The disease can be especially aggressive in Blacks
By Charles Hallman
A person living in the U.S. is diagnosed with multiple sclerosis (MS) every hour, according to the National Multiple Sclerosis Society, affecting more than 400,000 people — over 2.1 million people worldwide.
Medical studies have shown that MS is two to three times more common in women than in men and affects Blacks and Whites differently.
“Multiple sclerosis is an auto-immune disease. It is when the immune system turns on the body and fights the body,” explains Dr. Jonathan Calkwood, director of the Schapiro Center for Multiple Sclerosis at the Minneapolis Clinic of Neurology in Golden Valley. “This is a very challenging disease to treat because it has lots of different symptoms that it can cause, but primarily it affects the brain, the optic nerve and the spinal cord,” which impact vision, speech, memory and other bodily functions,
Studies also show that MS can be very aggressive in Blacks — oftentimes because Blacks are more likely to be diagnosed later, and they often develop severe disabilities and experience more relapses as a result.
Calkwood adds that young Black males “have the greatest risk of multiple sclerosis — their MS often is more aggressive and may not respond to treatment. We don’t understand why African Americans can have a more aggressive course of the disease — it’s a mystery.”
MS can come in many forms, notes Calkwood. One is “when people have…an attack of MS where they will have a sudden development of a few days or a few weeks of weakness, balance or bladder problems” that takes from a few weeks to up to six months to recover, says the doctor.
“A year or two later, something else happens and they recover from that. Over time, the disease can go into a progressive stage where instead of attacks they have a slow worsening or a fairly quick worsening.”
Furthermore, MS is hard to diagnose, Calkwood points out. The symptoms can include “numbness, weakness…loss of vision, changes in bladder functions,” he says. If the condition is “not explained by the first doctor you see, don’t give up. That could be a critical time when they need to start treatment.
For those who suspect they have MS or other undiagnosed illnesses, Calkwood says, “They have to be persistent and advocate for themselves. If they don’t feel that they’ve gotten a good explanation, don’t give up — ask your doctor to refer you to a specialist.
“This is a disease that we can prevent people being in a wheelchair [from as an end result], but we have to get to people early. We often see people who wait because their doctor didn’t diagnose them, or it’s five years before they get a diagnosis,” says Calkwood.
“All that I treat are multiple sclerosis patients,” the director says. “The treatment and management of multiple sclerosis has become so specialized that most people with MS, and especially African Americans, should really strongly consider being seen and treated by a multiple sclerosis specialist, someone who just treats MS.”
Blacks “are two to three percent” of his patient load, says Calkwood. “What I have seen in my African American patients basically mirrors what the research has shown us: A young Black male with MS tends to have frequent MS attacks, and they may not recover as well from MS attacks and…end up in a wheelchair.” The same applies to “Black women as well,” he adds.
Although there is no cure for MS, and the symptoms vary, there are three forms of treatment, says the doctor: 1) “try to stop or slow down the disease,” 2) treat the patient’s neurological symptoms “to speed up their recovery,” and 3) treat the daily symptoms associated with the disease.
Recognizing symptoms, early diagnosis, and proactive treatment are strongly recommended by Calkwood. He says patients “shouldn’t settle for the family medicine doctor treating their MS. They should ask to see a neurologist, and actually ask the neurologist how long [they] have been treating people with MS.” They also should contact the local Multiple Sclerosis Society for MS specialist information.
“Our research has shown that thesooner treatment for multiple sclerosis is started, the better it works,” says Calkwood. “The delay in treatment will result in people with MS having greater disability. So the best chance of avoiding being in a wheelchair is to get on treatment early, stay on treatment, and keep regular evaluations with your neurologist.”
Next: A Schapiro Center patient with MS
The Minneapolis Office of the Upper Midwest Chapter of the Multiple Sclerosis Society is located at 200 12th Avenue South; call 612-335-7900 or 800-582-5296 for more information.
Charles Hallman welcomes reader responses to [email protected]