Dr. Jacqueline Gerhart: Woman With MS Struggles With Decision to Have Children
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I am 32 and have MS. I am really struggling whether I should start a family because I am worried I might pass it on to my kids or that I will be too weak to take care of them or, even worse, that I will die young and won't see them grow up. What are my chances of this happening?
Dear Reader: I am so sorry to hear you have multiple sclerosis, and to hear you are struggling with the decision to start a family. This must be very difficult for you.
Let me first start by explaining a bit about what MS is and how you get it. Then we will discuss how likely your kids are to get it and how your symptoms may progress.
Multiple sclerosis is a disorder of the central nervous system, which consists of your brain, your spinal cord and your optic nerves. Your optic nerves are the main nerves of your eyes and are responsible for your color vision. Often, one of the first signs of MS is something called optic neuritis - where you notice changes in your visual field or in the colors you see.
So what causes these changes? Multiple sclerosis is caused when your immune system attacks the protective insulation of your nerve fibers. This insulation is called myelin.
Just as stripping the protective insulation off of an electrical wire causes an impaired electrical signal, destroying the protective cover of your nerves results in impaired transmission of nerve signals. This can result in symptoms such as numbness, weakness and decreased coordination and balance. It also can affect memory and concentration.
While most disorders related to weakness or memory loss manifest as one ages, MS is usually diagnosed between the ages of 20 and 50. It's three times more common in females, and is more common in Caucasians. But, there is no evidence that MS is directly inherited, meaning that you can’t assume you will pass it on directly to your children.
Although MS symptoms will progress over time, MS is not considered a fatal disease. Most people will live a normal lifespan. And many people will be able to live happy productive lives.
Unfortunately, the symptoms of MS are unpredictable in terms of which ones you will develop and when they will start. And most cases of MS follow a "relapsing-remitting" course, meaning sometimes symptoms will go away for periods of time and then come back much later. Sometimes symptoms may go away completely.
Regarding how to manage your symptoms once they develop, consider developing a "team approach." Your physician can help you consider medications that may modify or slow down the course of MS, and you can work with a physical therapist and psychologist. You also may need the help of specialists such as a neurologist or ophthalmologist.
The support and understanding of your family and friends is very important. You can find further support at local MS groups, or from the National MS Society.
The questions you ask are difficult ones. I truly hope that with the help of your family, friends and health care team you are able to make the decisions that are right for you.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 02/12/2013