April 28, 2004
Suzanne Kydland Ady
The Billings Gazette
Six days each week, Sandee Ratcliff gets up early to exercise. She lifts weights to build up the muscles in her arms and legs, and hits the treadmill for a cardio workout.
Like anyone else, there are days when Ratcliff doesn't feel like working out. But unlike many, Ratcliff, who has multiple sclerosis, said exercising is the main reason the disease hasn't taken over her life.
"Everybody who has MS should exercise," said Ratcliff, who was diagnosed 13 years ago. "It adds strength to the muscles to help them keep working."
Ironically, it was when Ratcliff was on daily walks near her house that she noticed something was wrong. As she ascended a nearby hill, her left foot began to drag. She also noticed some tingling in her legs. Trips to the chiropractor and acupuncturist didn't alleviate the problem, and a family physician soon sent Ratcliff to Dr. Patrick Cahill, a clinical neurologist at Deaconess Billings Clinic.
"He did an MRI, and knew right away it was MS," Ratcliff said. "I was glad to know it wasn't a tumor, but I just didn't know where this was going to go."
What is MS?
MS is a disease of the central nervous system. The first recorded diagnosis of MS was in 1849. Some researchers believe it to be an autoimmune disease in which the body launches an attack against its own tissues though the immune system.
According to the National Institute of Neurological Disorders and Stroke, during an MS attack, "inflammation occurs in areas ... of the central nervous system. This process is followed by destruction of myelin, the fatty covering that insulates nerve cell fibers in the brain and spinal cord. Myeline facilitates the smooth, high-speed transmission of electrochemical messages between the brain, the spinal cord and the rest of the body; when it is damaged, neurological transmission of electrochemical messages may be slowed or blocked completely, leading to diminished or lost function."
An estimated 350,000 Americans and 2 million people worldwide suffer from MS, which is typically diagnosed when a patient is between 20 and 40 years of age.
While women are affected at nearly twice the rate as men, Caucasians have also been found to be twice as likely to develop the disease as other races. Symptoms range from muscle weakness, tremor and speech disturbances to vision, vertigo and fatigue. A devastating aspect of MS is when it strikes young adults and slowly steals physical functioning in unpredictable ways.
Different kinds of MS
The disease is displayed in several forms. In a previous interview, Cahill told The Gazette relapsing-remitting is the most common type, affecting nearly 85 percent of MS patients.
In those cases, MS can show up and disappear before the patient is aware there's a problem.
"The first attack will cause some deficit to occur," Cahill said. "But sometimes, it's gone as though it never happened. After a variable period of time - it could be five, 10 or even 20 years - it will come back."
Primary-progressive MS is characterized by a gradual decline with no remissions, although there can be temporary relief from symptoms. Secondary-progressive MS begins with a relapsing-remitting course followed by a later primary-progressive course. On rare occasions, patients may have a progressive-relapsing course in which the disease progresses and is punctuated by acute attacks.
No cure for MS has been found. But some treatment drugs, shown to prevent or postpone MS disabilities, first became available in 1993.
"A few years ago there was nothing," Cahill explained. "Now there are well-established treatments for controlling the symptoms and the progression of MS."
The drugs Avonex, Betaseron and Copaxone, often grouped together and referred to as the "ABCs," have proven to be equally effective for many patients. Each of the trio is taken by injection.
With the addition of a drug called Rebif two years ago and the cancer drug Novantrone in 2000, the Food and Drug Administration has now approved a total of five drugs for treating the major forms of MS.
After Ratcliff was diagnosed in 1991, she read every book she could find on MS and was referred to neurologist Dr. Roger Williams at St. Vincent Healthcare. She opted to start on Betaseron to slow the disease's progression almost as soon as it became available. She also got used to injecting herself with the drug daily.
"When I was first diagnosed, there were no treatments available," she said. "I did well on the Betaseron for several years until it was reformulated."
Ratcliff feels fortunate to have health insurance pay for the $1,300-a-month cost of Rebif, which she now takes three days a week.
Living with MS
Ratcliff is one of more than 1,500 people in Montana with MS. When she told her patents about her diagnosis, she remembers her father was extremely upset. And Ratcliff has a few unanswered questions: Her maternal grandmother was in a wheelchair and no one in the family really knows why. Did she have MS? Is Ratcliff's bout with childhood measles to blame for her own MS? What other MS-related obstacles will she have to deal with?
Ratcliff is more certain of other things: Her disease doesn't improve, and heat is an MS patient's worst enemy.
"I wear a leg brace now. The MS just gets a little worse each year," she said. "But I really notice the heat. When I work out here at home, I have to have a fan on me. When I go outside, I'm on an electric skooter a lot. The heat just makes you really lose your strength."
Ratcliff and her husband, Keith, seem to take other hurdles in stride. When Ratcliff lost her balance and fell last year, the couple installed additional railings around the house. A few years ago, Keith even came up with "sliders," a plastic tip for the toe of his wife's shoes. If Ratcliff is walking and her foot catches, the shoe will help it slide instead of tripping.
Keith is also very up-to-date on Ratcliff's biannual checkups with Williams.
"He always runs a number of tests to see how her coordination and sensitivity has changed," he said. "And a blood test to check how her meds are working."
Ratcliff, who still helps with the family's home appraisal business, said Keith and her best friend, Liz, have been her biggest support system. She also enjoys weekend fishing trips and has been volunteering at the local MS Society office since last winter.
"I've always heard 'You have MS, but it doesn't have you,' " she said. "You just can't give in to it. I'm a fighter. I still fight it and always will."
The annual MS Walk will be May 1 starting at the LDS Church, 1000 Wicks Lane in the Billings Heights. Check-in and registration begins at 9 a.m., and the walk starts at 10 a.m. Frequent rest stops will be provided, and lunch is served between 11 a.m. and 2 p.m. For more information or to register, call (800) FIGHTMS (press #2). For more information on MS-related topics, visit www.nationalmssociety.org.
The MS Walk, in conjunction with the National Multiple Sclerosis Society,
raises money for research which helps more than 1,500 people in Montana
who live with multiple sclerosis. Last year in Billings, 472 people walked
and raised $34,085. The MS Walks in Billings, Helena, Great Falls, Anaconda
and Missoula raised $100,502.
Copyright © 2004, The Billings Gazette