Birthday presents: True diagnosis and a possible treatment

It was a strange day, well, certainly out of the ordinary!

I am talking about last Friday, November 8, 2019. First of all, it was my birthday (yep, now 67, getting on a bit) but it was also the day I had to see my neurologist for my regular MS check-up. Not the day I would have chosen for the appointment, but it was definitely one I couldn’t forget.

Prior to the trip to see the doctor, I had undergone a new MRI scan, and the full range of blood and urine tests.

The MRI scan confirmed that the lesions in both my brain and spinal cord remain inactive, as I was first told by Dr Fedorenko (pictured, left) in Moscow three years ago.

Laboratory tests on blood and urine proved to be normal – a description of me that my ever-loving wife Lisa finds somewhat unbelievable – with even vitamin D having recovered from ‘deficient’ to ‘sufficient’ with the help of supplements that the Spanish neurologist had previously prescribed.

We discussed my current abilities and disabilities, she asked me to demonstrate my leg and arm movements, and then she said I could have treatment to stop further deterioration but emphasised it would not do more than that.

Hospital Torrecárdenas, in Almería, where my neurology appointment took place,

Wait, what? For the very FIRST time since MS was diagnosed in April 2002, I was being offered a treatment which could slow its progress.

So, what was being suggested? Her first choice was Rituximab but I was unhappy as I know it has a high risk of unwanted side effects. Her second choice was Imurel (azathioprine), an oral medication more commonly used against lupus. I have not started that yet, so we’ll have to see where that goes.

Why such a long wait?

The question that remains is why it has taken more than 17½ years for me to be offered any MS treatment instead of just medications for pain, urine control and the like.

Well, let’s look at that!

Back in 2002, in the UK, the diagnosing neurologist said I had benign MS. Of course, back then I didn’t have the knowledge I have today. So, I didn’t know then that ‘benign’ is not a true type of the disease.

After three or four visits to the neurologist, he referred me to an MS specialist nurse, assuring me that Andy, the nurse, would arrange a neurologist appointment if I wanted one.

Visits to the nurse generally took the form of “why are you here?”, not a great start. Eventually, I asked to see a neurologist again but was told: “You had RRMS (relapsing), now you have SPMS (secondary progressive), there is no treatment, you don’t need to see a neurologist. He can do nothing for you.”

And that was that, except to say that the MS nurse is no longer in that position!

Later, while writing for Multiple Sclerosis News Today, I interviewed Dr Patricia Coyle (pictured, left) for an article for my column in the web-based digital publication. Dr Coyle is the Founder and Director of Stony Brook’s MS Comprehensive Care Center, in Stony Brook, Long Island, New York. She has several decades of experience with nervous system immune-mediated and infectious disorders. She has been involved since medical school with patient care and research focused on MS.

Anyway, with the interview over, we chatted about MS and she asked me about the symptoms I had experienced along with other probing questions. After all that, and without access to any of my records or test results, I could not expect her to make a diagnosis. However, she said from what I had told her, she believed I had PPMS (primary progressive MS).

That being said, on Friday I asked the question. What type of MS do I have? My neurologist, who does have my health records, replied without hesitation. “You have primary progressive,” she said.

So, it was a day when I finally found out my true diagnosis and was offered treatment for the first time. If not strange, it was certainly an extraordinary day. is the personal website of Ian Franks. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. More recently, he was a freelance medical writer and editor for various health information sites. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.

Late night police visit to pick me up

Police on your doorstep late at night is never a good sign. If their business cannot wait until the morning, it must be serious, right?

And, so, it happened. Just before midnight, a car pulled up and two uniformed officers came straight to our house.

No, we had done nothing wrong – they didn’t want to question us… or worse! There had been no accidents involving family or friends – they were not bringing us sad news. So, why were they here?

Well, as silly as it sounds, they had come to pick me up ……. off the floor.

You see, I had slipped while transferring from the sofa to my wheelchair, and ended up on the floor.

Despite continued and varied attempts on my part, I was unable to get up – so called 112. This is the emergency number here in Spain, equivalent to 911 in the US and 999 in the UK.

The operator was attentive, reassuring, and efficient. He listened to the facts, understood I have esclerosis multiple (multiple sclerosis), and, after ascertaining that I wasn’t injured and did not need medical assistance, said help was on the way.

And, just 15 minutes later, two Local Police officers arrived to pick me up. This they did quickly and effortlessly and were both courteous and friendly.

Talking of police in Spain, perhaps I should point out that we have three forces – the Guardia Civil, the Policia Nacional and the Policia Local.

