MS can do a triple whammy on vision

 Any multiple sclerosis battler knows there’s a lot more to MS than meets the eye.

 Here’s what the National Multiple Sclerosis Society has to say about MS and vision:

“Vision disorders are the first sign of multiple sclerosis for many people. The 3 most common disorders are optic neuritis, diplopia (double vision) and nystagmus. While these conditions can be frightening and uncomfortable, the prognosis for recovery is good with treatment.”

 

Here’s a quick peek at each of the most prevalent vision-related issues for those living with MS.

1.  Optic neuritis – Caused by an inflammation of the optic nerve, this can be a painful and troublesome symptom of multiple sclerosis. It usually shows up suddenly as blurred vision (often tunnel-like) or dimmed vision, often with blind spots and blurred colors. Affecting one or both eyes, optic neuritis also may bring sensitivity to bright lights and a flashing sensation with eye movements. Untreated, it can last months, although it may abate sooner for some with steroid treatment.
2.  Dyplopia – Commonly known as double vision, diplopia causes blurriness and decreased depth perception. This can affect one or both eyes, and it can be uncomfortable or even painful. During a bout with this, a person may be extra vulnerable to falling and is unlikely to be able to drive or operate machinery safely.
3.  Nystagmus - This condition is marked by rapid involuntary eye movements, which can be rhythmic and may move up and down, side to side, or round and round. Vision (in one or both eyes) becomes blurred and distorted. This can result in dizziness, a feeling of disorientation, and headaches. Nystagmus may result from issues with the brain, ears, or eyes – all of which can be affected by an MS flare-up.

 I’ve had personal experience with all three of those – and sometimes at the same time. Such flare-ups are usually accompanied by vertigo and often a feeling of motion sickness (with nausea), and they generally bring on or aggravate a migraine headache.

 

What about recovery?

 For many MSers, recovery can happen, at least until the next exacerbation or relapse. Then the symptoms (including vision issues) can crop up in the blink of an eye. (Sorry, had to.)

 For many, these vision symptoms may clear up on their own in time, at least for the most part. In stubborn cases, doctors may prescribe steroid treatments (intravenous or oral or a series of both), as this has been proven to shorten the vision attacks in plenty of cases. Although these can be helpful, they are not without side effects, so it’s important to discuss this option with the physician before taking such treatments.

 MS symptom triggers can beckon back these vision issues, even without a full-blown MS flare-up or new demyelinations/lesions. For example, I almost always experience blurred and bouncing vision when overheated. If I can find a way to cool off, my eyesight improves quite a bit.

 

Can eyeglasses or corrective lenses help with MS-related vision problems?

 Because all of these concerns are neurological in nature, they cannot be eliminated by the wearing of spectacles or contacts.

 Occasionally, a doctor will instruct an MSer with vision issues to wear an eye patch over the offending eye for a while, particularly if double vision and/or dizziness are evident.

 It’s important for each individual to keep an eye on his or her vision (so to speak). Eye pain and eyesight problems can point to many other health concerns besides an MS exacerbation. If these or other vision-related symptoms arise, it’s time to consult a neurologist, ophthalmologist, or other medical expert.

 

Related items:

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• MS symptoms fire when we’re sick.
• Optic Neuritis: A Look at Sudden Blindness
• Stress brings MS to excess

 Image/s:  Adapted from public domain image.

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Dizziness isn't always all-ears

 

Whirling vertigo often begins in the ears … but not always. Ask anyone with multiple sclerosis or migraines. Better yet, ask anyone with the double bonus of both. The combination abounds!

 Vertigo can be a symptom of migraine. And it’s extra special when it comes from an MS migraine, which is an entity (or agony?) all its own.

The American Speech-Language-Hearing Association put it this way:

 Specifically, vertigo, which is the sensation of perceived motion without actually moving, is reported by up to one third of people who have migraine, and general dizziness or unsteadiness is reported by up to three quarters of all patients with migraine.

The folks at Johns Hopkins Medicine point to vestibular migraine as a frequent source of vertigo and related symptoms:

 Migraine headaches are a common neurological condition. Although common migraines are characterized by a moderate to severe pounding or throbbing headache, vestibular migraine may or may not involve headaches in combination with vestibular symptoms such as vertigo, imbalance, nausea and vomiting.

Stanford Medicine agrees:

 Unlike the classic migraine, which is described as severe, throbbing headache, vestibular migraine has no pain associated with it 50% of the time. Vestibular migraine causes episodes of dizziness described as rocking, spinning, floating, swaying, internal motion and lightheadedness. They most often occur spontaneously, but can be triggered by stress, sleep problems, skipping meals, dehydration, other illnesses.

 Wow. So it’s possible (and not even unlikely) to have a migraine without suffering a severe headache.

Finally, someone’s talking my language!

 After years of going around and around (See what I did there?) with my primary care physician, in which he insisted that my frequent and severe vertigo / lightheadedness / dizzy / off-balance symptoms were caused by inner-ear crystals (including multiple physical therapy sessions for this diagnosis, which proved unfruitful and actually aggravated my symptoms, I found this migraine-related information to be a complete game changer.

