Multiple Sclerosis

SEPTEMBER 2009 YOUR GUIDE TO RESEARCH, TREATMENT, AND LIVING WELL

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2 ANINDEPENDENTSUPPLEMENTFROMMEDIAPLANETINTHEWALLSTREETJOURNAL
MULTIPLESCLEROSIS
CONTENTS
2 Welecome
2 What is MS?
3 Treating MS
3 Symptom Management
3 Research in Progress
4 Fast Forward
4 Moving Forward
4 Get Involved
5 Financial Planning
5 Panel of Experts
MULTIPLE SCLEROSIS
Publisher: Jon Silverman
jon.silverman@mediaplanet.com
Contributor:
National Multiple Sclerosis Society
generalmailbox@nmss.org
Design: Carrie Reagh
carrie.reagh@mediaplanet.com
Printer: Dow Jones
Photos: 2009 National MS Society
All rights reserved.
For more information about supplements
in the daily press, please contact:
Kayvan Salmanpour, 1 646 922 1400
kayvan.salmanpour@mediaplanet.com
This section was written by Mediaplanet
and did not involve The Wall Street Journal
or Editorial Departments.
www.mediaplanet.com
Any and all registered marks
are the property of their
respective owners.
Publishers Note:
Dear Reader,
I cant remember a time when mul-
tiple sclerosis was not a part of my life. My
mother, Amy Zeisler, has lived with the chal-
lenges of MS for over 25 years. She struggles
with her mobility, dexterity, energy, and to
What Is MS? AndWhyDoWeNeedtoKnow?
Stumbling, sudden blindness, unexpected fatigue, numbness, pain.... Every hour, every
day, symptoms such as these lead doctors across the country to make a diagnosis of
multiple sclerosis.
M
ultiple sclerosis (MS) is a disease
of the central nervous system.
While the cause isnt yet known,
its believed to be an autoimmune disease,
which means that in MS the immune sys-
toms will come and go, while others may
this case, the myelin that surrounds and
protects the nerves. The damaged myelin
forms the scar tissue (sclerosis) that gives
the disease its name. When any part of the
myelin sheath or nerve fiber is damaged
or destroyed, nerve impulses traveling to
and from the brain and spinal cord are
distorted or interrupted, producing the
variety of symptoms that can occur. Most
commonly, these include fatigue, loss of
The mission of the
MS Research Center of New York
is to apply innovative and unexplored
research to find the cause and cure for MS.
WE PROVIDE THE HIGHEST QUALITY, MOST COMPREHENSIVE AND EFFECTIVE CARE AND RESEARCH
To make a tax deductible donation to multiple sclerosis research, please visit www.msrcny.org or call 646-557-3864.
Welcome
A very successful pop-psychology book out a few years
ago was called All I Really Need To Know I Learned In Kin-
dergarten. My version of that book would be, All I Really
Need To Know About The National Ms Society I Learned On
My First Bike Ms Ride.
Joyce Nelson
President and CEO
The National Multiple Sclerosis Society
T
he year was 1985. Sometime
around Memorial Day I was pro-
moted to executive director of the
Mid America Chapter, based in the Kansas
City area. I arrived in late June, just in time
to begin plans for the chapters second-
ever Bike MS event, one of the Societys
largest athletic fundraising endeavors,
scheduled just 10 weeks away in early
September, which to a novice seemed like
a reasonable amount of time to finalize
the route, get a radio sponsor, print and
distribute brochures, and plan the other
complicated logistics that make this one
of the Societys most successful events.
We had a small committee of four dedi-
cated hard-core cyclists and one board
member. I had never ridden a bike more
than five miles then. Lets just say that it
was a difficult weekend.
Early September in Missouri can be
keep up her spirits every day. Through the
years, If we learned of a product, therapy,
or strategy that might help MS, shes tried it,
often to no avail.
It is because of my moms struggle to keep
moving, and her dedication to stay strong
that I have developed and championed this
