There is a sharing policy at my son's preschool. It's a parent-run co-op, so we have to have policies like this so that we will all handle situations relatively the same way. The policy is that a child can keep a toy as long as they want to. If another child wants the toy, they have to wait until the first child is done with it. We'll even "save" toys for the child if they have to go to the bathroom, go to the snack table, etc. so that it won't get taken before they're done. This applies to anything in the yard or school that can be played with, including swings and monkey bars.
At first, it didn't really occur to me to wonder why this was the policy. I just went with it, because that's the rule, and it didn't seem like a big deal to me. The kids all know the rule, so outside of maybe their first two weeks at the school, they don't throw a giant fit when you tell them, "You can have it when Sally Jo is done." But, lately I've been noticing a totally different attitude toward sharing in other places we go, and I'm starting to really know exactly why this is the school's policy.
Two Questionable Sharing Practices
Here are a couple of examples of questionable sharing practices that I've seen recently. The first comes from a good friend of mine. (And I hope she doesn't mind that I use her story as an example.) She and her almost-two-year-old were at the park one day. He had brought a small car from home to play with. Another child, a little bit older, wanted to play with the car and was demanding that my friend's son give him the car. A typical toddler scuffle ensued, and the other mother told her son, "I guess his mom didn't teach him how to share." Never mind the fact that the car belongs to him, and that when someone asks you to share, "No" is a perfectly legitimate response.
My second story happened one morning at the local rec center. Friday mornings they fill the gym with tons of Little Tykes climbing structures and those plastic cars they can drive around, tricycles, big balls, even a bouncy castle. Basically a toddler's dream play room. There's this one red car in particular my son really likes playing with, and the last time we went, he drove it around the entire hour-and-a-half we were there. While most of the moms with smaller kids will shadow their kids as they play, my son is old enough now that I can sit on the sidelines and watch. From there I watched a mom whose son wanted to drive the car approach my son repeatedly, saying, "Okay, now it's time for you to give him a turn!" Of course he ignored her, and eventually she gave up. There were a million other little cars for her son to drive, including one that was almost identical. Or maybe I would have stepped in at some point.
Real World Lessons
I don't agree with the approach of the mothers in either of these situations. I think it does a child a great disservice to teach him that he can have something that someone else has, simply because he wants it. And, I can understand the desire to give your children everything they want, we all have it. But it's a good lesson for you both to learn that this isn't always possible, and you shouldn't step all over other people to get these things.
Furthermore, this is not how things work in the real world. In your child's adult life, he's going to think he's owed everything he sees. This is already happening in the next generation. I read a fascinating article about how today's teens and twenty-somethings are expecting raises and promotions at their jobs for reasons like, "I show up every day."
If you doubt my reasoning, think about your own day-to-day adult life. You wouldn't cut in front of someone in the grocery checkout line, just because you didn't feel like waiting. And most grown adults wouldn't take something from someone, like a phone or a pair of sunglasses, just because they wanted to use it. (Well, maybe some of you would. In which case, this post may not be for you.)
It's hard, as with so many things about parenthood, but let's teach our kids how to cope with disappointment, because it happens. And we won't always be there to fix it for them. Let's teach them how they can get things they want through diligence, patience and hard work.
How do you feel about the concept of sharing where young children are concerned? I know you likely don't have a "policy," as I sure didn't before the preschool told me they had one. Now, I notice a variety of different takes on the subject from the parents I see around. Makes me wonder if we need to be talking about this issue a little bit more.
By very bloggy beth
http://www.circleofmoms.com/cms/display_content_user?id=3871&author_id=21477143995&trk=article_byline
Friday, May 18, 2012
Thursday, May 3, 2012
Letter from a Mother to a Daughter
To wonderful not to share. As my mothers caregiver this is so true.
My dear girl, the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If when we talk, I repeat the same thing a thousand times, don’t interrupt to say: “You said the same thing a minute ago”... Just listen, please. Try to remember the times when you were little and I would read the same story night after night until you would fall asleep. When I don’t want to take a bath, don’t be mad and don’t embarrass me. Remember when I had to run after you making excuses and trying to get you to take a shower when you were just a girl? When you see how ignorant I am when it comes to new technology, give me the time to learn and don’t look at me that way... remember, honey, I patiently taught you how to do many things like eating appropriately, getting dressed, combing your hair and dealing with life’s issues every day... the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If I occasionaly lose track of what we’re talking about, give me the time to remember, and if I can’t, don’t be nervous, impatient or arrogant. Just know in your heart that the most important thing for me is to be with you. And when my old, tired legs don’t let me move as quickly as before, give me your hand the same way that I offered mine to you when you first walked. When those days come, don’t feel sad... just be with me, and understand me while I get to the end of my life with love. I’ll cherish and thank you for the gift of time and joy we shared. With a big smile and the huge love I’ve always had for you, I just want to say, I love you... my darling daughter. "
Happy Mother's Day!
