What is an exacerbation?
An exacerbation of Multiple Sclerosis can also be referred to as an attack, a relapse or an episode. All the terms all mean the same thing which is the occurrence of new symptoms or worsening of an old symptom. These range from mild to severe enough to interfere with a person’s ability to function in daily life. The exacerbation will follow the following criteria:
- Previous symptoms become more severe or new symptoms have started to show.
- Symptoms last longer than 24 hours, commonly lasting days or weeks.
- A total of 30 days has passed since the start of the previous relapse.
- Healthcare provider has ruled out all other possible causes for an exacerbation, including infection, heat, and stress.
It is critical to know when this is happening because early treatment can help reduce the
impact on the person’s body. It must be known that no two exacerbations are alike and can change slightly.
The reason an exacerbation occurs is due to the immune system attack on the myelin sheath, which then causes slow or interrupted neuronal signals in the brain and spinal cord. An exacerbation can consist of balance problems, coordination, eyesight, bladder function, memory or concentration problems, mobility, fatigue, weakness, numbness or needle-link sensation.
Mild symptoms such as fatigue, numbness, and needle-link sensation could potentially improve on their own and not require treatment. More intense issues could be considered a severe exacerbation which could include vision loss, extreme weakness, and poor balance. During a severe exacerbation, a person’s daily activities could be 
affected and a short course of high-dose corticosteroids may be recommended by the specialist.
The high-dose of steroids helps reduce the severity and duration of the exacerbation. Even though steroids work well with the exacerbation, they can also have some rather unpleasant side effects including increased appetite, weight gain, fluid retention, high blood pressure, irritability, confusion or delirium, increased risk for infection, and easy bruising.
Symptoms for each person with Multiple Sclerosis are different. Being aware of common triggers for an exacerbation is vital for each person to know and even though symptoms can occur without any notice it is important to try avoiding certain things the best one possibly can.
4 Common Triggers for an Exacerbation:
- Stress- Part of living with an illness like MS is emotional stress which can lead to other common MS symptoms such as depression. Stress does have the potential to lead to additional MS symptoms such as fatigue and confusion. It is a crucial part of MS treatment to have a good and solid support network of people that can help out both physically and emotionally.
- Fatigue- Sleep is essential for those with Multiple Sclerosis. Small issues like lack of sleep can trigger MS symptoms. It is very important to have good healthy eating habits, sleep well, and getting exercise daily which will help combat MS fatigue.
- Infection- Infections cause about one-third of all exacerbation. Urinary tract infections are very common because some people with MS have reduced bladder function. Any infection can weaken the immune system; even the simple ones like a cold or the flu and cause an exacerbation. It is extremely important to avoid being around sick people, but when it is unavoidable be sure to wash hands frequently.
- Heat- Infections leading to fever can be something to worry about considering increased body temperature is a very common trigger. MS symptoms, especially tingling gets worse in the summer because of the heat. It is predominant to get into the air conditioning or take a cool shower to reduce heat symptoms from occurring.
Thank y’all for visiting my site and reading about what an exacerbation is. Speaking from personal experience an exacerbation can be awful and also frustrating. Even though I do know that steroids help the episode duration be shorter, they cause my mood to change so much that I have a hard time with them. They cause my temper to come out much faster than it normally would and also cause me to feel edgy and unable to sleep.
For any of you that have experienced an exacerbation and were put on steroids, how did the steroids make you feel and did they help the episode not last too long? Also, if you have anything you would like to add to this, please let me know. I always want to spread the awareness as much as I can because I think it is important. Even in 2020 I do still think there are a lot of misconceptions about MS and people are very quick to judge, which can cause feelings to be hurt. Please never forget that I am always sending y’all LOTS of love , comfort, and many positive vibes!
Always, Alyssa
known as demyelination.
being that 85% of those with MS are initially diagnosed with. Patients with this form will have relapses and periods of stability in between the relapses. Relapses are the episodes when new or worsening symptoms that are not caused by fever or infection appear. These episodes typically lase more than 48-hours. Between relapses are periods of remission where there is no clinical evidence of disease progression. Periods of remission can last for years, but this can range from person to person.
second phase of the disease. Most people that are initially diagnosed with RRMS will transition to this form at some point. Symptoms with SPMS will worsen steadily over time with or without occurrences of relapses or remission. There may or may not be times of relapses caused by inflammation, but will continue towards the progressive phase indicating nerve damage or loss. With this form of MS, the disability only continues to get worse.
other forms and only affects 10-15% of those with MS. On average people with PPMS start having symptoms between 35-39 years old. There is a slowly worsening of symptoms from the beginning with no relapses or remissions. With this type of MS there can be times of short-term, but temporary, minor improvements, however the decline of neurologic progression is constant. Symptoms of PPMS include pain, electric-shock-sensation running down the back and limbs when the neck is bent, trouble walking, vision problems, muscle weakness, trouble balancing, paralysis, numbness, prickling feeling, dizziness, shakiness, trouble thinking clearly, mood changes, depression, sexual problems, and trouble with bowel and bladder control.
be a steadily worsening of the state of the disease from the beginning with acute relapses, but no remission will occur. The symptoms of this form are the same as those with PPMS.
