Being diagnosed with multiple sclerosis (MS) presents new and important challenges, not just for those with the disease, but also for their loved ones and their caregivers. Moving forward, a person living with MS will be required to make personal adjustments and receive strong support from family, friends and organizations. By being proactive, those living with MS can take back control, find balance in their everyday lives and adapt to all the lifestyle changes that will occur.

The following sections provide strategies and insight into:

Lifestyle changes

Living with MS is a lifelong journey through which people develop awareness of their behaviours, nutrition, lifestyle and activities, which in turn could enable them to lead their best lives. It is an ongoing process that involves taking action and making positive choices across a whole range of areas.

  • Everyday tasks
  • Mobility 
  • Exercise
  • Energy levels and fatigue

  • Nutrition
  • Stress
  • Depression and anxiety
  • Bladder and bowel functions


EVERYDAY TASKS


Out and about

  • Many pharmacies offer a delivery service that can drop off regular prescriptions to your home, infusion clinic or doctor’s office. Doctors, nurses and pharmacists can provide information about how to start using this service.
  • Use a mobility, or motor, aid, such as braces, canes, crutches, walkers, wheelchairs or scooters, for the type of activities that demand more effort – like choosing a present or shopping for something to wear for a special occasion – to help you conserve energy.
  • In advance of going somewhere for the first time, research the facilities to help you efficiently plan your trip. Consult a map or diagram – are there elevators, steps, escalators or ramps?
  • People who can drive might want to consider switching to a car with an automatic transmission. If legs get weak, it may help maintain a sense of independence.
  • When considering a trip by plane or train, it is also important to plan ahead. Making sure there is plenty of time to make any connections and that elevators or ramps are available can make a real difference.

Shopping for groceries

  • Plan your menus before going shopping and bring a shopping list with you.
  • Use the same grocery store on a regular basis so you can become familiar with the layout and find what you’re looking for quickly.
  • Buy online and have items delivered right on your doorstep or use a home delivery service.

Kitchen and cooking arrangements

  • Store commonly used items on shelves or in areas that are within easy reach in order to minimize reaching, bending or stretching.
  • Keep cooking pots, pans and utensils near the stove and plates, glasses and eating utensils close to your sink or eating area.
  • Use trays or wheeled carts to move many items at a time and/or heavy items.

 

Meal preparation

  • Make sure you have good lighting and ventilation in your cooking area.
  • Gather everything you need to prepare a meal and then sit down while preparing it.
  • Choose foods that are easy and quick to prepare, such as dehydrate, frozen or canned foods or packaged mixes.
  • Double recipes and then freeze half for another time.
  • Slide heavy items across the kitchen top instead of lifting them.

Cleaning

  • Spread cleaning tasks out over a whole week instead of doing them all in one go.
  • Alternate heavy cleaning tasks with light ones and either get someone to help you or break up the heavier cleaning tasks into multiple steps.
  • Use brushes, mops or dusters with extended handles to avoid bending, stretching or reaching.

Laundry

  • Wash one or two loads as they accumulate instead of doing multiple loads less often.
  • Collect clothes in one place (e.g., a hamper) and then bring them to the laundry room in a wheeled cart if possible.
  • If your laundry room is in the basement, plan to stay there until your laundry is done and set up a place to relax while you wait.
  • Sit down when you iron and adjust the height of your ironing board as necessary.
  • Buy clothes that are easy to wash and care for.

Dressing

  • Lay out the clothes you are going to wear the next day from the night before.
  • Try to sit down while dressing.
  • Dress the weaker side of your body first, but undress the stronger side of your body first.
  • Use a long-handled shoe horn to avoid bending.
  • Wear clothes with Velcro fastenings or something equally easy to do and undo. This could make it easier to get dressed, undressed and go to the toilet.
  • Wear loose-fitting clothes with elastic waistbands rather than buttons or zippers.
  • Look for wrap-around rather than pull-over type clothing and clothing that opens in the front rather than the back.

Climbing stairs

  • When going up the stairs, step up with the strong leg first; when going down the stairs, step down with the weak leg first – the saying “up with the good, down with the bad” will make this easy to remember. In doing so, the strong leg does all the lifting and lowering.

Bathing and showering

  • Keep your toiletries together by the bathtub or shower.
  • Use grab bars to safely get in and out of the bathtub.
  • Use a tub bench or stool when showering or bathing.
  • Avoid hot water when showering or bathing as it increases fatigue.
  • Use a thermometer to check the temperature of your bath water.