OK, for the vast majority of vertigo sufferers, a simple physical therapy maneuver can work miracles. (Got vertigo? Try this first!)  But for the MSer (or anyone with central vertigo, rather than benign positional vertigo) or the migraineur, it generally proves a bust.

 I’ve had migraines since my Junior High years. But they always used to include major headaches. And apparently vestibular migraines (and the frequently associated vertigo) are most common among those who were particularly susceptible to motion sickness, especially as children. Bingo! That was me.

 Enter MS. Within the past few years (especially since hormonal changes kicked in with a vengeance), my migraines have evolved. Sure, I occasionally have the head-in-a-vise pounding variety. But more often, I battle a dull headache behind the agonizing whirling and unsteadiness of vertigo.

 Thankfully, my MS doctor affirmed my description of symptoms and flat-out said the frequent (sometimes daily) vertigo I face is related to migraines, which are common with MS. As such, she recommended avoiding food-related migraine triggers (as I already do), getting much-needed rest, drinking plenty of water, and taking travel-sickness medication when vertigo strikes. (See Simple OTC product helps vertigo?)

 That means no more neck twisting, which only aggravated some of my existing MS demyelination and didn’t fix the lightheaded spinning problem anyway.

 

Related items:

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• MS and vision: How many types of glasses do I need?
• MS is like the cancellation disease.
• MS makes me clumsy sometimes.
• Not all nose-dives are MS' fault.
• Self-advocacy: When therapy is not therapeutic
• Simple OTC product helps vertigo?

 

 Image/s: Excruciating Headache, M. Egerton, 1827, public domain

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The perfect storm can bring on an MS maelstrom

 I should have seen it coming. A full constellation of circumstances set me smack in the middle of the perfect storm, which invited a full-blown multiple sclerosis exacerbation.

 

If you live with MS (or love someone who does), you know where this is headed.

• It all started with a fuller-than-usual calendar, which drew me to overextend myself. (OK, I know that was a choice, but it still happened.)
• Seasonal allergies kicked up a few notches the same week.
• Then I came home from a jaunt in the woods, carrying a tick. The nasty little guy embedded himself in my lower back, and I didn’t discover him for 24 hours. (He may or may not have been a Lyme tick. And we all know how doctors like to confuse Lyme and MS.)
• Just in case, the ER doc gave me a tetanus shot. (Ever have a reaction to an immunization?)
  
• Right around that time, I began topical chemotherapy treatment on a couple of sites, following the instructions of my dermatologist.
• Enter flu season.

 

Wham. Bam. Slam. There’s the MS maelstrom.

 The dictionary defines “maelstrom” as a massive and powerful whirlpool, a tumultuous set of circumstances, pandemonium, or bedlam.

 

Kind of like an MS flare-up.

 The whirlpool part hits all too close to home for MSers like me, who battle vertigo frequently, especially when MS rises into full force.

 I was down for the count (flat on my back) for nearly two weeks. Violent vertigo, daily migraines, total fatigue, blurry vision, and nearly complete loss of appetite pounded me. Sinus pressure and drainage that ended up in my lungs, sending me into full-body coughing fits didn’t help.

 Two months later, I’m still staving off vertigo (as much as possible) with motion sickness medication and finishing the vestiges of a lingering cough.

 Looking at the list of possible MS exacerbation triggers, I cannot exactly tell which ones whipped the MonSter into such a frenzy.

 But it’s easy to tell that I was right in the middle of the perfect storm.

 

 

Maybe you’ve been there.

 Sometimes we can spot and avoid our most predictable MS triggers. But this crazy condition has a mind of its own. Sort of like Mother Nature’s fury, when she stirs things up into a superstorm.

 I’m thankful that this tempest seems to have tamed, at least for now.

 

Related items:

• Ain't nothin' pseudo about a pseudo-exacerbation
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• MS episode: Is it a relapse, a new lesion, or what?
• MS is like the cancellation disease

 Image/s: public domain photp

 

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MS and vision: How many types of glasses do I need?

 

Vision is an issue for almost everyone battling multiple sclerosis, or so it seems. Most of us have experienced optic neuritis in one or both eyes, when MS attacks the optic nerve, wreaking havoc on eyesight. We face tunnel vision, color blindness, eye pain, loss of depth perception, and general blurriness until it subsides. If we’re lucky, most of the damage is temporary – at least, until the next episode.

 Vertigo is another common complaint among those with MS. Reeling, unsteadiness, and dizziness can crop up anytime. And they do.

 

That makes vision care considerably more complex for MSers.

 Personally, I’ve been through the wringer, when it comes to finding useful and appropriate eyewear.

 Initially, all I needed was a pair of basic magnifying readers. I’d pick these up for reading, computer work, crafting, and other close-up activities. It was enough to keep a few pairs in strategic spots around the house, office, car, and other locations for quick grabbing.

 Eventually, I grew tired of the constant off-and-ons. And, like many, I began needing some vision help with distance sight as well. So I tried bifocals.

 Ugh!

