STAGES OF MULTIPLE SYSTEM ATROPHY( MSA)
• Urology and / or pelvic health therapy to manage urinary changes and constipation
• Possible referral for sleep study and to otolaryngologist for noisy breathing at night or during the day( called stridor)
• Occasional or regular professional care services( in-home care or adult day care) may be helpful for added support and assistance for the person with MSA and the family
• Driving evaluation
• Evaluation to capture baseline swallowing function; evaluations will usually be a modified barium study or a fiberoptic endoscopic evaluation of swallowing( FEES)
• Make future healthcare decisions before they need to be made, such as designating a power of attorney and deciding on advanced directives like a do not resuscitate( DNR) order or a living will
Advanced Stage
At this stage in the disease, individuals are no longer able to complete most or any daily activities on their own. Those with the disease need close supervision and are at higher risk of complications like big falls or infections. People in this stage often have a much more difficult time communicating, which can take a toll on them emotionally. Common symptoms of the advanced stage are: Motor Symptoms people may experience:
• Frequent falls
• Limited walking, especially without assistance
• Abnormalities of posture in some with head drop or spinal deformity.
• Impairment in fine motor movements, like writing or using utensils, that can make some daily activities impossible
Speech and swallowing symptoms people may experience:
• Significantly slow, soft and slurred speech to the point of having difficulty being understood
• Increased difficulty with swallowing food and liquids Autonomic symptoms people may experience:
• Difficulties with blood pressure regulation that can cause dizziness and lightheadedness, which can lead to fainting
• Urinary incontinence and possible bowel incontinence Impact on daily living:
• Assistance is required for most or all activities Treatment, care or resources people can utilize:
• Possible continued benefit from oral medications, such as carbidopa-levodopa for parkinsonism symptoms
• Dietary changes or medication to improve blood pressure, urinary function, and constipation
• Permanent catheter for urination
• Working with physical and / or occupational therapy for adaptations to the home environment to support safety and daily functioning, such as toileting devices, lifts and adding foam to corners