Columns Delicate Balance - a Column by Leigh Anne Nelson Facing a new symptom, I wonder: Is it from MS or normal aging? Facing a new symptom, I wonder: Is it from MS or normal aging? These days, it's harder for me to tell just what's causing some ailments by Leigh Anne Nelson | May 27, 2024 Share this article: Share article via email Copy article link I try not to attribute every new symptom I experience to multiple sclerosis (MS). When I was younger, I had an easier time attributing the cause of a new symptom: It was MS or something else. As I age, this differentiation is becoming more difficult. Recently, I experienced new-onset urinary frequency that lasted three weeks. I had no other symptoms. I’m aware that MS can commonly cause urinary symptoms, so I wondered if that was the case here. The frequency was mild to moderate and made me uncomfortable, but it was tolerable, so I carried on with my normal routine (other than more frequent trips to the bathroom). I finally sent a message to my MS clinician when it interfered with my sleep. That clinician suggested I see my primary care provider so I could be evaluated for a urinary tract infection (UTI). I think it’s been well over 25 years since I’ve had a UTI, but I remember what it felt like. I felt confident I wasn’t experiencing the infection because I didn’t have its classic symptoms (e.g., burning upon urination, pain, fever, and urinary urgency), which I experienced when I was younger. Recommended Reading September 1, 2023 Columns by John Connor Yet another urinary tract infection causes a complete change of plans After some research, I learned that the classic UTI symptoms may be less prominent in older people. Symptoms unrelated to the urinary tract ā such as increased heart rate, confusion, dizziness, drowsiness, poor appetite, nausea and vomiting, and increased risk for falls ā may be present. On the other hand, fever may not be present. My other thought was that the ailment could be the onset of post-menopausal bladder control problems. They typically present as urinary incontinence and leakage because of an overactive bladder. My symptoms were different, but I fit the profile: I was an older female, post-menopausal. After realizing that my urinary frequency might be unrelated to my MS, I scheduled an appointment with my primary care provider. Yet I woke up the next day with the problem completely resolved, so I canceled the appointment. My most recent magnetic resonance imaging (MRI) scans showed no new or active lesions, so for now, my MS clinician and I have decided the exact cause of my urinary frequency will remain a mystery. Memory and other troubles Urinary problems arenāt the only symptom I question. Approximately a year after my MS diagnosis, I felt I was becoming more forgetful, especially as it related to my work. For example, I couldn’t recall important details from committee meetings. I struggled to complete work that required me to carry over and apply new knowledge. If I didn’t immediately put an appointment or meeting in my calendar, I forgot it. Up to this point, I’d always felt I had a good memory, so this change was significant. I was in my early 40s, so age-related memory impairment shouldn’t have been an issue. Knowing that MS can cause memory problems, I completed cognitive testing, which revealed mild cognitive impairment. We determined that the cause was the gabapentin I was taking for peripheral neuropathy in my feet. I stopped taking it, and my memory improved. Fast forward to today: I feel I can’t remember anything! I’m not taking gabapentin, and my difficulties at work are the same. Yet I depend on lists, one for work and one for home. I’m horrible at remembering names and faces. If I meet someone new, I won’t recall their name the next time I encounter them. In fact, I may not remember it within minutes of the initial introduction. I know forgetfulness can be normal during the aging process. Once again, I wonder if my memory impairment is related to my MS or if it’s a normal part of the aging process. My recent MRI suggests no MS progression, so the cause of my recent troubles remains unclear. I plan to discuss my memory with my MS clinician at my next appointment. Some days I also experience mild fatigue, which waxes and wanes depending on my activity level. That’s slightly worsened over the past year. Fatigue is a common symptom associated with MS, but it’s also common to experience tiredness, lack of energy, and decreased endurance as we age. Once again, is this symptom related to MS or getting older? As I age, determining the cause of new or worsening symptoms has become more difficult. Symptoms that overlap MS and aging include bladder dysfunction, memory problems, fatigue, muscle weakness, vision changes, sleep disturbances, and balance difficulties. No