No Easy Answers: Treatment Decision-Making in MS
Every day you are faced with countless decisions. What should I have for breakfast? What clothes should I wear? Other decisions, of course, are more complex, such as which bill to pay first or how to strategize with a work team to impress a potential customer. Some decisions are reflexive, requiring minimal thought; others require thoughtful consideration of the implications and a process for arriving at the choice or plan that works best for you.
The challenges of multiple sclerosis can make even the simplest decision feel more difficult. For example, selecting what clothes to put on or what to make for breakfast can be complicated by MS fatigue or problems with cognition, balance, or fine motor coordination. And with MS, your challenging decisions are not limited to your daily routines. You must also make decisions related to the management of your MS and the symptoms it can cause. These individual decisions, while seemingly isolated, can have a snowball effect on your overall health. This requires a multidisciplinary approach to decision making.
For example, you may be considering ways to manage the spasticity and decreased sensation that are interfering with intimacy…or trying to figure out how to manage the fatigue and cognitive challenges that are affecting your performance at work. Perhaps, you’re struggling with the decision to use a mobility device – Should I...? Shouldn’t I...? What will people think? Do some or all of these challenges and scenarios sound familiar? Do you feel confused or uncertain about the best treatment options and management strategies for your MS? The good news is that you don’t need to make any of these decisions on your own. In addition to the healthcare professionals who help you manage your MS, Can Do MS and other MS organizations can offer valuable information and consultation and point you to helpful resources. Others living with MS can share their experiences, hard-earned wisdom, and “best practices” with you.
When making a decision, it’s important to consider what options are available, who in addition to yourself may be impacted (your support partner, other family members, colleagues at work, etc.), and how this decision will improve the situation. The best place to start when making a decision about managing your MS is with your healthcare team. Each member of the team can offer a valuable perspective because different disciplines may have different strategies for managing a challenging symptom. For example, MS related fatigue can be managed by a physician with medication and by a physical therapist with exercise and energy management strategies. With stress, a mental health professional may offer mindfulness strategies to reduce the stress that can contribute to feelings of fatigue, while an occupational therapist can make adaptations to your home to make daily activities easier. The goal of any discussion with members of your healthcare team is to arrive at a decision or plan that works for you. They can help you individualize a framework of priorities, which are the core values that guide your decisions.
Roy Disney once said “When your values and goals are clear, making decisions becomes easier.” All decisions should help you achieve or move you toward a functional, attainable, personal goal. If the chosen treatment or management strategies don’t move you closer to your goals, you can work with your healthcare team to identify plan B.
Click here to get even more great tips on this topic by viewing our archived webinar on Your Whole Health, Your Whole Team: Managing Your Complex MS Symptoms.