I got the phone call from the nurse at Shands Jacksonville today in response to that email I had sent my doc. I told her about my hand being numb for 3 days and the increased spasticity in my legs for those same days.
She asked me if I had a cold or any type of infection preceding that 3 day period. I thought back. I remembered that I pretty much have an ongoing UTI since my bladder doesn't empty well and I am slacking about drinking enough water.
I told her that while I was feeling lousy from the increased symptoms I was also trying to drink more water and take cranberry supplements to get the UTI under control.
It was kind of an "aha!" moment for both of us. She said they have to document any increase in opportunistic infections (such as upper respiratory infections and UTI, etc.) because the MS drugs, since they suppress the immune system to one degree or another, have a tendency to allow these infections to slip through past the immune sentries.
I asked if what I had was an exacerbation then. (Which was my original question) She explained to me that for those three days, while my immune system was sending out the infantry to fight the UTI, some of the army was misdirected and went chewing on my myelin instead. Therefor it was a "pseudo" exacerbation. Real in it's effects, but not instigated by the MS process to begin with.
So this is why it's so important to treat any type of infection...so it doesn't make the MS sit up and say "hey! we want to play, too!!"
UTIs apparently are lumped in the same group as the head colds when it comes to things Fingolimod (or Avonex) will allow to happen to you to a more pronounced degree.
I get to go see the doc on Thursday for my scheduled 6 month trial checkup, so if I am further enlightened, I'll spread the knowledge then.
I always thought a pseudo exacerbation happened when you got over heated or too tired and the nerve paths that were already damaged were just not functioning right. With rest or a cooling off period, things returned to normal. I didn't realize it could be actual disease activity.
I'm thrilled to learn something new about MS -- especially during MS Awareness Week/Month. How very appropriate.