I also wanted to say welcome...and I'm sorry. You are the first physician I have seen here with MS...I am a pediatrician and was diagnosed with MS in September of '02 and had to retire due to fatigue and concentration problems in March of '03...I had only been out of residency for 3 years when I was diagnosed. I did pretty well other than the fatigue for about 18 months and thought I was going to have a pretty "mild" case of MS if there is such a thing...but then things began to worsen. Quite a bit of sensory problems...intermittent weakness and spasticity in legs. Since February of this year I have developed ON in the right eye...which was pretty brief. Then I developed a VI nerve palsy resulting in diplopia that lasted 3 months (just getting over that) followed immediately by ON in Left eye. I worry more now about my vision than anything else. I have tried to avoid using steroids unless absolutely necessary (strong history of osteoporosis in the family). Any evidence that the long term outcome of my eyes would be any different with steroids.
I wondered if you have been able to continue working....developing a "new identity" has been pretty tough...worked a long time to get through med school/residency and now I have pretty much just had to distance myself from it completely. Hope you are doing well!
God Bless, Wendy
Hi Wendy! It is great to hear from you (although under unfortunate circumstances of course) because I have often wondered why I chose the profession I did...let me clarify that statement:
I am not a physician, as I am an optometrist. For those that do not know, an optometrist goes through 4 years of college for a bachelor's degree and then to 4 years of optometry school, not medical school. Our education is very much in the vein of dentistry, except we don't deal with mouths! A physician goes through the bachelor's degree and then to 4 years of medical school. However, only after medical school does the physician start a residency to learn a specialty. For example, an ophthalmologist will have at least 4 more years after medical school to become an "eye doctor". That explanation is not intended for you obviously, Wendy. I give this explanation to clear up the misconceptions of posters about optometrists vs. ophthalmologists.
Back to my original point: I had the grades and test scores to go to med school when I was in college. Because my best friend chose optometry school a year before I graduated college, I followed him. I just had this nagging feeling that I did not want to go to med school and risk not becoming an ophthalmologist if I could not get a residency. Also, I didn't want to go through 4+ more years of school that would have kept me in school into my 30s. It is funny how things work. I don't know if there was a higher power guiding me towards that decision or not, but I know now that I would have certainly had problems completing a residency/internship now that I have MS. Luckily, now I am just a lazy office worker and not having to go through the crazy hours/routine that a resident has to endure (I would just now be finishing my training for ophthalmology...I am only 31 years old). I am really sorry to hear that MS has caused you to prematurely retire. I am able to continue working currently. At times I feel very fatigued, and at other times I feel relatively normal. These periods seem to come in waves of weeks to months at a time. I have been pretty fortunate since my diagnosis in 2003: I have not had a recurrence of ON, and I generally only suffer from fatigue and bladder dysenergy. As the main source of income for my family, I am extremely concerned with my ability in the future to continue working. Luckily, I purchased disability insurance a year before I was diagnosed.
As for steroids and evidence of longterm outcome: my research of current articles and journals indicates that steroids affect and improve the short term visual recovery, but have no effect on the long term visual prognosis with MS patients. I would certainly recommend them for the short term visual recovery, however. I know that it was very beneficial for me to have the short course of IV Solumedrol and oral prednisone when I had my ON attack 3 years ago.
It is really nice to hear from you. I hope your ocular problems will stabilize soon. Please keep me informed, and if there are any further questions please do not hesitate to ask. I know all the "doctor" stuff about MS and the eyes, but more importantly I know about all the little thingsa I feel daily with my eyes that only us MSers will understand
Sorry for the wall of text I just wrote!