"Dr. Macaluso has written the Iliad and the Odyssey of multiple sclerosis while playing the part of Odysseus. Amazing!" Carlo Tornatore, MD, vice chairman, Department of Neurology Georgetown University Hospital, Washington, DC Vincent F. Macaluso was in medical school when he got the news: he had multiple sclerosis. He soon learned that almost a half million people in the United States have multiple sclerosis--and millions more worldwide. Many have obvious symptoms, such as trouble with walking, balance, and coordination, but the most insidious aspect of the disease is how it affects the mind. Macaluso shares insights from his vantage point as a doctor and an MS patient, helping his peers understand symptoms they may not grasp and offering wisdom for those who live with the disease. Learn how to - anticipate and overcome problems concentrating; - manage swirling emotions; - understand MS from a neurological standpoint; - preserve and continue to enjoy an active sex life; and - prevent the disease from ruining family life. Laced with humor and filled with diagrams and the author's own recollections about how he's kept MS from controlling his life, this account is essential reading for doctors, patients, and anyone who has an MSer in his or her life. Multiple Sclerosis from Both Sides of the Desk Two Views of MS through One Set of Eyes By Vincent F. Macaluso iUniverse Copyright © 2015 Vincent F. Macaluso, MD All rights reserved. ISBN: 978-1-4917-5745-1 Contents FIRST My House Is Your House, 1, SECOND What MS Is from a Neurological Point of View, 5, THIRD A Day and a Night in an MS Life, 14, FOURTH Immune Systems from a Neurological Point of View, 38, FIFTH With or without You, 46, SIXTH The Neurological Examination from a Neurological Point of View, 63, SEVENTH Neurological Exam in the Round, 83, EIGHTH MRIs and MS from a Neurological Point of View, 114, NINTH Mind, Meet Brain, 125, TENTH What MRIs Look Like from a Neurological Point of View, 133, ELEVENTH What I Heard the Doctor Say, 141, TWELFTH Neurocognitive Testing from a Neurological Point of View, 145, THIRTEENTH Imagined — Wished — Possible, 157, FOURTEENTH The MS Therapies from a Neurological Point of View, 160, FIFTEENTH My Life with You, 185, SIXTEENTH The MS ICE from Both Sides of the Desk, 241, SEVENTEENTH Sex from a Neurological Point of View, 292, EIGHTEENTH A Love Letter, 322, NINETEENTH How Stephen Colbert Has Helped Me to Understand MS Better, 324, TWENTIETH Family and MS from a Neurological Point of View, 329, TWENTY-FIRST, EPILOGUE The Breakup, 343, CHAPTER 1 Each friend represents a world in us, a world possibly not born until they arrive, and it is only by this meeting that a new world is born. — Anais Nin, author 1903–1977 My House Is Your House Welcome. This is my life. My life consists of my family and friends, being a doctor, comedy, multiple sclerosis, teaching, religion, computing, woodworking, writing , jogging, nookie, thinning hair, the Yankees , reading Spenser novels , and thinking about God. These are all things that are parts of my life. They're things that came into my life, and I treasure all of them because they're what make my life unique. This is Vincent Macaluso's life. I do not live with any of them. They live with me. It's my house. It is up to me to keep the things that I have control of in balance. I value my family beyond all else in this world. My wife is the axis of my existence. We are blessed with two beautiful children. The four of us work through life together. We are a close family, in a cozy house. This allows us to create a tremendous home. I love laughing. I love it when I laugh so hard it hurts and I can't catch my breath. Sometimes I get lucky and I laugh so hard that I can't catch my breath, and I start to black out, and I fall down. Then, when I'm lying on the floor, I start to think about how funny it must have looked when I keeled over. For me, that's a win-win-win situation. I like watching The Colbert Report because it makes me think about the things going on in the world around me. Dr. Colbert's character brings up the absurdity of a situation or creates absurdity when there is none just to be a nudge. He goes fast, and you have to look and read and listen and think all at the same time. Stephen Colbert is smart. He challenges us. He has hair that does not move. On the topic of hair, mine started an exodus several years ago. I didn't worry about it because I realized that I was getting older and it was a natural part of life. But as it grew thinner, I saw some pictures of myself and thought I would look better with hair — at least for a few more years. I started medication to keep my hair, and it had been working pretty well to slow down the loss. Unfortunately, the numbers continue to dwindle despite the medication. The countless many are becoming the cherished few. Well, I did what I could, but if this is my lot, so be it. I know I c