Ask the MS Expert: Lilyana Amezcua, M.D., M.S.by Stacey Colino
Why does my MS tend to get worse when I'm hot?
This is a very common complaint. We call it heat sensitivity, and it’s due to an increase in the core body temperature. Heat sensitivity isn’t just related to external factors like warm weather; it can be due to changes inside of you, such as your core body temperature increasing with exercise or a fever, for example. Heat sensitivity usually resolves when you cool down, so we recommend drinking chilled beverages, staying inside in air-conditioning, and using a device such as a cooling wristband or vest.
Should I be concerned about falling?
The risk of falling is higher than normal in people with motor disabilities and sensory and balance issues. So it’s always something we watch for in people with MS. Not everyone with the illness is affected in this way, but we certainly see it among many people with progressive disease. The National Multiple Sclerosis Society’s Free From Falls program can be helpful if you have concerns.
Does MS affect different populations differently?
We believe it does, based on the simple fact that it's not distributed evenly around the world. The highest prevalence of MS is among people of northern European backgrounds, but in recent years, the rate has increased among African Americans. In addition, when African Americans are affected with MS, they often develop disabilities at a faster rate than Caucasians do. Meanwhile, Hispanic Americans who develop MS tend to develop the illness at a younger age (three to ﬁve years earlier than Caucasians do).
What do you recommend to people who are feeling down due to their MS?
It’s very important to look for social support. We also screen for depression at doctor appointments, and depending on the degree of mental health issues we ﬁnd, we might recommend counseling or a visit with a psychiatrist. An occupational therapist may be able to help if you’re injured or disabled, in part by helping to work on and improve skills of everyday living and working, which may result in an improvement in mood.
Since I have MS, am I at a greater risk for other health issues?
Some studies suggest that people with MS are at increased risk for heart disease. With your doctor's help, be sure to take care of any heart disease risk factors such as high blood pressure, diabetes, and obesity.
What’s your hope for the future?
I have many hopes for people with MS. I’ve been working in this area for a decade, and the changes have been tremendous when it comes to diagnosis and treatment; we now have numerous drugs we can prescribe—many of which have been proven to slow down the disease. We’re also moving toward personalized medicine and accounting for the variability among individuals when it comes to treating MS. Yes, we need more advanced imaging tools and molecular-genetic diagnostic tests to get there. But I’m optimistic.