Multiple sclerosis (MS) is a complex autoimmune disorder that affects the central nervous system leading to a wide range of debilitating symptoms and even disability. The condition affects millions of people worldwide. It can, however, be treated using disease-modifying therapy. Discover more about this disease as Bloom explores the facts about this disease in more detail, including its impact on affected individuals and treatment options.

What is multiple sclerosis?

Multiple sclerosis (MS) is a chronic and progressive autoimmune disease that affects the central nervous system, which includes the brain and spinal cord. An autoimmune disease is where the body’s immune system mistakenly attacks healthy tissue and cells within the body. The result is inflammation, damage and dysfunction of the body’s organs or systems. MS occurs when the immune system attacks the protective myelin sheath that covers nerve fibres, which leads to severe inflammation. The resulting disruption damages the communication between the brain and body, causing a range of symptoms that vary in severity and intensity, depending on the stages of the disease.

The disease progression varies from person to person but it is characterised by the following types or stages:

1. Relapsing-remitting (RRMS) stage. This stage involves unpredictable relapses and flare-ups of the MS symptoms, followed by extended periods of remission. Over a period of time, most individuals will transition to the next stage.
2. Secondary progressive MS (SPMS) is a more aggressive stage where the disease gradually becomes worse. It can occur between 10-25 years after the initial diagnosis. Individuals experience partial recovery following a relapse or flare-up.
3. Primary progressive MS (PPMS) is a slow progression of the disease with no remission periods. While there may be an occasional plateau in the symptoms, this tends to be temporary.

As MS progresses, the myelin is gradually destroyed, which leads to scar tissue known as sclerosis. The demyelination disrupts the body’s nerve signals, causing debilitating symptoms that cause both physical and cognitive impairment. In the advanced stages of the disease, an individual’s mobility is severely affected, resulting in disability.

Symptoms of multiple sclerosis

Not everyone with MS will experience the same symptoms. The disease is quite unpredictable given the relapses and remissions. Some of the most common symptoms include the following:

• Fatigue. Individuals with multiple sclerosis suffer from an overwhelming tiredness that is not relieved by rest.
• Numbness and tingling, like a pins and needles sensation, are most often felt in the limbs.
• Muscle weakness. Difficulty moving certain muscles, which will affect balance and coordination.
• Muscular pain and spasms. This includes aching or sharp pain in the muscles.
• Vision problems. MS can also cause double or blurred vision. It usually affects one eye at a time.
• Cognitive impairments, include problems with memory, processing new information and difficulties concentrating.
• Bowel and bladder dysfunction, leading to incontinence.
• Speech problems, such as slurred speech and difficulty articulating words or sentences.
• Cognitive disruptions, and problems with planning, organising, learning and thinking.
• Emotional and psychological problems. Individuals with MS could develop depression or anxiety.

Health implications of multiple sclerosis

MS is variable, which means that not everyone will experience all of these health implications, especially given the advancements made in treatment plans, which can alleviate an individual’s symptoms and the disease progression. However, some of the most common health implications associated with multiple sclerosis include:

• Physical disability, including loss of mobility and difficulty with coordination.
• Chronic pain associated with musculoskeletal and neuropathic pain.
• Secondary complications, like osteoporosis.

Who is at risk of developing MS?

MS is a complex disease that is influenced by many factors, including genetics, environment and lifestyle choices. The exact cause of the disease is unknown but these factors will increase your risk of developing the condition:

• Genetics. If there is a history of MS in your family it does increase your risk of inheriting this disease.
• Age and gender. MS is more common in women than men. It most commonly presents between the ages of 20-40.
• Viral infections. Certain types of infections, like the Varicella-Zoster virus that causes chickenpox and shingles, have been linked to multiple sclerosis although there is no evidence that any virus is a direct cause of MS.
• Certain medical conditions. Individuals with types of autoimmune conditions or medical conditions, like Type 1 Diabetes or thyroid disorders are at a greater risk.

