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Opinion It's hard enough living with MS without having to push for support

A new EU index shows Ireland lagging in its care of patients with MS, writes Lauren McCauley.

I WAS ONLY 18 when the identity-shattering bombshell, otherwise known as ‘an MS diagnosis’ came barging into my life.

Receiving a diagnosis of a serious health condition is difficult for anyone to wrap their head around, but in my case, I was diagnosed with this incurable condition as a teenager.

During this time, I had to come to terms with what this meant for me and the rest of my life, whilst also dealing with the painfully standard problems everyone experiences during the transition from teenager to 20-something.

Needless to say, it has been a steep learning curve. 

Ireland must do better

Recently, I was invited to share my thoughts on the Irish results of an index of countries and how they fare in the treatment of MS sufferers – the FutureProofing Healthcare MS Index - covering 30 European countries.

The Index was led by an independent panel of experts from across Europe, in partnership with Roche.

According to the MS Index, Ireland ranks 22nd out of the 30 countries assessed and ranks rather poorly in most of the measures examined in this index.

While this result is disappointing, it is unfortunately not surprising based on my own experience.

My own story

When I was first diagnosed I thought that the hardest part of receiving this diagnosis would be dealing with the symptoms of the condition itself and assumed everything else would fall into place.

During the first year after my diagnosis, my life was a muddy melting pot of uncertainty, anxiety, low self-esteem and loneliness. That year my life jumped from one extreme to the next.

Being diagnosed with MS, dropping out of college, starting treatment, learning to drive, starting college (again), learning to manage my chronic pain, and making new friends.

At that time, I felt alone in my experience, as my MS diagnosis made it difficult for me to relate to other people my age. My mind was reeling with questions and worries, which had no easy or definite answers.

Now, four years later, some of the main symptoms I live with day-to-day include chronic nerve pain, numbness and fatigue; but there are also many more.

Grateful for where I am

The symptoms of MS vary greatly from person to person, but I’m lucky that so far, this condition has not affected my mobility. As well as this, I’m also grateful to be on a disease-modifying therapy which has been working for me for several years now.

However, that being said, the fact that my MS is invisible to others presents its own unique set of challenges.

While looking ‘healthy’ or ‘normal’ may be seen as an advantage, it can also create misunderstanding around the difficulties that invisible disability can cause in daily life.

MS aside, thanks to the help of my amazing family, friends and lecturers, I did finally finish my degree and even managed to graduate from DCU with first class honours in November 2019.

Now, I’m currently studying as a PhD student in the School of Nursing, Psychotherapy, and Community Health in DCU. Additionally, I’ve also been heavily involved in fundraising for MS Ireland since my diagnosis.

Some of the fundraising ventures I’ve taken part in include the mini-marathon, the MS Ireland Slovenia Trek and the MS Ireland Croke Park Abseil. I also hope to complete a skydive for MS Ireland in February of this year.

An uphill battle for support

I did not anticipate having to constantly self-advocate to secure the support I would need to maintain my quality of life and achieve the life goals I wanted for myself.

Having MS in Ireland today involves not only becoming an expert on the condition but also the arduous processes you must undertake to receive support in areas such as healthcare, employment, social welfare and disability aids.

Getting the necessary help can often seem like a losing battle, not to mention that the symptoms of MS itself can make managing these systems difficult.

Strict barriers to entry, eligibility criteria and other gatekeepers to support can often leave people with MS feeling frustrated, disheartened and overlooked. 

Daily living matters

For this reason, I was impressed that the Index included a section measuring ‘daily living’ factors impacting people with MS.

This well-rounded approach to health and wellbeing acknowledges that living well with MS is about far more than just medical care and treatment alone.

It is great to see factors such as disability benefits, sick pay, working arrangements, housing, youth support and transportation highlighted in the Index as being vital to the overall wellbeing of people with MS. 

Certain aspects of the Index stood out for me as a young person with MS. 

MS is one of the most common neurological conditions amongst young people, with most people being diagnosed in their 20s and 30s.

Given this, I was impressed that the Index included a youth support measure, for which Ireland came in tenth place.

Employment support and working arrangements was another area covered by the Index which could be considered particularly relevant to younger people living with MS who want to start or maintain their career whilst managing their illness.

Although Ireland ranked well in the area of sick pay (sixth place) and fairly for disability benefits (12th place), overall the country came in a disappointing 17th place for flexible working arrangements.

It is also worth noting that even a very small income excludes people with MS from being able to avail of a Medical or GP visit card, thus reducing the benefits of or incentive to try to work whilst managing an illness.

The addition of MS to the list of illnesses included in the HSE’s Long-Term Illness Scheme was welcome support to those with this condition.

