To See or Not To See is Professor Uthoff’s Question

You might be scratching your head about now wondering what the heck I mean. Not sure about you but vision is one of the top symptoms I deal with. For sure not the worse but one I sure could do without Professor Uthoff!

So, who is and why did I mention Professor Uthoff if vision is my problem? I am sure some of you know, for those who don’t Uthoff was a German Professor of Ophthalmology in the 1890s. While treating patients with Optic neuritis, a common symptom of MS, he noticed temporary blurry vision while exercising.

Initially, it was believed the exertion of exercising is what caused the blurry vision. Researchers eventually found it was not the exercising causing the issue, it was the increase in the patient's internal body temperature was the culprit.

A few decades later, patients were placed in a hot tube of water. If their vision became blurry MS was possible and the syndrome became known as Uthoff’s Syndrome.

Let’s take a look to understand Uthoff’s

It appears Uthoff’s impacts vision of 53 percent to 80 percent of those with MS depending on the study read. Heat is typically the key, which for me triggers only blurry vision. However, Uthoff’s can cause exacerbation of other symptoms as well. Some, notice worsening fatigue, pain, cognitive difficulty, and bladder sensitivity.

The exact science of Uthoff’s is not yet completely known. It is believed, the increase in body temperature might slow or block the connectivity of nerves with damaged myelin. As you know, this is the main factor that causes MS.

How do you manage Uthoff’s

The best way is to plan, plan, plan! Take the time to consider what your activity is, the time of day, weather forecast, type of clothes you will wear, and should you take a cooling device. Devices you might consider include, cooling packs, a cooling vest, misting device, or a portable fan.

Other keys to consider that might trigger Uthoff’s can be direct sunlight, using a hairdryer, a hot shower, sitting in a sauna, and hormonal fluctuations. Even a temperature change caused by an infection can trigger Uthoff’s.

Another method is precooling before your activity. Precooling should be done for thirty to sixty minutes prior. You can wear your cooling vest, sitting in a cool room, tub or shower at a temperature of 62 degrees. This method, however, will only keep your internal temperature low for an hour or so.

Is it really Uthoff’s or a relapse?

Uthoff’s as mentioned can cause temporary worsening of other symptoms. If you’re a new MSer I’m sure you are wondering if this is Uthoff’s or a new lesion? One way to tell, if the symptom goes away after cooling down, it’s Uthoff’s. If the symptom does not improve back to the baseline and continues you may be experiencing a relapse.

So, how do I deal with Uthoff’s and of course a laugh

I will say Uthoff disrupts your daily activity. Just a walk to the mailbox or around your neighborhood in hot weather will do it. I am a bit stubborn and haven’t found cooling equipment that works well for me yet. I will say stopping often to sit in the shade, using a fan, or a cool drink helps.

One of the biggest challenges is the gym. When working out I will complete one exercise then rest before the next. This allows me to cool a bit before the next set. After completing my workout, I’ll rest for ten minutes or until my vision clears. It truly makes your workout long, however, with Uthoff’s and foot drop falling can eventually happen.

Now for a smile and maybe a laugh. While out and about during one of Colorado’s hot summers my Uthoff’s hit me. My wife and I were walking at the outside section of the mall. Go on say it, not smart are you brainless. Yep, not smart and after about 30 minutes my vision began to blur.

I suggested we go inside the mall to cool down, rest, and a pit stop. As I walked out of the bathroom my thought was oh my this shall be fun. I could only see colors and outlines, no storefronts, or people’s facial detail.

Now, my wife was standing ten feet from me, and I had not a clue. She came closer while I was looking at her and I did not say a word. She finally asked, “are you ignoring me and checking out the ladies”. Oh my, busted!

You have to laugh at all we MSers deal with daily. Thank you again for your time and for reading my stories. I look forward to hearing your thoughts and topics you might like to hear about. Until next time be safe, happy, healthy, and spread kindness to everyone you meet.

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