MS: Then and Now

By Cherie C. Binns RN BS MSCN

I have been a nurse since the early 1970s.  In one of my Medical/Surgical nursing courses, I vaguely remember hearing about neuromuscular diseases such as MS, MD and ALS and the special nursing care needs these patients presented.   I even saw a few of them in clinical settings prior to graduation.   However, it was not until 1992 when I became a Home Care Case Manager, that I really began to understand the implications of untreated MS that had run its course! 

Of my 30 patient case load, there were three who were receiving regular care as a result of complications of MS.   One needed a monthly catheter change and had huge bed sores that were larger than my fist.  He was 41 years old and had uncontrollable tremors and spasticity and what time he was not in bed was spent in a motorized wheelchair in a ground floor apartment essentially alone except when the aid came in morning and night to bathe, dress and transfer him from bed to wheelchair or back or when I came in to do wound or catheter care. His wife had left him because the care needs were too great and the resources too small.

The next was a retired RN (early 60s) who was in a hospital bed and never got out of it.   Again, monthly catheter changes were required and there was depression!  This depression seemed to have no rhyme or reason and was not responding to any treatment offered by her physicians.  I started bringing her printed out nursing continuing education programs and her days brightened. Ultimately, she would have post-tests completed when I walked in and, as I was doing her care, we talked about the complexities of caring for the cardiac patient (her field of expertise) and the depression began to lift.

The third was a morbidly obese woman who took three of us just to change her soiled linens and cleanse and re-position her.   She was angry, hostile, and had one of the most difficult personalities I had encountered in all of my career.  And yet, she had a sense of humor!   I would walk in the door with a joke and the whole tenor of the atmosphere would change as we bantered back and forth while care was done.

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