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Health service woes

Long waiting times for public neurology services, coupled with poor public MRI access, is a dangerous combination which delays MS diagnosis and treatment, and ultimately can result in avoidable disease progression.

The Index reported the worryingly low statistic that Ireland only has two neurologists for every 100,000 people.

Rehabilitation services and mental health services also scored poorly in Index. In my opinion, good mental health services are particularly important for people with MS, because in addition to the obvious mental anguish that comes with an incurable and debilitating illness, MS also directly impacts the brain itself, damaging the very centre which controls our emotions, thoughts and cognition.  

Today people living with MS in Ireland must rely heavily on the support of organisations such as MS Ireland, without which many people with MS would be left floundering, without the ability or funds to access vital services and information. 

For those who live with MS, the daily grind of managing the debilitating symptoms can be difficult enough without the additional stress of having to fight tooth and nail to access basic supports.

I hope that the Health Service Executive and Social Welfare Systems will acknowledge and take on board the results of the Index and use them guide future funding, policies and strategies which are aimed at improving the lives of people living with MS in Ireland.

Lauren McCauley is a PhD student at Dublin City University, Twitter: @laurenamccauley  

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    Mute Gareth Wogan
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    Jan 20th 2020, 8:40 PM

    I’m 35 and have had MS for 15 years. I work full time and am active. Looking at me you’d say I’m grand. It’s a headwrecker of a disease though. Pins and needles, muscle pain, headaches i could go on but i won’t. I urge everybody to try and get top Dublin Castle this Saturday 12-4. The MS society will have a MS cafe there and it’s built in a way that enables people without MS to experience some symptoms i.e the ground is uneven so you’re balance is off, the menu goes blurry and then back to normal to show the vision problems people with MS have. Sometimes i find it all a bit too much, the pain, thinking about the future etc. It’s tough but we all just gotta keep moving. No matter how bad it gets we gotta keep smiling!!

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    Mute Everyone'sgonecrazy
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    Jan 20th 2020, 10:29 PM

    Great piece, well done and thanks for writing it. Keep going strong all you MS warriors, you are amazing xx

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    Mute Serge the llama
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    Jan 20th 2020, 10:00 PM

    MS has to be one of the worse autoimmune conditions out there followed by type 1 diabetes, Lupus, rheumatoid arthritis and autoimmune hepatitis.

    Little support is available for any of those sufferers. Type 1 diabetes is on the long term illness as is MS but if you have another co-morbid condition it’s not covered.

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    Mute Gazza Lazza
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    Jan 20th 2020, 9:25 PM

    To everyone hear who suffers from MS, I am curious to know if you’ve ever thought of using medicinal cannabis as a treatment or for relief. Genuine question.

    I have seen results from numerous studies that have been carried over the past few years, which suggest at a very minimum is helps relieve some of the symptoms related to MS.

    As far as I’m aware, the medicinal marijuana legislation passed in 2014 includes the prescribed use of “Sativex” specifically for those who suffer from MS.

    Has anyone been precribed this?
    Or has anyone applied for this?

    If so I would be really interesed to know, thanks

    Asking for a friend ;)

    https://floridasmedicalmarijuana.com/can-medical-marijuana-help-treat-multiple-sclerosis/

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    Mute Robert Joyce
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    Jan 21st 2020, 5:00 PM

    @Gazza Lazza: I have been using Sativex for over a month now and I have shared my experience on Facebook and Twitter. Look for @a30minutelife on either platform.

    It has helped me with spasticity and pain, and has other welcome benefits. It is not covered on the drug payments scheme or long term illness scheme and costs over €525 per month.

    As a treatment it has few side effects, in my experience, which is limited to over a month. Long term there maybe other effects.

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    Mute Robert Joyce
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    Jan 21st 2020, 5:01 PM

    @Gazza Lazza: I have been using Sativex for over a month now and I have shared my experience on Facebook and Twitter. Look for “a30minutelife” on either platform.

    It has helped me with spasticity and pain, and has other welcome benefits. It is not covered on the drug payments scheme or long term illness scheme and costs over €525 per month.

    As a treatment it has few side effects, in my experience, which is limited to over a month. Long term there maybe other effects.

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    Mute Robert Joyce
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    Jan 21st 2020, 5:01 PM

    @Gazza Lazza: I have been using Sativex for over a month now and I have shared my experience on Facebook and Twitter.

    It has helped me with spasticity and pain, and has other welcome benefits. It is not covered on the drug payments scheme or long term illness scheme and costs over €525 per month.

    As a treatment it has few side effects, in my experience, which is limited to over a month. Long term there maybe other effects.

