Multiple Sclerosis
(MS) primarily affects patients who are in their most productive years with
quality of life being disturbed, unemployment being high, and disruption of
career paths being prominent (Gordman, Feldman, Shipley & Weiss, 1997).
Often, after the initial diagnosis, patients are left with feelings of
helplessness and confusion and find it impossible to explain a disease in which
they cannot understand. With problems arising from slurred speech, bladder and
bowel control, spasticity, paresis, mobility, and more prominently, fatigue, it
is imperative for employers with employees who have MS to understand the
complexity of the disease, realize the complications of MS, and work with the
employee so he or she does not have to battle his or her employer while
battling the disease. Knowledge is power, and through research, both the
employer and employee can be powerful beyond measure. Through the understanding
of what Multiple Sclerosis (MS) is and how it affects every facet of the human
body and psyche, employers will have a better grasp of how employees affected
with MS should be treated and the accommodations that should be made available
to these individuals should they be needed.
MS is an
autoimmune disease affecting the central nervous system resulting in the
protective covering around the nerves in the brain, myelin, to be destroyed
causing scars (sclerosis) which prevent nerves from connecting properly (National
Multiple Sclerosis Society, 2011). There are four stages of MS:
relapsing-remitting MS, primary-progressive MS, secondary-progressive MS, and
progressive-relapsing MS.
Relapsing-Remitting MS
NMSS (2011)
explains that relapsing-remitting MS is the most common form of MS with nearly
85% of patients being diagnosed with this type. The attacks, or relapses, are
followed by near complete recovery periods in which no progression of the
disease occurs (NMSS, 2011).
Primary-Progressive MS
Primary-progressive
MS has slowly worsening neurologic function from the beginning with no distinct
relapses or recovery (NMSS, 2011). Nearly 10% of patients are diagnosed with
this type of MS experience various progressions over time containing periods of
plateauing and improvements (NMSS, 2011).
Secondary-Progressive MS
Secondary-progressive
MS is a type of MS that follows the initial period of relapsing-remitting MS in
which the disease worsens at a steadier pace (NMSS, 2011). Typically, relapses,
recoveries, and plateaus may or may not occur.
Primary-Relapsing MS
Finally,
progressive-relapsing MS is the rarest form of MS with 5% of patients being
diagnosed with this type (NMSS, 2011). Those diagnosed with this type of MS
experience steady worsening of the disease from the beginning with worsening of
symptoms along the course of the disease. Additionally, those with this type of
MS could experience some form of recovery following the relapse, but the
disease continues to progress (NMSS, 2011).
Since each
individual diagnosed with MS is different and the course of the disease is
different, it could be potentially difficult to accurately pinpoint the
direction the disease is going. Furthermore, even though there is no known
explanation for the cause of MS, scientists have explained theories about the
causes of MS which include immunologic, environmental, infectious, and genetic
(NMSS, 2011).
Immunologic
Said to be an
autoimmune disorder which is a response to the body’s immune system that
negatively affects the myelin in the central nervous system, it is still
unknown why or how MS is caused (NMSS, 2011). With research, scientists have
been able to derive a series of medications that can slow the disease, and
efforts are still ongoing to find medication to stop the disease.
Environmental
It has been
discovered that MS occurs more frequently in areas that are farther away from
the equator (NMSS, 2011). Those who are born in areas of the world with a
higher risk of MS who move to areas with a lower risk before the age of 15 will
acquire the risk of the new area they are in (NMSS, 2011). Additionally, it is
being suggested that those who are exposed to a certain environmental agent
(still unknown) before puberty may be predisposed to MS.
Though there are
no viruses or infections that have been a definite cause of MS, scientists
believe that the initial exposure to certain viruses, bacteria, and microbes
that cause demyelination and inflammation during childhood could be a
triggering factor of MS (NMSS, 2011). Viruses such as measles, canine
distemper, human herpes virus-6, Epstein-Barr, and Chlamydia pneumonia are
being investigated as possible causes of MS (NMSS, 2011).
Genetic
MS is not
hereditary, but having a relative such as a parent or sibling with MS increases
the likelihood that an individual carries the genetic predisposition of MS (NMSS,
2011). There are some scientists who believe that a person is born with a
certain genetic predisposition that reacts to an environmental agent, and upon
exposure, can trigger an autoimmune response (NMSS, 2011).
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