Beginning in the fall of 2011, a team of clinicians at the Providence VAMC began looking at ways to strengthen our commitment to providing quality care to Veterans with Multiple Sclerosis (MS). Their goal has been to develop a multidisciplinary MS System of Care, which includes a clinic that will provide timely access for Veterans to comprehensive specialized MS care. “Having a comprehensive system of MS Care,” says Jerri Jaffa, RN, who is the MS Nurse Coordinator of the clinic, “will provide our Veterans with services and treatments that they may have not been offered previously, including the newer disease modifying therapies that require special monitoring.” Doing so requires a team approach and will soon include clinicians from Sensory Rehabilitation, Prosthetics, the Ambulatory Diagnostic Treatment Unit, Pharmacy, Behavioral Health, Nutrition, Telehealth, and Primary Care. “The clinic,” Jerri adds, “hopes to raise the bar and become a recognized Comprehensive Care Center with the National MS Society (NMSS) through partnership with the Society’s Rhode Island Chapter.”
Multiple Sclerosis is a chronic, often disabling, disease that affects the central nervous system (brain and spinal cord). MS is an unpredictable disease. Symptoms vary greatly from person to person and vary over time in the same person. Symptoms of MS may be mild, such as numbness in the limbs; or severe, such as paralysis or loss of vision. MS is thought to be an autoimmune disease, where the body’s own defense system attacks myelin, the fatty substance that surrounds and protects the nerve fibers. The damaged myelin may form scar tissue (sclerosis). Often the nerve fiber is damaged.
An estimated 400,000 Americans have MS, and the VA currently serves approximately 40,000 Veterans with MS. The Providence VAMC currently treats an estimated 100 Veterans with MS.
While there is currently no cure for MS, there are disease modifying medications or therapies (DMT’s) approved by the FDA for people with the relapsing remitting form of MS. These medications have been shown to be effective in modifying the natural course of the disease. While taking these DMT’s, a person with MS will also require an increase in support and monitoring. There are also many medications and complementary therapies to relieve or moderate MS symptoms such as spasticity, bowel and urinary distress, pain, and fatigue.
In 2003, the VHA established the MS Centers of Excellence to serve the health care needs of Veterans with MS. The VHA Centers of Excellence are located in Seattle and Portland as well as in Baltimore; their mission is to improve services for Veterans with MS and provide a resource for providers through a specialized and collaborative integration of clinical care, education, research, and informatics. The Providence VAMC’s MS Clinic is part of this national network of VHA MS Centers of Excellence.
“There’s a great deal of MS research going on at the Providence VAMC as well,” says Albert Lo, MD, PhD, MS Clinical Director. According to Dr. Lo, MS research at PVAMC focuses mainly on clinical projects in understanding how MS affects mental and physical functioning. The research also concentrates on the extent to which MS affects independent adult functioning such as employment, interpersonal interaction, and the ability to perform important activities of daily living. “Many of these topics,” says Dr. Lo, “are encapsulated in the Rhode Island MS Study--a study which identifies all individuals in the state of Rhode Island with MS.” Another active study at PVAMC is the MS Quit Smoking Study, which is a study involving strength resistance training and smoking cessation. Other local research includes understanding how the latest robot technology can help people walk safer and further with less effort and with improved balance and coordination. Dr. Lo believes that, ultimately, all of these approaches might be combined with other pharmacological aspects for more effective synergistic effects.
For more information about the Providence VAMC’s Multiple Sclerosis Clinic, please contact Jerri Jaffa at (401) 273-7100, ext. 5978. If you would like more information about VHA MS Centers of Excellence, please click here.