Multiple Sclerosis

At school this week, we were asked to use the NHS website to summarise and present on a specified disease, and I was given multiple sclerosis, so I decided to post the backbone of my script, as I found it very interesting. Enjoy:

So what is multiple sclerosis?

The NHS website defines multiple sclerosis as a condition which can affect the brain and/or spinal cord, causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation and balance.

The disease affects over 100,000 people in the UK and is commonly diagnosed in people who are in their late 20s to early 30s. As a result of higher levels of the blood vessel receptor protein S1PR2, multiple sclerosis is four times more prevalent in women than in men, and I talk about this a bit ore later on.

Currently, it is considered incurable, although many of the symptoms can be treated to improve the quality of life for the patient.

What are the symptoms of multiple sclerosis?

The symptoms include, although are not limited to: problems with balance and muscle coordination; difficulty thinking, learning and planning; vision problems, and muscle stiffness and spasms.

The two types of multiple sclerosis:

Relapsing-remitting

In over 80% of cases, the multiple sclerosis patient suffers from what is known as relapsing-remitting MS. This means they suffer episodes known as relapses, in which the symptoms gradually worsen over a period of time that can range from a few days to several months, and then slowly improve over a similar period of time. These relapses can occur without warning and for no reason, although high stress levels or serious illnesses are thought to trigger them. Periods between relapses are called remission, and during this time, the patient can lead a relatively normal life. Unfortunately, later in life, this type of multiple sclerosis develops into secondary progressive (see primary progressive for symptoms).

 Primary progressive

Just over 1 in 10 people have primary progressive MS, in which, once the symptoms begin, they get worse and worse, and begin to accumulate along with other symptoms and consequently the health of the patient will deteriorate over time Although the life expectancy is not much less than that of a healthy person, the latter half could become painful, and this can be very upsetting for the family and friends to witness.

What causes multiple sclerosis

Multiple sclerosis os caused by an abnormal immune response, in which the immune system attacks the myelin coating nerve fibres in the CNS, causing damaging and scarring. This results in the nerves travelling much slower, or prevents them from getting through at all. Women have more S1PR2 protein receptors, which are involved in regulating the passage from the blood stream to the brain, which therefore enables immune cells to get to the brain and attack myelin. This is believed to be why there is a higher occurrence of multiple sclerosis in women than in men.

Treatments

Steroid medication to speed up recovery from relapses

Specific treatment for individual symptoms

Disease-modifying therapy to reduce number of relapses

 

Autologous haematopoietic stem cell transplant

There is also now a new treatment which can stop the progression of multiple sclerosis. It involves using chemotherapy to destroy the immune system, and then rebuilding it with stem cells harvested from the patient’s own blood, in the hope that it will produce a new healthy immune system which does not attack the CNS. Despite this, there are very high risks associated with this therapy, as it requires using toxic drugs in the chemotherapy which could have very harmful effects if procedure went wrong. However, in spite of the risks, a study carried out thirteen years ago has indicated that patients who underwent this therapy have experienced no long term effects and are now able to live normal lives free of multiple sclerosis.

 

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NHS Bed Shortages

Whilst we have all known that the NHS has been struggling to stay on its feet for a long time now, it appears that 2017 could be the year it finally crumbles, with 9 out of 10 hospitals reporting unsafe numbers of patients on their wards this winter, and record numbers of patients having to wait for longer than four hours for A and E care. It seems that the majority of the problems the NHS are facing stem from the our ageing population; for example, more and more operations are being delayed, and sometimes even cancelled as a result of there being no beds available for patients to recover in, primarily caused by elderly patients being unable to return home due to a lack of social care. Despite figures showing that only 1% of operations were cancelled last minute, this translates to just over 82,000 operations in 2016. Given that the NHS needs to be making the most of their resources, it seems like a terrible waste for surgeons to be sat around waiting, unable to perform their operations for something so trivial as a lack of beds.

Yet what can be done? It is simply not acceptable to just start discharging patients in an effort to free up more space, in the hope that they will manage just fine at home, and with so many elderly patients, this is often not possible anyway. GPs have been told they need to become open 7 days a week, and also need to advertise this fact, or they risk losing their funding, which is a positive start, although there are concerns over whether there will be enough trained staff available for this to be feasible across the country. In addition, much more funding needs to be directed towards caring for the elderly in all communities; allowing them to live comfortably from home should hopefully ease some of the pressure on the beds in the hospitals.

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Is camping the way to improve our sleeping habits?

Following research at an American University, evidence has come forward to suggest that spending a weekend camping in the great outdoors will have a positive influence on our ability to sleep better, as well as help those who struggle to get up in the mornings.

The reason being appears to stem from our natural body clock, which helps to regulate our  physical strength, mood, alertness, and when we feel tired, along with many other things. Scientists believe that the level of light helps our body clock to ‘keep time’ as it were, allowing it to anticipate when we may start to feel tired, and preparing our body for sleep in the evening, and vice versa in the morning. However, given that our lives not only revolve around, but have now become nearly dependant on technology, artificial light appears to be interfering with and altering the way we sleep. This is more noticeable in younger generations, and in teenagers especially, who now spend on average up to two hours a night after getting into bed on smartphones or laptops, meaning they are still wide awake long after their circadian clock says they should be asleep.

Not only does this offer one explanation for why some teenagers are so inexplicably tired throughout the day, and struggle so much to get out of bed in the morning, but also provides a suggestion as to why there are increasing cases of type 2 diabetes in younger patients and more issues with obesity (however this is almost certainly not the primary cause – easy and cheap access to sugary and fat filled food is the chief suspect).

Abandoning technology and modern life regularly for a weekend out in the countryside appears to be a great way to combat this struggle, as it would expose our bodies to more natural light in the day time, and less light at night, helping to reset our circadian clocks, providing us with a boost of energy and an apparent ease in getting out of bed in the morning. Despite this however, researchers added that this would not offer a permanent solution, and more drastic changes need to occur if people want to see a true and lasting improvement in their sleeping habits – examples of this include minimising our use of technology, but with modern life as it is, this may not be possible.

A study conducted in 2014, credited to scientists from Oxford University, suggested that people nowadays sleep between one and two hours a night less on average than people did sixty years ago. It was argued that this was potentially the result of human arrogance combined with the effect of technology on our sleeping patterns – humans believing that they could overcome our natural body clock, casting aside 4 billion years worth of evolution, in order to feed their addiction to phones and social media. Yet despite this, society continues to flourish, and we are living life at its easiest, so is sleep deprivation really causing us a problem? Or are we just more aware of the negatives than the positives?

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