YOUR HEALTH
Progress made in treatment of multiple sclerosis
DR. DONOHUE

DEAR DR. DONOHUE: My mother-in-law has multiple sclerosis. She is pretty active. She keeps house for her husband and herself; she cooks and cleans. I know very little about this disease. Could my husband come down with it? Has any progress been made in treating it? My mother-in-law rarely talks about it. -- H.Z.

ANSWER: The "sclerosis" of multiple sclerosis refers to scars found in the brain and spinal cord. "Multiple" means there are many of them. The scars result from an immune attack on the insulation material of nerves -- myelin. The attack causes myelin to crumble and leaves the nerve exposed, like an electric wire without any protective covering. Then scars form. All this interferes with the transmission of nerve messages, and that results in the typical MS signs and symptoms.

Loss of vision or double vision is often the first sign of this illness. Tingling in arms and legs is another early sign. Walking becomes a problem. Muscle weakness is prominent.

MS has an unpredictable course, and there are different varieties of it. The most common kind is the relapsing/remitting variety. Symptoms appear and then they disappear, only to be replaced by another set of symptoms differing from the first set. In time, the periods of having no symptoms become shorter, and the symptoms become permanent.

Your husband's chances of developing MS are greater than a person without any family history, but they are not overwhelming. If one parent has the illness, the child has a 1 in 50 chance of coming down with it.

In the past 20 years, great progress has been made in treating MS. Now there are medicines directed against the immune system to prevent myelin damage.

Acute attacks are treated with one of the cortisone drugs, and that has been standard treatment for many years.

DEAR DR. DONOHUE: What happens to a blood clot in a vein? Does Coumadin dissolve it? I had a clot in my left leg and was on Coumadin for it. Everything is fine now, and I am no longer taking any medicine. I wonder what happened to the clot. -- R.F.

ANSWER: Coumadin is a blood thinner. It doesn't dissolve clots; it prevents a clot from enlarging. In doing so, it also prevents pieces of the clot from breaking loose and traveling to the lungs, where they can be deadly.

Several outcomes are possible. The clot can shrivel up, and blood flow through the vein resumes as it did in the past. Or the clot can harden and a tunnel burrows through it to permit the resumption of blood flow. Or the clot can remain as is and block blood flow forever. The legs have a surplus of veins, and blood can take alternate routes to get back to the heart.

In a few instances, a persistent clot causes a condition called post-thrombotic syndrome. The leg swells. This hasn't happened to you, and it won't now that you're back on your feet.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853-6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved