Multiple Sclerosis
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Winter 2007
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From the Editor and Guest Editor (provided as webpage)
Multiple Sclerosis: The Basics and Beyond 
Allen Bowling, MD, PhD; Patricia M. Kennedy, RN, CNP; Julie N. Peck, RN, CNP
Multiple sclerosis (MS) is the most common acquired inflammatory demyelinating disease of the central nervous system. Over the past decade, there have been remarkable advances both in understanding the pathogenesis of MS and treating the disease. Immunomodulatory and immunosuppressive therapies have been developed that decrease relapse rate, slow progression of disability, and stabilize magnetic resonance imaging (MRI) changes.
Some Thoughts on Managing Mood and Multiple Sclerosis
Patricia Daily
Multiple sclerosis (MS) is a chronic disease with an unpredictable course and living with it poses multiple physical and emotional challenges to the patients who have it. How successfully they cope with these challenges is influenced by unpredictable factors that are unique to each patient. It is also strongly influenced by the quality of the relationship they have with, and the guidance they receive from, their health care provider.
Rehabilitation in Multiple Sclerosis
Karen Theriot, MD
Multiple Sclerosis, a highly prevalent neurologic condition of young adults, can cause progressive impairment over the individual's lifespan.This results in restrictions in participation in multiple areas of mobility, daily activities, and life roles. Research has demonstrated the value of rehabilitation in reducing disablement and improving health-related quality of life.
Adult Day Services
Patricia E. Breese, MA, CRC
Recent changes in the reimbursement structure of the healthcare delivery system have provided an opportunity and impetus to develop cost effective, inclusive community based services for people with disabilities as an alternative to institutional care. Adult Day Services is an important component of this continuum for people with chronic neurological conditions, such as multiple sclerosis. Adult day services may facilitate earlier discharge from acute hospital stays or avoidance of institutional placement in the latter stages of the disease process. This article provides an overview of the rational placement of adult day services in the treatment continuum for people with multiple sclerosis and recommends program structure and design. The King Adult Day Enrichment Program is emphasized as an example of model program operation.
Complementary and Alternative Medicine in Multiple Sclerosis Care
Allen Bowling, MD, PhD; Thomas Stewart, MS, JD, PA-C
Complementary and alternative medicine is difficult to define, but generally refers to health practices not presently considered to be part of conventional medicine. Even so, conventional practitioners who work with MS patients must understand these practices because they are widely used by people with MS. In addition, there are some CAM modalities that may be beneficial and some that may be harmful. To assist health care practitioners and patients understand these various potential benefits and risks, the Rocky Mountain MS Center has developed our multi-faceted CAM program. Selected resources made available through our CAM program are described.
Social Security Disability Insurance (SSDI) Benefits and the MS Patient
Thomas Stewart, MS, JD, PA-C
People with MS are at risk for becoming disabled, and the consequences of disability may include loss of income and loss of medical benefits. Social Security Disability Insurance (SSDI) is designed to mitigate these consequences. However, SSDI benefits are sometimes difficult for people with MS to access, especially when disability is related largely to fatigue and cognitive dysfunction. Health care providers can make it easier for their MS patients to access disability benefits by carefully documenting work-related difficulties and by making appropriate expert referrals. Practical suggestions for helping patients with their SSDI application are provided.
The Rocky Mountain MS Center Tissue Bank: Providing Building Blocks for the Future
Kenneth C. Dole, MHS, Erik S. Nilsen; Allen Bowling, MD, PhD
Human tissue is critical for multiple sclerosis (MS) research.Unfortunately, MS is such a complicated disease that basic science and animal model experiments can only provide a limited amount of information about what may be occurring in the human disease. Consequently, human tissue is absolutely essential to advance our understanding of the cause of MS, the ways in which MS affects the immune and nervous systems, and the best ways to treat the disease.
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