By: Spring in the Air
My dear girl, the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If when we talk, I repeat the same thing a thousand times, don’t interrupt to say: “You said the same thing a minute ago”... Just listen, please. Try to remember the times when you were little and I would read the same story night after night until you would fall asleep. When I don’t want to take a bath, don’t be mad and don’t embarrass me. Remember when I had to run after you making excuses and trying to get you to take a shower when you were just a girl? When you see how ignorant I am when it comes to new technology, give me the time to learn and don’t look at me that way... remember, honey, I patiently taught you how to do many things like eating appropriately, getting dressed, combing your hair and dealing with life’s issues every day... the day you see I’m getting old, I ask you to please be patient, but most of all, try to understand what I’m going through. If I occasionaly lose track of what we’re talking about, give me the time to remember, and if I can’t, don’t be nervous, impatient or arrogant. Just know in your heart that the most important thing for me is to be with you. And when my old, tired legs don’t let me move as quickly as before, give me your hand the same way that I offered mine to you when you first walked. When those days come, don’t feel sad... just be with me, and understand me while I get to the end of my life with love. I’ll cherish and thank you for the gift of time and joy we shared. With a big smile and the huge love I’ve always had for you, I just want to say, I love you... my darling daughter. "
Happy Mother's Day!
By: Spring in the Air
Tuesday, April 10, 2012
Life is a Journey
No matter how hard we try to stay connected or focussed on family; life doesn't stand still nor wait for the operative moments like we wish.
My husband and I have talked about going back down to Oklahoma the past 5 years to see his grandpa. It seems when you have the money, you don't have the time and likewise. All the kids now grown, truly dreamed of the little ones meeting their great great grandfather. It was a matter of everyone getting vacation at the same time and convoying down. Just last week we committed to making it a priority in early June.
I can't emphasize enough that life does not wait for that golden moment. That moment for my husband came on good Friday when he received the call that his grandfather wasn't expected to make it through the night. Despite our greatest efforts and a 14 hour trip before we could even attempt to get my husband on a plane time stood still and the lord took him home.
His journey, at least here had come to an end. He had led a wonderful life. Full of love. Love for his family, his friends, and his country. A man who served 20 years and 2 wars as a level 7 Chief before eventually retiring only to then continue by volunteering with the neighboring Tinker Air Force Base. He loved to volunteer and truly believed in service to others. He was one of the Founders of the Ronald McDonald House and was very involved with Special Olympics, even traveling so as not to miss any events.
Rest in Peace Grandpa Frank. Your work here on earth is done. You have touched the lives of so many. Your memories and lessons will live on through everyone you touched.
My husband and I have talked about going back down to Oklahoma the past 5 years to see his grandpa. It seems when you have the money, you don't have the time and likewise. All the kids now grown, truly dreamed of the little ones meeting their great great grandfather. It was a matter of everyone getting vacation at the same time and convoying down. Just last week we committed to making it a priority in early June.
I can't emphasize enough that life does not wait for that golden moment. That moment for my husband came on good Friday when he received the call that his grandfather wasn't expected to make it through the night. Despite our greatest efforts and a 14 hour trip before we could even attempt to get my husband on a plane time stood still and the lord took him home.
His journey, at least here had come to an end. He had led a wonderful life. Full of love. Love for his family, his friends, and his country. A man who served 20 years and 2 wars as a level 7 Chief before eventually retiring only to then continue by volunteering with the neighboring Tinker Air Force Base. He loved to volunteer and truly believed in service to others. He was one of the Founders of the Ronald McDonald House and was very involved with Special Olympics, even traveling so as not to miss any events.
Rest in Peace Grandpa Frank. Your work here on earth is done. You have touched the lives of so many. Your memories and lessons will live on through everyone you touched.
Thursday, March 22, 2012
MS Impacts US All
It's national MS Awareness Month.
