Questions to ask when starting a new treatment for MS

Multiple sclerosis (MS) is an autoimmune disease that damages the central nervous system (the brain and spinal cord). An autoimmune disease is a condition where the body’s immune system attacks healthy cells and tissues.

When a person has MS the immune system attacks myelin. Myelin is a layer of fatty tissues and proteins that cover and protect nerves. Damage to myelin disrupts communication between the brain and different parts of the body.

The symptoms of MS

Symptoms of MS can include muscle weakness, problems with balance and coordination, and problems with thinking and memory. People with MS may experience numbness, tingling sensations, and pain. People may also experience problems with the eyes, such as double vision, blurred vision, colors that appear gray, and uncontrolled eye movements.

Different types of MS

There are different types of MS. The most common type is relapsing-remitting MS (RRMS). People who have this type will have episodes where symptoms get worse or new symptoms appear. Between episodes, there are periods where a person experiences a full or partial recovery from symptoms. Other types of MS include:

• Secondary-progressive MS (SPMS): Many people with RRMS eventually develop this type. A person may experience partial recoveries, but symptoms will progress and become more severe with each episode.
• Primary-progressive MS (PPMS): Symptoms become progressively worse from the beginning and there are no periods of remission. Primary progressive MS affects about 15 percent of people with MS.
• Progressive-relapsing MS (PRMS): With this type, symptoms worsen at a steady rate and there are episodes where symptoms become more severe. About 5 percent of MS cases are PRMS.

Other conditions can also be categorized as MS. One example is clinically isolated syndrome (CIS). A person who has CIS will experience one episode of MS symptoms. This episode is similar to a relapse, but there are no additional episodes.

Treatment for MS

There is no cure for MS, but the condition can be managed. The main treatments for MS are disease-modifying therapies (DMTs). These are medications that help prevent episodes and slow the progression of MS. Therapies to lessen the severity of relapses and control symptoms are also a part of treatment. Exercise, physical therapy, lifestyle changes, and social support are also important.

MS treatment can change with time. A person may need to switch from one DMT to another for a variety of reasons—a medication is not working as well as it needs to, side effects, changes to insurance, or difficulty taking the medication as directed.

Changes in treatment should always be done under the guidance of a healthcare provider. As a person living with MS, it is also important to take an active role in your care.

Ask your healthcare provider these questions when changing treatment or starting a new treatment:

• What is the name of the medication?
• How is this medication taken? Is it a pill, injection, or infusion?
• What is the dosage that I will be taking?
• Why is this medication being recommended?
• How does this medication treat MS?
• Can this medication cause side effects?
• How will we know if this medication is working?
• When will we know if this medication is working?
• What can we do if this medication does not work?
• What does this medication cost?
• Can this medication interact with other medications? Your healthcare provider should have a list of all medications you are taking. This list should include prescription medications, over-the-counter medications, vitamins, nutritional supplements, and herbal supplements.
• Can this medication affect pregnancy? Tell your healthcare provider if you are pregnant or planning on becoming pregnant.
• What does this medication cost? Who can I talk to if I am concerned about the cost of this medication.

Your healthcare providers will be your best source of information. Always ask questions if something is not clear or you want an explanation.