mobility, bladder and bowel dysfunction,
vision problems, dizziness and vertigo,
sexual dysfunction, numbness or pain,
cognitive changes and depression. Over
the course of the disease, some symp-
teens as well as much older adults. More-
be more lasting.
One of MSs peculiarities is that its symp-
toms, severity and prognosis are different
in everybody. People with MS typically
relapsing-remitting, primary-progressive,
secondary-progressive and progressive-
moderate or severe. The majority of peo-
ple with MS do remain ambulatory.
JOINTLY DIRECTED BY SAUD A. SADIQ, MD
FOR PEOPLE WITH MS.
Please visit www.msrcny.org and www.imsmp.org for more information,
or to register for the annual patient symposium,
MS 2009: Vision for the Next Decade, on Sunday, November 15.
very hot and humid, and it was especially
so that year. This was before the days of
cyclometers so we thought the cyclists
wouldnt really notice that the route was
closer to 170 than 150 miles. We were
wrong about that. My committee had
assured me that experienced cyclists
wouldnt mind biking an extra four miles
to and from dinner at the end of the first
day. We were wrong about that. And the
98-degree heat resulted in my assisting a
parade of cyclists who were experiencing
heat exhaustion and dehydration.
The next day things continued down-
hill. The cyclists were up and ready to ride
well before we had set out breakfast. The
lunches for that day had been inadver-
tently left at the overnight stop. Therefore,
the first cyclists to arrive at the dinner buf-
fet consumed 300 peoples food in about
an hour. And just to top things off, a 12-
foot high rental truck discovered that it
couldnt pass under an 11-foot-6-inch
high viaduct.
When the time came to read the rider
evaluation forms, I was dreading the ex-
perience, but I found among the just com-
plaints, a community of people eager to
move us closer to a world free of multiple
sclerosis if we gave them the chance:
employers everywhere, moving together
willing to help next time around.
passionate about collaborations, and
club for three years. For all of our sakes,
let us help you next year.
Societies worldwide.
Wing motorcyclist. Have you thought
about recruiting motorcyclists to serve
as bike escorts? Heres his name and
club contact.
supplement because I know that there are
already hundreds of thousands of people
just like my mom needing to be heard.
MS is an equal opportunity disease, 25
years ago it struck my mother, but tomor-
row it could strike you, me or anyone we
love. Mediaplanet gives me the opportunity
It is estimated that there are over two
million people worldwide who have been
diagnosed with MS. While most people are
diagnosed between the ages of 20 and
50, MS can appear in young children and
directly inherited, epidemiologists have
over, two to four times as many women as
men are diagnosed with MS.
Arriving at a diagnosis of MS can be dif-
ficult and time-consuming because there
is no single symptom, physical finding or
laboratory test that can, by itself, deter-
mine if a person has this disease. Doctors
study the persons medical history, per-
form a neurologic exam and order various
tests, such as MRIs or blood tests that can
Lesson learned: There are hundreds, etys Promise: 2010 research initiative has
thousands, even tens of thousands of united researchers and institutions world-
wide in a quest to better understand and
by MS, many who have not, who still care
deeply about putting an end to multiple sclerosis.
- Half a million active volunteers now
ing to help. provide invaluable talents and resources
A lot has changed in the years since to help the Society fulfill our mission. They
my first bike ride in 1985. The National MS are the lifeblood of the organization. They
Society has become a model organization are critical to the success of our Walk MS
