Multiple sclerosis is strange and unpredictable.
No one knows what causes it. It has no cure.
What is known is that it is a chronic autoimmune condition that causes the immune system to attack the brain or spinal cord in the central nervous system and damage the myelin, a substance that surrounds and protects nerve fibers. This slows communication between the brain or spinal cord and the rest of the body.
Symptoms commonly include fatigue, numbness, tingling, blurred vision, weakness, memory issues, depression, pain and trouble with balance.
In its strange unpredictability, Tyler Livingston of Sagle had no idea he had MS. He just knew he was struggling to stay upright and had to leave his retail job in February, 2021.
“I couldn’t keep my balance,” Tyler said. “I was taken off work for my own safety.”
Tests showed Tyler had a vitamin deficiency. But when B-12 injections didn’t improve his worsening condition, he was fast-tracked to see Kootenai Health’s resident MS specialist Nina Bozinov, M.D., who diagnosed the 32-year-old film student with MS in March.
“At my appointment, they made the decision to hospitalize me,” Tyler said. “It was to put me on a steroid drip for a few days to lessen the damage the MS had done.”
The diagnosis was a shock.
At the same time, it was a relief.
“It was nice to just have an answer,” he said. “It wasn’t a great answer, but it was an answer. Dr. Bozinov and her team have been amazing.”
Tyler spent a week in Kootenai Health, then two weeks in Rehabilitation Hospital of the Northwest.
“It was nice being able to walk without being afraid I was going to fall forward,” he said. “I’m much better now, and walking unaided.”
This heavy and sudden change could have been scary and difficult, but the coordination and dedication of his care teams put Tyler at ease.
Kootenai Health uses a comprehensive, patient-centered care model that takes an individualized approach to each MS patient. Disease-modifying therapies are used to treat the MS, while physical, emotional and psychosocial well-being is tended to by a wide swath of care partners, including MS nurses, specialty pharmacists, neuroadiologists, rehabilitation professionals, neuropsychologists and more.
“I feel like if I do have an issue, I can bring it up with them,” Tyler said. “That’s been my biggest hurdle. I was always used to downplaying everything. Now, I can’t afford to downplay this.”
When he was feeling low and worried MS would ruin his life, Tyler’s care team helped ease that trouble, too.
“They have been able to talk me out of darker places,” he said. “I had these grand plans for what I’m going to be doing in five years’ time. Part of me felt like this would derail all that. They told me about how they would help me with this disease so my plans aren’t going to be derailed.”
Tyler’s diagnosis is not rare, but MS is more often found in women than men, at nearly three times the rate.
“There are still many men diagnosed with multiple sclerosis,” Dr. Bozinov said. “When we hear ‘MS,’ we think young females ages 20 to 40. This can cause a delay in the presentation or diagnosis of MS for men and older people. More often my male patients, including Tyler, will have seen an orthopedic specialist before being referred to a neurologist.”
Dr. Bozinov said it’s tricky to know the true prevalence of MS in the Pacific Northwest. She said a latitude gradient may play a role, as well as high rates of risk factors such as vitamin D deficiency and northern European heritage.
“The Idaho Panhandle has a latitude of approximately 46° N of the equator,” Dr. Bozinov said. “These factors likely contribute to the higher rates of MS in our region. We need more real-world research to understand what is unique to our region so we can find ways to intervene.”
Dr. Bozinov is the only MS expert in the Inland Northwest. She and her team will keep treating patients and searching for answers to this strange ailment, so patients like Tyler can continue to live life to the fullest.
“It is an incredible honor to be an MS provider for northern Idaho and the surrounding regions,” Dr. Bozinov said. “I am so proud of our clinic setup and what we can offer at Kootenai Health to people living with MS. I’ve had many interactions where patients say it feels like they are coming home. Caring for someone living with MS is a full-team collaboration and it has been wonderful to work with other providers in the area.”