b"Life with MSBarriers, Burdens, and HopeBarriers, Burdens, and HopeNNaavviiggaattiinngglliiffeewwiitthhmmuullttiipplleesscclleerroossiissBy Buse SengulI still remember the day I met Janelet'sUnfortunately, the challenges do not end call her that to respect her privacywhen sheat your diagnosis. Additional factors such as arrived at the emergency room while I wasthe high cost of DMTs, insurance coverage the on-call neurology resident. She was in herlimitations, and bureaucratic hurdlesincluding 20s and lived with multiple sclerosis far longerprior authorizations, medication denials, and than I had studied it. A full-time wheelchairformulary restrictionsoften delay treatment user, she relied entirely on her husband andinitiation. Additionally, limited access to family for daily care despite her young age.rehabilitation services and mobility devices, Her doctors tried to provide the necessarymany of which are not covered by insurance, care through disease-modifying therapies,further widens gaps in care.physical therapy, and home health services. ButFinancial burdenshe faced numerous barriers that preventedMS is most often diagnosed between the her from obtaining the treatment and careages of 20 and 40critical years for higher she desperately needed, which contributed toeducation, career growth, and nancial stability. her extensive disability.Research shows even before an official diagnosis, Unfortunately, Janes experience is not unique.silent symptoms of MS can reduce productivity and income. The nancial burden grows as Many people living with MS encounter signicanthealthcare costs increase, including expenses systemic challenges in accessing healthcare,for treatment and annual MRIs, often requiring securing assistance, and obtaining tools tosignicant out-of-pocket payments because improve their daily lives.of high-deductible insurance plans. Healthcare access and coordination For those unable to work because of the Many individuals are diagnosed with MSdisease, securing long-term income and benets, afterexperiencingtheirrstneurologicalincluding health insurance, can be extremely symptoms, which requires an evaluation bychallenging. Limited disability benets and a neurologist. This process involves imaging,frequent denials of Social Security Disability blood tests, and sometimes spinal uid analysisInsurance add to the struggle. Additionally, to rule out other neurological conditions.for those that remain in workforce, workplace While diagnosis can often be made withinaccommodations, such as exible schedules afewweeks,thesignificantshortageoforremotework,arenotalwaysavailable. neurologistsespecially MS specialistsinMoreover, living with a progressive disease during ones prime working years can hinder the U.S., particularly in rural areas, leads tocareer advancement, limit earning potential, delays. This delay in diagnosis further leadsand disrupt financial stabilitymaking it to delays in treatment, resulting in possibledifficult to maintain a steady income to cover permanentneurologicalsymptomsandfuture medical and life expenses during disability.retirement years. msfocusmagazine.org 18"