doubt, pinning symptoms to my MS was easier when I was younger. Note:Ā Multiple Sclerosis News TodayĀ is strictly a news and information website about the disease. It does not provide medical advice,Ā diagnosis, orĀ treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those ofĀ Multiple Sclerosis News TodayĀ or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis. Print This Page About the Author Leigh Anne Nelson Leigh Anne Nelson is a professor at the University of Missouri-Kansas City School of Pharmacy and a board-certified psychiatric pharmacist. She was diagnosed with relapsing-remitting multiple sclerosis (MS) approximately 10 years ago. She hopes her column, āDelicate Balance,ā will help people living with MS become more aware of MS symptoms and learn to advocate for themselves by providing personal stories of her journey with MS. Leigh Anne is passionate about educating others about MS. Tags aging, symptoms Comments Kara Postmenopausal urinary issues may be due to low estrogen, which can affect pelvic floor tissue. Talk to your GYN practitioner as there are estrogen tablet vaginal suppositories for use rather than systemically absorbed medication (patches, oral meds). See if you can relate any other triggers for bladder urgency. Besides caffeine, I realized B-complex vitamins are a bladder irritant for me. Overactive bladder meds (OAB) are anticholinergic medication that block those neurotransmitters. Perhaps that could contribute to memory issues. These are just thoughts to discuss with your doctor. Reply Mark Avery How do you write this article without mentioning your actual age? Reply Letha DeCaires Thank you for the article. Just turned 65 and ponder the same process when new things pop up. Mostly I have decided to note and then ignore, counting my blessings for still being above ground and very mobile! Reply Arlene Mowry Thank you for this article! It is often what I feel with similar issues. It sometimes is difficult to determine the cause and I go back and forth with my Primary Care and MS specialist. Age definitely has something to do with everything. Reply Walter Smoke I enjoy your e-mail. I will be 80 in July. I really relate to most of the issues raised here. Of course being male makes a difference. I have secondary progressive MS, and all movement is difficult. I am currently receiving PT treatment....very good!! Reply Mary Beth I was diagnosed at the age of 58. I am now almost 67. I also struggle with symptoms that either could be age related or MS. Iāve noticed that my memory and balance have markedly declined in the past year. Iām going for MRIs next week so we shall see ! Reply Valerie. S. Good one š Reply Pamela Toohey It is hard to recognize what is MS what is normal aging. The significance I find is if symptoms are transient or permanent; gradual or more intense; or even worse a combination of ms AND aging. I had a bout of incontinence that was so bad I was considering diapers for bed or a commode in my bedroom. This demoralizing time period lasted about a month. Then all over about 48 hours my bladder control became what I was used to. Definitely a flare. Confusion, memory loss, lack of attention, I believe is a combination since I had those symptoms well before my age should have played a part. Most importantly? Whether yo lay them at ms or aging doors not as important as learning how to cope and how to be at peace with a world that is narrowing in scope and ability when my yearns to still be active, to experience, to learn, are still alive within me along with a tiny spark of hope no matter how unrealistic I fo try to be content with my small world. Sometimes I panic because I canāt keep up with even daily chores never mind adding on anything special or out of the ordinary. I am sad when I grow impatient if something crops up that siphons my precious store of energy. I grt scared because I worry if I struggle now, what will happen in 5 or 10 years? Thank goodness I donāt think I will last much longer than my 70ās. I had expected before to live to my 80ās. Almost gratefully I realize now that has to be shortened. Because I am tired. So achingly tired. I accept I will not realize all my dreams. My life is finite but my soul is forever Reply Brenda Heitzman YES, SO TIRED. I AM TREATING SYMPTOMS OF ANY TYPE AS THEY OCCUR. YOUR POSTING MADE ME THINK. FOR ME ACCEPTANCE OF ANYTHING IS HARD FOR ME. BUT I FELT A SLIGHT MOMENT OF PEACE READING YOUR COMMENT AND I WILL ATTEMPT TO HANG ON TO THAT INSTEAD OF HOPE.. YOU KNOW THERE COMES A TIME WHEN THAT IS OK. NOT A TERRIBLE TRADE OFF REALLY. I AM 72. I AM TYPING IN CAPS TO SEE VERY COMFORTABLY. I AM NOT YELLING OR WHINING. Reply Lucinda Martinez I found this article extremely helpful. Its something a friend and I were discussing just the other day; ie MS symptom or ageing? Thank