Thursday, October 20, 2011

Have you ever fallen?


Raise your hand if you've fallen. I bet you didn't have to think long to come up with that answer. Most of us cannot remember what we ate for dinner yesterday without thinking about it a little while, but, boy, those falls are permanently imprinted on our memory and often come to mind at unexpected moments like other embarrassing situations that we have endured.

Most MS symptoms can be covered up. Bladder accidents can usually be hidden. If you have problems with your speech, you can simply participate in conversation with one-word answers. People with tremor often keep their hands clasped when not using them. However, a fall is public and obvious. And humiliating. If it happens when one is alone, it can be scary.

Falls separate us from "healthy" people in a very literal way. We are completely alone in that moment when we hit the floor, no matter who we were standing with seconds before. As we struggle to get up, our first instinct is to reassure everyone, including ourselves, that the fall was "no big deal," that we are "just fine."

However, often we are not "just fine." Among adults with MS who experience difficulty walking, 60% report that they have fallen. These are usually not isolated incidents, either – typically those who have experienced falls report having fallen about three times in the prior six months. Beyond psychological and emotional impact of falls, there is a very real physical danger, as one-third of the people who report falling say that a fall resulted in an injury.

This data comes out of a study presented at ECTRIMS 2011 by Dr. Nicolas LaRocca, Vice President for Health Care Delivery and Policy Research at the National MS Society. The survey, entitled, "The Frequency and Impact of Walking Impairment in MS," shines a light on a subject that often gets overlooked by researchers and docs, and often goes unmentioned by patients. In fact, although the majority of people with MS report difficulty walking or maintaining balance, 40% of people discuss this symptom with their doctor "rarely" or "never."

According to the survey findings, younger people with MS are less likely to bring up their walking difficulties with their doctor - on average, people with MS aged 41 or younger who do discuss trouble walking with their doctor initiate the conversation only 46% of the time, compared to 54% of people who are 61 or over.

As a person living with MS myself, I can imagine some of the reasons for this. Maybe people are afraid that their docs will immediately decree that they need an assistive device, when the patient may not be ready for such a move. Perhaps there are other symptoms that are bothering them more at the moment. Maybe they are waiting for the doctor to start this difficult conversation or perhaps they are too intimidated to bring it up.

However, it is important to discuss walking or balance issues with your doc, especially if you have fallen or afraid that you might. There are many things that can be done to address these difficulties. As Dr. LaRocca stated in his presentation, "The basic activities that constitute life are seriously disrupted by difficulties walking." If there is a way to reduce unnecessary stress and challenges around this symptom, we owe it to ourselves to look into our options.

1 comment:

  1. The first time I fell 9 months ago, I was alone and it was so horribly frightening not knowing what was wrong as I didn't have a diagnosis then.
    And then subsequently I fell 2 more times each when I was alone feeling the same pverwhelming fear that I experienced the 1st time.
    I had asked my doctor if I had MS two years prior to that first fall and she knew of my walking difficutlies but I was still able to walk slowly without a cane. When I asked that question, I was told "No" and my doctor refused to further discuss the matter.
    Now 2 1/2 years later I am diagnosed, walk with a cane and have fallen several times in the past eight months and flatly refuse to return to that physician as I have lost all confidence in her.
    This is heatlth care in Canada where I am unable to find another doctor because I am offically considered to have a doctor: this moron who refused to consider the posssiblity that I had MS until my symptoms got so bad that even she couldn't ignore them.
    So in my case I can't think what the point was of telling this doctor that I had trouble walking when she could see so with her very eyes and made no move to find the reason.