for special events, including Bike MS, Walk and Bike MS events that occur in hun-
MS and the Challenge Walk. In fact, other dreds of cities each year nationwide. They
organizations often look to us for guid- are critical to the day- to-day operations
ance to implement their own events. of the Society and they are critical in the
What makes our events and our organi- advocacy efforts that enhance the lives of
zation as a whole so strong and vital is that people with MS and show policymakers
the National Multiple Sclerosis Society is why improving conditions for people with
a collective of passionate individuals who MS makes sense for the entire country.
want to do something about MS now. I invite you to get involved with the Na-
Every hour someone new receives a tional MS Society and join the MS move-
diagnosis of multiple sclerosis. Through ment. Start by reading this special section,
our national office and 50-state network where youll learn just what MS is and why
of chapters, the Society addresses the you should care about it. Discover the lat-
challenges of each person whose life is af- est treatments available and the exciting
fected by MS. We fund research, advocate research underway to end MS. And, if you
for change, and provide programs and or someone close to you has MS, explore
services that enhance the lives of people what programs and strategies are avail-
able to help you move forward with your
them. In 2008 alone, the Society spent lives.
over $45 million to support 440 research Then talk to us about how you can get
projects worldwide and $148 million on involved to move us closer to a world free
service programs for more than one mil- of multiple sclerosis by participating in
lion people. Walk MS or Bike MS or by sharing your
Sylvia Lawry founded the Society in special talents or skills or more. Visit www.
1946 in hopes of finding a cure for her nationalMSsociety.org or call 1-800-344-
brother Bernards MS. While neither lived 4867 for more information.
to see that dream fulfilled, their vision is
very much alive: people, governments and Thank you.
Joyce Nelson
toward a world free of MS. Ms. Lawry was
helped to found the MS International Fed-
eration, which today consists of 43 sister
As the Societys current President and
CEO, I continue this tradition by building
collaboration into all aspects of the So-
cietys operations. For example, the Soci-
to produce reports that impact millions rectly affected by MS and inspire all readers
each time we publish, and I am simply over- to join the movement to create a world free
joyed at the efforts the National MS Society of multiple sclerosis.
has lent to this project, as well as the pas-
sion shown by our sponsors. Best Regards,
When you read this report I hope it will Jon Silverman
help and encourage all those who are di- #1 Fan of Mom
help rule out other conditions that cause cure it, or even prevent it from occurring
MS-like symptoms. It is generally accepted in the first place.
that, in order to make a confirmed diagno-
sis of MS, the physician must find evidence
of damage in at least two separate areas of
the central nervous system; find evidence
that the instances of damage occurred at
least a month apart; and rule out all other
OneofMSs
possible diagnoses. peculiaritiesisthat
While MS is neither contagious nor
itssymptoms,
identified factors in the distribution of
MS around the world that may eventually severityand
help determine what causes the disease.
These factors include gender, genetics,
prognosisare
age, geography and ethnic background.
A great deal of research is under way to
differentin
explore these factors.
Understanding what causes MS will be
everybody.
an important step toward finding more ef-
The International
Multiple Sclerosis Management Practice
offers unparalleled care, treatment,
and expertise.