Many people have heard of MS but may not no what MS is. The truth is most people no someone who has MS right now. Maybe it's a co-worker, a neighbor, your child, a spouse, or even yourself. MS affects all of us. Please watch the video to see how MS impacts us all.
http://www.youtube.com/watch?v=fIQTCCaz7lM&sns=em
Many people have heard of MS but may not no what MS is. The truth is most people no someone who has MS right now. Maybe it's a co-worker, a neighbor, your child, a spouse, or even yourself. MS affects all of us. Please watch the video to see how MS impacts us all.
http://www.youtube.com/watch?v=fIQTCCaz7lM&sns=em
FAQs about MS
Frequently Asked Questions about Multiple Sclerosis
What is multiple sclerosis?
Who gets MS?
How many people have MS?
What are the typical symptoms of MS?
What causes the symptoms?
Is MS fatal?
Does MS always cause paralysis?
Is MS contagious or inherited?
Can MS be cured?
What medications and treatments are available?
Why is MS so difficult to diagnose?
What is multiple sclerosis?
Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (the brain, optic nerves, and spinal cord). It is thought to be an autoimmune disorder. This means the immune system incorrectly attacks the person's healthy tissue.
MS can cause blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more. These problems may be permanent or may come and go.
Most people are diagnosed between the ages of 20 and 50, although individuals as young as 2 and as old as 75 have developed it. MS is not considered a fatal disease as the vast majority of people with it live a normal life-span. But they may struggle to live as productively as they desire, often facing increasing limitations.
Who gets MS?
Anyone may develop MS but there are some patterns. More than twice as many women as men have MS. Studies suggest that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited. MS occurs in most ethnic groups, including African-Americans, Asians and Hispanics/Latinos, but is more common in Caucasians of northern European ancestry.
How many people have MS?
Approximately 400,000 Americans have MS, and every week about 200 people are diagnosed. World-wide, MS affects about 2.5 million people. Because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, the numbers can only be estimated.
What are the typical symptoms of MS?
Symptoms of MS are unpredictable, vary from person to person, and from time to time in the same person. For example: One person may experience abnormal fatigue and episodes of numbness and tingling. Another could have loss of balance and muscle coordination making walking difficult. Still another could have slurred speech, tremors, stiffness, and bladder problems.
Sometimes major symptoms disappear completely, and the person regains lost functions. In severe MS, people have symptoms on a permanent basis including partial or complete paralysis, and difficulties with vision, cognition, speech, and elimination.
What causes the symptoms?
MS symptoms result when an immune-system attack affects myelin, the protective insulation surrounding nerve fibers of the central nervous system (the brain and spinal cord). Myelin is destroyed and replaced by scars of hardened "sclerotic" tissue. Some underlying nerve fibers are permanently severed. The damage appears in multiple places within the central nervous system.
Myelin is often compared to insulating material around an electrical wire; loss of myelin interferes with the transmission of nerve signals.
Is MS fatal?
In rare cases MS is so malignantly progressive it is terminal, but most people with MS have a normal or near-normal life expectancy. Severe MS can shorten life.
Does MS always cause paralysis?
No. Moreover, the majority of people with MS do not become severely disabled. Two-thirds of people who have MS remain able to walk, though many will need an aid, such as a cane or crutches, and some will use a scooter or wheelchair because of fatigue, weakness, balance problems, or to assist with conserving energy.
Is MS contagious or inherited?
No. MS is not contagious and is not directly inherited. Studies do indicate that genetic factors may make certain individuals susceptible to the disease.
Can MS be cured?
Not yet. There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging.
What medications and treatments are available?
The National Multiple Sclerosis Society recommends that a person consider treatment with one of the FDA-approved "disease-modifying" drugs as soon as possible following a definite diagnosis of MS with active or relapsing disease. These drugs help to lessen the frequency and severity of MS attacks, reduce the accumulation of lesions (areas of damage) in the brain, and may slow the progression of disability.
In addition to drugs that address the basic disease, there are many therapies for MS symptoms such as spasticity, pain, bladder problems, fatigue, sexual dysfunction, weakness, and cognitive problems. People should consult a knowledgeable physician to develop a comprehensive approach to managing their MS.
Why is MS so difficult to diagnose?
In early MS, symptoms that might indicate any number of possible disorders come and go. Some people have symptoms that are very difficult for physicians to interpret, and these people must "wait and see." While no single laboratory test is yet available to prove or rule out MS, magnetic resonance imaging (MRI) is a great help in reaching a definitive diagnosis.
