Multiple sclerosis - discharge
MS - discharge
What to Expect at Home
Your doctor has told you that you have multiple sclerosis. This disease affects the brain and spinal cord (central nervous system). Symptoms vary from person to person. With time, each person may have different symptoms. For some persons, symptoms may last days to months, then lessen or go away. For others, symptoms may not improve at all or only very little.
Over time, symptoms may get worse (progression), and it becomes more difficult to take care of yourself. Some persons have very little progression. Others may have more severe and rapid progression.
Try to stay as active as you can. Ask your health care provider what kind of activity and exercise are right for you. Try walking or jogging. Stationary bicycle riding is also good exercise.
Benefits of exercise include:
- Helps your muscles stay loose
- Helps you keep your balance
- Good for your heart
- Helps you sleep better
- Helps you have regular bowel movements
If you have problems with spasticity
, learn about what makes it worse. You or your caregiver can learn exercises to keep muscles loose.
Keep from Getting Overheated
Increased body temperature can make your symptoms worse. Here are some tips to prevent overheating:
- Exercise in the morning and the evening. Be careful not to wear too many layers of clothes.
- When taking baths and showers, avoid water that is too hot.
- Be careful in hot tubs or saunas. Make sure somebody is around to help you if you become overheated.
- Keep your house cool in the summer with air conditioning.
- Avoid hot drinks if you notice problems with swallowing, or other symptoms get worse.
Make sure your home is safe. Find out what you can do to prevent falls
and keep your bathroom safe to use
If you are having trouble moving around in your house easily, talk with your health care provider about getting help.
Your provider can refer you to a physical therapist to help with:
- Exercises for strength and moving around
- How to use your walker, cane, wheelchair, or other devices
- How to set up your home to safely move around
You may have problems starting to urinate or emptying your bladder all the way. Your bladder may empty too often or at the wrong time. Your bladder may become too full, and you may leak urine.
To help with bladder problems, your doctor may prescribe medicine. Some people with multiple sclerosis need to use a urinary catheter
. This is a thin tube that is inserted into your bladder.
Your health care provider may also teach you some exercises to help you strengthen your pelvic floor muscles
Urinary infections are common in people with multiple sclerosis. Learn to recognize the symptoms, such as burning when you urinate, fever, low back pain on one side, and a more frequent need to urinate.
DO NOT hold your urine. When you feel the urge to urinate, go to the bathroom. When you are not at home, take note of where the nearest bathroom is.
If you have multiple sclerosis, you may trouble controlling your bowels. Have a routine
. Once you find a bowel routine that works, stick with it:
- Pick a regular time, such as after a meal or a warm bath, to try to have a bowel movement.
- Be patient. It may take 15 to 45 minutes to have bowel movements.
- Try gently rubbing your stomach to help stool move through your colon.
- Drink more fluids.
- Stay active or become more active.
- Eat a foods with lots of fiber.
Ask your doctor about medicines you, or your loved one, are taking that may cause constipation (such as some medicines for depression, pain, bladder control, and muscle spasms).
If you are in a wheelchair or bed most of the day, you need to check your skin every day for signs of pressure sores
. Look closely at:
- Shoulders and shoulder blades
- Back of your head
Learn how to prevent pressure sores
Keep up to date with your vaccinations. Get a flu shot every year. Ask your doctor if you need a pneumonia shot.
Ask your doctor about other checkups you may need, such as to test your cholesterol level, blood sugar level, and a bone scan for osteoporosis.
Eat a healthy foods and keep from becoming overweight.
Learn to manage stress. Many persons with multiple sclerosis feel sad or depressed at times. Talk to friends or family about this. Ask your doctor about seeing a professional to help you with these feelings.
People with multiple sclerosis often get tired more easily than others. Pace yourself when you do activities that may be tiring or need a lot of concentration.
Your doctor may place you on different medicines to treat your multiple sclerosis and many of the problems that may come with it:
- Make sure you follow instructions. DO NOT stop taking medicines without first talking to your doctor.
- Know what to do if you miss a dose.
- Keep your medicines stored in a cool, dry place, and away from children.
When to Call the Doctor
Call your doctor if you have:
- Problems taking drugs for muscle spasms
- Problems moving your joints (joint contracture)
- Problems moving around or getting out of your bed or chair
- Skin sores or redness
- Pain that is becoming worse
- Recent falls
- Choking or coughing when eating
- Signs of a bladder infection (fever, burning when you urinate, foul urine, cloudy urine, or frequent urination)
Houtchens MK, Lublin FD, Miller AE, Khoury SJ. Multiple sclerosis and other inflammatory demyelinating diseases of the central nervous system. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 54.
Reitman NC. Care at home of the patient with advanced multiple sclerosis: part 1 of 2. Home Healthc Nurse. 2010;28:243-252. PMID: 20520264. Available at: www.ncbi.nlm.nih.gov/pubmed/20520264
Reitman NC. Care at home of the patient with advanced multiple sclerosis: part 2. Home Healthc Nurse. 2010;28:270-275. PMID: 20463509. Available at: www.ncbi.nlm.nih.gov/pubmed/20463509
Joseph V. Campellone, MD, Department of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.