Infant and child care

  • Avoid using your back muscles when lifting an infant or a child; make sure to always use your leg and arm muscles.
  • Wash, change and dress an infant or a child at waist height.

Working at a desk

  • Arrange the height of your desk and chair in a way that will help you maintain proper posture, which in turn reduces shoulder and neck pain.
  • Use a chair with good back support.
  • Arrange your computer, filing cabinets and other office equipment so they are as accessible as possible.
  • Rest the receiver on your shoulder to free your hands during long phone conversations or use a device that makes your telephone hands-free.


PRACTICAL TIPS FOR EVERYDAY TASKS

The following are practical lifestyle tips for managing everyday tasks, errands and responsibilities for people living with MS:


MOBILITY


Mobility means different things to different people.

For some, it means being able to go on long walks on the beach, while for others it means being able to get around and just run normal errands. No matter what mobility means to each of us personally, the ability to get where you want to go is important to everyone.

For those living with MS, it is important to recognize what symptoms may affect their mobility and to know that treatment options exist.

For a more in-depth look at MS and mobility CLICK HERE.


EXERCISE


It has actually been proven that exercise is your friend when you have MS. The benefits extend to both mind and body as it helps you develop a positive attitude and improves your overall ability to function.

Exercise not only helps reduce fatigue, depression and anger, but it also helps rebuild important connections and create nerve growth factors in the brain and nervous system. Studies have shown that exercising on a regular basis can also improve muscle strength, heart health, and bowel and bladder control. 

Please consult with a physician before starting any exercise plan.

There are 9 simple, quick and effective exercises that can be done anytime, anywhere – even while sitting on the toilet! All you will need is a chair, a bed or a sofa and the floor.

  • Lying knee bend
  • Knee roll
  • Bridging
  • Pelvic tilt sitting
  • Sideways lean
  • Single arm raise
  • Leg lift
  • Lunge
  • Stepping balance

CLICK HERE to download a more detailed description of these exercises.


ENERGY LEVELS AND FATIGUE


People living with MS can learn to renew and refresh along the way.

Being rested improves overall endurance and can provide you with the strength and energy to enjoy your favourite activities. Taking the time to rest during the day is a smart way to pace yourself for the day ahead.

Knowing when and how to conserve energy can help you manage the fatigue that can be so frustrating and debilitating when living with MS.


NUTRITION


Maintaining good health in general is very important for people with any chronic disorder and eating a healthy, well-balanced low-fat, high-fiber diet will help you achieve just that. Although there is no recommended “MS diet” or any evidence to support nutritional therapy in the treatment of MS, what and when you eat is greatly beneficial to your overall health. It improves energy levels and bladder and bowel control, and decreases the risk of heart disease, certain types of cancer and obesity.

Below are a few tips to help you with the planning and research required to achieve your nutritional goals.

Your daily checklist

Healthy eating is more than WHAT you eat. It is also about WHERE, WHEN, WHY and HOW you eat.

  • Be mindful of your eating habits
  • Take time to eat
  • Notice when you are hungry and when you are full
  • Cook more often
  • Plan what you eat
  • Involve others in planning and preparing meals
  • Enjoy your food
  • Culture and food traditions can be a part of healthy eating
  • Eat meals with others

Make healthy food a habit

  • Eat plenty of vegetables and fruits, whole grain foods and protein foods.
    • Choose plant-based protein more often.
  • Choose foods with healthy fats instead of saturated fat.
  • Limit highly processed foods – eat them less often and in small amounts.
  • Prepare meals and snacks using ingredients that have little to no added sodium, sugars or saturated fat.
  • Choose healthier menu options when eating out.
  • Make water your drink of choice.
  • Be aware that food marketing can influence your choices.
  • Choose foods that suit you and enable you to maintain an ideal weight for your height.

Maintaining health with good nutrition

  • Vitamins and minerals → play a vital role in the body’s chemistry, help nerves and muscles function properly and give strength to bones and teeth.
  • Carbohydrates → are an essential source of energy and assist muscles in using fat for energy.
  • Proteins → help growth and tissue maintenance and repair.
  • Fats → help the body absorb important nutrients, help insulate the body against heat and cold, and protect vital organs.
  • Fibre → makes stool softer and, therefore, easier and faster to eliminate.
  • Water → as the “medium of life processes” (our bodies are 60-70% water) water is essential for the body: it carries nutrients, removes cell waste and regulates body temperature.

