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    Multiple Sclerosis, A Simple Guide To The Condition, Treatment And Related Conditions
    Multiple Sclerosis, A Simple Guide To The Condition, Treatment And Related Conditions
    Multiple Sclerosis, A Simple Guide To The Condition, Treatment And Related Conditions
    Ebook202 pages3 hours

    Multiple Sclerosis, A Simple Guide To The Condition, Treatment And Related Conditions

    By Kenneth Kee

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    About this ebook

    Multiple Sclerosis is a progressive degenerative disease of the central nervous system with recurrent episodes of neurologic dysfunction disconnected in time and space and associated with evidence of demyelization of the central nervous system.
    It affects the patient in different areas of the nervous system at various points in time.
    The cause is unknown but believed to be related to an auto immune disease resulting from a viral infection.
    Multiple sclerosis results in destruction of the myelin surrounding the nerves of the CNS.
    The destruction is thought to be caused by the body's immune system attacking the myelin sheath disrupting the transmission of information in the CNS and lead to the symptoms seen in multiple sclerosis.
    The typical symptoms of Multiple Sclerosis are multiple and variable which explains its name.
    There may be mild cases which do not need treatment or severe cases which need confinement to wheelchairs.
    There is a typical course of exacerbations and remissions over a period of years and increased residual neurological deficit
    1. Impairment of vision is usually an early sign of MS
    2. Diplopia can occur with optic neuritis
    3. Unsteady gait due to the effect of the disease on the cerebellum which control balance and co-ordination
    4. Paresthesia or tingling sensation in the fingers and toes
    5. Weakness of the muscles leading to hemiplegia
    6. Facial paresis, vertigo and hearing loss
    7. Seizures when foci in the brain are over stimulated
    8. Constipation and urinary incontinence may also occur as a result of the weakened muscles
    9. One peculiar trait is that higher temperatures aggravate the symptoms in MS patients.
    Nerve conduction at higher temperature such as a hot shower cause the slowing in the transmission of messages in nerves that have already lost myelin
    The diagnosis of Multiple Sclerosis is difficult and involve
    1. History of a multiple symptoms involving the nervous system
    2. Physical and neurological examinations for peripheral neurological deficit.
    3. Blood count and chemistry, urine analysis is all routine laboratory tests used to rule out other diagnoses
    4. Cerebral spinal fluid evaluation may show mild mononuclear pleocytosis (less than 40 cells per cubic meter, protein normal or raised and high gamma globulin IgG.
    5. MRI can search for changes within the brain or spinal cord that are particular to multiple sclerosis.
    Multiple Sclerosis cannot be cured but can be suppressed:
    Supportive measures
    1. Bed rest
    2. Proper diet and nutrition to strengthen the muscles of the body
    3. Physiotherapy to strengthen muscles
    4. Occupational therapy to help stimulate the mind
    5. Speech therapy for speech and swallowing
    6. Social support
    7. Avoid triggers
    Medications:
    1. Glatiramer acetate is able to reduce the relapse rates of multiple sclerosis by about one-third and appears to reduce the overall progression of multiple sclerosis
    2. Natalizumab is a monoclonal antibody that binds to white blood cells which are thought to play a role in causing the nervous system damage in multiple sclerosis.
    It also reduces the rates of relapses of MS by two thirds.
    3. Fingolimod is a daily oral medication to treat MS by reducing the number of lymphocytes which is believed to cause inflammation in MS.
    4. Interferon which is an anti-viral agent has found to reduce relapses of MS by one third.
    5. Previous treatment used to be ACTH injections and corticosteroids. These are seldom used.
    MS is a multiple systemic disease which can affect the muscles, vision, bladder and bowels, cognitive function, genital dysfunction, anxiety and depression

    TABLE OF CONTENT
    Introduction
    Chapter 1 Multiple Sclerosis
    Chapter 2 More Facts of Multiple Sclerosis
    Chapter 3 Treatment of Multiple Sclerosis
    Chapter 4 Sarcoidosis
    Chapter 5 Vasculitis
    Chapter 6 Hash

    LanguageEnglish
    PublisherKenneth Kee
    Release dateJan 9, 2017
    ISBN9781370136414
    Multiple Sclerosis, A Simple Guide To The Condition, Treatment And Related Conditions
    Author

    Kenneth Kee

    Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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      Book preview

      Multiple Sclerosis, A Simple Guide To The Condition, Treatment And Related Conditions - Kenneth Kee

      Multiple Sclerosis,

      A

      Simple

      Guide

      To

      The Condition,

      Treatment

      And

      Related Conditions

      By

      Dr Kenneth Kee

      M.B.,B.S. (Singapore)

      Ph.D (Healthcare Administration)

      Copyright Kenneth Kee 2014 Smashwords Edition

      Published by Kenneth Kee at Smashwords.com

      Dedication

      This book is dedicated

      To my wife Dorothy

      And my children

      Carolyn, Grace

      And Kelvin

      This book describes the disease Multiple Sclerosis and Its Treatments and Related Diseases or in vernacular terms

      (What You need to treat Multiple Sclerosis)

      This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

      If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

      Thank you for respecting the hard work of this author.