For more information please visit the National MS Society http://www.nationalmssociety.org
What is multiple sclerosis?
Who gets MS?
How many people have MS?
What are the typical symptoms of MS?
What causes the symptoms?
Is MS fatal?
Does MS always cause paralysis?
Is MS contagious or inherited?
Can MS be cured?
What medications and treatments are available?
Why is MS so difficult to diagnose?
What is multiple sclerosis?
Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (the brain, optic nerves, and spinal cord). It is thought to be an autoimmune disorder. This means the immune system incorrectly attacks the person's healthy tissue.
MS can cause blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more. These problems may be permanent or may come and go.
Most people are diagnosed between the ages of 20 and 50, although individuals as young as 2 and as old as 75 have developed it. MS is not considered a fatal disease as the vast majority of people with it live a normal life-span. But they may struggle to live as productively as they desire, often facing increasing limitations.
Who gets MS?
Anyone may develop MS but there are some patterns. More than twice as many women as men have MS. Studies suggest that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited. MS occurs in most ethnic groups, including African-Americans, Asians and Hispanics/Latinos, but is more common in Caucasians of northern European ancestry.
How many people have MS?
Approximately 400,000 Americans have MS, and every week about 200 people are diagnosed. World-wide, MS affects about 2.5 million people. Because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, the numbers can only be estimated.
What are the typical symptoms of MS?
Symptoms of MS are unpredictable, vary from person to person, and from time to time in the same person. For example: One person may experience abnormal fatigue and episodes of numbness and tingling. Another could have loss of balance and muscle coordination making walking difficult. Still another could have slurred speech, tremors, stiffness, and bladder problems.
Sometimes major symptoms disappear completely, and the person regains lost functions. In severe MS, people have symptoms on a permanent basis including partial or complete paralysis, and difficulties with vision, cognition, speech, and elimination.
What causes the symptoms?
MS symptoms result when an immune-system attack affects myelin, the protective insulation surrounding nerve fibers of the central nervous system (the brain and spinal cord). Myelin is destroyed and replaced by scars of hardened "sclerotic" tissue. Some underlying nerve fibers are permanently severed. The damage appears in multiple places within the central nervous system.
Myelin is often compared to insulating material around an electrical wire; loss of myelin interferes with the transmission of nerve signals.
Is MS fatal?
In rare cases MS is so malignantly progressive it is terminal, but most people with MS have a normal or near-normal life expectancy. Severe MS can shorten life.
Does MS always cause paralysis?
No. Moreover, the majority of people with MS do not become severely disabled. Two-thirds of people who have MS remain able to walk, though many will need an aid, such as a cane or crutches, and some will use a scooter or wheelchair because of fatigue, weakness, balance problems, or to assist with conserving energy.
Is MS contagious or inherited?
No. MS is not contagious and is not directly inherited. Studies do indicate that genetic factors may make certain individuals susceptible to the disease.
Can MS be cured?
Not yet. There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging.
What medications and treatments are available?
The National Multiple Sclerosis Society recommends that a person consider treatment with one of the FDA-approved "disease-modifying" drugs as soon as possible following a definite diagnosis of MS with active or relapsing disease. These drugs help to lessen the frequency and severity of MS attacks, reduce the accumulation of lesions (areas of damage) in the brain, and may slow the progression of disability.
In addition to drugs that address the basic disease, there are many therapies for MS symptoms such as spasticity, pain, bladder problems, fatigue, sexual dysfunction, weakness, and cognitive problems. People should consult a knowledgeable physician to develop a comprehensive approach to managing their MS.
Why is MS so difficult to diagnose?
In early MS, symptoms that might indicate any number of possible disorders come and go. Some people have symptoms that are very difficult for physicians to interpret, and these people must "wait and see." While no single laboratory test is yet available to prove or rule out MS, magnetic resonance imaging (MRI) is a great help in reaching a definitive diagnosis.
For more information please visit the National MS Society http://www.nationalmssociety.org
How is MS Treated?
Although there is still no cure for MS, effective strategies are available to modify the disease course, treat exacerbations (also called attacks, relapses, or flare-ups), manage symptoms, improve function and safety, and provide emotional support. In combination, these treatments enhance the quality of life for people living with MS.
Modifying the Disease Course
The following agents can reduce disease activity and disease progression for many individuals with relapsing forms of MS, including those with secondary progressive disease who continue to have relapses.
