Spring is in full bloom and summer is beckoning. It’s a lovely and uplifting time of year, but for people with multiple sclerosis, summer’s heat and humidity can cause symptoms to become more extreme. These temporary flare-ups are called pseudo-exacerbations and they pack a powerful punch.
They are common enough that before the introduction of MRI and other modern testing, the “hot bath test” was sometimes used to diagnose MS. Doctors would observe people who were immersed in hot water and watch for neurological impairment that improved after cooling.
Unlike true exacerbations, pseudo-exacerbations do not involve neurological damage, although symptoms can be quite severe. Pseudo-exacerbations can be caused by any number of stressors such as urinary tract infection, fatigue, flu, or elevated body temperature.
Exposure to heat can quickly lead to trouble. Raised body temperature makes it difficult for already damaged nerve fibers to transmit electrical impulses, resulting in an exaggeration of existing symptoms which may include weakness, fatigue, dizziness, decreased cognitive function, numbness, and blurred vision.
As one who experienced this early on in my life with MS, I can say without hesitation that I do not ever want to experience it again. A little extra vacation sun in a climate much hotter than I was used to knocked the wind out of my sails in a major way, rendering me almost completely unable to move until I cooled down. Unable to drag myself back to the hotel room, it took an hour in the shade and several tall glasses of ice water to get me back on track, and another several hours to fully recover.
Temporary though it is, it is a frightening ordeal, and quite debilitating. I’ve given up on hot tubs and hot baths forever, I’ve sworn off mid-day sun, and I am cognizant of the pitfalls of traveling to warmer climates.
Spring is a good time of year to review the phenomenon of heat-related pseudo-exacerbations and what to do about them. If you have MS, you don’t necessarily have to avoid summer fun. There are several things you can do to help avoid pseudo-exacerbations caused by heat:
- avoid hot tubs, saunas, hot baths, and showers
- choose shade over direct sunlight
- enjoy an occasional cool dip in the pool
- some sunlight is good for you, but try stay out of the sun during the hottest part of the day, from 11:00 am – 3:00 pm
- wear lightweight breathable clothing made from natural, breathable fabrics like cotton
- wear a hat with a brim
- drink plenty of cool, refreshing water
If you begin to feel the warning signs of overheating, such as lightheadedness, dizziness, weakness, and extreme fatigue:
- find some shade, or try to get indoors to a room with air conditioning or fans
- drink something cool
- take a cool shower or bath
- use a spray mist bottle
Overheating is enough of a problem for people with MS that there are products like the cooling vest that are made specifically to help. For more information about these products, how they work, and how to get them, check out these cooling programs.
- Multiple Sclerosis Association of America Cooling Equipment Distribution
- Multiple Sclerosis Cooling Foundation
- Multiple Sclerosis Foundation Cooling Program
- National Multiple Sclerosis Society Cooling Product Information and Assistance