      Introduction

      Ode to Multiple Sclerosis

      Multiple Sclerosis is a progressive degenerative disease

      That occurs in the nervous system of people of 20-30 ages

      The cause is unknown but may be autoimmune due to infection

      Multiple sclerosis results in the body nerve cell myelin destruction

      There is diplopia and the impairment of vision

      There is weakness of the muscles and poor coordination

      There is vertigo, hearing loss and paresthesia

      Damage to the facial nerve can result in facial paresis

      Diagnosis is also based on the patient’s physical development

      There is evidence of peripheral nerve involvement

      Cerebral spinal fluid may show mild mononuclear pleocytosis

      MRI search for changes within the brain peculiar to multiple sclerosis

      Treatment is usually not a cure but suppression of symptoms

      Glatiramer, Natalizumab and Fingolimod are the main medications

      Supportive measures are bed rest, proper diet and speech therapy

      There is rarely need for any surgical therapy

      -An original poem by Kenneth Kee

      Interesting Tips about Multiple Sclerosis

      A Healthy Lifestyle

      1. Take a well Balanced Diet

      2. Treatment of Multiple Sclerosis:

      Multiple Sclerosis cannot be cured but can be suppressed:

      Supportive measures

      a. Bed rest

      b. Proper diet and nutrition to strengthen the muscles of the body

      c. Physiotherapy to strengthen muscles

      d. Occupational therapy to help stimulate the mind

      e. Speech therapy for speech and swallowing

      f. Social support

      g. Avoid triggers

      Medications:

      a. Glatiramer acetate is able to reduce the relapse rates of multiple sclerosis by about one-third and appears to reduce the overall progression of multiple sclerosis

      b. Natalizumab is a monoclonal antibody that binds to white blood cells which are thought to play a role in causing the nervous system damage in multiple sclerosis. It also reduces the rates of relapses of MS by two thirds.

      c. Fingolimod is a daily oral medication to treat MS by reducing the number of lymphocytes which is believed to cause inflammation in MS.

      d. Interferon that is an anti-viral agent has found to reduce relapses of MS by one third.

      e. Previous treatment used to be ACTH injections and corticosteroids. These are seldom used.

      3. Keep bones and body strong

      Bone marrow produces our blood

      Eat foods rich in calcium like yogurt, cheese, milk, and dark green vegetables.

      Eat foods rich in Vitamin D, like eggs, fatty fish, cereal, and fortified milk.

      Eat food rich in Vitamins B and C such as green vegetables and fruits

      Zinc and other minerals are important to the body

      4. Get enough rest and Sleep

      Avoid stress and tension

      5. Exercise and stay active.

      It is best to do weight-bearing exercise such as walking, jogging, stair climbing, dancing, or lifting weights for 2½ hours a week.

      One way to do this is to be active 30 minutes a day at least 5 days a week.

      Begin slowly especially if a person has not been active.

      6. Do not drink more than 2 alcohol drinks a day for a man or 1 alcohol drink a day for a woman.

      Alcohol use also increases the chance of falling and breaking a bone.

      Alcohol can affect the neurons and brain cells.

      Too much alcohol with smoking affects the brain cognition.

      7. Stop or do not begin smoking.

      It also interferes with blood supply and healing.

      Chapter 1

      Multiple Sclerosis

      What is Multiple Sclerosis?

      Multiple Sclerosis is a progressive degenerative disease of the central nervous system with recurrent episodes of neurologic dysfunction disconnected in time and space and associated with evidence of demyelization of the central nervous system.

      It affects the patient in different areas of the nervous system at various points in time.

      What causes Multiple Sclerosis?

      The cause is unknown but believed to be related to an auto immune disease resulting from a viral infection.

      Multiple sclerosis results in destruction of the myelin surrounding the nerves of the CNS.