FDA-Approved Disease-Modifying Agents
Avonex (interferon beta-1a)
Betaseron (interferon beta-1b)
Copaxone (glatiramer acetate)
Extavia (interferon beta-1b)
Gilenya (fingolimod)
Novantrone (mitoxantrone)
Rebif (interferon beta-1a)
Tysabri (natalizumab)
Disease Management Consensus Statement (.pdf)
Recommendations and principles from the Society’s National Clinical Advisory Board for health care professionals and people with MS—to guide treatment with the disease-modifying drugs.
The MS Disease-Modifying Medications (.pdf)
A booklet describing the approved use, dosage and route of delivery, side effects, benefits, and available support programs.
Patient Assistance Programs
A listing of the pharmaceutical company financial assistance programs to help manage the costs of the drugs.
Treating Exacerbations
An exacerbation of MS is caused by inflammation in the central nervous system (CNS) that causes damage to the myelin and slows or blocks the transmission of nerve impulses. To be a true exacerbation, the attack must last at least 24 hours and be separated from a previous exacerbation by at least 30 days. However, most exacerbations last from a few days to several weeks or even months. Exacerbations can be mild or severe enough to interfere with a person’s ability to function at home and at work. Severe exacerbations are most commonly treated with high-dose corticosteroids to reduce the inflammation.
Managing Symptoms
Symptoms of MS are highly variable from person to person and from time to time in the same individual. While symptoms can range from mild to severe, most can be successfully managed with strategies that include medication, self-care techniques, rehabilitation (with a physical or occupation therapist, speech/language pathologist, cognitive remediation specialist, among others), and the use of assistive devices.
Promoting Function through Rehabilitation
Rehabilitation programs focus on function—they are designed to help you improve or maintain your ability to perform effectively and safely at home and at work. Rehabilitation professionals focus on overall fitness and energy management, while addressing problems with accessibility and mobility, speech and swallowing, and memory and other cognitive functions.
Rehabilitation is an important component of comprehensive, quality health care for people with MS, at all stages of the disease. Rehabilitation programs include:
Physical Therapy
Occupational Therapy
Therapy for Speech and Swallowing Problems
Cognitive Rehabilitation
Vocational Rehabilitation
The Role of Complementary and Alternative Medicine (CAM)
CAM includes everything from exercise and diet to food supplements, stress management strategies, and lifestyle changes. These therapies come from various disciplines and traditions—yoga, hypnosis, relaxation techniques, traditional herbal healing, Chinese medicine, macrobiotics, naturopathy, and many others. They are referred to as complementary when they are used in conjunction with conventional medical treatments and alternative when they are used instead of conventional treatments.
Treatment Updates
FDA Updates Tysabri Label to Include Lab Test that Helps Identify Person’s Risk of Developing PML
Jan 23, 2012
The U.S. FDA has approved a change to the prescription label for Tysabri to show that a lab test that detects antibodies to the JC virus can help determine a person’s risk of developing PML, a severe brain infection. PML has emerged in some people who have taken Tysabri. The lab test should enhance the ability to weigh risks and benefits of this therapy.
European Medicines Agency Commences Safety Review of Gilenya
Jan 20, 2012
The European Medicines Agency has started a review of the oral medication Gilenya (fingolimod, Novartis) after reports issued on January 20 that there have been 11 deaths among patients who received treatment. Our sympathies go out to the families of all of these individuals. As more information becomes available, we will release it as soon as possible to the MS community.
Study Shows Potential of Lab Test to Detect Virus Which Causes PML in People with MS – ongoing study may help identify risk for PML in people treated with natalizumab
Dec 22, 2011
Biogen Idec researchers have published results on a blood test that detects antibodies to the JC virus, the virus responsible for PML. This paper reports that in an ongoing study of over 1,000 people being treated or considering treatment with Tysabri, 56% had evidence of JC virus antibodies. The presence of antibodies indicates that a person has at some point been infected by or exposed to the virus. Ultimately the study may show whether detection of antibodies to JC virus can help guide treatment decisions.
Possible Safety Issue Being Investigated with Novartis Pill Gilenya
Dec 12, 2011
Our sympathies go out to the family of an individual who recently died within 24 hours of receiving a first dose of the oral medication Gilenya. Novartis has confirmed this event and has reported it to the FDA. Until more information is available about the circumstances of this individual’s death, it is impossible to know what role Gilenya may have played in it.
