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Keith Roach, MD, syndicated columnist

Dear Dr. Roak: I was diagnosed with multiple sclerosis two months ago. Last week I got worse in the shower, my legs turned to jelly and I couldn’t even walk or stand. I have a lot to learn about my disease. Are these events common? In the next month or two I will start an infection with okra. I am now home and mobile, using a wheeled walker. Am I permanently disabled? – M.K

Answer: Multiple sclerosis is diagnosed in about one in 100,000 people, and is more common in women and in certain geographic areas. It is thought to be an immune disorder, where the body attacks myelin, the covering of nerve cells, but what exactly triggers MS is not known.

MS can cause a variety of symptoms, with eye symptoms, fatigue, weakness and unusual sensations in the limbs being among the most common early symptoms.

Most people initially diagnosed with MS have a flare-up (burning sensation or attack) and then full or partial recovery. This process is called relapsing-remitting. Others have progressive disease. In just two months, it can be difficult to know what type of MS you have, and I certainly can’t predict what your course will be.

Ocrelizumab (Ocrevus) is a specific antibody to reduce the immune response by antibody-producing B cells. It is effective against both relapsing-remitting and progressive subtypes of MS.

There are many places to read more about MS. Start with the Multiple Sclerosis Society of America at and the National Multiple Sclerosis Society at

Dear Dr. Rock: My husband blows his nose several times a day and screams constantly. He saw a doctor to no avail. He has been taking medicine, but nothing has helped. Had blood tests done and all levels were normal.

I wonder if you know what could be causing these symptoms? He’s been told that blowing his nose might somehow affect his voice, but he’s not conclusive yet.

He is healthy, a good weight (although I feel he is a bit thin), is 60 years old and runs about 6 miles every day. On other days he lifts weights. He doesn’t eat as many vegetables as I would like so his diet is what I think. No fast food or junk food and no soda. – J.P

Answer: Nose blowing and scratching are both common and even common, and the combination of the two does not make me think of a solid diagnosis, which is satisfactory.

Belching always means that there is gas in the stomach that needs to be expelled. Although carbonated beverages sometimes contain dissolved gas that can cause bloating, most cases are caused by swallowing too much air. I refer patients to speech and swallowing specialists to learn techniques for swallowing air.

Blowing the nose can cause excessive production of nasal and sinus mucus, which can be allergic or allergic.

Editor’s Note: Readers may email questions to or mail to 628 Virginia Dr., Orlando, FL 32803.

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