Could This Be A Relapse?

Posted on September 13, 2021 by Angel Blair

On MSAA’s Helpline we often hear questions about MS relapses and what constitutes a relapse. Individuals ask whether the symptoms they are currently experiencing are just due to their MS or if an exacerbation of symptoms may be occurring. These are great questions that warrant valid and informative responses. The challenging piece of this, on the part of the healthcare professional at times, is helping to identify a true MS relapse from a pseudoexacerbation.

To be diagnosed with a true relapse, there must be certain factors at play. Individuals will either experience new symptoms or a worsening/recurrence of existing symptoms. These acute symptoms have to be present for at least 24-48 hours, without signs of other infections or fevers. This is where it can become tricky identifying a relapse from a pseudoexacerbation. Because with the latter, one can experience a temporary worsening of symptoms without inflammation or nerve damage occurring. A pseudo flare can result from illness/infection, fever, stress, heat sensitivity and other factors.

It’s important to discuss these differences with your healthcare team so that you can better communicate if you’re feeling any changes in your symptoms. Ask your doctor what signs you should look for if a relapse may be present, and when you should reach out to their office for assistance. Talk about ways a relapse could be treated and managed if it occurs. And make a plan for what you should do if you’re not able to get in touch with your doctor’s office. Some individuals will seek emergency medical services if needed when they’re experiencing worsening symptoms. So ask your doctor if/when you should seek care in this manner. Asking questions about MS relapses can be an integral part of your overall treatment plan and follow-up care.

The “Common” Cold

Posted on November 29, 2017 by MultipleSclerosis.net

It’s that time of year again. Everywhere you turn, it seems like someone is sniffing, sneezing, or coughing. For most people, cold season is a nuisance, but for people with MS, cold season can be debilitating, and even lead to health complications.

Cold viruses often impact people with MS differently than the rest of the population, making cold prevention and recovery very important. This month, many in our MS community shared their experiences with the common cold and we thought you might relate as well. Do any of these sound familiar to you?

Symptoms & Recovery Time

“The past two winters, I have caught my daughter’s cold and I get hit HARD to the point I have to go to emergency and get booked into the hospital.”

“Like having life sucked out of you”

“Whenever the rest of my family gets a cold or virus, it passes within a week. When I catch it (and I almost always catch it) it lasts for weeks, PLUS I get pseudoexacerbations on top of it. No fun.”

It takes me 3 times as long to get over a cold than it does anyone else. So frustrating!”

“When I get a cold now, it lasts 2-3 weeks”

According to our MS community, the “common cold” is anything but common. While most people recover from a cold in seven to ten days¹, for MS patients, it can take much longer. According to many of our community members, cold symptoms are also more intense for people with MS, often making underlying MS symptoms more noticeable.

In addition to typical cold symptoms (such as fever, cough, congestion, body aches, and headaches¹), cold viruses can also lead to MS pseudoexacerbations, which usually last less than 24 hours and may mirror the symptoms of a full-blown MS relapse. Because a fever can trigger a pseudoexacerbation², you may want to ask your healthcare provider if over-the-counter fever reducers (such as acetaminophen or ibuprofen) are safe for you.

When You’re Surrounded by Sick People…

“Every time my parents get sick then I will catch it…I just wish they would learn about MS.”

“Unfortunately for us, even the hospital and doctor office can be risky.”

“People just don’t understand, no matter how much you explain it to them.”

I try to stay away from sick people.”

“Do NOT expose yourself to sick people. If they don’t get it, tough. Please protect yourself.”

MS is understood to be an autoimmune disorder.³ In terms of immune health, many community members have shared that MS has made them more susceptible to colds, as well as other illness. According to many of you, being around sick people almost guarantees that you catch whatever’s going around, making doctor’s offices, public transit, and even the workplace risky during cold and flu season.

For many community members, it can be difficult to avoid the cold germs, especially without accusations that you’re being “rude” or “overdramatic” when asking sick people to keep their distance. However, if you’re managing MS, your health is the priority. To stay healthy during cold season, many community members recommend avoiding sick friends, family, and strangers all together, and talking to people about how MS affects your immune system.

Cold Complications

“Sinus and ear infection, felt like I had the flu. Going on day 8. Ugh.”

“I have a cold and 2 infections right now. It can’t ever just be one thing.”

“Ear infections”

In addition to experiencing more intense cold symptoms, a longer recovery time, and increased susceptibility to the cold virus, individuals with MS are also more susceptible to infections.⁴ Common colds can spread to the ears, chest, and sinuses,⁵ leading many MS patients to experience other complications as a result of a cold, such as ear infections and sinus infections. Because MS can make it harder to fight infections, be sure to talk to your doctor if you think you’ve developed an infection, or if you experience a pseudoexacerbation lasting more than 24 hours.

Staying Healthy… or Recovering

“NO double dipping, sharing drinks, utensils, and most definitely, the cook must NOT lick the spoon the put it back…Even if your family and friends are not showing symptoms, they could have picked up something.”

“Wash your hands all day, all night, and eat tons of veggies. I drink a blender full, and it really helps. Take good care.”

“Wash your hands, don’t kiss anyone (except your honey), tons of veggies, exercise as tolerated, and get LOTS of sleep.”