Treating MS
G
ood news is plentiful in the world
of MS treatment, and each year
brings more progress and promise.
Although there is still no cure, effec-
tive therapies are available to modify the
disease course, treat exacerbations (also
called attacks, relapses or flare-ups) and
serve to enhance the quality of life for
people living with MS.
Though not a cure, clinical trials and
evidence over the last decade and a half
provide convincing evidence that the six
FDA-approved disease-modifying medica-
tions reduce disease activity and disease
progression for a significant percentage
of people with MS. The therapies appear
to be especially beneficial if started early
in the course of the disease. MRI studies
have confirmed that most people have
- fered alongside or as a replacement for
sions and brain atrophy can develop even
before people experience any symptoms
or attacks.
These drugs, which are all administered
by injection or infusion, have been ap-
Symptom
Management
M
S can also cause a wide variety
of symptoms, including fatigue,
pain, cognitive issues like mem-
ory loss or trouble multitasking, weak-
ness, blurred vision, numbness, prickly or
tingling sensations, heat sensitivity and
dizziness. These are highly variable from
person to person and from time to time
in the same individual. While symptoms
can range from mild to severe, most can
be successfully managed with medica-
tions, exercise, proper diet, coping strate-
gies, self-help techniques, counseling, and
support from family and friends. Reha-
bilitation with a physical or occupational
therapist, speech/language pathologist or
One mission : MS remission
Our mission to stop a disease like multiple sclerosis requires not just a single-minded
focusbut one thats as relentless as the disease itself. Thats why at Biogen Idec and
Elan, we view fighting MS as not only our job at work, but as our mission in life.
BIOGEN IDEC and the BIOGEN IDEC logo are registered trademarks of Biogen Idec. The ELAN logo is a registered trademark of Elan Corporation, plc.
2009 Biogen Idec
ANINDEPENDENTSUPPLEMENTFROMMEDIAPLANETINTHEWALLSTREETJOURNAL
proved by the FDA for use in reducing the
activity of the disease:
Avonex (interferon beta-1a)
Betaseron (interferon beta-1b)
(now also available as Extavia)
Copaxone (glatiramer acetate)
Novantrone (mitoxantrone)
(a therapy approved to treat MSs effects. Many advances, on several
worsening MS)
Rebif (interferon beta-1a)
Tysabri (natalizumab)
People, however, need to work closely
with their physicians to monitor any po-
tential side effects or adverse reactions to
these drugs.
Not everyone responds the same to
these medications, so having options to
choose among is important. One option
expected in the near future is oral disease-
modifying medication, which may be of-
and spinal cord. This helps tremendously
the current medications that are admin-
istered by injection or infusion. While a
small percentage of patients do well with
no therapy, no one can predict for whom
this will be true.
cognitive remediation specialist, among
others, may also be indicated.
In addition to physical symptoms, MS
may have profound emotional conse-
quences. It can be difficult to adjust to
having a disorder that is unpredictable,
has a fluctuating course and carries a risk
of progressing over time to some level of
physical disability. In addition, demyelin-
ation and damage to nerve fibers in the
brain can result in emotional changes.
Some of the medications used in MS, such
as corticosteroids, can also affect the emo-
tions, leading to, among other responses,
stress, anxiety, mood swings and depres-
sion.
08/09
3
MULTIPLESCLEROSIS
Research in Progress
AndIntriguingLeadsontheHorizon
I
ts a fascinating and hopeful time in elinate brain and spinal cord nerve tis- two years ahead of schedule by launch-
MS research, with scientists looking sue in mice. ing a small clinical trial of new medica-
far and wide to slow the diseases Thirteen new genes that predispose hu- tions. Six Pediatric Centers of Excellence
progress, eradicate it and even restore mans to MS were identified in large-scale are providing services and care to people
function to people who already have felt genetic screening, and a new genetics with MS under 18 and their families. The
project was launched to catalog and Sonya Slifka Longitudinal MS Study is re-
fronts, have been made in treating and validate the genes that affect MS sus- placing myths with facts about the social
understanding MS. Each advance interacts ceptibility. Finding these genes should and financial consequences of MS. And
with the others, adding greater depth and help scientists understand what causes the international team involved in the MS
meaning to each new discovery. MS and may lead to new therapies. Lesion Project is exploring a collection of
Over the last decade, our knowledge tissue samples from living people at all
about how the immune system works has on the potential roles played by sun- stages of MS, making it possible to see the
