47 msfocusmagazine.org healthcare team when first diagnosed. It also found that 71 percent of respondents believed talking to their doctor earlier or more openly would have made the first six months after diagnosis easier. The survey was conducted by Wakefield Research for Teva Pharmaceuticals among 1,000 women diagnosed with MS in the last five years. Dr. Thrower: This survey should be an eye opener for healthcare providers working with the MS community. According to this survey, we’ve got some work to do. MS is a complex health problem with many different issues to be addressed. Treatment options are growing, as is the need for safety monitoring with those treatments. In the midst of these technical advances, it appears that some very basic human questions are not getting answered. The resources mentioned in this article should be useful tools to help meet this need. I would also challenge newly diagnosed womentobeproactiveingettingyourquestions answered. Write down your questions and concerns prior to your visit. Ask about resources including support groups, case managers,vocational rehabilitation specialists. Survey: MS relapse is underreported Two surveys suggest patient-reported multiple sclerosis relapse rates may be higher than thought. The surveys found that approximately one in every two patients experiencing a relapse do not always report it to their healthcare provider. The findings were presented at the Joint ECTRIMS-ACTRIMS Meeting in Paris, France. Dr. Thrower: Most people with MS have the relapsing form of the disease. Relapses, also known as attacks or exacerbations, are defined as new or worsened neurological symptoms lasting at least 24 hours. There should be no better explanation for the symptoms. Relapses can disrupt a person’s life and may be associated with new and permanent disability. In general, we prefer to manage relapses by preventing them in the first place with one of the disease-modifying therapies. If a person has an MS relapse, it should be reported to your healthcare team. There are several questions to be answered: • Is this a pseudo-relapse? Pseudo-relapses are neworworsened neurological symptoms brought on by something like heat exposure or an infection (frequently a UTI or upper respiratory infection). • Does the relapse need to be treated? Studies have shown that treatment of a relapse with high-dose steroids may lead to a faster recovery. The degree of recovery may be the same, we just get there more quickly. The decision to treat or not depends upon how disruptive or severe the symptoms are, how well the person has tolerated steroids in the past, and whether there are any medical concerns regarding using steroids. • Does the long-term treatment plan need to be changed?The goal of a disease-modifying therapy is to prevent relapses, progression of disability, and new lesions on MRI. Ideally, we would like a perfect score on all accounts.When we don’t achieve perfection, we need to step back and look at several factors such as adherence to therapy and treatment alternatives.