Balance question

[amas]

I had a Neuro. appt this past Friday.  I was assigned a new neurologist. I liked him because he listened to all I had to say and ask.  After quickly reviewing my timeline (the last neuro didn’t) he believes that I have had MS since 1990. I was just dx May 08.

I mentioned that my balance was getting worse so he had me do the tandem gait test which I couldn’t even do. I was actually having a good day?.  He is sending me to PT so that they can fit me with a cane.  My recent falls were in May and June which left me quite bruised.  He told me I need to put a hand rail in my shower too.  I also go backwards immediately with the Romberg test.

Here’s a question I did not think of when I was there so maybe someone can help.  I’ve been tested four times with the tandem gait walk.  First time 10/07 no problem, second time 03/08 I was clumsy but was able to do it, third time 06/08 more clumsy and only able to take about 2 to 3 steps.  The fourth time was last Friday, I barely get my feet into position and I’m falling  (my right leg buckles).  I know symptoms come and go & some stay.  My balance issues have been with me since 04, just more obvious and a big issue now.  Will I always fail this test.  Am I headed for more falls?  Last week my husband hit the light switch accidently, when it went dark, I felt a little off balance, I swayed forward.  A couple days later a loud noise made me lose my balance.  How or are these situations connected with balance alone or something else?

Anamaria

[amas]

Updating.

Just like that, on Sunday I was able to do the Tandem Gait and Romberg Test.  WOW!
This last week I had noticed that my balance problems had lessened.  I've been on Copaxone for three months now.  Is that what did it or could I've been in an extremely long flare? My balance issues started in late 2006 but not being able to complete these test started in March 2008.  Any thoughts?

Anamaria

[jensequitur]

The Romberg's test is to see whether the nerves in your spine are affected.  If they're damaged, you can lose your sense of balance.  So if you have a positive for Romberg's, then there's some spinal involvement.  Did they also tap your knee (for the patellar reflex?)  If your knee didn't move at all, then that means that there's no signal going from that nerve up the spine - meaning that the nerve is disconnected at some point from the brain.

The tandem gait walk - is that the one where you walk heel to toe?  I can actually do that, now - but I still fail the Rombergs when I put my feet together.  So I think it's something your brain learns how to get around.

[amas]

Thanks Shoshin for the info.  I definately want to learn exercises to help with this. My balance issue might be worse because my weakness and spasticity in my legs are too.  I am glad I'll be going to PT.  It's interesting that you mention the vision as an issue.  I've noticed now for a while that when I'm in a crowded place with a lot of movement going on it seems like my balance issues start or get worse.  Also when I'm in tight places. Since there is always a level of noise with crowds I wandered how much of my issue was related to the noise or my eyes taking it all in.  

Sunnytoday, you poor thing.  I haven't fallen that much.  I am though always reaching out for things or people to catch myself.  I feel I spend too much time focusing on staying up or keeping straight when I'm walking. Do you use a cane or other aid?  
Good luck on your trip to NYU.

[Sunnytoday]

Hi! Thought I'd just post and say that ya'll are in good company... I'm at about the same place... I could have written that post myself!

Although, I've never been able to do the tandem walk or close my eyes and stand still this year. I fall over like a LOG. I too hope this will go away... so here's to HOPE!!!!

The piece about PT was good. I basically bashed PT when it made my joints so much worse this last fall, but you know, if it can help balance, i'm all for it. Falling all over the place every day is sure getting old. It's an every day occurance. I don't mark in on the calendar or put in on my timeline. If I did it would have to go all the way acrost from top to bottom "TODAY I FELL" Grin.

Ok, so I'm off to bed...

As you can tell,,,,, I talk when I'm nervous, and I'm nervous about going to NYU....
Bye now!
~Sunnytoday~!

[shoshin]

I don't know much, but this might help a bit. When I went to PT for walking, they actually worked as much on balance issues as any weakness or walking things (which I had no idea they could do). They gave me a test where I got in a box with a moving floor and a computer measures how well the three parts of the balance system are working (I have another post on this somewhere).

Anyway, there are three things that can go wrong with balance: (1) vision; (2) somatosensory, which is the feeling in the bottom of your feet; and (3) vestibular system, which is in the brain in the inner ear and has fluid in it that tells you which way you're oriented.

So if you have problems with (2) or (3) then you probably over-rely on your vision to keep your balance (apparently, that's what I'm doing anyway). And you're in a lot more trouble in the dark or during the Romberg test.

If you have reduced sensation in your feet (which I do), the PT can't do much about it. However, my vestibular system seems to be mostly out to lunch and they did give me exercises to work on that. When they tested me again after about four weeks, it had gone up from a little sliver to about 25 (I think; it was on a 0-100 scale). You would still not say I have good balance (as I was on my way out after my appt today, the neuro rather helpfully told me not to fall), but I think it has helped in that my footing is surer. Unfortunately, I think parallel to the vestibular system improving, I have been experiencing some lessening of sensation in my feet and increasing stiffness in my knees which are somewhat counteracting any progress.

Anyway, it is possible that PT could help with this, at least somewhat.

sho