Remember, proper nutrition is important for everyone – perhaps even more so for those living with a chronic illness such as MS.


STRESS


How often have you heard people say to you to just relax? Easier said than done, right? This is especially true when living with MS. To really give yourself a mental break, try to identify what is causing you stress and find ways to avoid it (if possible).

Below are a few techniques to help you manage stress and take back control:

Starting mornings right

Less stressful mornings demand some effort.

Learn to think in 24-hour periods: schedule more demanding tasks earlier in the day, as you’ll probably feel more tired as the day progresses. Get up 15 minutes earlier, make some preparations (such as setting out your clothes) from the night before and delegate a morning task so you don’t become overwhelmed. Try not to complicate how you start off your day; certain projects can be done later on in the day when you have more time.

The importance of relaxation

In times of stress, step back and take a deep breath. Then, take the time to destress.

Try a two-minute relaxation break.

If you notice you are breathing in a short, shallow pattern, then that’s your signal you are stressed out and need to take a break. Go to a quiet room, get comfortable and take some deep, slow breaths, while trying to relax every muscle in your body.

  • Start by inhaling slowly and deeply through your nose. Hold your breath for 4-5 seconds and then exhale slowly through your mouth.
  • Concentrate on what areas of your body feel tense or cramped.
  • Close your eyes, focus on the areas of tension and then relax and concentrate on the change.
  • Move your head forward and backward, as far as you comfortably can, while keeping your shoulders level. Feel the tension in your neck, shoulders and upper body, and then relax and concentrate on the change.
  • Stop immediately if you experience any discomfort.
  • Arch your back and push your arms upward while moving away from the back of the chair. Concentrate on the tension in your back and shoulders, and then relax and concentrate on the change.
  • Allow all your muscles to completely relax.

Stretch out, take another deep breath and then exhale slowly.

Calming the mind

While this is easier said than done, practicing this technique on a regular basis will help train your mind to calm down. It is an exercise you might find frustrating at first, or require some practice with, especially if you have trouble paying attention or concentrating, but in the end, it can be an enjoyable relaxation exercise.

  1. Choose a time when you have about 10 minutes free of any interruptions.
  2. Find a quiet place, free of noise or distractions.
  3. Loosen any tight clothing, take off your shoes and sit comfortably.
  4. Close your eyes, inhale slowly and deeply through your nose and exhale slowly through your mouth. Repeat a couple of times.
  5. With your eyes still closed, try to visualize a pleasant, restful place – your safe place.
  6. Try to visualize as many details as possible: colours, smells, sounds, etc.
  7. Concentrate on your safe place.
  8. If you have trouble visualizing your safe place, concentrate instead on one particular word, such as “calm”, or think a peaceful thought, such as “I am loved”.
  9. If your mind starts to wander, gently bring it back to your safe place or your chosen word or thought. Alternately, do another cycle of deep breathing.
  10. End with a good stretch and a deep exhale.

Deep breathing

Deep breathing can help you relax as well as help your mind and body feel more comfortable. Deep breathing only takes a few minutes and can be done anytime, anywhere. Practice it first thing in the morning and any time you feel stressed out.

Here’s how to do a deep breathing exercise:

  1. Sit comfortably with your back straight and your shoulders rolled back.
  2. Place your hands on your belly so you can feel it move as you breathe.
  3. Inhale through your nose slowly and deeply and try to follow the cool air as it spreads throughout your body.
  4. When the air reaches your belly, let your belly expand. The hands on your belly will help you feel the movement.
  5. Inhale as deeply as you can, then hold your breath for 4-5 seconds.
  6. When you’re ready to exhale, do so slowly by letting the air out between your lips.
  7. Focus on the warm air leaving your body.
  8. Feel your belly deflate under your hands.
  9. When there’s no air left in your lungs, sit quietly and then repeat the inhale-exhale cycle.
  10. Sit quietly for a few minutes and enjoy the calm.

Practical things to help with day-to-day stress  

  • Make a schedule and spread hard and easy tasks throughout the day.
  • Rest before you become exhausted and take frequent breaks.
  • Break activities into smaller tasks or enlist someone’s help.
  • Prioritize and do only what is absolutely necessary.
  • Use mechanical aids.
  • Use a fan or air conditioner to avoid getting overheated.
  • Use a microwave oven instead of a conventional one as it generates less heat.

