By Ed Lash
As I mentioned in part one of this article in the previous issue, I was amazed at the answers I received when I asked at my multiple sclerosis (MS) support groups, “Do you perspire?” A number of people told me they did not perspire at all, or perspired hardly at all. Many had problems with normal sweating, but most had never thought of it as a symptom of MS. Except for occasional cool baths or swimming, however, hardly anyone took any other corrective action, or even thought there was much they could do. Almost no one mentioned it to their doctor; but of those that did, only one got a positive suggestion from their doctor: “Try keeping your skin wet with a damp cloth.”
Some of my questions, with their answers, went like this:
“Do you perspire?”
“No.”
“Have you told your doctor?”
“No.”
“Why not?”
“Because he never asked me.”
Another typical interview went something like this:
“Are you heat sensitive?”
“Very.”
“Do you perspire?”
“Hardly at all.”
“Do you use an antiperspirant?”
“Certainly. Doesn’t everyone?”
Three people told me they had not perspired for a time, but were sweating normally again, concurrently with the disappearance or improvement of other symptoms. Like all MS symptoms, evidently perspiration can also improve or return to normal. One woman said she finally started perspiring again five years after being afflicted with the problem.
Two other people said they had noticed the lack of perspiration after starting on Ditropan (oxybutymin chloride) for urinary frequency and urgency problems related to MS. After mentioning this to their doctor, a change to another drug for the same purpose solved the perspiration problem for each of them. Do you take Ditropan and don’t perspire?
The subject of perspiration is difficult to find in books about MS. In one, Symptom Management in Multiple Sclerosis (Schapiro), at the end of a section about the different nervous systems, states: “The third nervous system is the autonomic nervous system. It has two divisions; the sympathetic and the parasympathetic. These are responsible for automatic types of function; e.g., heart beating, stomach growling, sweating, etc. This system also contains myelin, but like the PNS (peripheral nervous system), is not directly affected by MS. All of these nervous systems talk to each other. Thus, while only the CNS (central nervous system) ‘gets’ MS, the disease does produce indirect effects on the others and their functions.”
Another book, McAlpine’s Multiple Sclerosis (Mathews), offers the following: “Partial loss of thermoregulatory sweating was found in 20 of 50 patients examined by Cartilage, and 23 of 60 by Noraonha et al. In the latter series, there were two patients who could not be induced to sweat at all by the methods used, including intravenous pilocarpine (a sweat-inducer). In two patients, sweating occurred only on the face.”
What happens if the signal to the sweat glands never gets through and perspiration does not occur? Body temperature may continue to rise, and this may trigger the immune system to become more active. Since MS is a disease of an over-active immune system, as body temperature continues to rise, extreme fatigue may occur, old symptoms may worsen or, especially if prolonged, an exacerbation or MS flare-up with new symptoms could possibly occur. Fortunately, in most cases when the heat situation is relieved, symptoms usually go back to the level they were before.
To be concluded, with a list of excellent management techniques, in the next issue of Action.
Note: Self-help is not intended to replace medical treatment. It should be used together with the help of appropriate professionals in a team effort.
Ed Lash is a United Spinal member who lives in Trumbull, Connecticut. He can be contacted by e-mail at edlash.ms.selfhelp@juno.com, or by phone at 203-445-0118.
