I'm not arguing with you guys. Doctors CANNOT accurately predict the future course of an individual's MS. Now way, no how.
With that said, there are averages for everything. People are desperate to know what the course of their disease is going to be and I think they are being told what the averages are and I think they are being told that is the average situation and not necessarily what they are going to personally experience.
In the case of my wife and I.....our life was going along just fine until the sudden diagnosis of MS. It's too bad that I went into it with more than average knowledge of MS because otherwise?? at that point a nice big dollop of sugarcoating would have been fine with me.
I know that honesty is the best policy but even if they could predict future course with 100% accuracy, I'm not 100% sure that I could handle the truth, or that I would want to handle the truth.
(From the book "MULTIPLE SCLEROSIS: THE HISTORY OF A DISEASE)
The conclusions about prognosis varied over the century after Charcot’s
initial description of MS. Early in the history of the disease, patients were
diagnosed at a late stage, and only when they had a typical relapsing and
progressive course. Such advanced cases gave clinicians the idea that
patients did not live long. Many stated that patients lived only a few years
after the diagnosis, but a few felt that patients lived a long time. It is
worth noting that Saint Lidwina, Margaret Davies, Augustus d’ Esté,
Heinrich Heine, and Margaret Gatty all lived for many decades. Only in
the 1940s would it be recognized that life expectancy was only slightly less
Duration of MS (Modified from Thygesen, 1953)
Gowers, 1893 3-6 years (quoted by Allison, 1950)
Bramwell, 1917 12 years in 170 fatal and nonfatal cases
Curtius, 1933 10 years in 100 autopsy-proven cases
Gram, 1934 10.3 years in Danish Invalidity Insurance
Brain, 1936 12.5 years in 11 fatal cases; 13.6 years in
those surviving at follow-up
Drobnes, 1937 12.5 years in 46 fatal cases
Sällström, 1942 9.2 years in 285 fatal cases (range 1–41
Carter, Sciarra and 13 years in 46 autopsy-proven cases
Lazarte, 1950 13.7 years in 85 fatal cases
Limberg, 1950 27 years from US death certificates.
Average age at death: 54
Allison, 1950 19.5 years in 28 fatal cases, 27.8 years in
survivors at follow-up
Müller, 1949 16–34 years
There has been confusion about what features indicated a poor prognosis.
Birley and Dudgeon (1921)15 found the most favorable prognosis in
those who were having acute attacks, confirmed by Misch-Frankl (1931),
Brain (1936), and Miller (1949). MacLean et al. (1950) calculated thatthose with recurrent attacks became disabled at a rate of four percent per
year.16 Coates (1930) noted that those with a gradual onset were unlikely
to have remissions. Thygesen found from his cases that of those with a
progressive onset in the first year, 43 percent were dead at 15 years, while
of those with relapsing-remitting onset in the first year, only 21 percent
were dead at 15 years.17 It was accepted that those with signs of cerebellar
disease had a poor prognosis (Misch-Frankl, 1931; Brown and
Putnam, 1939; Thygesen, 1949) and those with a spinal form had a better
prognosis (Brain, 1936; Sciarra and Carter, 1950). Thygesen felt that his
cases and those of others showed that a late onset had a better prognosis
(Brain, 1936; McAlpine 1946; Thygesen, 1949). Others found a better
prognosis if the onset was at a younger age (Müller, 1949).18
Müller felt that the discrepancies concerning prognosis and other features
in the disease were:
“artificial, caused by ‘statistics,’ and a result of the different prognostic
criteria and extremely varying interpretation of ‘slowly progressive
disease,’ ‘rapidly progressive course,’ ‘persistent progression of symptoms,’
‘progressive bouts,’ etc. The inaccuracy of retrospective evaluation,
moreover, contributes to increase the confusion.”
R. Müller, 194919
Last edited by Lyon
on Mon Jul 09, 2007 2:06 pm, edited 1 time in total.