Multiple Sclerosis Emerging Therapies Collaborative - UPDATE
Nov 14, 2011
We are proud to announce the launch of the Multiple Sclerosis Emerging Therapies Collaborative. The Collaborative – which includes the members of the MS Coalition, the American Academy of Neurology, and the VA Multiple Sclerosis Centers of Excellence East and West – has as its mission:
For more information please visit the National MS Society http://www.nationalmssociety.org
Modifying the Disease Course
The following agents can reduce disease activity and disease progression for many individuals with relapsing forms of MS, including those with secondary progressive disease who continue to have relapses.
FDA-Approved Disease-Modifying Agents
Avonex (interferon beta-1a)
Betaseron (interferon beta-1b)
Copaxone (glatiramer acetate)
Extavia (interferon beta-1b)
Gilenya (fingolimod)
Novantrone (mitoxantrone)
Rebif (interferon beta-1a)
Tysabri (natalizumab)
Disease Management Consensus Statement (.pdf)
Recommendations and principles from the Society’s National Clinical Advisory Board for health care professionals and people with MS—to guide treatment with the disease-modifying drugs.
The MS Disease-Modifying Medications (.pdf)
A booklet describing the approved use, dosage and route of delivery, side effects, benefits, and available support programs.
Patient Assistance Programs
A listing of the pharmaceutical company financial assistance programs to help manage the costs of the drugs.
Treating Exacerbations
An exacerbation of MS is caused by inflammation in the central nervous system (CNS) that causes damage to the myelin and slows or blocks the transmission of nerve impulses. To be a true exacerbation, the attack must last at least 24 hours and be separated from a previous exacerbation by at least 30 days. However, most exacerbations last from a few days to several weeks or even months. Exacerbations can be mild or severe enough to interfere with a person’s ability to function at home and at work. Severe exacerbations are most commonly treated with high-dose corticosteroids to reduce the inflammation.
Managing Symptoms
Symptoms of MS are highly variable from person to person and from time to time in the same individual. While symptoms can range from mild to severe, most can be successfully managed with strategies that include medication, self-care techniques, rehabilitation (with a physical or occupation therapist, speech/language pathologist, cognitive remediation specialist, among others), and the use of assistive devices.
Promoting Function through Rehabilitation
Rehabilitation programs focus on function—they are designed to help you improve or maintain your ability to perform effectively and safely at home and at work. Rehabilitation professionals focus on overall fitness and energy management, while addressing problems with accessibility and mobility, speech and swallowing, and memory and other cognitive functions.
Rehabilitation is an important component of comprehensive, quality health care for people with MS, at all stages of the disease. Rehabilitation programs include:
Physical Therapy
Occupational Therapy
Therapy for Speech and Swallowing Problems
Cognitive Rehabilitation
Vocational Rehabilitation
The Role of Complementary and Alternative Medicine (CAM)
CAM includes everything from exercise and diet to food supplements, stress management strategies, and lifestyle changes. These therapies come from various disciplines and traditions—yoga, hypnosis, relaxation techniques, traditional herbal healing, Chinese medicine, macrobiotics, naturopathy, and many others. They are referred to as complementary when they are used in conjunction with conventional medical treatments and alternative when they are used instead of conventional treatments.
Treatment Updates
FDA Updates Tysabri Label to Include Lab Test that Helps Identify Person’s Risk of Developing PML
Jan 23, 2012
The U.S. FDA has approved a change to the prescription label for Tysabri to show that a lab test that detects antibodies to the JC virus can help determine a person’s risk of developing PML, a severe brain infection. PML has emerged in some people who have taken Tysabri. The lab test should enhance the ability to weigh risks and benefits of this therapy.
European Medicines Agency Commences Safety Review of Gilenya
Jan 20, 2012
The European Medicines Agency has started a review of the oral medication Gilenya (fingolimod, Novartis) after reports issued on January 20 that there have been 11 deaths among patients who received treatment. Our sympathies go out to the families of all of these individuals. As more information becomes available, we will release it as soon as possible to the MS community.
Study Shows Potential of Lab Test to Detect Virus Which Causes PML in People with MS – ongoing study may help identify risk for PML in people treated with natalizumab
Dec 22, 2011
Biogen Idec researchers have published results on a blood test that detects antibodies to the JC virus, the virus responsible for PML. This paper reports that in an ongoing study of over 1,000 people being treated or considering treatment with Tysabri, 56% had evidence of JC virus antibodies. The presence of antibodies indicates that a person has at some point been infected by or exposed to the virus. Ultimately the study may show whether detection of antibodies to JC virus can help guide treatment decisions.
