DR. HOOK- MS: A devastating nervous system breakdown
by JOHN HONG, MD, published September 20, 2007
There's another Dr. John Hong out there! Actually two! I've been getting emails to my new web page, only to be disappointed that the senders have confused me with a neurologist or a hospital administrator.
How many John Hong, MDs can there be? There aren't too many Hongs. I think that's why people usually get my last name wrong: Wong, Kong, Hwang, and Hung. I often say to people who ask for my name, "Think of Hong Kong, you know that famous Chinese city?"
Hong means "fragrant," so I smell good. "Dr. Kong?" Sigh. Can all of this lead to a nervous breakdown?
Multiple Sclerosis (MS) is a breakdown of the nervous system, afflicting over 350,000 Americans. It's the #1 cause of disability in young adults that isn't trauma related. Women have MS twice as frequently as men (such as actress Teri Garr). People of northern European descent have it more often, although it affects many African Americans (such as Montel Williams and the late Richard Pryor).
We aren't sure what causes MS and therefore there is no cure. The sheath of the nerves (called myelin) are attacked and destroyed by the body's immune system, which causes the nerves to stop functioning. So during a flare-up of MS, neurological problems can become pretty evident: movement problems, weakness, numbness, blindness, vertigo, and incontinence.
Four types of MS are described. The most common type is Relapsing-Remitting MS (RRMS). Acute flares occur before a period of "back off" that lets the nerves heal, and then they occur again. After enough attacks, the nerves are permanently destroyed.
Secondary-Progressive MS (SPMS) is an end result of RRMS in which the nerves just keep dying, regardless of whether there are flare-ups, leading to more neurological dysfunction.
Primary-Progressive MS (PPMS) is a chronic steady road to permanent neurological destruction without any obvious relapses in MS flares. Lastly, the rarest form, Progressive-Relapsing MS (PPMS), is a continuing series of flares.
So are we all bright and cheery right now? I hate MS. It's devastating to anyone afflicted with it. To make things worse, MS patients struggle with depression and fatigue. In fact, some people have depression and fatigue for years before being diagnosed with MS because MS strikes randomly in the central nervous system (brain and spinal cord). So symptoms can be very mild and very transient.
An MRI of the brain is probably the best way to detect MS, something health insurance absolutely hates paying for because it cuts their officials' world cruise on the Queen Mary 2 by at least a month. Lumbar puncture and evoked potentials can be of assistance in diagnosis, but sometimes it's difficult to confirm if someone has MS.
Treatment usually includes IFN-beta (such as Avonex). Also medicines can help with fatigue and depression (don't tell Tom Cruise because he'll say you're glib!!), but MS patients also need to pay attention to other issues such as cholesterol, osteoporosis, skin ulcers, PAP smears, etc.
I wonder if Annette Funicello (Mouseketeer, beach icon, MS survivor) has an impostor as well. If she does, the impostor definitely has some nerve.
Please participate in or support the National MS Society Bike Rides bikeorc.nationalmssociety.org
Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.
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http://www.readthehook.com/stories/2007/09/20/DRHOOK-MS-0638.rtf.aspx
posted by Bill at 2:19 AM
