I have been giving some more thought on the issue of getting action in Manitoba on Multiple Sclerosis. A big question that I am thinking about right now is: does the new NDP Minister of Health have the health care experience needed to handle this particularly important portfolio?
I think the new minister's handling of Multiple Sclerosis is an early test of her ability. Here is why.
Based on the figures provided at the Multiple Sclerosis conference this weekend, it is clear that this disease costs the health care system more than $100 million per year in Manitoba. Obviously, we need to get the prevention, diagnosis and treatment of this condition right. We need to have, in essence, a well-functioning 'Centre of Excellence in Multiple Sclerosis' in Manitoba which can integrate prevention, diagnosis, treatment, research and database management to make sure we are making progress. Here's some reasons why.
1) It is vitally important the Multiple Sclerosis is detected and treated early.
Evidence presented at the conference emphasized that early detection and treatment can modify the disease of Multiple Sclerosis and considerably improve the outcome for people – as well as decrease health care costs to our system.
So, we need much greater public awareness of the signs and symptoms of MS. For example, 40% of people with Multiple Sclerosis initially present with double vision (or in medical terminology – diplopia). For example, 64% of patients with Multiple Sclerosis have optic neuritis (an inflammation of the nerve which goes to the eye) and this will usually present with loss of vision or changes in vision leading to a decrease in the ability to see colours or to see contrast.
We also need a well coordinated province-wide approach to detecting and treating multiple sclerosis early on.
2) Multiple Sclerosis may be preventable in some people.Experts at the conference talked about the fact that there are both genetic and environmental reasons for developing Multiple Sclerosis. The environmental causes are not fully defined, but it is very likely that these are preventable causes.
Multiple Sclerosis is more often found in temperate and tropical climates. The reason may be related to sunlight or diet. If it is sunlight related, then some cases may be preventable with exposure to ultra-violet light or by ensuring people have adequate amounts of vitamin D.
Multiple sclerosis is also more often found inland that at the ocean. There is reasonable evidence that MS occurs less in areas where there is a higher intake of omega 3 fatty acids. Omega 3 fatty acids are found in fish, and are increasingly available in a variety of other foods (flax oil, omega 3 enriched eggs, etc.). Nutrition experts like Dr. Bruce Holub have been arguing for some time that Canadians generally have too little omega 3 fatty acids compared to the omega 6 fatty acids (found in milk and meats in particular).
If we can decrease the incidence of Multiple Sclerosis through changes in lifestyle, then this will have both major health benefits and major cost savings to our health care system. Manitoba should be part of a national effort to check which changes make a difference and what should be recommended to reduce the incidence of multiple sclerosis.
3) A major change is occurring in the treatment of Multiple Sclerosis from traetment in hospital to primary treatment in a clinic.
Presenters at the conference described the dramatic reduction in need for hospitalization for people with Multiple Sclerosis and the need for much more focus on care in a Multiple Sclerosis clinic. For example, one of the major presenting symptoms of MS is optic neuritis. This can now be almost always treated in the clinic. But to do this well, the clinic at the Health Sciences Centre (the major clinic for Multiple Sclerosis in Manitoba) needs to be much better supported and needs to be highly networked with physicians around the province to ensure the best possible care. Better support for this clinic will give better prevention, diagnosis and treatment, and the provision of more resources for the clinic will be offset by decreases in hospital and other treatment costs elsewhere in the health care system.
4) Home care versus personal care homes for those with Multiple Sclerosis.
Discussion I had with attendees at the conference also emphasized the fact that personal care homes are the wrong place to be caring for individuals who are at or near 50 years old with Multiple Sclerosis. The problem is that at present too many individuals who are of younger ages with Multiple Sclerosis are being put in personal care homes with much older individuals. We need much better alternatives for caring for those with multiple sclerosis.
As you can see, there was a lot of solid information to be gained from the conference as well as an opportunity to speak first hand with those with MS and those working with MS. It concerns me greatly not see the new Health Minister attend this event, even for a short while.