>Jane and Doc~
>
>I guess maybe I'm just not "getting it" -- I don't understand. I went back
>and reread Doc's note, and I didn't see any contradictions in Dr. Lynne's
>report quoted there, but, then, maybe I am just reading into it the info.
>obtained from this list. My understanding is that usually TM is a one time
>occurrence. But sometimes TM patients do go on to develop MS (Sharon M.,
>Marabeth, and I think some others I can't remember just now). And sometimes
>TM patients have what seems to be a relapse or a second occurrence -- an
>intensifying of existing symptoms or new symptoms -- without any of the
tests
>for MS showing that any of the signs of MS are there (Maria, Karen, Janie
>[SHIGETTE], others), thus the diagnosis of recurrent idiopathic (unknown
>cause) TM. Apparently recurring myelitis and MS are two different things,
the
>one major difference being that those diagnosed with recurring TM don't
>exhibit the lesions on the brain on an MRI and the other things that
indicate
>MS, so there seems to be a kind of no-man's land in-between.
>
>Maybe the problem is that the medical community has not come up with an
>across-the-board method of diagnosis? It seems I remember some on the list
>being told by their neurologists that a second occurrence IS MS. Yet some
>have experienced a second occurrence without the diagnosis of MS. Some drs.
>might be reluctant to diagnosis MS because of the havoc it can wreak with
>insurance companies unless there are very clear test results even though
the
>patient's symptoms might indicate MS. Some might be reluctant to diagnose
>"recurring" TM because TM is supposed to be a one-time occurrence. (Is that
>the contradiction you saw?) Yet, then, what do you call it when someone has
a
>second occurrence without MS signs?
>
>Am I off base or in the dark on this?
>
>And -- one question I have had -- when does a "flare-up" become a second
>occurrence? In my own way of thinking, I have considered an intensifying of
>existing symptoms that did not reach the level of the original TM attack as
a
>"flare-up" (which I have experienced often), but I would consider a relapse
>or a second occurrence to be a worsening of symptoms to the level of the
>original attack or beyond, or new symptoms, like numbness in an area that
was
>not numb before. But I have no idea whether that is how the medical
community
>defines it.
>
>To some this might be so much nitpicking and overanalyzing -- and I agree
>with what Robert and Mandy said, that no matter what "label" is put on it,
>you still go live your life best you can with the best attitude possible.
>Yet, some of us like analyzing details and trying to figure out just where
>the lines are drawn. And, the right "label" does have an effect on
insurance
>companies and treatment options -- I have wondered, like Karen, why TM
>patients cannot partake of MS medications like Avonex. I know in most
cases,
>TM is a one-time occurrence, so drugs like that would not be needed. But
when
>someone like Karen has had a second occurrence that was much worse than the
>first, is seems like those MS drugs should be offered even though there is
>not an "official" MS diagnosis.
>
>Let me know what you think.
>
>Barbara H.
>