you for it. Best wishes Reply Subodh Ramakant Sambre Hello Reply Wayne Fortney Hi Leigh Anne, I have all the systems you have except the bladder problem. MS News Today had an article on MRI's that didn't show new problems in the brain or spine. It stated " if I remember wright " it was common for MRI's not to show any changes, but people with MS had or showed worsening systems. Hang in there you are not alone in this fight with MS. Reply Kathy Allen As I read this article, I thought, I am not alone. Somehow, that helps. I am 70 years & have had MS for 51 years. However, I have never heard that B complex might be a bladder irritant. Will explore. Nor concern re gabapentin & memory, same. Thanks for article. Kathy Reply Anita S Wow. Look at all the people dealing with the same issue. Something for the neurologists to talk to their aging patients about! I was diagnosed with PPMS at 56. Just turned 65 and I have been wondering the same. Thankful I still walk w/o an aid although my P therapist says I should use one. If anything, my feet are getting a bit more numb esp when getting out of bed, my limp slightly worse. When I feel I have to go, I go. I donāt wait. Thatās a change and I do find my short term memory is decreasing a bit. Spouse and I play Wordle everyday. When we start, I ask myself what was yesterdayās word? 70% of the time I canāt remember. If the spouse gives me the first letter, I usually get it then. Age or MS? Not sure! Side note: I have been dealing with terrible hip pain for about a year and half. There was a point I said I needed a hip replacement. Thatās how bad it was. Sometimes in tears walking back him after walking my dog. I thought well, itās the MS. I have to learn to live with the pain. I finally saw a hip doc. He diagnosed me with hip bursitis. Gave me a cortisone shot and PT referral. Voila! About 90% of my hip pain is gone. I wish I hadnāt waited so long! Reply Gary Hendricks I just blame it all on my MS. My family is starting to call me on it. Life is good. Just keep plugging along Reply Mody I believe that symptoms of aging may appear in a MS patient due to his/her infection with this disease, regardless of age. Reply Cathy Clendenning Thank you Leigh Anne! This was so timely for me as I am dealing with new balance issues and ongoing bladder issues and not sure what is the cause - age or MS. One of the best articles I have read. Reply Kami Friebel Very helpful article. I'm 48 and was diagnosed when I was 24 so I know what it's like. The last couple years have been frustrating with symptoms from bladder issues to constant nerve pain. When knew symptoms happen I usually message my neurologist and his normal reply is to tell me that my symptoms aren't caused by MS or that it's uncommon symptom for MS. Which cost me money to see my PCP and get blood tests and urine tests. When the tests come back as normal my neurologist will finally give me options to help. It's been almost 4 months of trying to deal with constant pain and itching due to a new lesion on my spine. Good luck to all of you! Reply Halina Iām 60 (ON age 34, MS age 51). Foot drop is the only thing Iām sure I can pin on MS since the ON. Everything else from more fatigue, less intense/heavy exercise tolerance, changes in handwriting and fine motor coordination, new food sensitivities, insomnia, periodic struggles with focus, neuropathy symptoms, spasticity/difficulty swallowing, word-finding problemsā¦ are things my friends (aged 40-75), who donāt have MS, complain about as well. So I keep a Medrol dose pack handy but think really hard before using it now! I would never want to be 20 again bc at 60 Iām more confident and smarter about how I treat myself and others! Reply NIcholas Brown Interesting article, thanks. My experience is that the disease changes shape over the years - I'm at 47 years since diagnosis. Now I suffer fewer acute relapses but have lots of random pain and stuff stops working - losing hearing on one side, for example. I'm lucky in that for the most part I return to normal reasonably quickly but identifying what is MS and what's just physical/mechanical deterioration is sometimes difficult! I'm 70 and, of course, expect my body to function like a 28 year old! Reply Diana Reed-stair i get lots of understanding from reading all of your posts it helps to know you are not alone. i have all these problems to the extrem at times but fades in and out. i have been on my medications for years and when i try to cut back to get off i have seriousness attacks and have to be put right back on. i realize my body is probably addicted but no other way to deal with it. Reply Leave a comment Fill in the required fields to post. Your email address will not be published. Your Name Your Email Your Comment Post Comment
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