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TALKING ABOUT RELAPSING MS

There’s no right or wrong answer for talking about relapsing MS. The who, when, and why depends on a lot of different variables…

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SPEAKING UP FOR YOURSELF: Discussions About Relapsing MS Treatment Goals

TALKING ABOUT RELAPSING MS

By Rachel, Wife, Mother, Domestic Engineer

Ah, talking about relapsing MS. If we don’t talk about MS it goes away, right? NOPE! Like it or not, once you or someone you care about gets diagnosed with MS, you’re going to be doing a lot of talking about it. Talking to your healthcare providers, talking to your friends and family, talking to others facing this disease. Maybe even talking to a therapist (I know that doing this has been helpful for me and my family). Every conversation serves a different purpose.
There’s no right or wrong answer when it comes to talking about relapsing MS. The who, when, and why depends on a lot of different variables, including your personal comfort level. Sharing something as personal as a medical problem can be a highly emotional undertaking. It’s scary not knowing how people are going to respond to you. Will they be supportive and positive? Should you tell everyone or just some of the people that you trust? Even now, thinking of all the possibilities gives me anxiety! It can be exhausting. MS is unpredictable and it’s hard to explain to others what to expect when you can’t even know for yourself. So where to begin?

BEING OPEN WITH YOUR HEALTHCARE TEAM

First of all, you should always keep lines of communication open with your team of healthcare providers. If you haven’t already, it’s important to find a physician with whom you can develop a good working relationship. Relapsing MS is a chronic condition that requires ongoing care, so it’s good to find someone who has experience in treating this disease. I find it helpful to keep track of my non-urgent questions by writing them down so that I don’t forget, then I’m prepared to get the most out of my appointment. It’s also helpful to bring someone along with you to your appointments. That person can act as an extra set of ears for you.

SHARING WITH FRIENDS AND FAMILY

Another key group on your conversation to-do list is friends and family. I think this is a little more difficult to navigate because it can be so overwhelming to work through all of the emotions you’re feeling. MS shows up one day and becomes part of the family, so to speak. It’s like that relative who decides to move into your house one day and never leaves. Not only does this relative become a permanent resident of your household, but it’s not even a little bit considerate.
Something that I have found helpful when explaining relapsing MS to my friends and family is watching educational videos together or even attending learning events. Another great way to connect with others living with MS is by finding a local support group or even a support group that is online. You do not have to face this alone

ANSWERING CHILDREN HONESTLY

One of the top questions that comes up when I am sharing my journey at events—especially when my husband/care partner and I are sharing our story together—is how we handle talking about MS with our children. People ask how we handled it, what it’s been like, and how we have dealt with the emotions. One mom who was living with relapsing MS brought her young but grown daughter along to this particular educational event. They came up to us afterward and thanked us for sharing our story and being so relatable. Her daughter had asked us a bunch of questions about how we approached talking to our children, and the mother was nearly in tears because this was the first time her daughter had spoken up like that. Remember, MS is hard for everyone involved.

Three children walking through a shallow stream, surrounded by lush green grass.

Now I bet you’re wondering how we have handled discussing MS with our children. We’ve found the best way is to answer questions to the best of our ability when they arise and be as truthful as possible. We don’t avoid any topics—even if they’re hard ones. Children, no matter what the age, can worry and feel anxious. My oldest daughter recently came to me and told me that she doesn’t worry about me as much. Having an open and ongoing conversation about MS as a family has helped us to be better communicators in general. That doesn’t mean that those conversations aren’t challenging, but they are worth having. It’s also taught all of us perseverance, how to work as a team, and to not give up! My children have learned to not judge others so quickly and to be compassionate. I’m so proud of them and their strong character. And we have all learned to appreciate the good in each day.

As you can see, the conversations differ depending on who you’re talking to and why. Everyone’s MS is different and everyone’s comfort level is going to be different—and that’s okay. How and when you choose to have these discussions is something that you’re allowed to be in control of. Please, please make sure you are working with a healthcare provider with whom you are able to remain in open conversation. That is one of the most, if not the most important, conversation to be having when it comes to talking MS. There are many resources out there to help get you started and help you along the way. You can even get in touch with one of the helpful Case Managers from MS One to One® during business hours at 1-855-676-6326

I wish you the best of luck with your treatment decision.

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Important Safety Information

LEMTRADA is a prescription medicine used to treat relapsing forms of multiple sclerosis (MS), to include relapsing-remitting disease and active secondary progressive disease, in adults. Since treatment with LEMTRADA can increase your risk of getting certain conditions and diseases, LEMTRADA is generally prescribed for people who have tried 2 or more MS medicines that have not worked well enough. LEMTRADA is not recommended for use in patients with clinically isolated syndrome (CIS). It is not known if LEMTRADA is safe and effective for use in children under 17 years of age.