Possible Safety Issue Being Investigated with Novartis Pill Gilenya
Dec 12, 2011
Our sympathies go out to the family of an individual who recently died within 24 hours of receiving a first dose of the oral medication Gilenya. Novartis has confirmed this event and has reported it to the FDA. Until more information is available about the circumstances of this individual’s death, it is impossible to know what role Gilenya may have played in it.
Multiple Sclerosis Emerging Therapies Collaborative - UPDATE
Nov 14, 2011
We are proud to announce the launch of the Multiple Sclerosis Emerging Therapies Collaborative. The Collaborative – which includes the members of the MS Coalition, the American Academy of Neurology, and the VA Multiple Sclerosis Centers of Excellence East and West – has as its mission:
For more information please visit the National MS Society http://www.nationalmssociety.org
How is MS Diagnosed?
At this time, there are no symptoms, physical findings or laboratory tests that can, by themselves, determine if a person has MS. The doctor uses several strategies to determine if a person meets the long-established criteria for a diagnosis of MS and to rule out other possible causes of whatever symptoms the person is experiencing. These strategies include a careful medical history, a neurologic exam and various tests, including magnetic resonance imaging (MRI), evoked potentials (EP) and spinal fluid analysis.
The Criteria for a Diagnosis of MS
In order to make a diagnosis of MS, the physician must:
Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
Find evidence that the damage occurred at least one month apart AND
Rule out all other possible diagnoses
In 2001, the International Panel on the Diagnosis of Multiple Sclerosis updated the criteria to include specific guidelines for using magnetic resonance imaging (MRI), visual evoked potentials (VEP) and cerebrospinal fluid analysis to speed the diagnostic process. These tests can be used to look for a second area of damage in a person who has experienced only one attack (also called a relapse or an exacerbation) of MS-like symptoms — referred to as a clinically-isolated syndrome (CIS). A person with CIS may or may not go on to develop MS.
The criteria (now referred to as The Revised McDonald Criteria) were further revised in 2005 and again in 2010 to make the process even easier and more efficient.
The Tools for Making a Diagnosis
Medical History and Neurologic Exam
The physician takes a careful history to identify any past or present symptoms that might be caused by MS and to gather information about birthplace, family history and places traveled that might provide further clues. The physician also performs a variety of tests to evaluate mental, emotional and language functions, movement and coordination, balance, vision, and the other four senses.
In many instances, the person’s medical history and neurologic exam provide enough evidence to meet the diagnostic criteria. Other tests are used to confirm the diagnosis or provide additional evidence if it’s necessary.
MRI
MRI is the best imaging technology for detecting the presence of MS plaques or scarring (also called lesions) in different parts of the CNS. It can also differentiate old lesions from those that are new or active.
The diagnosis of MS cannot be made solely on the basis of MRI because there are other diseases that cause lesions in the CNS that look like those caused by MS. And even people without any disease — particularly the elderly — can have spots on the brain that are similar to those seen in MS.
Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5% of people who are confirmed to have MS do not initially have brain lesions on MRI. However, the longer a person goes without brain or spinal cord lesions on MRI, the more important it becomes to look for other possible diagnoses.
Evoked potential (EP) tests are recordings of the nervous system's electrical response to the stimulation of specific sensory pathways (e.g., visual, auditory, general sensory). Because damage to myelin (demyelination) results in a slowing of response time, EPs can sometimes provide evidence of scarring along nerve pathways that does not show up during the neurologic exam. Visual evoked potentials are considered the most useful for confirming the MS diagnosis.
Analysis of the cerebrospinal fluid, which is sampled by a spinal tap, detects the levels of certain immune system proteins and the presence of oligoclonal bands. These bands, which indicate an immune response within the CNS, are found in the spinal fluid of about 90-95% of people with MS. But because they are present in other diseases as well, oligoclonal bands cannot be relied on as positive proof of MS.
Blood Tests
While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including Lyme disease, a group of diseases known as collagen-vascular diseases, certain rare hereditary disorders, and AIDS.