  • Find less demanding fun/family activities to avoid pushing yourself to exhaustion.
  • Maintain a positive attitude and build a strong social support network.
  • Choose easy- and quick-to-prepare foods.

  • Rest often so you have energy for activities you enjoy.
  • Conserve and use your energy wisely.


BLADDER AND BOWEL FUNCTIONS


At some point during the course of the disease, many people living with MS will experience problems with incontinence (lack of bladder control) and urination. Specific bladder dysfunction problems common in MS include incontinence, which occurs mainly at night while sleeping, increased frequency of urination, urgency, dribbling and hesitancy. These issues can impact energy levels by interfering with sleep patterns, kidney health, infection prevention, personal independence, self-confidence and overall quality of life.

An urologist is a doctor who specializes in treating bladder dysfunction problems and who can suggest ways to help you manage your bladder problems by:

  • Drinking enough fluids to keep your bladder flushed
  • Urinating frequently on a schedule with set times as well as voiding completely (until you feel there is no urine left in your bladder)
  • Treating bladder spasticity with medications
  • Wearing incontinence pads or devices for extra protection
  • Doing regular pelvic floor (Kegel) exercises to strengthen pelvic floor muscles, which in turn improves bladder control

Specific bowel dysfunction problems most common in MS include constipation, incontinence (lack of bowel control) and diarrhea.

For those experiencing constipation, incontinence or diarrhea, which may be caused by limited physical activity and/or nerve damage, suggestions include:

  • Training your bowels – having bowel movements at the same time every day
  • Drinking 8-12 glasses of fluids daily
  • Taking medications for constipation
  • Increasing fiber intake


DEPRESSION & ANXIETY


For people living with MS, as well as their families, one of the most challenging symptoms of the disease is depression. It therefore follows that they would like to learn how to recognize, understand and manage the mood changes that so often accompany depression.

People living with MS consistently say that learning how to deal with these mood changes, along with a healthy diet and regular exercise, is very important to achieving personal wellness.

However, MS patients who suffer from more severe mood changes may not be able to implement any self-care strategies, such as MS management, emotional wellness strategies, regular exercise or a healthy diet.

Therefore, efficient depression management is necessary to help those living with MS feel better and improve their quality of life, as well as to make it possible for them to practice self-care and implement lifestyle changes to improve their overall health and well-being. Talk to your doctor about finding ways to manage depression.

Mobility

Mobility means different things to different people.

For some, it means being able to go on long runs or hikes, while for others it means being able to walk and perform their daily activities just like they always have. No matter what mobility means to different people, the ability to get from A to B is something that is important to all of us.

In multiple sclerosis (MS) nerve cells, or neurons, which carry messages to and from the brain and the rest of the body, get damaged. This slowed or sometimes altered nerve performance can result in muscle weakness and stiffness (spasticity), pain, fatigue, unsteadiness and dizziness, and shaking and loss of coordination, which can all affect a person’s ability to move around and be active.


Keeping track of changes

For those living with MS, it is important to recognize and acknowledge changes in their physical condition. The progressive nature of MS can include exacerbations (also called attacks or relapses that cause a sudden onset of new symptoms or worsening of old symptoms) and remissions (in which symptoms return to their previous level or stabilize). Keeping track of changes in mobility is very important. It can provide your health care team with information that can be compared over time.

Using a pedometer , a device that often looks like a watch and counts each step a person takes, can provide a measure of how long it takes to walk a certain number of steps. Consider using a pedometer to measure how long it takes to take a set number of steps and keep a log book to measure mobility changes.

Keeping a record of results in a journal or with the use of a smartphone app can be useful.


MOBILITY AIDS AND MEDICAL TREATMENTS


There are many approaches that can be taken to help manage mobility issues including exercise, physical therapy, mobility aids and medical treatments.

When looking for a mobility device, consider needs, lifestyle and budget.

Mobility aids can help people get where they want to go while helping them conserve energy and preventing them from falling. For example, by using a walking stick in the morning for everyday tasks could help people living with MS preserve their energy to enjoy other activities, accomplish more during the day and even walk unaided later on in the day.

Discuss your mobility issues with your doctor and ask about a medical treatment that can help manage mobility issues in adults living with MS.

SYMPTOMS THAT CAN AFFECT MOBILITY

One or a combination of several MS symptoms can influence mobility. These are discussed below.