With all the possible symptoms one can experience, there are ways to manage most of them. Bladder control can be something one can experience and this can be rather embarrassing if it happens out in public, but there some suggested strategies to manage this.
urination.
today! I hope the information I provided to you was helpful. There is a chance I have stated the same thing in previous years, but I do feel it is important for us to spread as much awareness as we can because it does not seem like this illness is going away anytime soon. I do want to believe that someday in our life time there will be a cure, but until then we must continue to live our lives the best we can. I hope you are having a great day and feeling the best you can. Please never forget that I am always sending y’all LOTS of love 
I recently had to deal with my specialist’s office, in regards to the medication I take to limit the progression of my Multiple Sclerosis. Since the doctor that diagnosed my condition retired, the office he was at has been on a downward spiral. The amount of incompetence and lack of compassion are the only things that are steadily increasing, which is terrible.
to get a refill for my medication caused me nothing but massive stress and frustration. This would have been difficult regardless, but when the nurse decided to be ugly the situation escalated unnecessarily. All I am trying to do is anything necessary so I do not have a nasty relapse, especially without insurance.
The medication I take to slow my progression down is Gilenya. I have been on this same medication for a long time, so I know the processes and the ridiculous out of pocket with NO insurance. Honestly, I do not believe any normal person could afford this medication and I definitely can’t.
insurance and without access to life-altering medication.
going to be a bunch of bull shit!
I think y’all already know that I have battled with this unpredictable, not so fun autoimmune disease known as Multiple Sclerosis for almost 20 years. For nearly half of my life, I have wanted to not only help others struggling with this disease but also do all I can to help find a cure or at least find easier ways to get through this life. 
raise money for through Smile Amazon. The Amazon Smile Foundation will donate 0.5% of the purchase price to the charity of your choice. I received an email at the end of last week informing me that the charity I chose, The National Multiple Sclerosis Society received $258, 617.47 year to day in donations because of Smile Amazon. Of course, it still upsets me to think that any Amazon workers are mistreated, but I am still thankful for the donations made to a cause so close to my heart. I can only hope 
the donations Smile Amazon has made to the National Multiple Sclerosis Society will help find a cure for this awful disease.
dear family member. In 1945, the strong-willed and very determined young lady, Ms. Lawry, placed a small classified notice in the New York Times, “Multiple Sclerosis. Will anyone recovered from this disease please communicate with patient.”
writing in a journal as well. There might be times when I may not be ready or comfortable sharing how I am feeling with anyone yet and writing these feelings down in private offers me serenity. I find that writing down what is going through my mind at any given time allows me to reread what I am dealing with and gain some perspective. I think that by writing in a journal, I can just be honest with myself and not have to worry about what anyone else thinks or someone trying to tell me how I should feel or how I should cope with my struggles. There are many times that I just wanting to come up with solutions on my own, but then there of course times I do want advice.
share with y’all, but also gain some amazing feedback from y’all!! I have told y’all many times before that I am very critical of my own writing, but reading your thoughts helps me in so many ways. I have always dreamed of being a writer and having freedom to write about whatever I want! My ultimate dream is to gain the confidence to write the book I have mulled over for many years. I do believe that if I continue writing on my blog, which I do intend to, I will gain a tremendous amount of knowledge from each of you and about my own skills. ![sunrise_music300[1]](https://fightmsdaily.files.wordpress.com/2019/05/sunrise_music3001.gif?w=390&h=491)
journal, or do you even consider writing to be an outlet at all? 
do things I really needed to do, like clean the house and rest. I know how crazy that just sounded, cleaning the house and resting seem like they are opposites, but for me being able to get the house nice and clean is a great feeling. Of course all the extra work did create a lot of pain for me, but now I am able to spend the remainder of the weekend resting and preparing myself for another LONG week at work and unfortunately I have to work next weekend! 
I think and what I have tried training my mind to think and believe. It is amazing what we can trick our minds into believing! The things that work for me might not work for anyone else, after all we are all different. Sometimes simply taking a nice hot bubble bath can make a HUGE difference! I think it is something about the calming feeling of the warmth that eases my aching body. Of course, my doctor has told me numerous times that hot water isn’t 
good for me because it is not supposed to mesh well with Multiple Sclerosis, but it helps me. It is just like while at work my heating pad becomes my best friend!
pain I am feeling. This could be reading a good book, writing either on my own blog or commenting on another’s, watching some mindless TV show (my favorite is General Hospital, which I know sounds insane) or even watching a good movie (my favorites are anything from the Fast & The Furious). Little things can create a distraction for the mind and possibly alleviate our pains, even if it is for a short time.
this before, but I strongly feel the only way to fail is to give up. 
stronger! WE can fight this battle together and WE can win the war together!
leasing consultant’s desk and the manager keeps his office locked, which makes absolutely NO sense!!I ended up calling my co-worker on his day off, after all this was his lease and should have been handled on Friday. I was not at all surprised that he did not know which apartment the couple was moving into or what they owed. We tried contacting the property manager, who of course did not answer his phone or return the phone call. I ended up having to explain to the couple we would have to postpone their move in date until Monday because I was not able to get any of the information we needed. Thankfully, they did still have their other apartment, so they 
would not be forced to get a hotel room for the weekend. 
worker early in the week to make sure ALL his move-ins were completed, which would have meant walking through the apartment to ensure there were NO issues, the lease was signed and apartment keys were waiting in the file. I gave him several days’ notice to handle things properly and in my opinion how he handled them were unacceptable. I blame him and the manager for how terrible things went yesterday, but I do plan to make some suggestions on Monday morning so this kind of thing NEVER happens again! I do not think this sets a horrible feel for someone moving in to a new apartment when nothing was handled in an appropriate manner!
avoided. Another HUGE issue I was dealing with was, phone call after phone call with residents complaining their air conditioner was not working. The maintenance person informed me that the new management company was not allowing them to buy Freon from the vendor they had been using for years, but did not have another vendor lined up. The residents are paying to live these apartment and therefore important things like a working air conditioner when the temperatures are in the high 90’s is a priority and should 
also be a requirement! 
