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Symptom Management in Multiple Sclerosis, 3rd Edition

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    Symptom Management in Multiple Sclerosis, 3rd Edition. By randall t schapiro. (Pp 176, US$19.95). Published by Demos Medical Publishing, New York, 1998. ISBN 1-888799-22-6.

    This is one of a new type of medical textbook written to meet the needs of an increasingly informed patient population. Aimed very much at those with multiple sclerosis, their families, and careworkers, it is simple and clearly written with jargon and technical terms kept to a minimum but without patronising. Chronic diseases, and especially multiple sclerosis, are not always well managed by the physician. Too many of us think that there is no cure and feel helpless in a busy clinic faced with the patient with a long list of complaints. There are too few specialty multiple sclerosis clinics in which neurologists, pain specialists, uroneurologists, physiotherapists etc liase.

    Patients often feel left in the dark, unaware which of their symptoms can be attributed to their multiple sclerosis and whether it is “worth bothering a busy doctor”. Many can cite bad experiences in their past when they have been fobbed off with well meaning reassurance but without practical help. Dysaesthesia, sexual problems, and urinary incontinence are only a few of the symptoms that can bring misery to the lives of patients and their families and which are poorly addressed by doctors. This book, in a language accessible to most (and with a glossary to explain some unavoidable jargon), explains multiple sclerosis, its symptoms, and what might realistically be obtained in terms of symptom control. All aspects are covered and nothing considered too trivial; constipation or cold feet might be extremely trying for an individual patient and each is considered.

    The old idea that is doesn’t help a patient to know too much about his disease (“it will only make him introspective and hypochondrial”) is outdated. Multiple sclerosis can hit anyone and patients now want, and deserve, to be informed. While doctors find it challenging to be faced with a patient equipped with the latest information down loaded from the internet or well informed having read a book such as this, this is a challenge to which we must be ready to rise. This textbook provides the information patients want and fills the gap left by busy doctors. It should be marketed appropriately and we must be ready to respond to the reaction of patients. Perhaps someone with multiple sclerosis should have been invited to write this review.