LEMTRADA can cause serious side effects including:

Serious autoimmune problems: Some people receiving LEMTRADA develop a condition where the immune cells in your body attack other cells or organs in the body (autoimmunity), which can be serious and may cause death. Serious autoimmune problems may include:

  • Immune thrombocytopenic purpura (ITP), a condition of reduced platelet counts in your blood that can cause severe bleeding that may cause life‑threatening problems. Call your healthcare provider (HCP) right away if you have any of the following symptoms: easy bruising, bleeding from a cut that is hard to stop, coughing up blood, heavier menstrual periods than normal, bleeding from your gums or nose that is new or takes longer than usual to stop, small, scattered spots on your skin that are red, pink, or purple.
  • Kidney problems called anti‑glomerular basement membrane disease, which, if not treated, can lead to severe kidney damage, kidney failure that needs dialysis, a kidney transplant, or death. Call your HCP right away if you have any of the following symptoms: swelling of your legs or feet, blood in the urine (red or tea‑colored urine), decrease in urine, fatigue, coughing up blood.

It is important for you to have blood and urine tests before you receive, while you are receiving and every month for 4 years or longer, after you receive your last LEMTRADA infusion.

Serious infusion reactions: LEMTRADA can cause serious infusion reactions that may cause death. Serious infusion reactions may happen while you receive, or up to 24 hours or longer after you receive LEMTRADA.

  • You will receive your infusion at a healthcare facility with equipment and staff trained to manage infusion reactions, including serious allergic reactions, and urgent heart or breathing problems. You will be watched while you receive, and for 2 hours or longer after you receive, LEMTRADA. If a serious infusion reaction happens while you are receiving LEMTRADA, your infusion may be stopped.

Tell your HCP right away if you have any of the following symptoms of a serious infusion reaction during the infusion, and after you have left the healthcare facility:

  • swelling in your mouth or throat
  • trouble breathing
  • weakness
  • fast, slow, or irregular heartbeat
  • chest pain
  • rash

To lower your chances of getting a serious infusion reaction, your HCP will give you a medicine called corticosteroids before your first 3 infusions of a treatment course. You may also be given other medicines before or after the infusion to try to reduce your chances of having these reactions or to treat them if they happen.

Stroke and tears in your arteries that supply blood to your brain (carotid and vertebral arteries): Some people have had serious and sometimes deadly strokes and tears in their carotid or vertebral arteries within 3 days of receiving LEMTRADA. Get help right away if you have any of the following symptoms that may be signs of a stroke or tears in your carotid or vertebral arteries: drooping of parts of your face, weakness on one side, sudden severe headache, difficulty with speech, neck pain.

Certain cancers: Receiving LEMTRADA may increase your chance of getting some kinds of cancers, including thyroid cancer, skin cancer (melanoma), and blood cancers called lymphoproliferative disorders and lymphoma. Call your HCP if you have the following symptoms that may be a sign of thyroid cancer: new lump, swelling in your neck, pain in front of neck, trouble swallowing or breathing, hoarseness or other voice changes that do not go away, cough that is not caused by a cold.

Have your skin checked before you start receiving LEMTRADA and each year while you are receiving treatment to monitor for symptoms of skin cancer.

Because of risks of autoimmunity, infusion reactions, and some kinds of cancers, LEMTRADA is only available through a restricted program called the LEMTRADA Risk Evaluation and Mitigation Strategy (REMS) Program.

Do not receive LEMTRADA if you:

  • are allergic to alemtuzumab or to any of the inactive ingredients in LEMTRADA
  • are infected with human immunodeficiency virus (HIV)
  • have an active infection

Thyroid problems: Some patients taking LEMTRADA may get an overactive thyroid (hyperthyroidism) or an underactive thyroid (hypothyroidism). Call your HCP if you have: excessive sweating, unexplained weight loss, unexplained weight gain, fast heartbeat, eye swelling, nervousness, feeling cold, worsening tiredness, constipation.

Low blood counts (cytopenias): LEMTRADA may cause a decrease in some types of blood cells. Some people with these low blood counts have increased infections. Call your doctor right away if you have symptoms of cytopenias such as: weakness, chest pain, yellowing of the skin or whites of the eyes (jaundice), dark urine, fast heartbeat.

Inflammation of the liver: Call your HCP right away if you have symptoms such as unexplained nausea, stomach pain, tiredness, loss of appetite, yellowing of skin or whites of eyes, or bleeding or bruising more easily than normal.

Hemophagocytic lymphohistiocytosis: LEMTRADA may increase the risk of overactivity of the immune system that can be fatal if not diagnosed and treated early. If you experience symptoms such as fever, swollen glands, or skin rash, contact your HCP right away.

Adult Onset Still's Disease (AOSD): LEMTRADA may cause AOSD, a rare condition that can cause a high fever lasting more than 1 week, pain, stiffness with or without swelling in multiple joints, and/or a skin rash. If you experience a combination of these symptoms, contact your HCP immediately.

