Overcoming MS!Dr Torsak Follow-Up14th July,2014

Update from last visit (March’14)

• Condition very stable in March and April

• Started physical therapy sessions (four times in a week from

end of March)

• Travelled solo in April!

• Overall morale quite high

When suddenly..

• Loss of vision in left eye noticed on 30th Apr

• Vision dropped to around 15% on 2nd May

• Admitted on 2nd May

• Show:

– Discharge Summary

– MRI

– VEP Test Report initial and latest

PLM Charts (MS Specific)

Following are some of the charts through which a patient can

create a log of symptoms/ condition which is otherwise very

difficult to quantify:

1) My Symptoms

2) Multiple Sclerosis Rating Scale (MSRS)

3) Quality of Life (QOL)

My Symptoms Chart

Patient can rate the severity of some or all the symptoms (on an interval scale) of MS on a given day

My Symptoms

Fatigue and spasticity : have decreased from Mid May onwards Moderate mood swings post steroids

Multiple Sclerosis Rating Scale

Patient can rate the impact of MS symptoms (on an interval scale) on day-to-day life

MSRSOverall Summary

First monsoons, loss of balance and problem in walking

After 1st session After 2nd session

Optic Neuritis

Recovery

Activity 20th Feb 7th May 12th May 2nd June 12th Aug 22nd Sep 23rd Oct 9th Nov 23rd Nov 6th Dec 15th Dec 23rd Feb 2nd Apr 9th May 6th June 3rd JulyWalkingUpper Limb FunctionVisionSpeechSwallowingThinking/Memory CognitionSensation/Burning/Pain

MSRSDetailed Break-up of MSRS Activities

No Symptoms MildNone Moderate

•Improvement in walking and Burning Sensation•Left Eye Vision also recovered mostly

Quality of Life: PhysicalQOL Score indicates how one’s condition and treatment affects one’s physical, social

and mental well-being

Quality of Life: Mental QOL Score indicates how one’s condition and treatment affects one’s physical, social

and mental well-being

Quality of Life: Social

QOL Score indicates how one’s condition and treatment affects one’s physical, social and mental well-being

My QOL Scores

•Improved mobility and also excellent mood!•Throat infection and weather change, getting back

Next Steps

• Progressive MS or RR MS?

• Inflammation in Progressive MS? (Inflammation was low in last blood test,

Mar’14)

• Can GcMAF induce inflammation? GcMAF advisable in RR MS?

• New MRI: What does it say ?

• Steroids: how do they work? Is it sustainable?

• More prone to cold and throat infections (Tonsillitis) again, Immune

system action?

• What’s next? Immunosuppressive drugs like Interferon and Tysabri?

• Ongoing follow-ups

I’ve already overcome this!