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msfocusmagazine.org
 Ask the MS Nurse
Ask the MS Nurse 
Cherie Binns is a MS-certified 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 quarterly column addresses the issues of living with MS.
Dear MS Nurse, 
I have a prescription for Clonazepam for 
my tremors but am hesitant to take it  
regularly because I hear it is addictive. What 
can I do? – Irina K. 
Binns: This medication is a benzodiazepine, 
as are Xanax, Ativan, Ambien and other 
antianxiety medications. They can be highly 
addictive if taken daily. They have also been 
shown to negatively affect cognition if taken 
for extended periods of time. Your concerns 
should be expressed to your prescriber so 
they can provide guidance on how frequently 
and in what dosage you should take them or 
perhaps come up with an alternative therapy. 
Dear MS Nurse, 
The lesions on my spine are causing terrible 
hip and lower back pain that cripples me by 
the end of the day. This pain is only relieved by 
opioids. Is there anything else I might do to 
calm the pain from the lesions? – Mellody B. 
Binns: Lesions do not hurt. There are no pain 
receptors in the lesions. The pain is most likely 
due to gait irregularities that are likely because 
of weakness in one of your legs. This is one of 
the most common symptoms that send people 
with MS to a physical therapist. I would  
recommend a physical therapy consult and, if 
relief is minimal, seek counsel from a pain 
clinic. 
Dear MS Nurse, 
I am on Kesimpta and just found out I need 
a colonoscopy because of a positive Cologuard 
test. They tell me I have to stop my medications 
two days before the procedure. Because MS 
is an autoimmune disease, should I even do 
this? I am sensitive to many medications and 
am afraid there will be reactions.  – Perkins L. 
Binns: Medications that may need to be stopped 
for a couple of days prior to a colonoscopy would 
be fiber-bulking ones such as Metamucil, ones 
that prolong bleeding time such as aspirin, fish 
oils, or omegas, and prescription drugs such as 
Coumadin. I recommend asking your doctor to 
clarify which medications need to be stopped, 
and if that includes your DMT ask why. The 
medications listed above can be resumed after 
the procedure. People with autoimmune con­
ditions are, as a rule, generally safe to have 
colonoscopies done. Propofol is generally the  
sedating medication used for this procedure 
and most people are awake within a half hour 
(or less) after receiving the medication. It is  
important that all of us with MS do regular 
screening exams such as colonoscopies,  
mammograms, and prostate exams. 
Dear MS Nurse, 
I was given a script for Tizanidine for  
whole-body spasms when I first get out of 
bed. Does this help? – Frank O. 
Binns: You may find that stretching before 
you get out of bed will minimize the intensity 
of the whole-body spasms. Stretching your 
calves, quads, hamstrings, and ankles should 
help. Tizanidine can be sedating so I would 

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