The Guardia Civil (Civil Guard) is Spain’s conventional police force which is organised along paramilitary lines and controlled by the Ministry of the Interior. The Guardia has wide ranging responsibilities for national law enforcement and have the resources, powers and facilities of a normal police force. The Guardia Civil polices rural areas and smaller towns as well as the country’s highways.

The Policia Nacional (National Police) is the urban police agency of Spain. They are under the sole authority of Spain’s Ministry of Interior. Like the Guardia Civil it is a conventional police force, that polices cities and larger towns. It is also responsible for border security and issues residencia certificates for anyone wanting to become a resident in Spain and the essential national-registry identification number (NIE). It also undertakes the security of the Spanish royal family and the government. 

Policia Local (Local Police) is the force that is controlled by the relevant regional or local authority. It does not investigate crime but deals with minor matters. These include parking, local traffic control, bylaw issues, and, of course, picking me up off the floor. 

Wife who is carer is really a wonderful, loving, angel

It’s been an eventful few days for the two of us at home here in Spain.

On Saturday, nine days ago, my beloved Lisa asked me to help put the washing out to dry. It’s an easy job that I can do sitting down, so I readily agreed. The trouble was that it was not one of my best days. Thanks to multiple sclerosis, I managed to fall while walking out of the back door onto our terrace.

I still have no idea how but the nail of the big toe on my left foot was torn upright. It was 90 degrees from its usual position. There was pain and blood – and plenty of the red stuff.

carerMy wife Lisa is also my carer and is quite used to me spending time on the floor and could not see my injury, so she didn’t rush to my side. But she certainly arrived fast enough when I told her what was wrong.

In next to no time, she had stopped the bleeding and strapped up my toe. Luckily, once bandaged, the pain eased so that it only hurt if touched.

Wife and carer is an angel

A couple of days later, I visited our doctor. He removed the dressing and the nail came off with it. The wound started to bleed again but he quickly stopped it and sent me to a nurse to get it redressed. That started a series of one visit every two days, something I had to get used to here. The Spanish health service goes the extra mile to see that patients receive the best treatment.

However, these regular visits to the health centre are putting more stress on Lisa. Lifting my electric wheelchair out of, and back into, our car is a task that should not be repeated often. Meanwhile, at home, she is doing virtually all the work. She is my carer and refuses to ask me to help in case I am hurt again. In fact, while doing anything involving standing or walking is difficult, I try to do what I can.

One thing though, Lisa is always so grateful for whatever help I can give. But all she does for me makes her even more than my loving wife and carer.

She is my wonderful, loving, guardian angel who walks here on earth.

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* * * * * is the personal website of Ian Franks, a Features Writer with Medical News Today. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.

One year on: Living with MS in sunny Spain


It was this Sunday a year ago that Lisa and I arrived in Spain to start our new life in the sunshine, just 15 minutes from the Mediterranean.

Yes, although even the two of us find it hard to believe, we have lived here in Spain for 12 months. And we love it.

Two of the main reasons that we decided to relocate to the south of Spain were for better weather and for a hoped-for improvement in my health, having been diagnosed with multiple sclerosis in April 2002.

So, let’s have a look at what is going on in Spain:

  • My health: Well, of course, I still have MS but from an MRI scan last month I know that the lesions on my spine and brain are inactive. Now, I am not going to attempt to explain the technical details but will just say that my symptoms seem to have stabilized. I am now beginning to be able to move a few steps without holding on to furniture and walls, which is a good sign. It seems that I have got no worse since our move; whether that is linked to the sunny weather, I don’t know.
  • Weather: Sunny and warm most of the year. The area is renowned for having upwards of 320 days of sun per year. Such a change from the UK climate. Before we moved, it was not unusual to have to wear winter jackets in July; but here, in January his year, we were dressed in summer clothes sitting out in the sunshine. Luckily, my version of MS-related heat sensitivity is not affected by warm weather but by sudden fluctuations; this makes Spain an ideal place to live.
  • Healthcare: Like the UK’s NHS, the Sistema Nacional de Salud de España (Spain’s National Health Service) provides socialised healthcare for all residents. Our experience of this has included fast and efficient hospital service, both as in-patient and out-patient, efficient local health centre where our GP is based – including the ability to make appointments online. Prescriptions charges are so low as to be negligible and pharmacists here can provide certain products that require a doctor’s prescription in the UK.
  • Dentists and Opticians: While these are not covered by the health service, and so we have to pay, the costs are not excessive and even the sight test is free if you buy spectacles from the same place.
  • Roads and driving: Spain has the most amazing network of roads that are mostly wide, open and free. Some of the newest motorways, known as autovias, are toll roads. They have different designations. Near us, we have the A7 (free autovia) and the AP7 (toll autovia). Of course, like all mainland European countries, the USA and many more, the Spanish drive on the right-hand side of the road, unlike the UK. But, despite having driven on the left for more than 40 years, driving a left-hand drive car on the right side of the road has come naturally to me.
  • Restaurants, Bars and Cafés: There are so many from which to choose, featuring a wide variety of cuisines. Many also offer a Menú del Día option which is a reasonably priced Menu of the Day including a drink.
  • Shopping: We are well serviced by supermarkets, specialist shops, economy stores and the usual wide range of high street shops. No-one does home deliveries or click-and-collect however. Those advances haven’t reached Spain yet, at least not the rural part.
  • Motor fuel: Whether you want diesel or gasolina (petrol), they are both reasonably priced and cheaper than in the UK.
  • Electricity: The costs are higher in Spain but not so high as to detract from living here.
  • People: We have found everybody so pleasant and helpful; something quite unlike anything we’d previously experienced. Only two days ago, as Lisa was packing our shopping into bags at the supermarket checkout, a young man appeared and helped her, and then loaded them back into the cart. We thanked him but he insisted on escorting us back to our car where he folded and loaded my electric wheelchair plus all the shopping into the vehicle and even took the cart back and reclaimed the one Euro coin and returned it to Lisa. I was surprised to receive similar treatment in the USA but Lisa explained that the guy was paid to do it; it was his job. The man in Spain was not wearing the supermarket uniform, in fact it does not employ packers. He was just a member of the public who wanted to help!
  • Language: Our linguistic skills are improving and I find myself understanding the gist of what someone is Spainsaying in Spanish and being able to make myself understood.

To sum it all up, one year on from our big move, we both absolutely love it. We are healthier (in my case, with MS, I equate ‘no worse’ to being healthier), happier and financially better-off.

Now, where’s my Sangria?

new strap

ian is the personal website of Ian Franks, who is Managing Editor (columns division) of BioNews Services. BioNews is owner of 50 disease/didorder-specific news and information websites – including MS News Today. Ian has enjoyed a successful career as a journalist, from reporter to editor, in the print media. During that career he gained a Journalist of the Year award in his native UK. He was diagnosed with MS in 2002 but continued working until mobility problems forced him to retire early in late 2006. He now lives in the south of Spain. Besides MS, Ian is also able to write about both epilepsy and cardiovascular matters from a patient’s perspective and is a keen advocate on mobility and accessibility issues.

Hotel group bans disability scooters

Disability scooters parked on the pavement.

Disability scooters parked on the pavement.

Able-bodied people are being blamed for hiring and misusing mobility scooters leading to one of the leading hotel chains in Benidorm, Spain, to ban the scooters that are essential mobility aids for people with one or more of a whole range of disabilities.

As I live with multiple sclerosis and use a powered wheelchair, you will understand that this caught my attention.

According to Benidorm All Year Round website, “there is a local bylaw which forbids rental companies from hiring them out to under 55s with no disabilities, they are obviously flouting this.”

Hotel Castilla, one of Servigroup's nine hotels in Benidorm.

Hotel Castilla, one of Servigroup’s nine hotels in Benidorm.

Xavier Gil is Operations Director of Servigroup which has nine hotels in the area. He said: “We have nothing against people with disabilities and all our hotels are adapted to accommodate people who are less mobile. All public areas are accessible, with ramps leading to the bars, restaurants and pool areas in addition to specially adapted rooms for disabled guests.”

Wheelchairs are still allowed for guests that have mobility issues but those chairs must be stored in their own rooms.

Mr Gil added: “The situation with regards to mobility scooters has got totally out of hand and we have had to take action following numerous complaints from other guests – primarily for safety reasons.

“The sheer volume of scooters left in the lobby and reception areas are causing serious problems for both staff and guests, with anywhere in the region of 25 scooters obstructing passageways and exits. There have been countless accidents, with glass panes broken and furniture frequently damaged – and they are running out of room.”

Some tourists with mobility problems genuinely rely on the scooters and feel outraged by what they feel is discrimination by the hotel group. Others agree that there is a problem that needs to be addressed, not just in hotels but in Benidorm itself, one such person said: “This is about the able-bodied hiring scooters when they shouldn’t be using them.”

