Say the words MS diagnosis and what do you think of?
People in wheelchairs for the rest of their lives? Well thankfully for many patients, if diagnosed quickly enough, this is not necessarily the case.
Today is World MS Day, something us in Scotland should sit up and take notice of as sadly we have the highest rate of the disease in the world. But there is hope and treatments have developed rapidly over the last 20 years.
Dr Niall MacDougall is a consultant neurologist, working from the Queen Elizabeth University Hospital in Glasgow. He said: “For many patients, if well managed life can be almost ‘normal’. One person with MS that we know ran the London marathon and many more do very well.
“When people hear the words MS, they think their life is over. And while it still is a terrible diagnosis to have, this is not true for everyone. Now, if MS patients do become disabled, it’s often in later life.
“There are so many treatment options. The aim is to diagnose and treat early before disability happens. No drugs are perfect and they don’t make patients feel much better. It’s a bit like an insurance policy for later life – reducing your risk of disability.”
When a diagnosis is made, Dr MacDougall and the MS nurse team will, if possible, meet with the patient a few times before deciding the best course of treatment for them.
Dr MacDougall said: “Sometimes a patient can have maybe have two attacks and then no more. But if it looks aggressive, it’s often better to treat right away. It’s about getting the right balance.
“The side effects range from rashes and hot flushes to flu like symptoms and upset bowels. They also lower a patient’s immune system and cause hair thinning.
“But there are new drugs coming out all the time. Things are moving very quickly and I believe in 10-20 years they will be much better again.
Dr MacDougall also urges caution when it comes to treating MS with stem cell treatment.
He said: “I don’t think stem cell treatment is proven to be better than using the stronger available drugs. Often hype about stem cells raises false hope for people and they pour all their life savings into going abroad to have this treatment. People are understandably desperate and for this reason they can be conned. If it worked we would be doing it here. It’s an area that needs more research.
“In treating MS, we say time is brain, so we don’t want to wait years to start treatment. Smoking also accelerates MS, so we urge patients to give up.”
There is no single diagnostic test for MS and doctors look at a range of things over several weeks, including examining the patient, taking a medical history, scans, spinal fluid examination and about 20 blood tests to exclude other potential reasons for their symptoms.
Dr MacDougal said: “One of the most shocking things about MS is that Scots have the highest MS rate in the world.
“People living locally have approximately a 1 in 420 risk of developing MS, compared to 1 in 800 for those living in London. Scots also ‘take’ MS abroad with them, with areas for example in Canada with large ex pat populations also having high MS rates.
“It is all a bit of a puzzle and there are about 200 different genes which affect our risk –genetic factors do have a bearing as well as levels of vitamin D and possible viral triggers.
“MS is an important and common disease in Scotland. We have many more treatments than we did 20 years ago and hopefully things will improve further over the next ten.”
For further information either telephone 0141 201 4429,