Fatigue

  • Fatigue is an overwhelming sense of physical or mental tiredness and is the most common symptom of MS.
  • It may be caused by a combination of damage to the central nervous system (CNS), medications used to treat MS symptoms, and certain MS symptoms such as muscle weakness or stiffness, sleep disorders, pain, physical deconditioning (due to lack of exercise), and psychological factors such as anxiety, depression and chronic stress.
  • Fatigue may cause other MS symptoms, such as difficulties with balance, vision or concentration, to get worse temporarily or may bring on symptoms experienced during previous relapses.
  • It occurs whether or not you have MS, following overexertion or a lack of sleep, for instance.

Changes in vision and vision problems

  • Damage to the nerve pathways that control eye movement may cause a lack of coordination between the two eyes, resulting in double vision (diplopia) or twitching eye movements (nystagmus).
  • Inflammation of the optic nerve (optic neuritis) – the most common visual disorder in MS, which can affect one or both eyes – can cause pain with eye movement, colour disturbances, blurred vision or blind spots.
  • The symptoms of optic neuritis may be worse in the first few days or weeks but then gradually improve. Some people recover within a month and others within a year. The good news is that most people regain normal or nearly normal sight.

Muscle spasms and spasticity (muscle stiffness)

  • Spasticity means involuntary muscle stiffness and spasms, or sudden muscle contractions.
  • Spasticity is believed to be caused by increased sensitivity in the areas of the muscles responsible for tightening, relaxing and stretching. This may be caused by demyelination (damage to the protective cover – the myelin sheath – that surrounds nerve fibres) of the nerves connected to the affected muscles, which in turn leads to excessive firing.
  • In more severe cases, the spasms are painful and may cause twisted arms and legs, which can affect mobility and other physical functions.

Muscle weakness

  • Muscle weakness is caused by the poor transmission of messages along damaged nerve pathways within the brain and spinal cord.
  • Muscle weakness in arms and legs may cause people to experience difficulty walking.
  • Muscle weakness is often associated with fatigue.
  • While exercising is good, excessive exercising may cause fatigue and actually worsen muscle weakness.

Decreased balance and dizzyness

  • Damage to the complex nerve pathways in the brain that coordinate vision and other inputs needed to maintain balance can cause dizziness or problems with balance.
  • Other MS symptoms such as muscle spasms, stiffness and weakness along with a lack of endurance and coordination, may also influence balance and therefore impair walking, which is a major problem in MS.

Changes in sensation and pain

  • Damage to nerves can cause abnormal sensations such as numbness, burning, aching, tingling, and electric shock or pins and-needles sensations. People with MS also often complain of pain, which may sometimes be difficult to differentiate from non-MS pain.
  • Other MS symptoms such as muscle weakness, spasticity (muscle stiffness and spasms) and difficulty balancing may affect posture, which in turn could also cause low back and joint pain.

Tremors

  • Tremors are uncontrollable shaking or trembling to-and-fro movements of the extremities and sometimes of the head and neck.
  • The most common tremor in MS is caused by damage to an area of the brain called the cerebellum, which is responsible for balance and for coordinating muscle movement.
  • Not every tremor is related to MS. An example of a non-MS tremor would be the shaking or trembling a person might notice when their arms are outstretched.

Rehabilitation, occupational therapy and physiotherapy

Rehabilitation specialists can help to identify the tools and strategies that best meet mobility and accessibility needs, keeping people living with MS active, productive and involved. If symptoms begin to interfere with everyday activities, a rehabilitation team can address problems with mobility, dressing and personal care, role performance at home and work, and overall fitness.

The rehabilitation plan for a person with MS depends on the nature of that individual’s disability or disabilities, but is likely to involve:

  • Physiotherapy (stretching, strengthening and retraining muscles to improve function)
  • Therapy for speech and swallowing difficulties

  • Occupational therapy (to enhance independence and safety in all activities related to personal care, employment and leisure activities)

Rehabilitation will often focus on two main areas:

Improving all levels of function that may have been changed or lost (following a relapse or attack, for example)

Maintaining the best possible function as the disease progresses

Monitoring symptoms and relapses

MS usually progresses through various stages and manifests in different ways for different people. People with MS develop varying degrees of visual, cognitive, physical and psychological disability, depending on which area of the central nervous system is affected. [O’Connor, 21T] Along the way, it is very important to monitor and record symptoms as the condition progresses. Most importantly, identifying when relapses occur and making note of them will be helpful information to bring to the attention of your doctor.


