Managing your multiple sclerosis : practical advice to help you manage your multiple sclerosis

Note to reader ix 1 Multiple sclerosis explained 1 What is MS? 1 Types of MS 3 Symptoms of MS 4 The causes of MS 8 Diagnosing MS 11 2 Medical management of MS 12 Treatment rather than cure 12 Approaches to treatment 13 The beta-interferons and the managment of MS 14 Glatiramer acetate (Copaxone) and the management of MS 19 The future of DMTs (disease-modifying therapies) in MS 20 Steroids 21 Getting more information on drug therapy 23 Team approach to management 24 Visiting your GP/neurologist/MS Specialist Nurse 26 Other support 28 MANAGING YOUR MULTIPLE SCLEROSIS 3 Complementary therapies and MS 31 Assessing the value of complementary therapies 31 Safety of complementary therapies 33 Finding a practitioner 34 Costs involved 34 Some types of CAM therapy 35 4 Problems with urination and bowels 44 Bladder control 44 Bowel function 55 5 Sexual relationships 59 Problems for women 59 Difficulties with erections 61 Psychological problems and ‘libido’ 64 Problems during intercourse 65 6 Sensations and pain 68 Sensations 68 Balance 71 Pain 72 7 Fatigue, cognitive problems and depression 78 Fatigue 78 Cognitive problems 80 Depression 87 Mood swings and euphoria 89 8 Mobility and managing everyday life 92 Professional help 92 Exercises 93 Aids and equipment 105 Driving 120 vi CONTENTS 9 Speech difficulties 125 Voice production 125 Dysarthria 126 Helping yourself 127 Further help 127 10 Eating and swallowing difficulties; diet and nutrition 129 Eating and swallowing difficulties 129 Diet and nutrition 132 11 Eyesight and hearing problems 141 Eyesight 141 Hearing problems 144 12 Employment 145 Telling your employer 145 Promotion 146 Telling your colleagues 146 The Disability Discrimination Act 1995 and employment 147 13 Finances 150 Benefits 150 Insurance 156 Healthcare finance 158 Managing finances 159 14 Housing and home adaptations 161 Getting help for housing adaptations 161 Getting help for housing repairs 163 Re-housing 164 Sheltered housing 166 vii MANAGING YOUR MULTIPLE SCLEROSIS 15 Care 167 Care in the community 167 Respite and residential care 172 16 Leisure, sport and holidays 174 General information on leisure activities and hobbies 174 Day trips out 177 Holidays 179 17 Pregnancy, childbirth and the menopause 182 Pregnancy 182 Childbirth 183 Other women’s issues and the menopause 185 18 Research 187 Types of research 187 New lines of research 198 Finding out more 200 Glossary 202 Appendix 1: Useful addresses and websites 210 Appendix 2: Useful publications