General health routines may have also become disrupted over the last year and a half. It may have been more difficult to get to appointments and there may have been questions around the safety of going to medical facilities. It is important to notice which health routines have been neglected and to get back on track with them and to make sure you’re adhering to the disease modifying therapy (DMT) strategy decided on by you and your neurologist.
MS DMT Treatment Adherence
At the very beginning of the pandemic, some people may have altered their MS DMT schedule while medical professionals sought answers about how COVID-19 may intersect with MS and the various treatments. Thanks to the tireless work of doctors and international databases tracking MS patients, we have some answers now. The RMMSC has produced several webinars that discuss these findings, go to www.mscenter.org/covid to watch. If you have not consulted with your neurologist about your DMT schedule, it is a good time for a check-in.
Other reasons for disruptions in your DMT schedule may include: normal routines that reminded you to take MS medications have changed; you have enough on your plate and MS is too much to deal with; you feel guilty about getting off track and are worried about talking with your doctor about it so you can’t make a plan to get back on track. All of these are very common experiences for people living with MS, but with MS medications, treatment adherence is extremely important. Make an appointment to talk with your doctor (in-person or via telehealth) to discuss any issues that have prevented you from taking your MS medication as prescribed so that the two of you can make a game-plan.
Routine Health Care Visits
MS is not the only health concern a person may face and preventing or managing other health conditions can improve your overall lifelong brain health and how well you feel day to day. In fact, research studies show us that living with MS and other health problems has been associated with longer delay in the onset of MS symptoms and MS diagnosis, more severe disability, faster disability progression, and a higher mortality. Preventative and routine healthcare can help avert or manage these comorbidities that can make your MS feel worse.
Many routine and preventative care appointments may have been put on hold, but it is important to keep up with these as well. Doctors and medical offices have always been champions of cleanliness but that has been taken to a whole new level now. Many medical facilities require masks and perform frequent cleanings of waiting and exam rooms. Try to hone in on what you’re nervous about exactly: if it’s being in a room with your doctor, ensure they will be wearing a mask, office visits are quite safe at this point; if it’s being in a waiting room with others, ask if you can wait in your car and have them call you when they’re ready for you; if it’s the elevator ride with strangers, advocate that you would like to ride alone- most people are understanding; or if it’s you haven’t been in so long you’re worried about what has come up, waiting won’t make it go away and oftentimes taking action is an antidote to anxiety.
Telehealth has advanced rapidly during this time and you may not have to leave your house at all. For any visit that does not involve an in-depth physical examination, this may be a great option. Always do a pre-test of your computer, camera and microphone, even if you don’t think you will have problems. Write your questions down ahead of time. Have a list of your medications handy. When given an option, embrace the video call over the telephone. Please see our COVID page for telehealth tips at MSCenter.org/covid.
It always seems easier to put off an appointment until it isn’t. Preventative and routine healthcare can help keep you out of the ER and urgent care. Once a problem becomes urgent, you have less control over scheduling how to take care of it, and COVID related disruptions in care are more likely to affect your treatment options. By proactively scheduling routine and preventative care, you have more control over when and where it takes place.
It’s best to start early while you’re not rushed to be seen. What if you wake up on the morning of your appointment feeling ill? In many cases you will be asked to reschedule which will be fine if the appointment is routine but could be dire if your issue is urgent. Reach out to your doctor’s office if you feel unsure about timing your visit- they know your medical history and can help you weigh the risks and benefits.
Screenings are essential to detecting bigger health problems before they progress, delaying them could result in long term consequences. See the “Preventative Care Checklist” on page 13 for a list of routine and preventative care you may need to catch up on.
As people start to get back to more social activities, they may experience colds and other respiratory illnesses generally present in the fall and winter. It’s important to stay home if you experience any symptoms of illness and to keep up with your general sleep, eating, and activity routines. Get the flu shot. Keep up on other recommended vaccinations. If you have any illness that includes a fever, you may experience a pseudo-relapse. Symptoms of a pseudo-relapse are generally ones you’ve had before and will go away within 48 hours of resolving whatever is causing them (a fever or other overheating, a bad night of sleep, extreme stress, etc.). These pseudo-relapses are not signs of a new lesion, but instead your brain is running into old damage that it had previously found a way around. If your symptoms are new or worse than you’ve had in the past or last for more than 48 hours, it’s time to check in with your doctor as that may a sign of a true relapse. For more on psuedo-relapses, please see a recent talk from the MS Center’s Dr. Timothy Vollmer at tinyurl.com/InforMS-flares.
Now is the time to talk with your doctor if you’ve been experiencing any issues with your mental health. Increased isolation and uncertainty have taken a toll on many. Doctors and mental health specialists are able to discuss tools that could help including medications and talk therapy. You are not alone in experiencing this and help is possible- it starts with a conversation. Getting in control of one thing could help both your mental and physical state so please, make the call and schedule an appointment you’ve been putting off.
