Flu season is upon us, and this year we have to contend with ordinary seasonal flu as well as the H1N1 (swine flu) strain that has been in the news so much lately. For many MS patients, a viral infection such as the flu can trigger symptom relapse and, potentially, disease progression. Reports indicate that MS patients may face a greater risk of both catching H1N1 and developing complications from the virus.
In response to the heightened concern this year’s flu season brings, the National Multiple Sclerosis Society recently updated its recommendations on flu prevention and treatment. First, the NMSS reiterates its longstanding recommendation that MS patients get a regular flu shot. The shot is safe and effective for preventing flu, and can be administered even if a patient is using one of the disease modifying treatments (Avonex, Betaseron, Rebif, Tysabri, Copaxone, or Novantrone). MS patients using any of these medications should not, however, receive FluMist as a substitute for the flu shot since it contains a weakened live virus.
On September 15, 2009, the FDA approved four (4) vaccines for H1N1 – three (3) that are administered as “shots” and contain “killed” or deactivated virus and one (1) administered as a nasal spray that contains weakened live virus. Since there is not currently enough H1N1 vaccine for everyone, the CDC has identified five (5) groups for early vaccination: pregnant women, people living with or caring for infants under 6 months of age, healthcare and emergency service personnel, individuals from 6 months to 24 years of age, and people between 25 and 64 with medical conditions placing them at higher risk for flu-related complications. While all MS patients may not fall within the CDC’s high priority group, the NMSS Society recommends that:
• People with MS should consult with their physician about obtaining a regular flu shot as soon as possible.
• They should also discuss with their neurologist whether they should get the de-activated H1N1 vaccination because (1) catching the flu would put them at greater risk of an exacerbation, or (2) their MS symptoms are severe enough to put them at risk for flu complications.
• The FluMist nasal spray vaccine and the live, attenuated nasal spray version of the H1N1 are not recommended for people with MS.
http://www.nationalmssociety.org/news/news-detail/index.aspx?nid=2115.
Trevis Gleason, an MS patient who writes “Multiple Sclerosis Blog: Living with MS,” consulted with physicians, researchers, and the NMSS for his October 15, 2009 entry on MS and flu.
As Mr. Gleason noted, if you are allergic to eggs, you should not receive the seasonal flu or H1N1 vaccines. Physicians may advise a delay in vaccination for patients recovering from a recent serious relapse, or receiving high-dose steroids or Novantrone. If you have not gotten a flu shot and begin to feel ill, it may not be easy to tell whether you are experiencing the flu-like symptoms that can accompany MS treatments, regular seasonal flu, or H1N1 “swine” flu. Anti-viral medications such as Tamiflu have been demonstrated as effective against H1N1 and seasonal flu, so you should call your doctor right away if you have flu symptoms.
Filed under Medical research by on Oct 28th, 2009. Comment. 
An article in the Fall, 2009 issue of Injuryboard Magazine references a new 
study published in the Archives of Neurology suggesting that smoking can increase the progression of multiple sclerosis. A group of 891 patients were tracked for three years to identify how many changed from relapse-remitting MS to secondary progressive MS.
The study concluded that conversion from relapse-remitting MS to secondary progressive MS occurred faster in current smokers compared with those who had never smoked. Significantly the conversion rates were similar between those who had never smoked and those who had given up smoking.
One of the study authors, Dr. Alberto Ascherio of the Harvard School of Public Health suggests that quitting smoking can help delay the progression of this disease.
The study also confirmed prior studies which had concluded that cigarette smokers are at a higher risk for developing MS.
If you are an MS patient with a pending disability claim, you should expect the judge hearing your claim to ask you if you smoke. If you are not yet able to testify that you have quit, it can help to report that you are enrolled in a stop-smoking program. Judges like to see claimants who are trying to help themselves. If you smoke and show no interest in quitting you can expect a less than sympathetic response from your judge.
Filed under Hearing strategies, Medical research by on Oct 7th, 2009. 1 Comment.
There are 2 main ways in which you can be approved for Social Security disability benefits if you suffer from Multiple Sclerosis. The first way is to meet Social Security’s listing, which is described in further detail here.
If you don’t meet or equal the listing for MS, however, you can still be found disabled by showing that the limitations arising from your disease would prevent you from performing significant work activity. Therefore, you must be able to really define your symptoms and communicate to Social Security how these symptoms impair your ability to work. Below, you will find some examples of common MS symptoms and how they might impact one’s ability to perform work-like activities:
Fatigue – Regarded as the most common symptom of MS. Typically displayed by muscle weakness, distorted mental ability, and drowsiness. This will affect most typical work functions including lifting, typing, and any type of job requiring you to be “on your feet.
Heat sensitivity - A frequent MS issue, typically displayed by an escalation of MS symptoms in response to any type of heat source (heater, climate, hot water, etc.)
Spasms/Tremors – These interfere with muscles and limbs. Treatment is considered to be much more difficult. They affect one’s ability to voluntarily control movement.
Impaired Thinking - Decreased brain functions leading to impaired thinking, concentration, and memory functions. Can be severe enough to make performing simple tasks extremely difficult.
Other important limitations that can help with your Social Security Disability claim are the need to use the bathroom frequently, dizziness, difficulty using hands both grasping and feeling, dealing with stress, visual limitations (acuity, depth perception, accommodation, and field of vision), and muscle weakness. Many people with MS also have depression and any limitations from this condition can also be helpful in proving disability.
If you suffer from MS, pay attention to how any of the above symptoms impair your ability to work. You will also need medical records that back up your allegations of such symptoms. Also helpful are RFC forms filled out by you doctor to show how your physical and/or mental limitations impair your ability to work.
Filed under MS Case Strategies by on Oct 5th, 2009. 1 Comment.
MS has special issues in a Social Security case. One of the largest problems we often see has to do with the onset of new symptoms. Keep in mind, the first 2 levels of appeal (the initial application and the reconsideration) may take a year to work through the system. By the time you get to Court, you may have been waiting eighteen months. As you know, MS is a disease that can produce new and different symptoms with each flare-up.
If you now claim symptoms that were not identified in your initial application, the Judge may postpone your case to a later date by sending you to one or more consultative examinations (independent medical exams) with Social Security approved specialists. This is especially true if you have developed significant depression after you have completely filled out your application.
You can actually help your case and your lawyer by keeping copies of all the forms and applications you completed for Social Security. That way, you and your lawyer will be able to clearly see the symptoms you alleged on your most recent forms. So in the event that you develop new symptoms (like depression, for example), you can be sure to update your case file, notify Social Security of any changes, and schedule any consultative exams early so as to avoid any last-minute delays prior to the hearing. After potentially waiting for up to several years for a hearing, the last thing you want it a hearing postponement just because you or your lawyer failed to update your case file!
Filed under MS Case Strategies by on Sep 2nd, 2009. Comment.
