The article touched on one of the big problems with getting an MS diagnosis. The fallout of the MS diagnosis itself is often separate from the disease. It has especially grim effects in the US with only private insurance available. Getting medical insurance becomes impossible (at least in the US). Getting life insurance is extremely prohibitive if not impossible. This impacts the ability to carry a mortgage. Employment options become much more limited. This all happens even if a person recovers from the event that prompted the diagnosis and has few to no symptoms for months or years, perhaps not even for many years if ever, because who really knows what will happen? I asked my neuro for a prognosis, and he just laughed and shook his head. That was a truthful response. Yet I feel the diagnosis has turned me into a total pariah. It is said repeatedly that MS is not necessarily a terminal or totally disabling disease, but the system hedges its bets and considers it one, to be on the safe side. So I have to consider MS to be a terminal disease when I make the remaining choices in my life, regardless of how I progress.
MRIs and CRABs really changed things. The MRIs pick up the lesions, and having the CRABs, with the indication that early treatment is best, give neuros reason to make the diagnosis, whereas in the past the neuros were less likely to pronounce it based on symptoms only, they didn't have the imaging to see lesions, and there was no treatment to offer anyway. This has a double-edged effect. Getting a diagnosis brings some clarity, but the availability of CRABs doesn't give prospective employers any more confidence in hiring. It certainly doesn't encourage medical and life insurance companies to underwrite. I'm not advocating that the diagnosis not be made. However, for a potentially growing number of people on the mild end or early end of this long broad spectrum that is called MS, the diagnosis can be far more damaging and life-limiting than the disease itself. This is something I don't see discussed much in the journals. Thanks for the article, Bromley.