Recognizing and Avoiding MS Triggers to Prevent Exacerbations

When the cause of so called Multiple Sclerosis is eliminated the need for preventing exacerbations will be gone!!!!! #CCSVI

I've read similar accounts and have to ask clarifying questions...are you speaking of "pseudo-exacerbation" which are effectively the onset and intensification of underlying issues/symptoms brought about by inflammation and/or Uthoff's phenomenon-related heat intolerance...or are you speaking of demylination of nerves brought about by your body attacking itself; leading to permanent, irreversible damage in the classic definition?

I ask this as when I have any fever or infection or even just not feeling well in that my internal core body temperature is elevated, my symptoms intensify. The damage is there, but without inflammation, symptoms are less severe.

The most serious example for me, and terrifying in many ways, was a nighttime fever I had a couple of years ago. I was in my upper 40's and woke up to a fever slightly over 100 and getting worse...my wife wanted me to go to the ER and I told her that if she did, to call an ambulance because at that time, I could no longer stand much less walk. Several Ibuprofen and a couple of hours later, I was recovered and went in to work that morning...a most bizarre experience and I really don't know what triggered the fever...it came and went. During the height of the fever, I was all but incapacitated.

Inflammation is the key for what I now know as "pseudo exacerbation" and I am very susceptible to Uthoff's. As time has progressed, my disability has progressed too...often without the dramatic flare ups though I have not transitioned to secondary progressive...and hopefully won't. Much to understand and learn. Diet is key to managing inflammation as well though like most people, managing a healthy diet is difficult at best and most serious to me, as disability increases, exercise decreases which compounds the struggle.

I sent a comment earlier and perhaps is being evaluated. Anyway, another key is keeping saturated fat to under 10 grams/day. Very doable!

I was dx'd 12+ years ago. I have been on Copaxone only for all that time. I don't have flu symptoms and other than occasional site itching, and unfortunate skin atrophy which will never go away, I don't have any other side effects from medications. I do take a LOT of supplements b/c I try to follow a low carb lifestyle and not sure I get all the nutrients from diet. I don't worry about saturated fat too much; I don't eat all that much fat put it has 0 calories so in my book it doesn't count. I did lose a lot of weight and I keep it off by watching carbs. I eat Eggs, dairy, vegetables. Due to silent acid reflux I've been told to avoid certain foods which really puts a cramp in my style! Most all the articles I read say that diet has little if anything to do with MS but a health diet is good for everyone. It is my theory (and I may be wrong) and I've read this in a couple of places that there may actually be different types of MS mild, for example, that is am entity in itself so that it won't become another form like progressive. I can only hope that is true for me. Maybe it would have made no difference had I not spent thousands of dollars on medications, but then I wasn't willing to take that chance. I'm 70 now and I can only hope I won't get worse. Time will tell.

Yet one more trigger: I am allergic to beef since it makes my right eye blurry. Easy to avoid it!

I think you need to be more careful and clear in your language choices and this is so critical for the whole community as it perpetuates the confusion that’s out there. For example, you say “the cold sent my MS into a full blown exacerbation”. Exacerbation, flares, relapses - without clear and consistent usage of these terms we won’t help others. After reading your article several times I still don’t know if you’re talking about a pseudo relapse where old symptoms flare and you feel bad but it won’t hurt you long term , or an actual relapse, where a cold triggers immune response and then triggers disease progression with further and new demyelination? The latter is much more serious and requires steroids and other intervention as well as has the potential for permanent disability.
This is what scares many most about catching a cold - the risk of the illness triggering further disease progression . While a temporary increase in symptoms obviously feels terrible and disrupts quality of life temporarily, it’s not cause for WORRY.
I know I would appreciate it if you clarify and hope that you as well as others be more careful with language in this area.

Hi Michelle,
I understand what you are saying and I will clarify my position. This is how the National Multiple Sclerosis Society (NMSS) classifies exacerbations, attack’s flare-ups and relapses. “An exacerbation of MS (also known as a relapse, attack or flare-up) causes new symptoms or the worsening of old symptoms. It can be very mild, or severe enough to interfere with a person’s ability to function at home and at work. No two exacerbations are alike, and symptoms vary from person to person and from one exacerbation to another.”
It is very clearly stated, that exacerbations, flare-ups, attacks, and relapses are all words used to describe the same occurrence. The difference is in the severity of each occurrence and each is different from person-to-person. You are correct that I could of stressed more about the different severity levels of exacerbations. I also could have added that my enhanced MS symptoms lasted more than 24 hours. Which on one site suggested a real MS flare-up.

I wrote my article about my experience, I described how my body felt and reacted to an attack from an outside source. That was the main focus of my article, to be aware and avoid the triggers that can send MS into an exacerbation (flare-up, attack or relapse).
There is no way of knowing if my relapse caused my body more damage, not without a comparison MRI.
I always look for more ways to be more helpful to my readers, so I truly appreciate your comments. Best to you,Debi