Okay, this may sound dumb - but how do you know if a flare-up has ended?

For those of you who don't know - I'm new to this - dx 3 months ago - been in a flare - have had 2 sets of steroid treatments in that time.

The steroids helped with many of the symptoms. Some went away altogether, some went away only to return a week after each treatment. Some newer symptoms have shown up....some of these have abated, etc.

My question is - how do I know if this episode has ended - or maybe the question is - how do I even know if this even is an episode as opposed to just progression (as in - maybe I don't have RRMS)? Or maybe this was an exacerbation and it ended but I didn't return to "normal" - and these are just lingering or permanent things?

Uggg.

~Keri

Keri,

You have asked the "Million Dollar Question" to which I have not heard a clear answer.

Generally, when the symptoms are gone and funtionality returns to the previous condition, then the exacerbation is over.

Sometimes it takes a while for functionality to return to normal, and sometimes it returns with a slight decrease in effectiveness.

The details of MS progression are difficult to define. It can easily drive one crazy...so don't let it. Just take each day one at a time.

-Vic

I went to my neuro on tuesday because I was having new (and old) symptoms that were really bad and had been around for longer than 24 hours.

The neuro told me that he needed to "educate me on the difference between an exacerbation and a psuedo-exacerbation".

If that was a pseudo-exacerbation, I really dont want to see what my next actual exacerbation is going to be like. Basically all the problems that I've had for the past year or two have all been psuedo-ex's except for my two cases of optic neuritis (my 2nd symptom) and the vertigo I had last spring/summer.

I wish I knew. My first exacerbation was when both my legs went numb. I could still walk and drive - just had the pins and needles sensation and it lasted about 2 months. At the time I didn't know I had MS. Thought it was a pinched nerve.

Second exacerbation was about 2 years later when I had double vision. It totally took me out of commission and it lasted about three months. This episode got me to the doctor and I got the dx of MS.

I've had a couple of episodes since then - one visual and the one I'm in now with my right side. I was numb on all my right side (with the exception of my head) and now it's just my right hand and arm. It's been about 5 months since it started but it's slowly getting better. I believe that my right hand is probably as good as it's going to get - it's still numb but I've regained most of the function (writing and some dexterity).

It seems like my flare ups always begin in October/November, too. It's a strange disease. I start to get anxious when Fall begins now.

My Neuro says I'm still RRMS.....I have no idea how they determine which stage you are. If I went to my Neuro with every ache and different symptom I have I'd be there every week!! I tend to wait and watch - and try not to get to freaked out over any one thing. It is what it is and I'm not going to do IV steroids anymore - I'll just wait it out if it's a true exacerbation.

Your dx is still fairly new - I know when I was first dx I micromanaged my MS to the point of distraction. I didn't want it to consume every minute of my life so I just decided that, although I do take a DMD, I was not going to let it rule every moment of my life. If something really strange happens then yes, I call the doctor. Otherwise - I try to work my way around it - ignore it but still stay aware of changes. Just my way of staying sane!

Good luck to you! I'm glad you found this board - it's got a waelth of information and caring people.

Hi Keri,

Lady Express 44 explains this well in some of her posts. You might want to do a search on her posts or maybe we will get lucky and she will drop in. Here is one post from her that may help a bit
"If you are RRMS, and are experiencing "new or worsening of existing symptoms, lasting longer then 24 hrs", you either have an infection going on, or are in an attack (relapse, not remission). "
These are the exact words I use to determine what is happening. So far she has been 100% correct.

Take Care
Sheena

Unfortunately, the end and beginning of a flare can be a little confusing for some of us. My first major flare of tremors lasted for three months. The tremors went away, only to be replaced by numbness on the same side. For me, most of my other flare symptoms have stuck around. Just not as constant as they were during the flare.

I have learned to only call the neuro for very new symptoms. Partially due to the fact that he's one of those that are MRI happy. Old symptoms getting temporarily worse usually indicates (for me so far) that I have an infection,I'm overheated, or I pushed my stubborn self just a little too far.

Hang in there.

For each of us, there is a unique set of parameters. Sometimes my neuro will say it has been one attack, others she says have been a string of small ones. In other words, no one knows for sure.

The 24-hour rule is good for determining if a single event is likely an attack, but not a conclusive measure.

Only you can know your body and its relative normal. Do you keep a journal of your symptoms? I recommend it, get a dayplanner that is exclusive to your daily ups and downs, record everything that you notice. After time, patterns will emerge and it's very telling.

I agree with Vic, life can only be lived one day at a time and that is true for all people. Hang in there, you'll find your pace.

I'm with you RP, trying to figure out when to call the doc and when to take steroids, when is it a flair.

I'm in a flair now with my legs filled with jello and feeling like they're going to give out any minute, and my arms feel much the same. I'm also feeling a couple other minor things, but since I can still function and haven't gone numb or anything, I figure I'll try to wait this one out.

Like I told my husband when I picked up my walking stick. "It will either get better or worse. If it gets worse, I'll call the doctor."

Keri, the attached link might help (hopefully not make it more confusing ):

http://www.mult-sclerosis.org/whatisms.html

Erin, the definition of a real vs psuedo exacerbation is probably best described in the attached link:

http://www.mswatch.ca/ContentRoot/Ed...ry/Relapse.pdf

Cherie