As we move into cold and flu season, many of our community members have suggestions for staying healthy and cold-free, such as good handwashing, maintaining a healthy diet, and getting enough sleep. If you do develop cold symptoms, consider these tips for fighting a cold. To prevent the flu, you should also talk to your healthcare provider about getting a flu shot, especially if you are exposed to family members and co-workers who may carry the flu virus.

Works Cited

Mayo Clinic. “Common Cold.” Mayo Clinic, www.mayoclinic.org/diseases-conditions/common-cold/ symptoms-causes/syc-20351605. Accessed 27 Nov. 2017.
Editorial Team. “Is It an MS Relapse or a Pseudoexacerbation?” MultipleSclerosis.net, Health Union, 6 Mar. 2017, multiplesclerosis.net/living-with-ms/relapse-or-pseudoexacerbation/. Accessed 27 Nov. 2017.
Health Union. “What Is MS?” MultipleSclerosis.Net, Health Union, multiplesclerosis.net/what-is-ms/. Accessed 27 Nov. 2017.
Montgomery, S., et al. “Hospital Admission Due to Infections in Multiple Sclerosis Patients.” European Journal of Neurology, vol. 20, no. 8, Aug. 2013, pp. 1153-60, dos:10.1111/ene.12130. Accessed 27 Nov. 2017.
NHS. “Common Cold: Complications.” National Health Service, NHS, www.nhs.uk/conditions/common-cold/complications/. Accessed 27 Nov. 2017.

Never an Easy Season with MS

Posted on June 24, 2015 by MSAA

By: Matt Cavallo

I was really excited. My allergies were horrible and I was feeling absolutely miserable. Why does this excite me you ask? When I feel horrible, I get inspired to write and was going to write a piece on allergies and MS as a follow-up to last year’s, Is There a Relationship between MS, Allergies and Histamine blog.

Then, this happened to my local weather in Arizona:

Out here in Arizona, we say that three straight days over 100 degrees kills all the pollen. I don’t know if this is true or not, but my allergies certainly haven’t been bothering me since it got into the 100’s at about Friday of last week.

But guess what? The heat has been killing me!

Luckily, I got a Kool-Max cooling vest, similar to those in the MSAA’s Cooling Program. Now, even in the dog-days of summer, I can still participate in activities or chores and not feel trapped inside by the summer heat.

This got me to thinking, is there ever a perfect season to have MS? We all know that the summer heat, no matter where you live, is not good for MS. The symptoms of heat exposure can cause a pseudoexacerbation, or brief episode of neurological symptoms not classified as a relapse. These pseudoexacerbations can come and go all summer long as the heat and humidity persist.

However, during the cold dark of winter, us MSers yearn for a hot summer day. The low light of winter is not generally considered good for people with a Vitamin D deficiency, as most of us living with MS may experience. Winter also presents trip hazards with ice and snowy conditions, so those of us more prone to falls have a harder time getting outdoors and staying active during the winter.

Fall presents many of the same trip hazards. As soon as the leaves turn colors, they drop to the ground and become slippery to walk on. Fall also has dramatic temperature fluctuations where it can be summer hot one day and then brutally cold the next. This is where cold and flu season start to come into play along with the pseudoexacerbation possibility from those really gorgeous summer-like fall days.

That leaves spring as the only possibility for an easy season living with MS, am I right? Wrong. Spring is the reason I started writing this blog. It was nice this year, but the pollen kept me from enjoying it. I could not differentiate from an MS day or a sick-with-allergy day. The inability to breathe really caused excess fatigue rendering me unable to discern the difference between allergies and MS symptoms.

The truth is there is no easy season when you live with multiple sclerosis. However, each day is what you make of it. Don’t let the changing seasons stop you from living your life, rather adapt with the seasons and plan accordingly. Wear sunscreen, stay cool and don’t let MS stop you from having the best summer ever!

*Matt Cavallo was diagnosed with multiple sclerosis in 2005. Matt is an MS blogger, author, patient advocate, and motivational speaker. Matt also has his Master’s degree in Public Health Administration. Matt is the proud father of his two sons, loving husband to his wife, Jocelyn, and best friend to his dog, Teddy. Originally from the Boston suburbs, Matt currently resides in Arizona with his family. To learn more about Matt, please visit him at : http://mattcavallo.com/blog/

What is a Pseudoexacerbation?

Posted on July 24, 2013 by Angel Blair

For many individuals with MS, the summer can be a difficult time. The heat and humidity may cause MS symptoms to flare and become agitated because of heat affecting one’s body temperature. For some who experience a worsening of symptoms in warm environments, this may actually be an example of a pseudoexacerbation. A pseudoexacerbation is a temporary worsening of MS symptoms, without the presence of actual myelin damage or inflammation. Other than heat, individuals may experience this as a result of other illnesses or infection. It is important to take note and be aware of what symptoms you are experiencing, how long they occur, and your environment surroundings. If you find yourself heat-sensitive, try to avoid warmer settings. Stay in air conditioned places, do outdoor activities either early in the day or after sunset when the temperature is cooler, and wear lighter weight clothing when needed. If you have concerns about or are experiencing new symptoms it is important to be aware of your activity and surroundings, especially during these warm summer months!

For more information on pseudoexacerbation, see the MSAA brochure, Understanding and Treating MS Relapses, https://mymsaa.org/publications/understanding-treating-relapses.

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