    1
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    Mute Stephen Bender
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    Jan 21st 2020, 7:02 AM

    Great article.
    Thank you for highlighting these issues.
    I don’t have MS, but have Psoriatic arthritis and come across the same issues. I here it from all chronic illness sectors. When I was talking about it with my GP recently, with regard to holistic approach and case management, he said the GP’s are ideally suited to that role but are stretched to the limits combined with poor communication and coordination amongst the different parts of health and social services!!

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    Mute Angela Godfrey Maher
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    Jan 21st 2020, 12:37 AM

    You poor girl I have Pakinsons diease .Similar to MS the nerve pains are so horrible I also have tired days too .There are several neurology diseases that are unfairly been a good system to treate patients . I have seen it and heard about .Loved ones help as hard as they can and you find out who your friend are . Your article is a good one But hey scientists are trying their best to find a cure for MS and PD xxxxx

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    Mute Dave Stewart
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    Jan 20th 2020, 9:26 PM

    Sam Typical arrogant obnoxious blue shirt comment, do us all a favour and go to another country yourself

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    Mute sam
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    Jan 20th 2020, 8:26 PM

    Just go to a different country to get treatment.

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    Mute Gareth Wogan
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    Jan 20th 2020, 8:45 PM

    @sam: why?? Most drugs for, if not all, are free here.

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    Mute Ashling Visser Bishop
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    Jan 20th 2020, 8:48 PM

    @sam: do you know someone with MS. There is not just one treatment for MS but when another neurological problems comes along. There can be lost of different treatments. For example, every week I could be in UHG for treatment and the same week over to Beaumont Hospital for rehabilitation to learn to walk again. As I couldn’t drive my husband had to take leave from work and then we had 3 small kids at the time. Trying to find someone who has the time to do school runs and collecting and spending time with them until we have returned. But if you can tell me where to go for treatment that would be brilliant.

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    Mute Ashling Visser Bishop
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    Jan 20th 2020, 8:52 PM

    @sam: where do we go. I am in for treatment in 2 hospitals in Galway and 1 in Dublin. If I could get my treatment in place I would gone. But I’m not just talking about getting the medication. There is a huge long list of things that happens to the body of a MS person. So I would be grateful if you could advise on where this place is that you write about. Thank you.

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    Mute Gareth Wogan
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    Jan 20th 2020, 9:07 PM

    @Ashling Visser Bishop: Don’t use up your energy on saps like that Ashling. Stay strong ya warrior!!

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    Mute 2thFairy
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    Jan 20th 2020, 9:16 PM

    @sam: you are a heartless troll.

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    Mute Serge the llama
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    Jan 20th 2020, 10:02 PM

    @sam: lots of countries won’t give you a visa if you have a serious medical condition as you will be a drain on the system.

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    Mute Bluebeard67
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    Jan 21st 2020, 4:36 PM

    @sam: seriously on what

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    Mute Helen Farrell
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    Jan 21st 2020, 5:20 PM

    I was diagnosed with MS in 1998 and I’m still working half-time. It can be gruelling at times, with pain, spasticity, extreme fatigue and that can be even after medicating for those symptoms. That said I am doing well for 22 years with MS. The HSE keeps delisting essential medications from the Long Term Illness Scheme. A recent removal was Vitamin D, something my neurologist prescribed. Don’t get a GP visit card (despite a Govt promise that LTI Scheme recipients would, a few years ago) which would really help financially, as the side effects of my MS disease modifying meds cause a lowered immunity to infection. It’s a constant fight to keep on top of things. Physio – private. Many meds – pay privately. GP – pay privately. All on reduced income, while I wish I could work fulltime..

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    Mute Bluebeard67
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    Jan 21st 2020, 4:33 PM

    I have RRMS diagnosed at 46 am lucky still able to work & am active what most people fail to grasp as regards MS is that no 2 patients are the same which makes the search for a cure all the more difficult. I live in NW & it’s all the more acute in terms of neurological supports as for my first few years we only had 1 neurologist for Sligo Donegal & Leitrim but thankfully he now has two registrar’s but there are numerous neurological auto immune diseases that they treat, mnd Parkinson’s multiple system atrophy plus a host of others I can’t name. This is a great article but as it’s election time I will leave you on this note: at last election when Donegal was changed from 2 X 3 seat constituencies to 1 X 5 seat I emailed ALL candidates & sitting TDs in relation to poor access to neurology services in NW. The response? One reply from the outgoing & RETIRING Dinny McGinley. Ignored by ALL others independents his party colleagues FF SF & Labour. Now what does that say about “cherishing all the children (people) if this nation equally? (Last election was after all in 2016!)

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