Gilenya: Why Follow-up Exams are Crucial

I started Gilenya and originally my first follow-up appointment was to be three months after I began the DMD (disease modifying drug) but because of a delay caused by my doctor's failure to supply their reports to my neurologist in a timely fashion, I was delayed.

I did continue to keep up with others taking the Gilenya pill and was very mindful of the fact that macular edema could be lurking in the background but once

Initially I experienced vision problems but for a time the eye problems lessened so I felt confident I had time to get the condition checked out.

My current neurologist assured me that macular edema and ocular edema are the same. In fact he told me there is no such thing as macular edema. Ocular edema is the correct term.

My neurologist made sure I understood all the latest information about Gilenya including disclosing the deaths that occurred. ( I had read about the deaths and precautions put into place so I was quite comfortable with staying on the drug.)

He expressed his desire that I follow up on all other procedures and appointments in order to determine how my liver and immune system were holding up to the oral medication.

Blood Pressure

My first shocker involved my blood pressure. Looking back I know I had no right to be surprised. My blood pressure had been at good levels for so long I hoped it was a "sign" that it could hold its own without the three different prescriptions my general practitioner had prescribed over the course of the past fifteen years. Boy was I wrong! Although I didn't need to be rushed to the emergency room, my blood pressure was high enough to get my attention.

Sleep Apnea

I told my doctor how much better I was feeling since beginning Gilenya. I explained that I no longer need to take Prozac for energy and that my leg pain has decreased so much that I did not need Lyrica any longer. He felt that my improvements were good news but wondered about the source of my leg pain. As we talked he began wondering about the source of my fatigue as well. I was reminded that fatigue can come from other sources besides MS. I told him I never had sleep issues before developing MS and he expressed interest in having me take a sleep apnea test.

I was forewarned that if the technicians woke me during the night it meant I failed and would indeed have sleep apnea in which case we would take necessary steps from there.

The test proved I did not have sleep apnea. Although I had a very hard time falling asleep and staying asleep once I dozed off, I was assured that I was asleep long enough to rule out sleep apnea.

MS is therefore the main culprit behind my sleeping difficulties and adds to the constant state of fatigue I face each day.

In times past, my right knee barely moves when tapped with a reflex hammer. The normal MS reaction is that a knee tap causes the leg to fling upward in an exaggerated way, which is exactly what happened during the exam. I specifically asked if my reaction was due to taking Gilenya. He said he couldn't be sure it could also be that I had an injury that had nothing to do with MS which healed on its own.

Although I hoped my eye problems were unrelated to taking Gilenya, it turns out Gilenya was the culprit. My vision problems caused me to stop driving a great deal of the time. This is a problem that cannot be fixed with a stronger eye-glass prescription.

Ocular edema gave me blurred vision and effected by depth perception. My eye exam yielded very strange findings that caused the ophthalmologist to call my neurologist for a consultation. I was informed that the only way to account for my distorted vision was to attribute it to taking the Gilenya. I was told to immediately discontinue its usage.

I enjoyed the added energy afforded to me, but it was far outweighed by the vision loss.