grown at an amazing rate. Such work is ex- light, vitamin D and Epstein-Barr virus disease as never before.
pected to yield a variety of new potential in triggering MS. A growing number of therapies are now
therapies. Tools such as MRI are proving available that effectively treat the underly-
invaluable in monitoring disease activity, immune system in people with MS, ing course of MS or treat MS symptoms.
making it possible to visualize and follow are another area of study, with a large In addition, there are a number of treat-
the development of MS lesions in the brain trial under way to test whether the ments under investigation, some of them
hormone estriol can decrease disease oral rather than injected or infused, that
in assessing new therapies and can speed activity. may curtail attacks or improve function of
the process of evaluating new treatments. - demyelinated nerve fibers. Over a dozen
Now and in the coming decades, re- bama at Birmingham are studying clinical studies testing potential therapies
searchers will be working on improving whether a type of physical therapy that are in late stage trials moving through
control of inflammation and the immune has benefited people with stroke, trau- the MS pipeline, and additional new
response; repairing myelin; and develop- matic brain injury and cerebral palsy treatments, including therapies aimed at
could help those with MS too. repairing MS damage, are being devised
protect myelin from damage. MS research is ongoing on literally doz- and tested in animal models.
The National MS Society has responded
to scientists expanding knowledge of MS
by creating ever-wider networks of coop-
ens of fronts. The Societys Promise: 2010
campaign, which includes four major
components, has united the MS commu-
At present there is no cure for multiple
sclerosis, but to the countless scientists,
physicians and researchers who are bring-
eration. The most dramatic example is the
Nervous System Repair & Protection Initia-
tive, a five-year grant funded by the Soci-
nity behind some very big but achievable
targets. The Nervous System Repair &
Protection Initiative reached a milestone
ing us closer to understanding MS, it is not
etys Promise: 2010 campaign. The proj-
ect is so big that it has not one but four
principal investigators and encompasses
institutions, researchers and collaborators
based at universities in 11 time zones in
North America and Europe.
The Society also supports hundreds of
other projects. Here are just a few recent
findings and possibilities:
designed to improve nerve conduction,
is presently before the FDA for review.
Two more oral therapies, both disease-
modifying drugs, are expected to go to
the FDA soon.
nervous system progenitor cells to my-
Committed to a cure
0-3508-01
4 ANINDEPENDENTSUPPLEMENTFROMMEDIAPLANETINTHEWALLSTREETJOURNAL
MULTIPLESCLEROSIS
Fast Forward
MoreTreatments,Faster
D
ecades of basic and applied re-
search into MS and the funda-
mental workings of the immune
and nervous systems have built a critical
platform of knowledge that is serving as a
springboard for progress. We know more
demic and industry communication.
in translating that laboratory knowledge
into treatments gets wider every day.
Fast Forward is a nonprofit organization
established by the National Multiple Scle-
rosis Society to bridge that gap between
Get Involved AndHelpMoveUstoaWorldFreeofMS
T
here are many easy, fun and mutually
beneficial ways individuals and com-
panies can get involved that will help
improve the lives of people with MS and
move us closer to a world free of multiple
sclerosis. These include:
discovery research and drug develop-
ment. It does this by funding emerging
biotechnology companies engaged in MS
research; encouraging the repurposing of
existing or off-patent drugs to expedite
therapy development; and facilitating aca-
essential to maintaining a healthy, happy
Since its creation in Fall 2007, Fast For-
ward has moved aggressively to establish
its footprint in MS space. It announced its
first sponsored research agreement in De-
cember 2008, awarding $1 million to the
young biotech firm Apitope Technology
to conduct a proof-of-principle clinical
trial on a promising new vaccine designed
to target and redirect immune response.
This award was followed with another
partnership in May 2009 with Provid
Pharmaceuticals to fund development of
a compound intended to redirect the ab-
normal immune response. In August 2009,
Fast Forward established a collaborative
relationship with Amplimmune, Inc. to
support the development of a novel and
proprietary biological molecule designed
to target and prevent abnormal immune
responses associated with MS.
At a time when economic challenges
abound, Fast Forward has also entered
into a $19 million strategic partnership
- own program, that help manage the
ate innovation and commercial develop-
ment of MS therapies through a group of
soon-to-be-determined, mutually agreed
upon seed-to-early-stage projects. This
strategy provides Fast Forward with an ad-
ditional resource stream for funding new
