followup 13th july
DESCRIPTION
Dr Torask follow-upTRANSCRIPT
Overcoming MS!Dr Torsak Follow-Up14th July,2014
Update from last visit (March’14)
• Condition very stable in March and April
• Started physical therapy sessions (four times in a week from
end of March)
• Travelled solo in April!
• Overall morale quite high
When suddenly..
• Loss of vision in left eye noticed on 30th Apr
• Vision dropped to around 15% on 2nd May
• Admitted on 2nd May
• Show:
– Discharge Summary
– MRI
– VEP Test Report initial and latest
PLM Charts (MS Specific)
Following are some of the charts through which a patient can
create a log of symptoms/ condition which is otherwise very
difficult to quantify:
1) My Symptoms
2) Multiple Sclerosis Rating Scale (MSRS)
3) Quality of Life (QOL)
My Symptoms Chart
Patient can rate the severity of some or all the symptoms (on an interval scale) of MS on a given day
My Symptoms
Fatigue and spasticity : have decreased from Mid May onwards Moderate mood swings post steroids
Multiple Sclerosis Rating Scale
Patient can rate the impact of MS symptoms (on an interval scale) on day-to-day life
MSRSOverall Summary
First monsoons, loss of balance and problem in walking
After 1st session After 2nd session
Optic Neuritis
Recovery
Activity 20th Feb 7th May 12th May 2nd June 12th Aug 22nd Sep 23rd Oct 9th Nov 23rd Nov 6th Dec 15th Dec 23rd Feb 2nd Apr 9th May 6th June 3rd JulyWalkingUpper Limb FunctionVisionSpeechSwallowingThinking/Memory CognitionSensation/Burning/Pain
MSRSDetailed Break-up of MSRS Activities
No Symptoms MildNone Moderate
•Improvement in walking and Burning Sensation•Left Eye Vision also recovered mostly
Quality of Life: PhysicalQOL Score indicates how one’s condition and treatment affects one’s physical, social
and mental well-being
Quality of Life: Mental QOL Score indicates how one’s condition and treatment affects one’s physical, social
and mental well-being
Quality of Life: Social
QOL Score indicates how one’s condition and treatment affects one’s physical, social and mental well-being
My QOL Scores
•Improved mobility and also excellent mood!•Throat infection and weather change, getting back
Next Steps
• Progressive MS or RR MS?
• Inflammation in Progressive MS? (Inflammation was low in last blood test,
Mar’14)
• Can GcMAF induce inflammation? GcMAF advisable in RR MS?
• New MRI: What does it say ?
• Steroids: how do they work? Is it sustainable?
• More prone to cold and throat infections (Tonsillitis) again, Immune
system action?
• What’s next? Immunosuppressive drugs like Interferon and Tysabri?
• Ongoing follow-ups
I’ve already overcome this!