barsha
Hello!
clinical profile
Today, we would like to bring to mind the portraits we have been discussing during the past days.
Nov 2008 o Reported attack of fatigue, mild coordination loss, and ”tingling in feet” for the past month associated with fatigue; MRI: 2 periventricular T2 lesions, EDSS: 2.0
WHO SHE IS
o Treatment initiation: Immediate start on injectable IFN ß-1a
38-year-old; female; mother of 2; married; homemaker; active in children’s education and hobbies Expresses extreme worry about her ability to care for her children, especially the inability to drive her sons to school
o There was activity while on treatment considered of ‘mild’ nature and not considered enough to trigger a tx switch Nov 2014 (6 years later): o 2 reported relapses in past year with worsening impairment of balance on ambulation, new concerns over bladder issues. 4 week duration with generally good recovery o MRI showed 2 new T2 lesions in the cerebellum and brain stem o Change in EDSS: 2.5 o Treatment decision: switch patient to Tecfidera
What barsha feels is most at stake: Actively participating in children’s lives
Jan 2017 (2 years 2 months later): o Bladder incontinence o Ataxia o Spinal cord MRI with 2 Gd+ lesions
“Will my MS make me an unfit mother? I am terrified that my disability won’t allow me to do something as simple as making breakfast. Someone else will have to drive my sons to school. I feel that they will only know me as the woman who was once a part of their lives—waving from the window as they play outside”
o GI side effects related to current treatment o EDSS: 3.0