Dear Dr. Roach: I was diagnosed with multiple sclerosis two months ago. I spent the past week hospitalized after an exacerbation during a shower, when my legs turned to jelly and I could not walk or even stand. I have a lot to learn about my disease. Are these incidents common? I’ll be starting Ocrevus infusions in the next month or two. I am home and mobile now, using a wheeled walker. Am I permanently disabled?
M.K.
Multiple sclerosis is diagnosed in one person in 100,000, and it’s more common in women and in certain geographic areas. It is presumed to be an immune disorder, where the body attacks myelin, the coating of the nerve cells, but exactly what triggers MS is unknown.
MS can cause many different types of symptoms, and eye symptoms, fatigue, weakness and abnormal sensations in the limbs are among the most common early symptoms.
Most people initially diagnosed with MS have exacerbations (flare-ups, or attacks) followed by complete or partial recovery. This process is called relapsing-remitting. Others have progressive disease. In only two months, it may be difficult to determine what type of MS you have, and I certainly can’t predict what your course will be like.
Ocrelizumab (Ocrevus) is a specialized antibody to reduce the immune response by antibody-producing B cells. It is effective in both relapsing-remitting and progressive subtypes of MS.
There are many places to read more about MS. Start with the Multiple Sclerosis Association of America at mymsaa.org and the National Multiple Sclerosis Society at .
Dear Dr. Roach: My husband blows his nose many times a day and belches constantly. He has seen a doctor, to no avail. He has been on medication, but nothing has helped. He has had blood tests run and all levels are normal.
I am wondering if you know what could be causing these symptoms? He was told that blowing his nose could somehow could be affecting his belching, but he has no conclusions yet.
He is otherwise healthy, good weight (although I feel he is a bit thin), is 60 years old and runs almost six miles every other day. He lifts weights the other days. His diet is what I consider so-so, as he does not eat as many vegetables as I would like him to. He does not eat fast food or junk food and no sodas.
J.P.
Blowing one’s nose and belching are both common, even normal, and the combination of the two of them does not make me think of a single unifying diagnosis, as satisfying as that would be.
Belching always means that there is gas in the stomach that needs to come out. Although carbonated beverages contain dissolved gas that sometimes causes excess belching, the vast majority of cases are due to excessive swallowing of air. Many people who swallow air do not know they are doing it. It is more common in people who eat quickly. Gum chewing and smoking tend to worsen air swallowing (the medical term, which is from the Greek, is “aerophagia”). I have referred patients to speech and swallowing experts on rare occasions to help learn techniques to reduce air swallowing.
Blowing one’s nose can originate from excess nasal and sinus mucus production, which can be allergic or nonallergic.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
