Supporting individuals with disabling multiple sclerosis

The paper by Jeremy Gibson and Andrew Frank (December 2002, JRSM¹) is a valuable contribution, bringing together understandings and advice which my wife, who has suffered from relapsing—remitting MS for 20 years, only gradually acquired despite being seen by many eminent neurologists in Britain, the United States and Italy. Though she received honest advice about the prognosis and essential untreatability of the condition, the many possible remedial actions and interventions discussed by Gibson and Frank were little considered and the most useful one which was provided—help from a very skilful neurophysiotherapist—was limited to six sessions because of NHS underfunding. We are fortunate to be able to pay for a parallel intervention in the form of Thai massage, a very active intervention producing major symptomatic improvement for 2-3 days.

Two additional points may be of general interest. First, in my wife's case high environmental temperatures produce major difficulty in walking and mental confusion, but these are instantly reversible by immersion in cold water. Second, I believe she might well have ended up needing a wheelchair had she not responded to phases of increased lower limb weakness and incoordination by furiously forcing herself to walk and so discovered that this restored sensation and coordination to their usual level. Phases of mental slowness are, it seems, similarly relieved by playing (and usually beating me at) chess.