DEAR DR. DONOHUE: I have just learned that my favorite cousin has multiple sclerosis. I dread visiting her because I am not sure how I will react if she is confined to a bed or a wheelchair. Why aren’t there any medicines for this disease? – V.D.

ANSWER:
There are medicines for this disease, and, furthermore, your cousin is not likely to be confined to a bed or a wheelchair.

The “sclerosis” of multiple sclerosis refers to scars that inexplicably form in the brain and spinal cord. The “multiple” refers to the multiple sites of those scars in the nervous system and the multiple symptoms that they can produce.

Although the cause has not been identified, there are many proposed theories to explain why it occurs. Some feel it results from a misfiring immune system. Others propose that it could be the result of a viral infection. A third group makes the case for both of these mechanisms as the likely cause.

The largest group of MS patients have the so-called relapsing-remitting kind of MS. This kind of MS is defined by the appearance of symptoms and then their disappearance. An arm or hand might be weak, or vision might be disturbed, and then these symptoms improve. Later, a new set of symptoms appears. The time span between recovery from original symptoms and the onset of new ones can be quite long.

Three drugs can slow the progression of MS. They are Avonex, Betaseron and Copaxone. They are not cures for MS, but they can delay the evolution and advancement of symptoms.

Visit your cousin. I am sure you’ll be surprised at seeing how well she is doing. It takes about 15 years from the first appearance of symptoms to the point where a patient has to use aids to get around.

Not all MS patients follow this description. A few people have a rapidly progressive illness.

DEAR DR. DONOHUE: Every time I shower I break out with a terrible itch. Why? Am I allergic to soap and water? – H.M.

ANSWER:
No, you are not allergic to soap and water. However, in a few people, contact with water can produce a picture that looks very much like an allergic reaction. Water causes these people’s mast cells to disgorge histamine. Histamine brings on the itch. Allergies do the same. But this condition – aquagenic pruritus – is not an allergic reaction, although it has the same mechanism that allergies have.

You can try a few things to stop the itch. Over-the-counter antihistamines, taken an hour before bathing, might stop the itch. Taking a bath with bath water containing sodium bicarbonate is another trick that sometimes works. Capsaicin cream is another reputed remedy.

If none of these helps, then see a dermatologist, first and foremost to find out if your condition truly is aquagenic pruritus. The second reason is to obtain prescription medicines that have a greater impact on preventing histamine release than do over-the-counter drugs.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

Am I delusional? – A.N.

ANSWER: You are not delusional. Many arthritis patients say the same as you. They can tell a storm is on the way because their joints begin to hurt.

There is a basis in the medical literature that supports this phenomenon. Studies have shown that when the barometric pressure falls and when the humidity rises, some arthritis patients can detect those changes by the increased joint pain they experience.

I don’t know why this happens. It doesn’t happen to everyone who has arthritis, but it happens to enough to give this observation a foundation in fact.


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