It’s a time of hope and optimism for people living with multiple sclerosis (MS).


“I saw three new diagnoses this morning and the message is the same,” said Dr. Matthew “Max” Carraro, a neurologist at Novant Health Neurology & Sleep in Charlotte. “You can have kids, you can travel, you can go for that promotion. The goals are high.”

Multiple sclerosis is an unpredictable disease affecting some 1 million people in the United States. In MS, the immune system attacks the protective covering of nerve fibers (myelin), disrupting the flow of information between the brain and the rest of the body. It causes many different symptoms including vision loss, bladder problems, pain, numbness, trouble walking and even paralysis. The symptoms and severity vary from person to person.

Prior to 1993, there were no approved treatments for MS.

“Crudely put, they used to call this ‘diagnose and adios,’ because there were no treatments,” Carraro said. “Today, it is a completely different ballgame. Not only do we have multiple highly effective therapies, we also have a much-improved understanding of the importance of wellness and patient participation.”

‘Let this be as minimal a part of your life as possible’

Dr. Matthew Carraro sees a patient at Novant Health Neurology & Sleep.
Dr. Matthew "Max" Carraro sees a patient at Novant Health Neurology & Sleep.

Today MS patients have multiple treatment options, many of them highly effective. Medication can be ingested or injected at home. Other patients opt to receive IV therapy at an infusion center. In some cases, this medication can prevent new symptoms, slowing down the progression of MS.

Once a patient is on treatment and stable, the rest of the heavy lifting is wellness.

“We like to talk about expectation. We dig into the issues that are going on. It’s not just superficial – ‘here’s a prescription,’” Carraro said. “It’s challenging a patient with difficulty sleeping to start working out more so they’re more fatigued at night and can sleep better. It’s asking them to put in some of the hard work, too. Their efforts make real and significant difference, and we have to help foster that understanding. I think this is extremely empowering for people living with MS.”

Carraro’s patients are asked to provide real-time updates through MyChart, a secure and easy tool that allows people to email their care team, find a doctor or see medical records. The goal is staying proactive. Close follow-ups, thorough monitoring and honest conversations about symptoms are crucial.

“I think if we don’t face that together in clinic in an honest way, we can’t expect as good of an outcome. So, it’s not easy to have these conversations, but I just think it’s critical. It’s how you take good care of people.”

Novant Health to participate in TREAT-MS trial

Newly-diagnosed multiple sclerosis patients at Novant Health will have an opportunity to participate in a Johns Hopkins University study comparing the efficacy of MS therapies.

Right now, Carraro said there’s a lack of evidence-based guidelines on which treatments work best with different patients. The trial, named TRaditional versus Early Aggressive Therapy for Multiple Sclerosis (TREAT-MS), will try to establish guidelines that doctors can use to direct the treatment that’s best for individual patients.

“Real-world data is always challenging to obtain with the highest of scientific standards,” Carraro said. “They’ve done a lot of work to make this an excellent study, so we’re excited.”

Novant Health will begin enrolling patients in the trial in the coming months. Hear more about TREAT-MS by listening to the Healthy Headlines podcast.

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