Decisions about treatment for MS

Everybody we spoke to knows that there is no cure for Multiple Sclerosis (MS). Depending on the stage and type of the illness, various treatments are available which can slow its progress or control its symptoms. Decisions to have these treatments were negotiated between the person with MS and their doctors, often with the active support of their partner. Sometimes all concerned agreed that the best thing was to have no treatment because the side effects might be worse than the symptoms.

Because MS is unpredictable, a treatment which seemed to work for a while often seemed to become less effective over time and was stopped. Sometimes the side effects of a drug were so bad that the person stopped taking it and wouldn’t have it again. Occasionally, people talked about their relative, partner or friend wanting to try a drug which their doctor didn’t think was right for them. Some people suspected that these decisions were funding related.

Ray and his wife have detailed discussions with her doctors about the best treatment for her.

Age at interview 17

Gender Female

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Several people with MS had taken part in drug trials. Partners encouraged this, for the sake of their spouse but also to contribute to knowledge for the sake of other people with MS.

Many also used non-drug treatment such as physiotherapy, oxygen treatment, yoga, massage, reflexology and a healthy diet with fish oils and vitamins. These were all seen as beneficial, though some people said their partners didn’t always do their physiotherapy exercises. Karl said that his partner tried acupuncture when she was first diagnosed but there was no noticeable effect. Some people had tried unconventional treatments such as drinking sunflower oil, but most were sceptical about the value of anything that was marketed as some kind of miracle cure. A few people tried a treatment against the advice of their doctor.

Some people we spoke to very actively looked for information about treatment and used the evidence they found to negotiate particular treatments for their relative. Both Bernard and Paul Z found research articles on the Internet and showed them to consultants. Bernard’s story shows that people react differently to any given drug, and that drug availability changes over time.

Paul found evidence that steroids could be given as tablets rather than through a saline drip in hospital. The consultant agreed to try it, with good results.

Age at interview 56

Gender Male

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Bernard found an article in the Lancet which supported his view that his wife might benefit from Betaferon. The consultant agreed and she appeared to benefit from this treatment for ten years.

Age at interview 59

Gender Male

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Emma’s husband decided which treatment to have, but Emma helped him to decide by finding information and using her scientific background to help him understand it. She also makes sure that he eats specific foods which she thinks will help.

As her symptoms progressed, the doctor suggested to Anthony’s wife that she might have treatment with an interferon. She decided against it for the time being, but appreciated having the drugs explained in detail.

Age at interview 43

Gender Male

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Sometimes the ability to pay for treatment, or to get funding from the relevant part of the NHS, was important. Robin advises not to buy your own medicines, but to get them on prescription; but Betty, with shrinking savings and little income, has to get low dose naltrexone on a private prescription and was, at the time of the interview, waiting on a decision on whether the PCT would fund cannabis spray (Sativex) for her partner. Jeff’s wife had to go to a different city for botulinum toxin (Botox) treatment. It was uncertain for a while whether Emma’s husband, a non-EU citizen, would be eligible for treatment. Stella feels grateful that, despite the drop in their income since her partner had to stop working, they can still afford to pay for alternative therapies. Kay Z’s husband could get beta interferon from America (through relatives living there) before it was available in the UK.

Jeff and his wife were very pleased with the effect of Botox injections on her painful feet, after initial difficulties in getting funding for the treatment.

Age at interview 62

Gender Male

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Betty has got her local MP involved in discussions about funding to make cannabis spray (Sativex) more readily available in her area.

Age at interview 58

Gender Female

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Kay and her husband were glad to have beta interferon, although it was expensive to buy it from America, when no treatments for him had been available in the early years of having MS.

Age at interview 49

Gender Female

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Some people were optimistic about the prospects for new treatments based on scientific research. Treatments that weren’t based on evidence were generally disapproved of but some people said their relative had tried them, or wouldn’t discount trying them, anyway. Ian’s wife decided against her doctor’s advice to have a controversial treatment to widen the vein which takes blood from the brain (CCSVI).

Ian’s wife wanted to explore every avenue and decided to go ahead with CCSVI treatment even though her consultant thought it unproven and dangerous.

Age at interview 57

Gender Male

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Emma thinks that non-scientific treatments are not valid, though she understands why people try them hoping they might work.

Age at interview 37

Gender Female

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Anthony and his wife are realists’ with their feet on the ground’ when it comes to expectations of treatment. But they are open minded’ and were glad to try low dose naltrexone on the GP’s recommendation.

Age at interview 43

Gender Male

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Louise is optimistic about stem cell research and future treatments for MS. She thinks alternative therapies can make you feel better psychologically, but don’t help the medical condition.

Age at interview 61

Gender Female

Kay travelled with her brother to Holland for him to have stem cell treatment, because you just want to do anything to try and make them better.

Age at interview 38

Gender Female

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Some relatives had heard about people who had ‘overcome’ their MS. Most thought that this probably meant they had a mild form of MS with long periods of remission, rather than that they had been cured. But it mattered to Stella to hear this, ‘Because we were always told it was something that you have, and you need to make do with it, and you need to accept it. Which is true as well. But then there’s always hope. Always, for anything’.

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