What are the side effects of Ocrevus?

Hello,

Welcome to icliniq.com.

I am really sorry to hear about the challenges you are facing, and I understand how deeply this situation is impacting your life and career.

Balancing your passion for dance with the realities of managing multiple sclerosis (MS) can be incredibly difficult, but it is important to approach this with care and thoughtful consideration of both your health and your artistic goals.

A. Continuing to perform:

1. Listen to your body: MS symptoms, such as the loss of spatial awareness, muscle weakness, and balance issues, can worsen with physical exertion and stress. Given that you have already experienced falls and difficulties with balance, continuing to perform might increase your risk of injury.
2. Heat sensitivity: The heat from stage lights exacerbating symptoms, as well as double vision, could make it challenging to perform safely, especially during high-intensity movements like pirouettes and jumps.
3. Fatigue and performance: The extreme fatigue you are experiencing as a side effect of Ocrevus (Ocrelizumab) is a significant concern, especially given how demanding professional dancing is. Fatigue can impair your performance quality and increase the likelihood of accidents, which could further complicate your MS symptoms.
4. International tour: A six-month international tour is a physically demanding commitment. Given your MS diagnosis, touring might be overwhelming with the unpredictability of symptoms, fatigue, and the need for careful management of your health. You may need to consider the long-term impact on your well-being, especially if symptoms worsen.

B. Alternative therapies:

1. Pilates: Pilates could be a very effective way to maintain and even improve your flexibility, strength, and balance while minimizing strain on your body. Pilates focuses on controlled, low-impact movements, which could help you work around your MS symptoms without overtaxing your system. It also emphasizes core stability, which may improve balance and spatial awareness. I would recommend discussing pilates with your medical team to ensure it is tailored to your specific needs.
2. Physical therapy: In addition to Pilates, working with a specialized physical therapist experienced in MS rehabilitation could help you manage symptoms like muscle weakness, balance difficulties, and fatigue. They can create a program that helps you maintain your flexibility and strength while protecting your joints and muscles from further strain.

C. Ocrevus and fatigue:

1. Ocrevus (ocrelizumab) is a disease-modifying therapy for MS that works to reduce relapses and slow progression. However, fatigue is a common side effect for many people on Ocrevus. If you find the fatigue debilitating, it may be worth discussing with your neurologist whether dose adjustments or switching to a different medication could be an option for you. Managing fatigue with MS also often involves incorporating lifestyle changes, such as better sleep hygiene, regular but moderate exercise, pacing yourself, and ensuring adequate rest between performances and rehearsals.

D. Visual and balance challenges:

1. Double vision: The double vision you are experiencing under stage lights may be due to MS-related damage to the optic nerves or brainstem. Discussing this symptom with your neurologist is crucial, as there may be therapies or interventions to manage or mitigate it (for example, prism glasses or other treatments). Continuing to perform with double vision can be risky, especially when coordinating complex movements or performing in front of an audience.
2. Balance: MS often affects proprioception and balance, which can be a significant challenge for a dancer. It is important to adjust your dancing routine to accommodate these changes. If pirouettes are too dangerous, you may need to avoid them or modify choreography to focus on movements that feel safer and more manageable.

E. Consideration for choreography:

1. Transitioning to choreography: Your artistic director’s suggestion of switching to choreography may seem difficult to consider, especially if dance is your life, but it could be a valuable option for continuing your passion without compromising your health. Choreographing can still allow you to stay immersed in the world of dance while adapting your career to your new reality.
2. Balancing creativity and health: Choreography allows for creative expression while providing more flexibility with physical exertion. It is also less physically demanding, and if you feel that performing could further compromise your health, choreography may offer a fulfilling alternative.

F. Next steps:

1. Consult your neurologist and healthcare team: It is essential to work closely with your neurologist, as well as your physical therapist, to and

   manage your MS symptoms tailor your activities accordingly. Consider discussing alternative MS treatments, as well as potential therapies for symptoms like fatigue, double vision, and balance issues.

2. Adjusting dance and repertoire: You may need to adapt your dancing style and repertoire to accommodate your MS symptoms. This might mean scaling back on the most physically demanding moves (like jumps and pirouettes) while focusing on more controlled, less strenuous movements that still allow you to perform with artistry and grace.
3. Exploring artistic flexibility: While you may not be able to continue performing at the same level, there are still many ways to stay engaged in the dance world. Choreography, teaching, or other creative roles within the company could allow you to maintain your artistic expression without compromising your health.

Ultimately, it is about finding a balance between maintaining your passion for dance and taking care of your body. While this is a challenging moment, there are still ways to stay connected to your art while prioritizing your health and well-being.

I hope this helps you.

Thank you.