Other Conditions Cause Demyelination (Damage to Myelin)
Demyelination in the Central Nervous System
Although MS is the most common, other conditions can damage myelin in the CNS, including viral infections, side effects from high exposure to certain toxic materials, severe vitamin B12 deficiency, autoimmune conditions that lead to inflammation of blood vessels (the "collagen-vascular diseases"), and some rare hereditary disorders.
Demyelination in the Peripheral Nervous System
Demyelination of the peripheral nervous system (the nerves outside the brain and spinal cord) occurs in Guillain-Barré Syndrome. After some injuries, the myelin sheath in the peripheral nervous system regenerates, bringing recovery of function.
Some demyelinating conditions are self-limiting, while others may be progressive. Careful (and sometimes repetitive) examinations may be needed to establish an exact diagnosis among the possible causes of neurologic symptoms.
For more information please visit the National MS Society http://www.nationalmssociety.org
The Criteria for a Diagnosis of MS
In order to make a diagnosis of MS, the physician must:
Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
Find evidence that the damage occurred at least one month apart AND
Rule out all other possible diagnoses
In 2001, the International Panel on the Diagnosis of Multiple Sclerosis updated the criteria to include specific guidelines for using magnetic resonance imaging (MRI), visual evoked potentials (VEP) and cerebrospinal fluid analysis to speed the diagnostic process. These tests can be used to look for a second area of damage in a person who has experienced only one attack (also called a relapse or an exacerbation) of MS-like symptoms — referred to as a clinically-isolated syndrome (CIS). A person with CIS may or may not go on to develop MS.
The criteria (now referred to as The Revised McDonald Criteria) were further revised in 2005 and again in 2010 to make the process even easier and more efficient.
The Tools for Making a Diagnosis
Medical History and Neurologic Exam
The physician takes a careful history to identify any past or present symptoms that might be caused by MS and to gather information about birthplace, family history and places traveled that might provide further clues. The physician also performs a variety of tests to evaluate mental, emotional and language functions, movement and coordination, balance, vision, and the other four senses.
In many instances, the person’s medical history and neurologic exam provide enough evidence to meet the diagnostic criteria. Other tests are used to confirm the diagnosis or provide additional evidence if it’s necessary.
MRI
MRI is the best imaging technology for detecting the presence of MS plaques or scarring (also called lesions) in different parts of the CNS. It can also differentiate old lesions from those that are new or active.
The diagnosis of MS cannot be made solely on the basis of MRI because there are other diseases that cause lesions in the CNS that look like those caused by MS. And even people without any disease — particularly the elderly — can have spots on the brain that are similar to those seen in MS.
Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5% of people who are confirmed to have MS do not initially have brain lesions on MRI. However, the longer a person goes without brain or spinal cord lesions on MRI, the more important it becomes to look for other possible diagnoses.
Evoked potential (EP) tests are recordings of the nervous system's electrical response to the stimulation of specific sensory pathways (e.g., visual, auditory, general sensory). Because damage to myelin (demyelination) results in a slowing of response time, EPs can sometimes provide evidence of scarring along nerve pathways that does not show up during the neurologic exam. Visual evoked potentials are considered the most useful for confirming the MS diagnosis.
Analysis of the cerebrospinal fluid, which is sampled by a spinal tap, detects the levels of certain immune system proteins and the presence of oligoclonal bands. These bands, which indicate an immune response within the CNS, are found in the spinal fluid of about 90-95% of people with MS. But because they are present in other diseases as well, oligoclonal bands cannot be relied on as positive proof of MS.
Blood Tests
While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including Lyme disease, a group of diseases known as collagen-vascular diseases, certain rare hereditary disorders, and AIDS.
Other Conditions Cause Demyelination (Damage to Myelin)
Demyelination in the Central Nervous System
Although MS is the most common, other conditions can damage myelin in the CNS, including viral infections, side effects from high exposure to certain toxic materials, severe vitamin B12 deficiency, autoimmune conditions that lead to inflammation of blood vessels (the "collagen-vascular diseases"), and some rare hereditary disorders.
Demyelination in the Peripheral Nervous System
Demyelination of the peripheral nervous system (the nerves outside the brain and spinal cord) occurs in Guillain-Barré Syndrome. After some injuries, the myelin sheath in the peripheral nervous system regenerates, bringing recovery of function.
Some demyelinating conditions are self-limiting, while others may be progressive. Careful (and sometimes repetitive) examinations may be needed to establish an exact diagnosis among the possible causes of neurologic symptoms.
For more information please visit the National MS Society http://www.nationalmssociety.org
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