Valley is a 'hotbed' for Multiple Sclerosis, Youngstown clinic offers personal care - WFMJ

YOUNGSTOWN, Ohio -

March 30th marks an international day of awareness for Multiple Sclerosis. 

The disease has made headlines internationally lately, gaining awareness when famous actress Selma Blair announced her fight. 

Here in the Mahoning Valley, cases of multiple sclerosis are particularly high. 

"Unfortunately, M.S. is quite common in the Valley," says Jesse McClain, a Doctor of Nursing Practice, APRN in Mercy Health's neurology department. "It's more common amongst women, 3-to-1 over men. It's more common in Northern European populations which is a hotbed in the Youngstown area. And research has shown that its most popular above the thirty-seventh parallel above the equator across the world, and Youngstown sits right in that."

"Youngstown is a huge hotbed of MS activity, and we have a number of patients here," McClain said. 

For many with Multiple Sclerosis, a major part of the disease is understanding wellness management and juggling doctor's visits. 

Fortunately, a major resource sits right in the heart of Youngstown- the only Multiple Sclerosis Clinic in the Valley can be found inside St. Elizabeth's Hospital in Downtown. 

"You don't have to drive 60 miles or an hour and a half fight that traffic of major cities when we have one just in our backyard that is seeing patients a number of times a month to fulfill the need in the area," McClain explained. 

"They're able to get a multitude of resources from a physiatrist as well as a neurologist and other specialty services that the clinic can offer," he said. 

In addition, McClain explained that patients can get the most up-to-date medications, physical therapy, orthotics, and imaging options. 

"Basically they're monitored every couple of months, every six months, once a year MRI's depending on what that patient's needs are, monitoring the treatment plan and a lot of the other diagnostic workup that they may need," he continued. 

The technology and medications continue to change, as researchers learn more about Multiple Sclerosis. 

Multiple Sclerosis is diagnosed in patients when the immune system causes inflammation that damages myelin — the fatty substance that surrounds and insulates the nerve fibers — as well as the nerve fibers themselves, and the specialized cells that make myelin, according to the National Multiple Sclerosis Society. 

"The covering of the nerve that transmits those electric signals gets damaged, and it's your own body doing the damage," said McClain.

But modern day medicines can stop the damage in its tracks. 

McClain explained,  saying "26 years ago, as early as 1992 and 1993 there were no FDA approved medicines for M.S. And the first FDA approved medicines for M.S. were an injection form, and over the years they've evolved to a multitude of different self-injectors, as well as I.V. Or we even have oral medications that people can take once a day or twice a day."

"M.S. being diagnosed today is completely different than M.S. being diagnosed, 10, 15, even twenty years ago. Now it's not a disability sentence, we have treatment options, to help delay that from occurring or from ever occurring at all," he continued. "So before we had none of those treatment options we had charts where within 5 years you may need a cane, within ten years you may need a walker, within 15 years you'll be wheelchair bound. Those charts are a thing of the  past." 

Here in the Valley, doctors are specifically attuned to diagnosing Multiple Sclerosis and monitoring for symptoms, simply because it is so popular in this area. 

"In this area, we have many family physicians that have rotated with neurology, or even family nurse practitioners that have rotated with neurology," said McClain. "And because we're in the Youngstown area they have more of their patients suffering from this disease. And when you have a lot of your patients suffering from it, you gain more knowledge on it." 

The difficulty for many physicians lies in diagnosing something they aren't told about. 

"People tend to ignore something that they may feel. You wake up in the middle of the night and your arm is tingling and weak and you're like 'oh, I must've slept on it wrong' and you totally ignore the symptom and don't bring it up," McClain said. "You know most people go to their family provider, be it a nurse practitioner or a physician when they're sick or not feeling well, so when they are addressing their problems they're more worried about that common cold that they have at that time, not 'oh by the way, last month I lost vision in my right eye for 24 hours." 

Testing to determine if patients could have MS typically include scans of the brain and spinal cord, as well as neurological tests. 

Anyone who may be experiencing symptoms of Multiple Sclerosis should talk to their family practitioner. The most common symptoms of M.S. are described by the NMSS as: 

• Fatigue

  Occurs in about 80% of people, can significantly interfere with the ability to function at home and work, and maybe the most prominent symptom in a person who otherwise has minimal activity limitations.

• Walking (Gait) Difficulties

  Related to several factors including weakness, spasticity, loss of balance, sensory deficit and fatigue, and can be helped by physical therapy, assistive therapy, and medications.

• Numbness or Tingling

  Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.

• Spasticity

  Refers to feelings of stiffness and a wide range of involuntary muscle spasms; can occur in any limb, but it is much more common in the legs.

• Weakness

  Weakness in MS, which results from deconditioning of unused muscles or damage to nerves that stimulate muscles, can be managed with rehabilitation strategies and the use of mobility aids and other assistive devices.

• Vision Problems

  The first symptom of MS for many people. The onset of blurred vision, poor contrast or color vision, and pain on eye movement can be frightening — and should be evaluated promptly.

• Dizziness and Vertigo

  People with MS may feel off balance or lightheaded, or — much less often — have the sensation that they or their surroundings are spinning (vertigo).

• Bladder Problems

  Bladder dysfunction, which occurs in at least 80% of people with MS, can usually be managed quite successfully with medications, fluid management, and intermittent self-catheterization.

• Sexual Problems

  Very common in the general population including people with MS. Sexual responses can be affected by damage in the central nervous system, as well by symptoms such as fatigue and spasticity, and by psychological factors.

• Bowel Problems

  Constipation is a particular concern among people with MS, as is the loss of control of the bowels. Bowel issues can typically be managed through diet, adequate fluid intake, physical activity, and medication.

• Pain & Itching

  Pain syndromes are common in MS. In one study, 55% of people with MS had "clinically significant pain" at some time, and almost half had chronic pain.

• Cognitive Changes

  Refers to a range of high-level brain functions affected in more than 50% of people with MS, including the ability to process incoming information, learn and remember new information, organize and problem-solve, focus attention and accurately perceive the environment.

• Emotional Changes

  Can be a reaction to the stresses of living with MS as well as the result of neurologic and immune changes. Significant depression, mood swings, irritability, and episodes of uncontrollable laughing and crying pose significant challenges for people with MS and their families.

• Depression

  Studies have suggested that clinical depression — the severest form of depression — is among the most common symptoms of MS. It is more common among people with MS than it is in the general population or in persons with many other chronic, disabling conditions.

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