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Old 09-12-2012, 11:42 AM   #1
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Attacks vs Flare ups ect...

I'm trying to understand the difference in all this. While waiting for my MRI, I have been trying to make sense of what is going on with me. (I realize I wont necessarily find answers, but I want to understand as Much as I can, so I know which direction to go when I get results no matter the results.

I understand that a new symptom has to last a full 24 hours at least to be considered an attack, correct? Then flare ups, are recurring symptoms that get triggered, and can last any length, and be at any degree. Is this correct?

I was thinking that MS could definitely fit regarding all I have experienced, then last weekend, I was woken to a sharp pain, I thought it was like ovarian pain from ovulating, but it increased in severety, to the point of crying. It then seemed to shoot across more toward my back side, (At this point I realize this is electical pain ) and was like an explosion of fire, severe burning. Much more painful then the pain I already had. Then down the back of my leg to mid thigh, where it stopped and repeatedly was like a poking sensation, or better yet, it was like the rubber band snap, but very electrical/shocking and the worst of my pain. It subsided enough for me to get back to sleep after a half hour or so.

I was thinking this was nothing related to what I have going on with me, and it wouldn't fall into the catagory of MS. I have in the past had that electrical pain run down my leg in the past.

Just a recap, Doc is doing an MRI because of some eye issues on the right side and numbing. She found my whole right side more dull than left, and my balance is off. I did give her a history of other neural issues I have had, but I don't know if the MRI is based on any of that. I think it's mostly based on, that the eye issues and numbing came on gradually, was strong, (Never blinding though) and then has gotten lighter again.

Last edited by Becky1971; 09-12-2012 at 11:44 AM.

 
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Old 09-12-2012, 12:17 PM   #2
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Re: Attacks vs Flare ups ect...

Quote:
Originally Posted by Becky1971 View Post
I'm trying to understand the difference in all this. While waiting for my MRI, I have been trying to make sense of what is going on with me. (I realize I wont necessarily find answers, but I want to understand as Much as I can, so I know which direction to go when I get results no matter the results.

I understand that a new symptom has to last a full 24 hours at least to be considered an attack, correct? Then flare ups, are recurring symptoms that get triggered, and can last any length, and be at any degree. Is this correct?

I was thinking that MS could definitely fit regarding all I have experienced, then last weekend, I was woken to a sharp pain, I thought it was like ovarian pain from ovulating, but it increased in severety, to the point of crying. It then seemed to shoot across more toward my back side, (At this point I realize this is electical pain ) and was like an explosion of fire, severe burning. Much more painful then the pain I already had. Then down the back of my leg to mid thigh, where it stopped and repeatedly was like a poking sensation, or better yet, it was like the rubber band snap, but very electrical/shocking and the worst of my pain. It subsided enough for me to get back to sleep after a half hour or so.

I was thinking this was nothing related to what I have going on with me, and it wouldn't fall into the catagory of MS. I have in the past had that electrical pain run down my leg in the past.

Just a recap, Doc is doing an MRI because of some eye issues on the right side and numbing. She found my whole right side more dull than left, and my balance is off. I did give her a history of other neural issues I have had, but I don't know if the MRI is based on any of that. I think it's mostly based on, that the eye issues and numbing came on gradually, was strong, (Never blinding though) and then has gotten lighter again.
An attack or flare is the same thing basically. They have to last between 24-48 hours for most docs to consider them a true flare instead of a pseudoflare and consider treating them.

What I think you are asking about is a new symptom. They also have to go on for >24 hours to be treated. Most of us have to have motor symptoms to be treated with IV steroids (not just sensory.)

Your eye symptoms I am guessing consist of decreased vision along with numbness are what are getting your MRI. That is a good thing.

The electrical shock symptom you are feeling could be from a number of things. Of course we have all felt electrical shocks...pains etc. Where yours starts and stops are a bit curious anatomically just due to where the nerve runs. However, you may have an inflamed disk or something.

Have you had numbness or weakness in your limbs?

I hope your MRI is clean...I don't wish this disease on anyone else!

OH, did you see an ophthalmologist when you had your eye problems? It would be a good idea. They can do a VEP to check your optic nerve...it is a very sensitive test. Many neurophalmologist offices have it, and some regular MD ophalmologists have the test as well (retina specialists).

 
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Old 09-12-2012, 12:26 PM   #3
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Re: Attacks vs Flare ups ect...

Attack versus flare-up (from my MS pamphlet I got from my doctor):

"An exacerbation of MS (also known as a relapse, attack, or flare-up) causes new symptoms or the worsening of old symptoms. It can be very mild or severe enough to interfere with a personís ability to function at home and at work. No two exacerbations are alike, and symptoms vary from person to person and from one exacerbation to another."

Note to be considered a true exacerbation, the attack must last at least 24 hours and be separated from the previous attack by at least 30 days.

An exacerbation can last for a few days OR months! I am currently battling nerve pain as you described. For me it started the 2 week of August and may last until November/December. on a 10/10 scale I went through a few days of 12's. I use a heating pad which, for me, is the most relieving treatment I have found. I start at the point of the most pain and I will follow the pain from there before I start all over.

Confused? Your doctor may use terms which you might want to ask. Ask your doctor to define attack and flare-up so that when you see him you will "be on the same page".
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Old 09-12-2012, 12:37 PM   #4
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Re: Attacks vs Flare ups ect...

Thanks for your reply!

I was thinking new symptom, and that it meant nothing because it was so short. But I thought too, that I have had sciatic pain, and a period of it was bad enough I could barely walk, like my leg/hip was just giving out on me. SO I wondered if (Hypothetically) Ms linked, that could be like min flare or something, just the left over symptoms of that sciatic issue. I know I'm speaking with little knowledge here, so hope that makes sense.