biotech projects. For more information
visit fastforward.org.
because employees say that a companys
MS, Bike MS or the Challenge Walk which
together raise over 60% of the funds the
Society uses to support its research and
program services. Every year hundreds of
companies bring teams to Society events
work with Fast Forward, LLC to close
the gap between laboratory discoveries
Moving Forward AfterAnMSDiagnosis
O
nce someone receives an MS di- and the Societys Web site about pre- ory and complex attention. These chal-
agnosis, managing the disease ventive health care and the role of lenges can involve difficulty in learning
becomes an ongoing process, exercise, diet, stress management and and remembering information; focusing,
beginning with the very first symptoms other complementary and alternative maintaining and shifting attention; and
and continuing throughout the disease strategies in optimizing general health. organizing, planning and problem-solving.
course. Knowing what to look for, where The 50-state network of Society chap- To address this, the MS Technology Col-
to find it, and how to work effectively with ters offers a broad scope of services laborative, an alliance of Bayer HealthCare
doctors and other health professionals is and programs to people with MS, their Pharmaceuticals, Microsoft and the Na-
families, and their health-care provid- tional Multiple Sclerosis Society, recently
quality of life. ers, ranging from the most current and launched a way for people living with
The National Multiple Sclerosis Society comprehensive information on MS, to MS to exercise their brain power with
offers comprehensive information and networking with community resources,
programs, typically provided through to self-help and peer support programs, designed specifically for people with MS.
its 50-state network of chapters, that are to educational teleconferences, exercise -
designed to help everyone with MS, from and wellness programs, to social activi- MyWay.com, an online portal that features
the newly diagnosed, full of questions ties for the whole family. They also in- information and resources on technology.
on every aspect of their new reality, to clude employment counseling, respite Functional Electrical Stimulation (FES)
the more seasoned person with MS who services, durable equipment loans and FES is another technological advance
might be checking out a new therapy or advocacy. To learn more about local being used with increased frequency to
new tools to manage a troubling symp- programs either call 1-800-344-4867 address MS symptoms. The technique
or visit the Societys Web site at www. uses low levels of electrical current to
with MS spectrum, there are specially tar- nationalMSsociety.org. stimulate nerves in extremities that have
geted Society programs. Assistive Devices and Adaptive been impaired due to spinal cord injury,
The following are just some of the re- Technology head injury, stroke or other neurological
sources available: An assistive device is a tool or imple- disorders. FES is not a cure but may restore
ment that makes a particular function or improve function in nerves that control
making, financial planning, employ- easier or possible to perform. It may be specific muscles or muscle groups. Some
ment strategies and intimacy. as simple as an electric toothbrush, or as people with MS have found FES and FES
elaborate as an environmental control products helpful in alleviating foot drop, a
pharmaceutical company patient-assis- system that can be operated with a mouth condition caused by weakness or paralysis
tance programs or other financial assis- switch. Braces, canes or walkers can help of the muscles involved in lifting the front
tance programs, including the Societys those who have trouble walking. Wheel- part of the foot.
chairs and electric scooters can provide
costs of MS drugs and other daily living mobility for those who need additional
expenses. assistance. Transfer boards and lifts can be
used to help people with MS get in and
success of private disability insurance out of a bed, tub, automobile or wheel-
claims; theyre customized for people chair.
with MS, health-care professionals and About half of people living with MS de-
disability insurance professionals. velop cognitive challenges, often in the
areas of processing speed, working mem-
www.NationalMSSociety.org
events, visit BikeMS.org or WalkMS.org. search and program initiatives
charitable activities are important to them
help the Society move forward with its and events
an important skill among business lead- goal to end MS
ers. To learn more about team-building the public policies and programs that af-
through participation in Society special or services to support Society-led re- fect people living with multiple sclerosis
EMD Serono, Inc. is proud to
and life changing therapies
For more information about Fast Forward and
funded research projects visit: Fastforward.org
 ANINDEPENDENTSUPPLEMENTFROMMEDIAPLANETINTHEWALLSTREETJOURNAL 5
MULTIPLESCLEROSIS

