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 fatigue on an
incredible
level that might have some numbness or
some tingling
well that should kind of make sense
because we'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
that might have issues with their sex
acts
they have pain itching emotional changes
and maybe very labile
they might have trouble walking
difficulties 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 into 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 have problems with their
bowel they can have some cognitive
changes
they just may not seem like themselves
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 experiences
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 complications 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 they
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 or
weakness 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
now let's look at a mobility 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's at risk for pressure
source so
secondary symptoms can be treated but
our goal as health care providers in 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 we'll
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 of the
patients 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 alters
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 a 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 she
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
conversational questions
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 that relationship
they'll open up more and more to you
now depression 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 so 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