COOLING FOR MS

[Guest guest]

TALKING ABOUT COOLING DEVICES,,,I THOUGHT YOU MAY ALL BE INTERESTED

IN THIS ARTICLE....SALLY

Many people with MS, perhaps 60-80%, experience a worsening of

symptoms when they get warm. These symptoms usually occur soon after

exposure to heat and resolve soon after the warm conditions have

subsided. Although heat-related symptoms are usually temporary,

there are a few reports of more prolonged problems related to

exposure to heat.One theory to explain heat sensitivity in MS is

that heat decreases the ability of damaged nerves to conduct

electrical impulses. In other words, under some circumstances,

electrical impulses travel adequately through nerves that have been

injured by MS. However, with increased temperature, impulses are no

longer adequately conducted.While heating may provoke symptoms,

cooling may improve symptoms in some people with MS. One study

concluded that cooling core body temperature by about 1 degree F

(or 0.5 degree C) can produce an improvement in symptoms. Cooling

may work by improving the conduction of nerve impulses among people

with MS who have heat sensitivity.Many of the studies of cooling in

MS have involved a method of cooling that is referred to as " active

cooling, " which involves the circulation of cooling liquid

throughout a garment that covers the head, trunk, and legs. This

kind of system may sometimes provide short-term improvement in a

wide variety of MS-related symptoms. These reports describe

improvement in fatigue, walking problems, urinary difficulties,

weakness, spasticity, speaking problems, visual difficulties, sexual

problems, incoordination, and cognitive problems.To clarify the

possible benefits of active cooling garments, a large clinical trial

has recently been conducted by researchers at the National

Aeronautics and Space Administration (NASA). This study involved

approximately 100 people with MS from 6 different MS centers. The

data from this study are currently being analyzed. Cooling systems

that are " passive " are marketed to people with MS. Passive systems

use cold packs or evaporation to cool the body. Such systems are

less well studied than the active systems. However, these systems

may provide sufficient cooling for symptomatic relief. One study

found some benefit with simpler cooling strategies: the use of wet

clothes with a fan and drinking an ice slurry. Less expensive ways

of achieving the benefits of cooling have been suggested. These

include such common-sense measures as cotton clothing, personal

fans, ice packs, spray bottles, heat avoidance, and air

conditioning. Although not well studied, trying such inexpensive and

generally safe approaches is reasonable for those who suffer from

heat-related symptoms.In addition to its effect on symptoms, cooling

may also act on the immune system. One study of eleven people with

MS found that cooling produced changes in immune system chemicals

that, in theory, may be beneficial for people with MS. Although

interesting, this evidence is too scant to suggest that cooling

should be used for any purpose other than symptom control.One

particular type of heat-related symptom is a temporary decrease in

visual function that is related to exercise. This is sometimes

referred to as Uhthoff's Phenomenon. This process, unlike the more

general kind of heat-related worsening of symptoms described above,

occurs in a minority of people with MS. One report involving only

two people suggests cooling while exercising may be a useful

strategy for managing Uhthoff's Phenomenon. Other strategies that

may be beneficial are taking cool showers or acetaminophen (Tylenol)

or ibuprofen (Advil) prior to exercising.In summary, cooling may be

a reasonable strategy for the large number of people with MS who

experience heat-related symptoms. Strategies to achieve cooling

range from expensive, electrical devices to simple and inexpensive

strategies such as the use of cold packs and spray bottles. It may

be best to try inexpensive measures first. In the summer heat, some

of these would be reasonable for anybody to try! For those with

serious heat-related problems, the more expensive strategies (active

or passive cooling garments) may provide some short-term relief of

symptoms. Under limited circumstances, costs related to air

conditioning or to cooling garments may be tax deductible.