Living healthy: prevention, management and treatment of multiple sclerosis

Preventing multiple sclerosis is a challenge because the exact cause of the disease is complex. However, there are some strategies a high-risk individual can employ to reduce their risk of developing the condition. This includes:

• Know your family medical history. You have a greater chance of developing the disease if a close relative has been diagnosed with MS.
• Maintain a healthy lifestyle. Maintain an optimal weight, exercise regularly and eat a balanced, nutritious diet with plenty of fresh fruit and vegetables, lean protein, healthy fats, high fibre and dairy.
• Reduce or quit unhealthy lifestyle habits. Limit your alcohol intake and avoid smoking as this has been linked with inflammation.
• Vitamin D. Ensure you get the recommended dose of Vitamin D, especially if you have a deficiency.

Discover more about How to prevent chronic disease for more tips about reducing your risk through a lifestyle management plan.

Advances in MS research and treatment options have improved the prognosis for many individuals with the condition. Early diagnosis and medical care, like disease-modifying therapy, can help those with MS better manage their symptoms and the associated health implications, which means they are able to maintain a higher quality of life. Some of the treatment programmes available for MS include:

1. Disease-modifying therapy or treatments. This refers to a category of medication used to manage chronic diseases, especially autoimmune and neurological conditions. The drugs alter the course of the disease by targeting its progression rather than simply treating the symptoms. DMTs can achieve the following:

• Reduce relapse frequency. DMTs can decrease the amount of and severity of MS relapses or flare-ups.
• Slow down the disease progression by reducing inflammation and activity within the central nervous system.
• Manage inflammation and its response by preventing the immune system from attacking and damaging the myelin sheath and nerve fibres in the brain and spinal cord.

DMTs are not a cure for MS and the effectiveness of the therapy will vary from one person to the next. They’re available as oral medication, infusion-based therapies and injectables. The choice of DMT will depend on the type of multiple sclerosis an individual is experiencing (secondary progressive or primary progressive, for instance), the combination and severity of symptoms and possible side effects.

2. Corticosteroids. High doses of corticosteroids are used to manage MS by reducing inflammation.
3. Symptomatic treatments and therapies are used to manage the various symptoms of the disease, including:

• Occupational therapy can assist the individual with mobility and teach them how to adapt to their limitations
• Muscle relaxants to alleviate spasms and stiffness
• Pain medication to alleviate discomfort
• Speech therapy for communication difficulties

Takeaway: What do we cover?

Bloom is committed to healthy living. You will need specialist medical care and services if you have a serious chronic condition or disease, like multiple sclerosis. Make sure you and your family are covered for chronic benefits and get the right healthcare coverage.

We have a wide portfolio of healthcare options that will suit your medical needs and budget. Choose from:

1. Health Insurance. We have partnered with the respected Momentum Health4Me provider for health insurance that provides top-quality, affordable plans to people on a budget, including;

• Health4Me Gold. This is our most popular and premium, yet affordable health insurance option.
• Health4Me Silver is a balanced health insurance option that brings you high-quality and competitively priced private healthcare.
• Health4Me Bronze is our entry-level health insurance option that provides you with quality healthcare at an affordable premium.

2. Medical aid. Together with our partner, Momentum, we also offer affordable medical aid solutions across three categories. Take a look at the benefits to decide which plan best suits your particular medical needs.

• Ingwe is an affordable, entry-level medical aid plan that’s perfect for first-time earners and students. You will receive hospital coverage, and day-to-day and chronic illness benefits using the network providers.
• Custom includes cover for hospitalisation in private hospitals. The Custom option provides cover for a range of day-to-day benefits such as preventative screening tests, specific check-ups and more.
• Evolve is for digitally savvy individuals looking for affordable hospital cover and virtual GP visits, with the ability to manage their membership from their devices in the comfort of their homes.

3. Gap cover. This option takes care of medical expense shortfalls. Many healthcare services charge above medical scheme rates, which means that you would need to cover the difference out-of-pocket. Let Gap Cover assist with these extra expenses. Compare:

• Gap Core is the affordable answer to extra medical expenses. It covers the gap between what your medical aid covers and what hospitals and specialists charge.
• Gap Max is the premium and comprehensive answer to unexpected medical expenses. This option covers the shortfall between what your medical aid covers and what hospitals and specialists charge, with many added benefits

Momentum Health4Me Gold will cover the cost of your chronic medication and services for multiple sclerosis provided that it has been approved and prescribed by a network GP from the list of 26 chronic conditions. Once you’ve received approval and authorisation, simply fax or email your prescription to a Medipost Pharmacy and let them know where to deliver it. You can fax through to 0866 82 33 17 and email to mhealth@medipost.co.za