Financial Planning ForThoseLivingwithMS MARTIN M. SHENKMAN, CPA, MBA, PFS, JD

I
f you or someone you love has been
diagnosed with a chronic illness such
as multiple sclerosis this news will pro-
vide a new lifelong lens through which
you will now view the world and which
will affect all future plans, including fi-
nancial planning to protect you and your
family. The first step in financial planning
is to assess your current health status
and the likely course of your disease with
your healthcare provider. Next define your
goals, present your advisers with the facts,
create a plan, then implement and moni-
tor that plan. See Estate Planning for Peo-
ple with a Chronic Condition or Disability
on www.demoshealth.com.
The following is a brief roadmap that
can assist in your financial planning. For
ance or government programs? are in your 30s, you may need a more ag- to hire an estate planner to execute this.
tab on www.laweasy.com. Protect yourself gressive investment plan in order to reach Give back
Define your goals -What do you wish living with MS dont experience significant your financial goals, as you may not be
to accomplish? Every person has a unique cognitive issues, enough do that the risk sure how long you will be able to continue annuities are commonly used to obtain
set of goals. Identify and write yours down. of this should be planned for. Simplify and working. higher cash payments than could be ob-
Determine your resources consolidate your investment accounts, use Customize and sign a durable power tained from a Certificate of Deposit or
have determined your goals, you need to automatic bill paying as frequently as pos- of attorney money market account. If you or a loved
assess the resources youll have to meet sible, have duplicate monthly statements a power of attorney, which authorizes a one is living with MS, the added bonus is
those goals. Prepare a balance sheet. List sent to a trusted family member or friend. named person (agent) to handle financial that they will help the organizations help-
the sources of cash flow that you have and Disseminate emergency informa- matters for them. If you have MS you need ing you. Consider speaking to your invest-
projected changes in earnings. tion - to tweak the standard powers to fit your ment manager and estate planner about
Estimate your needs - count numbers, locations and contact in- situation. For instance, to deal with the using charitable remainder trusts.
tion of every financial and estate plan is formation of all key personal, financial and possibility of an unexpected attack, con- Conclusion
a budget. For those living with chronic related information, and give it to several sider a power that is effective immediately. planning is important for everyone, but if
illness, additional costs typically have to trusted friends and family members. Sign and implement a revocable liv- you or a loved one is living with MS, it is
be estimated. For instance, what do your Plan your investments - ing trust - even more vital that you take steps to plan
therapies and other medical needs cost ment plan must be tailored to your spe- tect you during the advance of your MS is and protect yourself and all those who de-
and how much of that is covered by insur- cific age and situation. For example, if you pend upon you.

Panel of Experts

STEPHEN KANTER SAUD A. SADIQ, MD

Doctor of Physical Therapy, PT, ATC Director D
Supervisor of Rehabilitation Senior Research Scientist
International Multiple Sclerosis Multiple Sclerosis Research
Management Practice

One of the most significant impairments we see in working with hun-
dreds of people with MS every year is foot drop. Foot drop is partial leg
paralysis that prevents the foot from lifting, causing instability and mak-
ing walking difficult. Foot drop often occurs in persons who have condi-
tions such as multiple sclerosis, stroke, traumatic brain injury, incomplete
spinal cord injury and others.
Bioness has developed an advanced therapeutic, non-pharmaceutical
option for foot drop. The NESS L300 sends low level stimulation to the
muscles and nerves that lift the foot and is the only adaptive, wireless
neurostimulation device for foot drop offered in acute, inpatient, and
outpatient rehabilitation centers as well as for home use.
People with MS who suffer from foot drop and whose muscles and
nerves respond to stimulation may be good candidates. Benefits may
include an improvement in gait (a manner of walking) and greater range
of motion.
Patient support services are essential to people living with MS. They
for most patients with MS. Within a year or two, some oral drugs will be provide the support to help them better understand the disease and the
on the market that may be an alternative to injected or infused medica- resources that can help them manage it. Its important for people who
tions. In five years, its likely that significant advances will be made in are diagnosed with MS to try to stay positive and learn about the disease,
reversing neurological dysfunction. Another exciting area may lie in de- the MS therapies and services available.
veloping biomarkers in blood or spinal fluid that will tell if the disease is Support may include injection training, contact with MS-trained
under control or not; these will enable physicians and patients to make nurses, and educational programs. In todays challenging economic cli-
earlier and better decisions about treatment. Obviously, while all this mate, companies have support programs that may help remove cost as
is going on, labs are investigating the causes of MS. Until we know the a barrier to treatment. Programs may offer access to specialists who work
with health insurers to assist qualified patients in managing coverage or
best doctor they can, then trust their doctor. The patients who do poorly co-pay programs to help make MS therapy more affordable.
tend to be the ones who make up their minds about treatment before It is important that healthcare professionals work together, across all
they came to see me. healthcare disciplines, to help provide people with MS the support and
tools they may need to maintain a long-term commitment to therapy
and their overall health.

