Kootenai | Kootenai Health | Issue 1, 2021

KH . ORG 9 How is MS treated? Answer: During an MS attack or relapse, steroids may be used for treatment. We now have over 20 FDA-approved, disease-modifying therapies to treat MS. The goal of treatment is to prevent any additional MS relapses and slow the course of MS. There is a lot of research into medications that may be able to repair prior damage to the myelin, but these have not yet been approved for use. Vitamin D supplementation, regular physical exercise, and stopping smoking are other important lifestyle changes. There are also many treatments for MS-related symptoms. “We’re proud to offer comprehensive care for our MS patients,” Dr. Bozinov said. “In addition to the disease-modifying therapies to treat MS, comprehensive care focuses on the physical, emotional and psychosocial needs of a person living with MS. We use a patient-centered care model that provides an individualized approach to the person living with MS.” This care model uses a robust care team, which may include MS nurses, specialty pharmacists, neuroradiologists, infusion services, rehabilitation professionals, primary care providers, ophthalmologists, urologists, gastroenterologists, neuropsychologists and social services. “In many ways multiple sclerosis care today is very different from the past,” Dr. Bozinov said. “Although we still don’t know the cause or the cure, the field is making dramatic improvements in both the treatment and monitoring of people living with MS. Having specialty pharmacists as part of the care team in the clinic is critical to our comprehensive MS care model.” Consult with the best Nina Bozinov, M.D., M.S., is an MS specialist at Kootenai Clinic Neurology. You can learn more about our services at KH.org/neurology or by calling (208) 625-5100 . Answer: MS can be unpredictable in its course. For people diagnosed with relapsing remitting multiple sclerosis (RRMS), we know the greatest number of relapses (MS flares) occur during the first five years following diagnosis. The MRI and neurologic exam can help us determine who may be at risk for a worse MS course, and knowing this allows us to consider stronger medications from the beginning. The goal of MS treatment is to prevent any new relapses, changes in the neurologic exam, or MRI changes. If the medication is not controlling the MS, we will discuss changing treatment. After a relapse, most people experience a partial or a full recovery. People can also experience a pseudo relapse, which is when previous symptoms get worse during a time of illness or stress. After many years of living with MS, some people have steady worsening of their symptoms with or without new relapses. One goal of early MS treatment is to prevent or delay this worsening later in life. How is MS diagnosed? Answer: MS is a clinical diagnosis. That means your physician relies on a careful medical history, neurologic exam, and tests such as an MRI and sometimes a spinal tap to confirm the diagnosis. There are other autoimmune conditions that are similar to MS, and you may need additional blood work to rule them out. If you’re worried you may have MS or experience multiple symptoms, Dr. Bozinov suggests first reaching out to your primary care provider. “Based on how long you have had symptoms and your exam, your primary care provider may recommend some initial work- ups like an MRI or treatment with steroids,” Dr. Bozinov said. “The diagnosis of multiple sclerosis is clinical and based on many factors that need to be carefully evaluated.” Sources: National Institutes of Health; National Multiple Sclerosis Society Nina Bozinov, M.D., M.S.