RELAPSES


A relapse is a relatively sudden episode of MS symptoms lasting more than 24 hours, occurring at least 30 days after the onset of a prior relapse, in the absence of fever or infection.

An MS relapse (also referred to as an attack, exacerbation or flare-up) occurs when new symptoms appear or existing symptoms suddenly get worse in a person who has been diagnosed with MS.

The symptoms of MS relapses differ from person to person, often vary in frequency and severity, and can change and fluctuate over time.

Symptoms may come and go and people may feel better but later experience episodes of worsening symptoms.

Recording how long relapses last and what symptoms you experience can help your MS team learn more about what is happening.

Relapses can be very mild and have little effect on your ability to function or they can be severe and interfere with your ability to carry out normal tasks at home and at work. It is important to keep track of when these relapses occur.

Speaking openly about MS

Talking about MS can be hard, especially soon after diagnosis. However, it is an important step in learning how to live with MS.

It is up to you whether or not to tell people you have been diagnosed with MS. However, your family and close friends may be able to help you get used to your new diagnosis and learn how to live with this change.

It is okay to talk about it.

Certain MS symptoms – depression, bladder issues and changes in sexual function –may be more difficult to talk about, but speaking with a doctor is important as they may not otherwise ask you and many of these symptoms can be managed successfully.

Doctors are trained to deal with both the physical and emotional aspects of living with MS and can help connect you with the resources you may need.

Whatever approach is chosen, those living with MS are the ones who make the decision.

Talking to family and close friends openly and honestly about your MS diagnosis is also important and can help shed light on what they too are going through. Grief and worry are normal emotions for family members to feel when someone they love has news about their health.

MS affects families, not just individuals.

Though it may be difficult at first, talking openly and honestly about your thoughts and feelings can make it easier to deal with MS.

Organizations such as the Multiple Sclerosis Society of Canada (MSSC) provide services to people with MS and their families and fund research to find the cause and cure for this disease.

Turning to organizations such as these for assistance in overcoming challenges is an important first step, as they aim to provide help to as many people affected by MS as possible.

– Talking to a doctor

Doctors are partners in managing MS

Managing MS is a team effort and requires the partnership and expertise of many different health care professionals, each bringing to the table a unique set of skills in managing the disease and its many symptoms. The goal is comprehensive and coordinated care to promote comfort, function, independence and wellness. In most cases, the neurologist serves as the team leader, as it is their job to diagnose MS, find treatment strategies and coordinate treatments with the rest of the team.

People may wish to speak to a doctor or MS nurse about their treatment options if they:

  • Are newly diagnosed with MS
  • Want more information on treatment options
  • Have started a new medication
  • Notice the present MS treatment does not seem to be working as well as it used to
  • Think they may be having side effects from the MS treatment
  • Are having trouble giving themselves injections

  • Are having trouble remembering to take their medication
  • Are not quite sure how to use their medication
  • Find their MS seems to be getting worse
  • Are pregnant or breastfeeding
  • Are planning a pregnancy
  • Have any other concerns or questions about their MS or MS treatment

CLICK HERE to download a list of questions designed to help you prepare for your next doctor’s visit.

Doctors will likely ask many questions about a patient’s health.

Be prepared to describe your symptoms and how they may be affecting your daily life, talk about any other medical conditions you may have and whether you are taking any other medications.

Make a list of changes that occur. Recording symptoms between appointments can be helpful.


Start by creating a “Questions to ask your doctor” list. Some things to consider include:

  •  Do I have MS or could another condition be causing my symptoms?
  •  Which form of MS do I have?
  •  How does MS progress?
  •  Is there any way to predict how my condition will change over time?
  •  What treatment options are available to me?
  •  What are the benefits and risks of each option?
  •  Do any of the available therapies alter the natural course of the disease?
  • How are MS drugs administered?
  • Why are some MS therapies administered by injection?
  • Are there different injection schedules for the various MS drug treatments?

  • Which treatment option would you recommend for me and why?
  • Are some MS medications easier to use than others?
  • How does the treatment work?
  • When will the treatment begin to work?
  • How long can I expect the treatment to keep working for me?
  • What are the side effects and how should I manage them?
  • Will the treatment interact with any of my other treatments, foods or activities?
  • Do you have any other tips for coping with MS?
  • Are there any lifestyle changes that would help me manage my MS?
  • Where can I go for more information and support?