The National MS Society is proud to be a source of information about multiple sclerosis. Our comments are based on professional advice, published experience and expert opinion, but do not represent therapeutic recommendation or
prescription. For specific information and advice, consult your personal physician. Any reference to a commercial or noncommercial product, process, service or company is not an endorsement or recommendation by the National MS
Society. The National MS Society does not endorse or recommend products, services or manufacturers. The National MS Society assumes no liability whatsoever for the use or contents of any product or service mentioned.
 Mobility impairment is a major
concern for patients with MS.1-3

The 2008 Multiple Sclerosis Association of America (MSAA) poll, which included more than
2,400 persons with MS, revealed that4*:

77% of people with MS said they experienced

some limitation to their mobility

In a study of 166 patients with MS of either <5 or >15 years duration, 162 responded to a
questionnaire designed to force rank 13 bodily functions based on severity and relevance to their
experience. Of the 162 useable responses, 82 had MS for <5 years and 80 had MS for >15 years.
The graph below shows the percentage first rank for each of the bodily functions.5

Please visit www.msmobility.org to learn more and register for complimentary tools for your practice.

References: 1. Paltamaa J, Sarasoja T, Leskinen E, Wikstrm J, Mlki E. Measures of
physical functioning predict self-reported performance in self-care, mobility, and domestic life
in ambulatory persons with multiple sclerosis. Arch Phys Med Rehabil. 2007;88:1649-1657.
2. Martin CL, Phillips BA, Kilpatrick TJ, et al. Gait and balance impairment in early multiple
sclerosis in the absence of clinical disability. Mult Scler. 2006;12:620-628. 3. Provance PG.
Physical therapy in multiple sclerosis rehabilitation [clinical bulletin]. New York, NY: National
Multiple Sclerosis Society; 2004. 4. A Patient Survey of Mobility and Exercise Issues
Among MS Patients [poll]. Poll commissioned by: Acorda Therapeutics, Inc. and the Multiple
Sclerosis Association of America. February 21, 2008. 5. Heesen C, Bhm J, Reich C, Kasper
J, Goebel M, Gold SM. Patient perception of bodily functions in multiple sclerosis: gait and
visual function are the most valuable [first published May 27, 2008]. Mult Scler. 2008;00:1-4.
doi: 10.1177/1352458508088916.
* Poll commissioned by: Acorda Therapeutics, Inc.
and the Multiple Sclerosis Association of America.
February 21, 2008.
97.9% of the sample (2,471 people) were aged over 25 years. Patient
breakout: 64% with RRMS; 15% with SPMS; 8% with PPMS; 5% with
PRMS; 8% were listed as unknown/dont know/no response/benign.
Key abbreviations: RRMS, relapsing-remitting multiple sclerosis; SPMS,
secondary-progressive multiple sclerosis; PPMS, primary-progressive
multiple sclerosis; PRMS, progressive-relapsing multiple sclerosis.

2009 Acorda Therapeutics, Inc. All rights reserved. Aug 2009 MB00474
Sponsored by Acorda Therapeutics