b'Medicine & ResearchA s k t h e M S Nu rs eA s k t h e M S Nu rs eCherie Binns is a MS-certied nurse living with MS. She is the patient healthcare liaison for MS Focus and a member of the MS Lived Experience Advisory panel for the Foundation. Her monthly column addresses the issues of living with MS.Dear MS Nurse,Dear MS Nurse, My doctor wants me to go to physical therapyDo I need to stop driving because of MS? again. I have done this several times alreadyI nd there are days I feel less aware of my and it doesnt work. Why should I go? Chris S.surroundings.Susan H. Binns: A physical therapist evaluates theBinns: There are symptoms that can affect our problems we have with gait, strength, or paintness and safety when it comes to driving, and intervenes to help us manage those issues.such as slowed response time, visual problems, For pain, they may use special tools such asweakness in legs, or cognitive symptoms. You ultrasound, electrical stimulation, or anti-might benet from a visit to an occupational inammatory gels or creams with deep tissuetherapist. They evaluate these responses and mayprescribeinterventionstoimprove massage. For gait problems or foot drop, therecognition, response time, attention to detail, or may be tools such as ankle foot orthotics, aeven the addition of hand controls to improve walking aid, or a lift in a shoe. For falls, there maysafety. Safe driver courses through AAA or be exercises to increase core or limb strength.AARP may offer tips on driving safety as you The exercises need to be done daily, not justage, or may be dealing with decits related to when you are with the physical therapist. Thesean illness or injury. That said, on days when exercises need to be continued indenitelyyou feel less than safe, it would be wise to after discharge for the intervention to beavoidgettingbehindthewheelwhenever effective. These are some of the measurespossible. Remember, it is not just you that that a physical therapist can use to managecould be in danger. pain, falls, and gait issues.Dear MS Nurse, Dear MS Nurse,Does Ampyra really help walking? It is Are cardiac issues caused by MS? expensive and I dont know if it is worth trying.Edward L. Missy M. Binns: Ampyra (also known as fampridine or Binns: In some (rare) instances, cardiacdalfampridine), does improve both walking irregularities may be affected by lesion locationstrength and speed in about 40 percent of those (generally brain stem lesions). We should betaking it. If you are one of the people who have aware that not all new symptoms are MS-a positive reaction to Ampyra, you will notice related. We should be doing regular age- orimprovement in one or both of these within gender-related health screenings annually tothe rst two to three weeks after starting it. If minimizeorpreventproblemsthatmightyour walking abilities do not improve within worsen our MS or negatively affect quality ofthat timeframe, you do not need to rell it. life.For a less costly option, you might consider msfocusmagazine.org 44'