Some people like to bring a family member or close friend to their visit for support, to help them remember what the doctor said during the visit and to remind them to ask the questions they had prepared for the visit. If so, arrange it in advance so the person will be available to attend.

– MS and work

Everybody experiences MS differently.

After being diagnosed with MS, some people may find they can continue to work as before, while others may have to make changes and adjustments. Disease-modifying drugs, new technologies, better symptom management, legal employment protections and community resources can help you remain employed and stay employed for longer.

Career choices are personal ones and going over options will help identify priorities and lead to rational and informed decisions.


Exploring employment options may involve thinking about some of the following:

  • Modify your work schedule (e.g., flexible work hours, working from home, shift change)
  • Modifying your workstation (e.g., relocating it closer to the washroom or raising it)
  • Modifying your job description
  • Training for another position within your organization

An important role

Planning for uncertainty can be very hard for people living with MS, eroding their coping skills and often causing depression and social isolation. In the face of such challenges, maintaining a healthy, loving relationship with your spouse or partner will be of the utmost importance.

People with MS often have difficulty asking for and accepting help, while the people who want to help them also feel inadequate.

Family members and friends will react and cope in their own way, and in their own time. MS will impact their lives as well. They may be faced with taking on more responsibility and having to manage their own feelings of depression, anger and stress. 

Be realistic about the kind of care you need (at-home care or nursing home?) and what your caregiver can and is willing to offer in terms of time, types of care and financial support.

Strong, honest communication is key.

Ways to help

Living with MS requires a team effort by the caregiver and the person with MS.

Levels of care will vary for every individual, and as MS changes over time, those living with it will require a wide range of support from caregivers.

Assistance may involve addressing few functional difficulties at first (such as helping with injections or being present when consulting with health care professionals) but later demand more daily attention (such as toileting, feeding, dressing, etc.). Emotional care will also play an important role as MS presents new challenges, and will demand flexibility and understanding for all those involved.

Employment, financial planning, transportation and housing considerations represent some of the many practical decisions that will need to be evaluated. Reaching out to those with the proper expertise will be important.

The more you and your caregiver can each learn about MS, the better able you will be to deal with the challenges ahead.

Medical professionals

Health care professionals are partners in MS.

An MS health care team can include few or many members:

  • General practitioners or family doctors
  • MS nurses
  • Neurologists
  • Rehabilitation specialists (physiotherapists, occupational therapists, speech and language therapists)
  • Nutritionists
  • Mental health specialists (psychologists, psychiatrists, neuropsychiatrists)
  • Urologists
  • Pharmacists

Collectively, they can help explore opportunities and provide guidance. They can also provide ongoing care as the disease progresses, assess risks and benefits, and help make adjustments to treatment along the way.

Medical professionals are an excellent source of information. They are able to help you learn more about the condition, the treatment options available, how to use treatment safely and how to manage any side effects that may occur.

Community groups

MS may leave some feeling frustrated and lonely, but there are thousands of patients, caregivers and health care professionals facing the same challenges every day.

Connecting with the MS community can empower those affected by MS and help them effectively manage and cope with the disease.

Self-help, online and social media

In today’s day and age, the Internet offers those living with MS, as well as their family and friends, access to health information that allows for more personal research and self-help.

Websites and social media (Facebook, Twitter, YouTube, etc.) can provide links for finding care and community health resources and the ability to consult with social support networks and connect with people in similar situations as their own.

As people more actively and increasingly use the Internet to help shape their own personal MS management program, it is important to remember that everyone’s MS situation can be different.

Discussing all new discoveries with medical professionals before taking any actions is critical.

Multiple Sclerosis Society of Canada (MSSC)

The mission of the MSSC is to be a leader in finding a cure for MS and enabling those affected by the disease to enhance their quality of life.

Since being founded in 1948, the core support of the MSSC has been from tens of thousands of dedicated individuals, companies and foundations in communities all across Canada.

The head office of the MSSC is located in Toronto, with division offices located in Dartmouth, Montreal, Toronto, Winnipeg, Regina, Edmonton and Vancouver.

The MSSC provides services to both people with MS and their families, as well as funds research to find the cause and cure for this disease. They have 17,000 members and are the only national voluntary organization in Canada to support both MS research and MS services.

The MSSC endeavours to provide access to accurate, current and comprehensive information in a number of formats to people with MS, their caregivers, and family and friends.