Ask the Doctor
By Dr. Jack Burks
Q: I've been on Copaxone® since October 2010. I have large (1/2 palm-size) purple patches and (dime-size) bruising at every area where I inject, and these have not gone away. I use the auto-injector and have tried various depths. I live near extensions of Denver's Rocky Mountain MS Center and Colorado Neuro Institute facilities.
A: This is a serious problem and needs expert attention to allow you to keep taking Copaxone. You are fortunate to live near the Rocky Mountain MS Center. I would request to have a doctor or nurse specialist from the center evaluate these skin reactions. Take your injector with you so the nurse can observe your technique and make sure that the auto-injector is working properly. Another option would be to speak to the pharmaceutical patient program's nurse supervisor and explain your situation.
Q: I am a 66-year-old woman diagnosed with MS in 1983. I have had unrelieved chronic neuropathic pain for five years, and have had epidurals, cortisone injections, neuro-stimulators, Marinol®, and have seen an orthopedic doctor. Do you have any suggestions? Would Botox® help?
A: Many MS patients suffer from neuropathic pain/dysesthesias/parenthesis. However, you have not mentioned the treatments that I recommend. The first
is ice packs or cooling vests, etc. The
next approach is medication for seizures
and other pains such as gabapentin (Neurontin®), pregabalin (Lyrica®), duloxetine (Cymbalta®), carbamazepine (Tegretol®), and others.
Q: I was 33 when diagnosed with MS almost two years ago. I had been experiencing numbness and tingling, and was prescribed 1,000 mg daily IV infusion of Solu-Medrol® for five days. My only previous experience with steroids was with 10 mg oral prednisone, and I experienced shortness of breath and chest tightening. I was given Tylenol® and a Benadryl® for any allergic reaction and then began the IV infusions. One day after stopping the Solu-Medrol, I had an IPH brain hemorrhage stroke on my left side. Have you ever experienced any problems similar to this? Also, this incident delayed my starting Rebif® until July of 2010, following an MS attack in May. My MRI at that time showed new lesions. Could the delay in treatment have caused these new lesions or attack?
A: I have not encountered a brain hemorrhage after steroids in my 40 years of seeing MS patients and treating hundreds of MS patients with steroids. I could not find any references in the medical literature that documented such an event. I feel very badly for you. In my opinion, steroids seem like the appropriate treatment for your symptoms.
Q: How is one's sex life affected by MS? In our case, the relationship is good, but I am suffering because of our lack of intimacy. My husband has decided to sleep in a separate bedroom. Although he remains faithful, he doesn't want to go for outside help. Can you give me any advice?
A: Lack of sexual intimacy plagues many couples, with or without MS. MS can cause significant sexual problems in both men and women. The most frequent issues for couples are the lack of understanding and communication between spouses. Men with MS are often helped by drugs (like Viagra®, Cialis®, and Levitra®), an injection into the penis, a vacuum pump, an implant, etc. Women are often helped by a good personal lubricant, vibrator, etc.
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Jack Burks, MD is the chief medical officer for MSAA. He is an international MS neurologist, writer, lecturer, and researcher, who assists with the development of new MS therapies.
|Last Updated on Monday, 22 June 2015 10:54|