If you hear hoofbeats, unless you are in Africa, it’s probably horses.” He heard horses where the first physician wanted to hear zebras.
Which one of them was right? The orthopedic surgeon. I still have screwed up wrists, tendonitis and nerve damage in my arms, but I have never developed any of the other symptoms of multiple sclerosis.
The cause of multiple sclerosis is still being investigated, and there is no known cure. It is usually an intermittent problem, with periods of relative well-being alternating with periods of varying degrees of disability. Treatment is directed towards stopping the bouts of inflammation as quickly as possible, and towards avoiding whatever increases the risk of attack.