When asked if other hotels are likely to follow Servigroup’s lead, Antonio Mayor, President of HOSBEC – the local Hoteliers Association that represents 88% of the hotels in Benidorm – said: “No, I don’t think so. We will open our hands out to those guests as it is a necessity for many.”

Interestingly, Servigroup is not a member of the association.

The streets of Benidorm are similarly affected. A Benidorm All Year Round report says: “Only this weekend I saw so many young able-bodied joyriding on them. I can testify that there was nothing wrong with one pair of lads, as I saw them jumping off and on a double scooter.

“But it is not just the young, the over 55s are just as guilty. I have had to walk onto the road many a time to pass as they have been parked up outside bars and cafes, clogging up the pavements.”

I wonder if Benidorm is the only holiday resort that has an issue with the use and abuse of mobility scooters. Do you know of any others?


It might have been April 1 but it was no joke


April Fools Day is not a feature of life in Spain1 but yesterday’s events certainly appeared like a huge practical joke but, sadly, they weren’t.

First I need to explain that all Spanish people are given an identity number, known as a DNI, and anyone from foreign countries planning to live in Spain for longer than three months needs to apply for an NIE. That’s the equivalent of the DNI but for citizens of other nations.

Knowing we needed one each, Lisa and I used the services of a gestoria to make our lives a bit simpler. A gestoria, or gestor, is a person who deals with administrative bureaucracy on behalf of a client.

Our appointments this morning were at the nearest office to our home – but that was in the city of Almería, more than 100 kilometres away.

We arrived in time, checked in and waited for our numbers to be called. So far so good, the agent looked through our papers and everything seemed in order, except one. Instead of being able to pay for our NIEs there and then, we were told to collect the necessary forms from the reception, complete them, take them to a bank, pay the money and then return to the office with the receipted form.

Simple, yes? Sadly, no – in fact far from it.

The first bank said we had to pay at an automatic machine but it kept coming up as ‘technical error’; attempts at other banks encountered the need to give our NIEs first. The mere fact that we wanted to pay the money to get an NIE seemed to get lost. No NIE, no payment accepted, no receipted form.

Just how anyone is supposed to enter their NIE on a form that they need to use to get their NIE is beyond me. Sounds like a script good enough for a top comedy show.

Then Barry, our Spanish-speaking friend who drove us to Almería, had a bright idea and went to the branch of the bank where we have an account. There the money was paid, without the need for a NIE, and the forms duly stamped as paid. To solve this muddle had taken visits to seven banks and taken nearly three hours since we left the office.

Great, now we could return and get our NIEs.

Well, that was our fond dream. It turned out that the NIE office, which stays open until 5pm from Mondays to Thursdays, closes at 2pm on Fridays.

After leaving Almería, we returned to the town nearest our home in an attempt to see the gestor to ask him to arrange new appointments for us. But, by then it was 4.40pm; his office will reopen on Monday.


1 Spain has its own equivalent of April Fools Day. It is December 28, ‘Day of the Holy Innocents’.

Scanned again – but not for MS

CT scan, library picture (not me).

CT scan, library picture (not me).

Back to hospital today for a second CT scan as part of the follow-up to my life-saving visit to the same Spanish health service hospital six weeks ago – which is when I made my first trip to the same machine.

Regular readers will no doubt remember that I was urinating blood and the cause was traced back to blood-thinning medication that was prescribed for a heart condition.

Since then I have seen, at the same hospital in Huercal-Overa, a haematologist to sort out my blood thinning meds and a urologist who requested today’s scan to see how my waterworks are, generally, and to make sure that there is nothing else untoward going on.

My appointment was arranged for 4pm, with instructions not to eat or drink anything for five hours but just after 9.30 this morning, the hospital phoned bringing my scan forward one hour, so nothing to eat or drink after 10am. Great!

Fast forward to 2.45pm, Lisa and I arrive at the hospital where I am seen almost on time. Incredible.

The CT scan with contrast, which meant that I was given a dye intravenously to give a clearer image. was completed so quickly that the two of us were soon sitting in a nearby tapas bar enjoying a late afternoon meal and coffee for an incredible 10.30€ for the both of us. Great food, ridiculously low prices.

Just as we finished, the phone rang. The hospital wanted me to go back.

That didn’t sound good but when we got back it turned out that they needed to scan another area to get the complete picture that the urologist had requested.

This time, though, contrast was not required and the fact that I’d eaten less than hour earlier seemed not to matter. Strange, when there was a five-hour ban in place for the earlier scan.

Still now I have to wait for another visit to the urologist to get the full story.