I feel pressure around my eye, but since the numbing I'm not too sure if its just numbing or pressure, I definitely have pressure on that side of my head. And then the vision is like diminished color, like a graying, and some blurring that the eye doctor couldn't find an explanation for.

Right now my doc is wanting the MRI, she's also wants me to come back in for my GI issues, so we can get me to a GI specialist. But I don't have insurance, my husband have looked into insurance, trying to figure out what we need and if we can make it happen. At this point I am apply At OHSU for a discount on the MRI, and I think we are kinda waiting till that happens to see where we will need to go.

So is the eye doctor or regular doctor checking my pressure on my optic nerve kinda useless? I have read some about the VEP test, and thought that may be a good idea depending on what the MRI shows, cause there definitely is something going on there. I let my eye doctor tell me pretty much that It was all in my head, I didn't go back to her, but it left me feeling crazy till all this came up with my regular doc.

Quote:
Originally Posted by MS22 View Post
An attack or flare is the same thing basically. They have to last between 24-48 hours for most docs to consider them a true flare instead of a pseudoflare and consider treating them.

What I think you are asking about is a new symptom. They also have to go on for >24 hours to be treated. Most of us have to have motor symptoms to be treated with IV steroids (not just sensory.)

Your eye symptoms I am guessing consist of decreased vision along with numbness are what are getting your MRI. That is a good thing.

The electrical shock symptom you are feeling could be from a number of things. Of course we have all felt electrical shocks...pains etc. Where yours starts and stops are a bit curious anatomically just due to where the nerve runs. However, you may have an inflamed disk or something.

Have you had numbness or weakness in your limbs?

I hope your MRI is clean...I don't wish this disease on anyone else!

OH, did you see an ophthalmologist when you had your eye problems? It would be a good idea. They can do a VEP to check your optic nerve...it is a very sensitive test. Many neurophalmologist offices have it, and some regular MD ophalmologists have the test as well (retina specialists).

 
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Old 09-12-2012, 12:48 PM   #5
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Re: Attacks vs Flare ups ect...

Thank you!

I'm so sorry you are going through this.

I remember reading something you said about using a fan on your legs. I related to that so much. I also use hot baths to help with my legs and now my arm, but I have become more sensitive to the heat so now if I do it, then It makes things worse, so I'm frustrated about not having that little bit of a brief relief anymore.

There's a part of me that's feels like no way this could be MS, (along with other stuff going on, I was thinking maybe if I do have MS, that affects the immune system? Kinda beats your body down?) But it also would make perfect sense of things. At the same time, it's quite scary, especially thinking about the worst of the pain, and knowing it could be worse, or the possibility of my eye sight not getting better, I don't drive at night now at all, it has to be something very important. I don't feel safe doing it. My heart really goes out to you guys!

I have also done MS walks, and I wanted so bad to make it a run this year, and it just wasn't possible, I have just been too weak. The thought of that not being a possibility ever is sad, but it's a goal I won't give up on.

Quote:
Originally Posted by MSJayhawk View Post
Attack versus flare-up (from my MS pamphlet I got from my doctor):

"An exacerbation of MS (also known as a relapse, attack, or flare-up) causes new symptoms or the worsening of old symptoms. It can be very mild or severe enough to interfere with a personís ability to function at home and at work. No two exacerbations are alike, and symptoms vary from person to person and from one exacerbation to another."

Note to be considered a true exacerbation, the attack must last at least 24 hours and be separated from the previous attack by at least 30 days.

An exacerbation can last for a few days OR months! I am currently battling nerve pain as you described. For me it started the 2 week of August and may last until November/December. on a 10/10 scale I went through a few days of 12's. I use a heating pad which, for me, is the most relieving treatment I have found. I start at the point of the most pain and I will follow the pain from there before I start all over.

Confused? Your doctor may use terms which you might want to ask. Ask your doctor to define attack and flare-up so that when you see him you will "be on the same page".

 
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Old 09-12-2012, 01:01 PM   #6
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Re: Attacks vs Flare ups ect...

Your eye doctor can check your color vision (ishihara test), and test your visual acuity. If you can read 20/20, you probably do not have optic neuritis.

ON does come with pain behind the eye, and can have soreness. The color change usually consists of a dulling of color, usually red colors. I have optic nerve atrophy in both eyes from having many episodes of ON. I can no longer drive because my vision is like 20/200 in each eye.

The eye doctor also looks in your eye at your optic nerve to check for inflammation. On occasion, the optic nerve can be inflamed behind the disk and the doctor cannot see it, therefore an MRI is needed to check for retrobulbar optic neuritis.

It is good you are getting the MRI.

It does sound more like you have sciatica for the leg pain.

I would wait for the MRI before trying for a VEP. You might want to invest in insurance, even a cheap plan, before you get the MR just in case you have anything...might not be MS but something else, and then you have a preexisting condition.

 
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Old 09-12-2012, 02:38 PM   #7
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Re: Attacks vs Flare ups ect...

Yes, at night I will often overheat; therefore, I do better with a fan blowing over my legs.

I would love to have days even hours free. I have found that because this is not possible, I reset my benchmark. What are good days for me might be bad days for others. It can be frustrating in waiting for brief relief, but if you linger on with such a thought, it can cause you stress which you do not need.

The heating pad can drain your energy, but pain relief for me is better.

I do not do much night driving nowadays simply because at the end of the day, I am tired! I do drive with hand controls and would encourage any MSer with leg concerns to get hand controls.

I hope you do better soon and I certainly hope you get answers!
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