Facing The Perfect Storm – When MS Triggers Collide

The month of May was quite literally the perfect storm when it comes to Multiple Sclerosis (MS).  Last week I wrote about how hard it is to keep up with everyday life when you have this disease. I want to talk about how different aspects of life can actually impact MS triggers.

When I say that it has been the perfect storm, I’m referring to the simultaneous conversion of factors that are known to make MS worse.


Let’s start with stress.  Many people with MS know that stress is one of the MS triggers.  Too much stress can lead to an exacerbation of symptoms. Our neurologists tell us this, the literature tells us this, and our bodies tell us this.  When most people get too stressed, including “healthy” people, their immune systems retaliate.  The immune cells get worn out, the glands that help eliminate any toxins in our body slow down, and we are now vulnerable to outside invaders.  Andrea Anderson’s article on scienceline.org, addresses an experience many of us can relate to: getting the cold or flu the day after Final Exams (Why Do I Always Get Sick After Final Exams?).  Why should stress in other parts of life be any different?

I can’t deny that the last month has been stressful!  Breaking my foot hasn’t just been about adapting to a physical injury.  It has caused financial stress since I’m working less hours in order to heal quicker, I have to rely on others more which for me personally is an emotional stress, and my responsibilities (and goals) got pretty backed up so attacking the piled high to do list now that I’ve started to heal is also incredibly stressful.

Researchers at UC San Francisco conducted a meta-analysis of studies examining the effects of stress on MS (Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis).  I found it very informative and definitely recommend reading at least the Results and Conclusions sections.  The fact that the researchers’ analysis found evidence to support that stress leads to exacerbations wasn’t a surprise to me.  What I found interesting though is one possible suggestion the authors provide to explain why stress aggravates MS.  They explain how the stress hormone cortisol can make our immune systems more sensitive or vulnerable to certain types of molecules that increase inflammation in the body.  Inflammation is what we want to AVOID in MS.   It’s possible that our increased cortisol when stressed could be increasing inflammation which could result in MS symptoms.


There is no doubt that, for myself, emotional distress is the main trigger out of all MS triggers.  Losing my grandpa has been incredibly painful.   Each person is different and I have learned that of all types of stress, emotional distress is the quickest surefire way to bring on an MS attack.  I also find it the hardest to manage…for example, “stop being sad!”  Easier said than done!  I have definitely built great coping mechanisms, but that’s another topic.


The National MS Society (NMSS) points out here that there is no scientific evidence to show that physical injury exacerbates MS (NMSS article on physical trauma & MS).  I think it goes without saying though that depending on the injury, adapting to a physical injury could certainly be  one of the MS triggers.  Being on crutches all day is exhausting!  Those of us with MS know how lethal fatigue is for our bodies.  Which brings me to the last component of my perfect storm….


Sleep plays an important part in maintaining health with MS and in maintaining a healthy immune system.  Similar to what the UCSF researchers explained, it has been shown that when we don’t get enough sleep, inflammatory cytokines (proteins made by the immune system which send messages & instructions to other cells) increase (sleep & the immune system). Surprise, surprise!  There’s that word inflammation again!

The week of my grandpa’s funeral I think I slept a total of 8 hours in 5 days.  That was just because of the flights and all the planning that had to be done.  It wasn’t even about the grief yet.  On top of that, learning to sleep with a boot on and my foot raised has been quite the experience.  Sleeping in bed with my foot raised on pillows was a bust since i just kicked the pillows off the bed.

As a result, I now sleep upside down on a chase lounge…not what you might consider a natural position.  By now I’ve fully adapted and fall right to sleep as soon as I’m in this position.  But it took several sleepless nights before my body finally agreed to sleep!

Last week I was reflecting upon all these factors converging at once and seriously thanked The Man Upstairs for allowing me to still have any ounce of functioning left.  I mean, truly, it is remarkable to me that MS hasn’t retaliated yet…although I hope I can delete the “yet!”

Once this is all over, I fully intend to keep taking it easy to avoid any chance of MS pouncing!  I just really hope that my perfect storm will be coming to a close soon!

As you know I think it’s really important to know your body.  Reflect on the timing of your flare ups (no matter what illness) and the timing of different life events.  If you feel comfortable, I encourage you to comment below and share what your biggest MS triggers are since our bodies are different and it might help someone else to start looking for particular patterns.

Anyway, as far as I’m concerned…it’s been fun Hurricane May but you are no longer welcome here!  

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