Anjali Shah, M.D. Answers Questions On: Multiple Sclerosis

When I started my training, we had less than five options for medical treatment of MS, and that number has now doubled.

We have better means of diagnosing patients earlier, as well, so patients are getting earlier treatment and better treatment. I find that exciting.

It’s also promising that we’re now treating the whole patient ­– not only medically, but also physically, socially, and spiritually, by recognizing that exercise, nutrition, and mental health are also important aspects of maintaining quality of life.

The symptoms of MS can run the gamut and can include any combination of fatigue, spasticity, bowel and bladder dysfunction, sexual dysfunction, mood disorders, pain, osteoporosis, and balance and mobility issues.

But often it’s a hidden disease in its earlier stages; patients often don’t “look like” they have a disability. They’re out and about, and they may use handicapped parking and people around them won’t understand why. Patients tell me that people often say, “But you look so good,” and they don’t realize that the patient doesn’t feel good.

Some people with MS actually end up isolating themselves because they are afraid they’ll say goofy things or have bladder and bowel accidents in public.

I always want to see patients before disabilities start to accumulate. There could be minor issues – with his gait, with his bowels, his speech, or cognition. A lot of times patients don’t realize that the issue is related to their MS and that we can address those issues. Treatment can help them maintain their employment, help their relationships with family and friends, and make them less likely to become isolated. We work really hard to make people feel able and empowered to stay functional and fully involved in their lives.