Stacy Kinsel was in a meeting with clients one day in 1999 when she suddenly experienced extreme numbness in her legs and feed. A forensic accountant with bachelor’s and master’s degrees in accounting from the University of Southern California, Kinsel used her well-honed research skills to find the best source for diagnosis and treatment and soon found her way to the USC Multiple Sclerosis Comprehensive Care Center at Keck Medicine of USC.

After a series of tests, she was confirmed with a diagnosis of multiple sclerosis (MS), an autoimmune disease that affects the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerves.

What did this mean for her future? As head of her own forensic accounting firm, Kinsel Forensics, Kinsel’s work calculating economic damages requires her to be on the witness stand for hours, in addition to spending hours conducting research and preparations.

“It can be a little intense, to say the least, and it requires a lot of stamina,” Kinsel says. “And I wanted to have a family so I worried how it would affect my ability to carry a pregnancy to term. Needless to say, I was pretty scared.”

The fact that the progression of the natural course of MS is notoriously unpredictable did not make it any easier to take stock of the situation. The type and severity of MS symptoms vary widely. While the cause is unknown, MS is believed to result from the body’s immune system attacking its own nerve tissues.

The resulting nerve damage can manifest in symptoms as mild as tingling and numbness or as debilitating as major loss of muscle control. It also can bring on vision problems, memory failure, fatigue, loss of bladder or bowel control and severe mobility impairment.

“MS is one of the diseases for which you can change the long-term outcome if treated methodically,” says Kinsel’s physician, Regina Berkovich, MD, PhD assistant professor of clinical neurology at the Keck School of Medicine of USC. “As a neurologist, I’m really happy to be in a field where we can change the long-term destinies of our patients. That’s why we take a very active position in educating our patients.”

Berkovich has the kind of passion that comes from being personally touched by MS. As a young girl in her native Russia, she watched her aunt slowly and painfully lose vitality to the disease. “If I have a patient reluctant to go on therapy, I think about my aunt,” she says.

“A real sense of community”

In the early 1970s, little could be done to treat MS; diagnosis often was delayed for observation of developing symptoms and analysis of spinal fluid. With the advent of the MRI, however, it became possible to detect specific MS lesions in the central nervous system and to diagnose it much earlier. The first long-term, disease-modifying therapy (DMT) became available in 1993 and since then, drugs to treat MS have become increasingly numerous and effective.

Kinsel has the most common type of MS, known as “relapsing-remitting,” which tends to bring on disease attacks followed by periods of relative stability, called remissions. The goal of treatment is to minimize the chance of exacerbations, further growth of lesions and associated MS progression. Her current treatment involves a weekly infusion of the drug natalizumab at the USC MS Comprehensive Care Clinic. The drug, which works by blocking white blood cells from entering the brain and spinal cord, can cause some side effects and has potential risks, but Kinsel says she has not experienced a reaction. And although she has had four attacks since her initial diagnosis, she has recovered fully from each one and hasn’t had a new attack in years.

“There’s a real sense of community at the center,” Kinsel says. “People reach out to each other. People like me who’ve been living with MS for a long time are always happy to help newer people. I’ve always been comfortable with the care I’ve received, and I’d certainly recommend the center and Dr. Berkovich to anyone.”

Close Collaboration and Trust

Kinsel counts herself as particularly fortunate, but Berkovich says her experience is not so uncommon; good prognosis in MS is achievable, and it requires a very close collaboration and trust between the patient and the MS specialist with the support of the entire MS center. Kinsel’s career has flourished without interruption and her wish to have a family was fulfilled with two successful and completely normal pregnancies.

“What makes people successful like Stacy?” Berkovich asks rhetorically. “Number one is a proactive, positive attitude and determination to stay on top of the disease. That requires a trusting relationship with your physician; we really need to know if you’re not tolerating your treatment well so we can adjust it or change it to make sure you are comfortable, because staying on MS DMT is extremely important. I want my patients to tell me everything they experience because we’re in the same camp. And our mutual opponent is MS.”

MS: at a glance

  • Early symptoms can include weakness, tingling, numbness and blurred vision.
  • Other possible signs: muscle stiffness, cognition problems and urinary problems
  • An estimated 350,000 in the United States are diagnosed with MS
  • 200 new cases are diagnosed every week (source: National Institutes of Health)
  • Women are two times more likely than men to be affected by MS
  • People of distant Northern European ancestry are at a higher risk of contracting MS

Learn more at: ms.keckmedicine.org

By Martin Booe