Okay, now I have
a very long list for you
because this disease
can be life-altering.
One of the most common symptoms is fatigue.
The patients experience
a fatigue on an incredible level.
They might have some numbness
or some tingling.
Well, that should kind of makes sense
because they've got problems
with the nerves.
They may have weakness
because they can't control things
like they used to be able to.
They could be dizzy
and have vertigo.
They might have issues
with their sex acts.
They have pain, itching,
They be very labile.
They might have trouble walking
Remember if you have weakness
and fatigue and dizziness and vertigo.
And then they have a hard time
controlling their legs.
It might get worse
and turn to like spasticity
where they really lose control
in periods of exacerbation.
It can also affect their eyes.
They can have problems
with their bladder.
They may have problems
with their bowel.
They can have some cognitive changes.
They just may not seem
It can also include depression.
Now, depression may show up
as a primary symptom
or as a result
of what they're dealing with.
These are actually a pretty good list
of the most common symptoms of MS.
But different patients may have different.
So, this is where you come in
and can really make a difference.
When you have a patient that we think
might have MS or does have MS,
you need to plan extra time
in communicating with them.
Make sure you appear unrushed.
You listen to their symptoms,
make sure you document them,
and make sure you understand
how important it is to them
to feel heard and validated.
See how vague
some of these symptoms are?
Sometimes people with MS
feel like people are calling them whiners
or they're not taking
their symptoms seriously.
You can quickly establish trust
in a therapeutic relationship
with a patient struggling
with these issues.
If you'll slow down, sit down,
make eye contact,
and ask them questions
about what they're experiencing.
You'll be amazed at what a difference
it makes for that patient.
Now, those were the primary symptoms.
These are the secondary symptoms.
These are complications that can come
from the primary symptoms.
So they can have bladder dysfunction.
Well, they might have repeated UTIs.
And those are miserable.
If you've never had a UTI,
take it from those of us who have.
That is really uncomfortable
and very inconvenient.
Now, they might have complication
with being inactive
because they might have
loss of muscle tone.
They might have that weakness.
They could have poor posture.
Their bone density may go down,
which no female needs,
so they're gonna have
an increased risk of fractures.
Wow, stop and think
about that for a minute.
They have decreased bone density
that could have increased
risk of fractures.
Well, you know due
to the primary symptoms,
they're at a really
increased risk of falling
if they're having spasticity
So, you can see
why this is a really big deal.
They also might have problems
with shallow and inefficient breathing
which is just going to add
to their fatigue.
They also get immobility.
There's a difference
between inactivity and immobility.
Immobility is not able to move.
They spend long periods of time
sitting or laying,
then the patient is at risk
for pressure sores.
So, secondary symptoms
can be treated,
but our goal as healthcare providers
and the whole team
is to help avoid the secondary symptoms
by trying to help the patient deal
and address with the primary symptoms.
So, the more we can help the patient
control and minimize the primary symptoms
will reduce the value
of the secondary symptoms.
Okay, we looked
at the primary symptoms.
Remember that full slide of symptoms?
We look at the secondary symptoms
which we can treat,
but remember our goal is to try
to control the primary symptoms
as much as possible,
so we minimize the impact
of the secondary symptoms.
Now we're going to look
at tertiary symptoms.
Okay, these result from the impact
of the disease on the patient's life.
You know if you're working
in a hospital setting,
we get really focused
on what we're doing in the hospital setting
and we sometimes don't pay enough attention
to what the patient is dealing with,
all the other days of their life
when they're not with us in the hospital.
That's tertiary symptoms.
So, they can include the impact
on their social life,
their vocational world,
and psychological complications.
So, think how this would be.
We've talked about the primary symptoms
and some of the secondary symptoms
that we try to avoid.
But think if the patient
is no longer able to drive or walk,
how would that affect your life
if you could no longer go somewhere
when you wanted to,
or even walk when you got there.
That may affect their ability
to hold down a job
and to feel like getting out
and being independent.
So, if MS has gotten to the place
where the patient
can no longer walk on their own
or drive themselves
where they need to go,
this can really play a huge role
in their psychological complications.
If it impacts their job,
think about the extra stress
that would bring into their life.
So, the stress and strain
of dealing with MS
often alter someone's social networks.
It's not as easy for them
to get to places.
They don't feel like socializing.
And so they end up
sometimes losing relationships
and support systems
that they really need
when they're going
through something like this.
So, patient could have problems
with bladder control,
tremor or swallowing.
These are not things that would
make me want to be out with people.
It would be difficult to deal with.
So they might want to withdraw
from social interactions
and become more and more isolated.
So, you can make
a difference as a nurse
if you ask the patient
some not harsh questions,
but just some easy
about how often
they're able to be with friends
or to be with people
outside their families.
Just ask some questions
that are open-ended
and allow the patient to share
what they feel like sharing.
Over time as you build
they'll open up more and more to you.
is a very common sign
in people that are dealing with MS.
But, really, depression is a problem
in any patient with a chronic disease.
But let's talk specifically about MS.
See, it might be both
a primary or a tertiary symptom
because it could be caused
by the disease process itself of MS
or it might have been triggered
by the challenges
that we've talked about
in these previous slides.
Either way, it's our role
as healthcare providers
to address this area of health
with the patient.
So, you'll have--
this might be awkward for you,
but it is so important to practice.
Practice having difficult conversations
that could really make
a difference for your patient.
Be calm, sit down,
make eye contact, be unhurried,
and listen to what they have to say.
You may be the one person
that they'll feel comfortable
to opening up to.