      The destruction is thought to be caused by the body's immune system attacking the myelin sheath disrupting the transmission of information in the CNS and lead to the symptoms seen in multiple sclerosis.

      1. In Multiple Sclerosis, there are multiple scattered greying well defined lesions from few small mm sizes to few cm in size present in the white matter and extending to the grey matter of the brain.

      2 .The lesions vary from partial to complete destruction of the myelin sheath with relative sparing of the axon, glia and other structure.

      Who is at risk of Multiple Sclerosis?

      Multiple Sclerosis occurs between 20 to 50 years old.

      It is more common in Northern Europeans.

      Women are affected 2 times more than men.

      Triggers that can cause the onset of MS are:

      1. Infections

      2. Trauma

      3. Surgery

      4. Emotional upset,

      5. Stress

      6. Pregnancy

      What are the symptoms of Multiple Sclerosis?

      The typical symptoms of Multiple Sclerosis are multiple and variable which explains its name.

      There may be mild cases which do not need treatment or severe cases which need confinement to wheelchairs.

      There is a typical course of exacerbations and remissions over a period of years and increased residual neurological deficit

      1. Impairment of vision is usually an early sign of MS

      2. Diplopia can occur with optic neuritis

      3. Unsteady gait due to the effect of the disease on the cerebellum which control balance and co-ordination

      4. Paresthesia or tingling sensation in the fingers and toes

      5. Weakness of the muscles leading to hemiplegia

      6. Facial paresis, vertigo and hearing loss

      7. Seizures when foci in the brain are over stimulated

      8. Constipation and urinary incontinence may also occur as a result of the weakened muscles

      9. One peculiar trait is that higher temperatures aggravate the symptoms in MS patients.

      Nerve conduction at higher temperature such as a hot shower cause the slowing in the transmission of messages in nerves that have already lost myelin

      How is the diagnosis of Multiple Sclerosis made?

      The diagnosis of Multiple Sclerosis is difficult and involve

      1. History of a multiple symptoms involving the nervous system

      2. Physical and neurological examinations for peripheral neurological deficit.

      3. Blood count and chemistry, urine analysis is all routine laboratory tests used to rule out other diagnoses

      4. Cerebral spinal fluid evaluation may show mild mononuclear pleocytosis (less than 40 cells per cubic meter, protein normal or increased and high gamma globulin IgG.

      5. MRI can search for changes within the brain or spinal cord that are particular to multiple sclerosis.

      What are the complications for Multiple Sclerosis?

      1. Weakness of the muscles leading to hemiplegia

      2. Spasticity of the muscles with rigidity and cramps

      3. Poor co-ordination and imbalance

      4. Urinary and bladder problems

      5. Visual loss and pain suggesting optic neuritis, an inflammation of the eyeball

      What is the treatment for Multiple Sclerosis?

      Multiple Sclerosis cannot be cured but can be suppressed:

      Supportive measures

      1. Bed rest

      2. Proper diet and nutrition to strengthen the muscles of the body

      3. Physiotherapy to strengthen muscles

      4. Occupational therapy to help stimulate the mind

      5. Speech therapy for speech and swallowing

      6. Social support

      7. Avoid triggers

      Medications:

      1. Glatiramer acetate is able to reduce the relapse rates of multiple sclerosis by about one-third and appears to reduce the overall progression of multiple sclerosis

      2. Natalizumab is a monoclonal antibody that binds to white blood cells which are thought to play a role in causing the nervous system damage in multiple sclerosis. It also reduces the rates of relapses of MS by two thirds.

      3. Fingolimod is a daily oral medication to treat MS by reducing the number of lymphocytes which is believed to cause inflammation in MS.

      4. Interferon which is an anti-viral agent has found to reduce relapses of MS by one third.

      5. Previous treatment used to be ACTH injections and corticosteroids. These are seldom used.

      What is the prognosis of Multiple Sclerosis?

      MS is unfortunately still not curable at this time.

      Most patients about 65 % with the relapsing and remitting form may improve to a stage where relapses are very much reduced.

      Unfortunately they continue to have more disabling symptoms or secondary progressive multiple sclerosis.

      15% become worse with progressive relapses.

      10% has primary progressive MS with no remissions in between.

      Death usually results from pneumonia and heart trouble.

      Chapter 2

      More about Multiple Sclerosis

      Multiple sclerosis (MS) is an immune-mediated inflammatory disease that attacks myelinated axons in the central nervous system destroying the myelin and the axon in variable degrees and producing significant physical disability within 20-25 years in more than 30% of patients.

      The hallmark

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