Am I Having an MS Relapse?

As I sit down to write this week’s column, it’s hard for me to concentrate. I’d planned to write about new MS mobile apps, but I can’t get my brain to focus on the task.

I’ve been bragging about how I’ve been feeling sharper and able to concentrate better the past several months, but not today. As my friend Debi Wilson wrote a few years ago, “Thinking has become my second job.” Distractions currently are more distracting than usual.

The past two days, my legs have felt weaker than usual when I get out of bed in the morning, even though I’ve had a pretty good sleep each night. I’ve been feeling tired, too. Right now, in fact, I feel like dozing off. Fatigue and MS go together like beer and a burger, or fish and chips for my U.K. pals. I’m always a little tired, but I had been feeling less tired lately, until a few days ago.

Definition of a relapse

An MS relapse, also called a flare or an exacerbation, has a specific definition. It requires that the symptoms, old or new, must last at least a day. There must be no other reason for the attack, such as an infection or stress, and the new attack must be separated from a previous one by at least 30 days. It can be mild or seriously debilitating.

My last exacerbation was long ago — I think it occurred during the second Gulf War. I was treated with Solu-Medrol (methylprednisolone), an IV steroid, early in the morning as an outpatient so that I could spend the rest of the day at work. I guess I had about a half-dozen exacerbations over the first 15 years of my MS, but none since about 1995. That was when I started treatment with a disease-modifying therapy.

I’ve been treated with Avonex, Tysabri, Aubagio, and Lemtrada. I think each has helped slow the progression of my MS, and I’ve written about some of them in several “MS Wire” columns.

Maybe it’s a pseudo-relapse

I’m hoping my symptoms are just a pseudo-relapse. In a pseudo-relapse, no new neurological inflammation occurs, but old symptoms are re-triggered temporarily. This could be caused by stress or heat, and I’ve had plenty of both recently. Or, maybe I’m just suffering from a lack of exercise.

I’d really hate it if after all these years I regressed into a genuine exacerbation. But life can be like that with an unpredictable illness like MS. If that’s the case, I’ll deal with it.

Meanwhile, I’m going to do what I’ve wanted to do since I began writing this column this morning: take a nap.

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Update from the following day: I woke up feeling strong and alert. Chalk this one up as a pseudo-relapse.

You’re invited to visit my personal blog at www.themswire.com.

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