 I would imagine it’s tricky enough to nod one’s head constantly up and down, finding the sweet spots on bifocals for far and close sights. But with MS attacking spots up and down one’s spine, all that neck movement can be a real headache. (See what I did there?)

 And the shifting back and forth from near and far tends to be jarring. It sure was for me. So I tossed the bifocals.

 Then my eye doctor suggested progressive lenses.

 Oh, boy.

 Progressive lenses somehow blend the distance prescription down to the close-up prescription without visible dividing lines. They’re particularly pricey, but plenty of people crow about how wonderful they are. (Actually, I have never heard an MSer praise them, now that I think about it.)

 Ah, hindsight!

 OK, so the vision center expert minimized the possible struggles I might encounter, simply defining a “short-term learning process” with progressive lenses.

 That didn’t even come close to describing the blurriness, double vision, and vertigo I experienced when I began wearing a very pricey pair of progressive lens eyeglasses. Yes, I even barfed.

 Then I did a little reading on the issue. Apparently, progressive lenses can bring blurry vision, headaches, nausea, balance problems, and an impression of still objects bouncing around. Some people even trip or fall when wearing them. Sounds a little dizzying and disorienting, right? Just the ticket for someone with MS?

 I reverted to my trusty pairs of cheap readers. At the time, I still didn’t need much help for distance viewing. I figured I could live with a little squinting, rather than reeling from the weird lenses.

 

Ah, but things change in time, don’t they?

 My latest eye exam revealed I need more distance vision help. When I protested about bifocals and progressives, my eye doc recommended I try using one pair of glasses for distance and another for close-up.  And because most of my need for distance viewing is while driving, I also picked out a pair of prescription sunglasses.

 Gee, this will be fun, trying to keep track of all that eyewear.

 Life with MS. No one ever said it would be simple.

 

Related items:

·        Eye Pain - Facing MS symptoms from A to Z

• MS style: Sporting shades in the shade ... or fog or rain
• MS symptoms fire when we’re sick
• Optic Nerve Issues - Facing MS symptoms from A to Z
• Optic Neuritis: A Look at Sudden Blindness
• Side-to-side eye movement may help memory, but it makes me wanna hurl

  Image/s: public domain photp

 

 

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Self-advocacy: When therapy is not therapeutic

 

Multiple sclerosis pits a person against his or her own body – and sometimes against medical experts.

 Ask any of us who battle MS daily, and you’ll likely hear about how our own bodies betray us, as our central nervous systems mutiny against our limbs, eyes, and countless other components. Maybe that’s why it seems extra frustrating when we have to combat false assumptions and unhelpful advice, particularly when it comes from medical professionals we have enlisted to help us.

 

Ouch.

 Recently, my physician sent me for vestibular therapy, explaining that my recurrent (and increasingly severe) vertigo episodes might be traced to benign paroxysmal positional vertigo. Simply described, that’s a condition that arises when inner-ear crystals slip out of place, causing dizziness.

 

That’s not what’s caused my vertigo.

 More than a decade ago, my (now-retired) neurologist/MS specialist attempted the Epley Maneuver on me, simply to rule out BPPV. This little trick involved lying flat (supine) on the exam table, while the practitioner bends and turns my head to one side and then the other.

 

The Epley Maneuver can work wonders for someone with BPPV. But for the MSer, it can wreak havoc.

 Way back when (and again recently), this technique sent me spiraling into vertigo hell for hours.

 

Fast-forward to last week.

 The young physical therapist, apparently specializing in vestibular issues, put me through a full battery of balancing, rolling, and head-turning trials. She set me supine on the flat exam table and tipped the top (head) section downwards by 30 degrees. Adapting the popular 1-10 pain scale, my vertigo went from a 3 to an 8.

 In our initial discussion, I had already explained to her that I needed to elevate my head at least 30 degrees whenever on my back (as for an exam, fitness class floor exercises, or a yoga class). I mentioned that I sleep with two pillows. All of these allowances are vertigo-preventative, as I have demyelination in my cervical spine area.

 Ever determined, however, she put me through the paces.

 Then she concluded that my vertigo was not vestibular-related, but only after I’d endured her full checklist of tests and potentially therapeutic head positions and movements. Even so, she said she recommended repeating the same exercises, intentionally precipitating vertigo, on the chance that might retrain my brain to adjust to vertigo.

 

Um, what?

 Afterwards, I contacted my physician and reported on the experience. I told him I was not inclined (no pun intended) to continue the vestibular therapy, as it only triggered and increased my symptoms and as my vertigo clearly was not vestibular in nature.

 Holy moley. My head is still spinning over this ordeal. But I had to find my way to standing on my own two feet (literally and figuratively) to avert repeat occurrences.

 Phew! They don’t call us MS Warriors for nothing. (At least, perhaps they should.)

 

Related items:

• I bucked the system and skipped the spinal tap
• MS is like a carnival thrill ride without the thrill
• MS makes me wanna cheer anyone struggling to exercise
• Simple product helps vertigo?
• Who goes with you to your MS appointments?

 

Image/s: 3 Wise Monkeys at Tosho-gu Shrine, Nikko, Japan, by Ray in Manila - CCA lic.

 

 

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