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Meeting the Challenge of Progressive Multiple Sclerosis
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Meeting the Challenge of Progressive Multiple SclerosisMeeting   the Challenge of Progressive Multiple Sclerosis
  Patricia K. Coyle, M.D.
  June Halper, MSN, ANP, FAAN
  2001, 123 pages
  Demos Medical Publishing
  Reviewed by Dorothea Cassidy Pfohl

Free   Preview: Chapter 7

"Meeting   the Challenge of Progressive Multiple Sclerosis" lives up to the promise of   its title. Dr Coyle and June Halper have created a concise, practical and useful   overview of worsening MS and the dilemma faced when progression presents its   challenges to patients and those who care about them. The language is straightforward   and does not shy away from difficult topics yet always presents information   with the reassurance of realistic hope.

From   the first pages, which define and clarify current thinking about progressive   forms of MS, this book ably explains classifications and transitions and answers   questions frequently posed by the person fearful of the very term "progressive".   There is a comprehensive review of diagnostic criteria and detailed explanations   of what specific testing is expected to reveal. Tables list characteristics   of progressive forms of the disease yet offer complexity with brevity. Indeed,   in the chapter addressing symptom management, the tables are presented so elegantly,   they serve as concise templates for developing individualized plans of care.   The section on disease modifying therapy strives to be inclusive and unbiased   and the review of research studies is remarkably up to date considering the   speed with which change occurs in these areas. (The exception is the IMPACT   study of double dose Avonex, which is completed, but listed as ongoing.)

"Meeting   the Challenge" offers tools for the transition, explains the varied roles of   rehabilitation specialists and provides a list of resources and additional readings.   Quality of life preservation and advocacy feature prominently in chapters where   suggestions for formal and informal arrangements encourage making the most of   difficult circumstances.

Throughout   the book, the needs and concerns of caregivers are addressed. Important topics,   from sexuality and gender issues to parenting, patient rights and resource management,   make each section useful and thought provoking. Always, options are presented   as "choices that can evolve into hope." (preface ix)

Equally   affirming is the "wellness" approach encouraging the person with progressive   MS to face worsening disease with a holistic approach to health-"making room   for the disease without giving it more space, more time, or more energy than   it absolutely needs." (Chapter 7, p85). Both encouraging and informative, this   book is a welcomed addition to the education areas of centers, resource rooms,   patient libraries and professional offices. It's clarity makes it of value to   the health care professional as well as the layman. The authors assert that   "in facing worsening disease, people with MS must be empowered with tools for   the help them adapt to change and remain functional and productive   members of their families and the community" (P66). This thin book itself is   such a tool.

About   the Reviewer:
  Dottie (Dorothea Cassidy) Pfohl RN BS is clinical coordinator for the Comprehensive   MS Center at the University of Pennsylvania Health System, Philadelphia, PA.  She has been involved in neurological clinical research for over twenty years   and has specialized in the care of people with MS since 1989. She is active   in the community and committed to health education. She is a founding board   member of IOMSN and chairperson of the membership committee.

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