Thrombotic thrombocytopenic purpura (TTP): LEMTRADA may cause blood clotting problems that can be fatal. Call your HCP right away if you experience symptoms such as: purplish spots on skin or in mouth due to bleeding under skin, yellowing of skin or whites of eyes (jaundice), feel tired or weak, very pale skin, fever, fast heart rate or short of breath, headache, speech changes, confusion, vision changes, seizure, low amount of urine or dark or bloody urine, stomach pain, nausea, vomiting, or diarrhea.

Autoimmune encephalitis (AIE): LEMTRADA may cause AIE, a brain disorder which may include symptoms that seem like an MS relapse. Call your HCP right away if you have any of the following symptoms: personality changes, mood changes, seeing things that are not there (hallucinations), agitation, short term memory loss, confusion, movement disorders, or seizures.

Bleeding disorder (acquired hemophilia A): LEMTRADA may cause acquired hemophilia A. Call your HCP right away if you have any of the following symptoms: bruising, nose bleeds, bleeding from a cut that may take longer than usual to stop, painful or swollen joints, blood in urine, dark or bloody stools.

Inflammation of the colon (colitis): Tell your HCP if you have symptoms of colitis, such as diarrhea (loose stools) or more frequent bowel movements, stools that are black, tarry or have blood or mucous, or severe stomach-area pain or tenderness.

Serious infections: LEMTRADA may cause you to have a serious infection while you receive and after receiving a course of treatment. Serious infections may include:

  • listeria. People who receive LEMTRADA have an increased chance of getting a bacterial infection called listeria, which can lead to significant complications or death. Avoid foods that may be a source of listeria or make sure foods are heated well.
  • herpes viral infections. Some people taking LEMTRADA have an increased chance of getting herpes viral infections. Take medicines as prescribed by your HCP to reduce your chances of getting these infections.
  • tuberculosis. Your HCP should check you for tuberculosis before you receive LEMTRADA.
  • hepatitis. People who are at high risk of, or are carriers of, hepatitis B (HBV) or hepatitis C (HCV) may be at risk of irreversible liver damage.

These are not all the possible infections that could happen while on LEMTRADA. Call your HCP right away if you have symptoms of a serious infection such as fever or swollen glands. Talk to your HCP before you get vaccinations after receiving LEMTRADA. Certain vaccinations may increase your chances of getting infections.

Progressive multifocal leukoencephalopathy (PML): A rare brain infection that usually leads to death or severe disability has been reported with LEMTRADA. Symptoms of PML get worse over days to weeks. It is important that you call your doctor right away if you have any new or worsening medical problems that have lasted several days, including problems with thinking, eyesight, strength, balance, weakness on one side of your body, using your arms or legs.

Inflammation of the gallbladder without gallstones (acalculous cholecystitis): LEMTRADA may increase your chance of getting inflammation of the gallbladder without gallstones, a serious medical condition that can be life-threatening. Call your HCP right away if you have stomach pain or discomfort, fever, nausea, or are vomiting.

Swelling of lung tissue (pneumonitis): Some people have had swelling of the lung tissue while receiving LEMTRADA. Call your HCP right away if you have shortness of breath, cough, wheezing, chest pain or tightness, or are coughing up blood.

Before receiving LEMTRADA, tell your HCP if you:

  • have bleeding, thyroid, or kidney problems
  • have a recent history of infection
  • are taking a medicine called Campath® (alemtuzumab)
  • have received a live vaccine in the past 6 weeks before receiving LEMTRADA or plan to receive any live vaccines. Ask your HCP if you are not sure if your vaccine is a live vaccine.
  • are pregnant or plan to become pregnant. LEMTRADA may harm your unborn baby. You should use birth control while receiving LEMTRADA and for 4 months after your course of treatment.
  • are breastfeeding or plan to breastfeed. You and your HCP should decide if you should receive LEMTRADA or breastfeed.

Tell your HCP about all the medicines you take, including prescription and over‑the‑counter medicines, vitamins, and herbal supplements. LEMTRADA and other medicines may affect each other, causing side effects. Especially tell your HCP if you take medicines that increase your chance of getting infections, including medicines used to treat cancer or to control your immune system.

The most common side effects of LEMTRADA include:

  • rash
  • headache
  • thyroid problems
  • fever
  • swelling of your nose and throat
  • nausea
  • urinary tract infection
  • feeling tired
  • trouble sleeping
  • upper respiratory infection
  • herpes viral infection
  • hives
  • itching
  • fungal infection
  • joint pain
  • pain in your arms or legs
  • back pain
  • diarrhea
  • sinus infection
  • mouth pain or sore throat
  • tingling sensation
  • dizziness
  • stomach pain
  • sudden redness in face, neck, or chest
  • vomiting

Tell your HCP if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of LEMTRADA. You may report side effects to FDA at 1-800-FDA-1088.

Click here for full Prescribing Information including Serious Side Effects.

Click here for medication Guide including Serious Side Effects.