Weathering the Storm: Why FOX meteorologist Janice Dean's forecast for life with MS is bright.

Childers, Linda

Neurology Now:
doi: 10.1097/01.NNN.0000459059.51446.6c
Features: Janice Dean
In Brief

FOX News meteorologist Janice Dean is known for her tenacious coverage of rocky weather. Yet nine years ago, Dean was surprised to learn that a threatening neurological storm was brewing inside of her, resulting in a diagnosis of relapsing-remitting multiple sclerosis.

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Photographs by Chris Carroll

To watch a video interview about advances in MS treatment with AAN member Clyde Markowitz, MD, director of the Multiple Sclerosis Center and associate professor of neurology at the Perelman School of Medicine at the University of Pennsylvania, go to bit.ly/NN-MSvideo.

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Janice Dean has been nicknamed “The Weather Machine” and “Weather Queen” by her FOX News colleagues as a testament to her tenacious coverage of hurricanes, tornadoes, and winter storms. Yet nine years ago, the 44-year-old meteorologist was surprised to learn that there was a threatening neurological storm brewing inside of her, resulting in a diagnosis of multiple sclerosis (MS).

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In 2005, Dean was working long hours covering Hurricanes Dennis, Emily, Katrina, Rita, and Wilma, when she began feeling an overwhelming fatigue, numbness in her thighs, and loss of sensation in the soles of her feet. She initially chalked it up to her busy work schedule.

But even after the work let up, Dean's symptoms persisted, and she made an appointment to see her physician. After being told her symptoms could be anything from a slipped disc to MS, Dean's primary care doctor referred her to a neurologist.

Dean was diagnosed with MS, an unpredictable and often disabling immune-mediated disease of the central nervous system, on the basis of a neurological exam, a magnetic resonance image (MRI), and a spinal tap. According to the National Multiple Sclerosis Society, MS affects an estimated 500,000 people in the United States and 2.3 million worldwide. In MS, the body's immune system attacks the nerve linings, called myelin, of the brain and spinal cord and leaves behind what doctors call a lesion, which is actually a scar.

“I had lesions on both my brain and spine,” Dean says. “The spinal tap fluid also showed the protein they look for in MS patients.”

Like many people, Dean thought MS was a disease of the elderly. She was surprised to learn that it is most commonly diagnosed between the ages of 20 and 50, and that two to three times more women than men are diagnosed with the disease.

“At the time, I knew very little about MS, and the things I had heard about the disease scared me,” she says. “I envisioned a wheelchair in my future.”

After consulting with several other doctors for a second opinion, they all agreed that Dean had relapsing-remitting MS (RRMS), characterized by periods of relapse (symptom flare-ups) followed by remission (periods of recovery). Symptoms may vary from mild to severe, and relapses and remissions may last for days or months. More than 80 percent of people who have MS begin with relapsing-remitting cycles.

Luckily, treatment options for RRMS exist. “Over the past 10 years, MS has become a treatable disease,” says Patricia K. Coyle, MD, vice chair of neurology and a professor of neurology at the State University of New York-Stony Brook. Dr. Coyle is also director of the Stony Brook Multiple Sclerosis Comprehensive Care Center and a Fellow of the American Academy of Neurology (FAAN).

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A MENTOR STEPS IN

When Dean was diagnosed, she couldn't help but wonder how MS would affect her dream of getting married and having children. She also wondered if her MS symptoms would eventually prevent her from continuing her broadcasting career. She was thankful when she found a mentor and a source of solace in a colleague at FOX News: Neil Cavuto, FOX Business senior vice president, anchor, and managing editor, who was diagnosed with MS in 1997. [Neurology Now featured Cavuto in our August/September 2012 issue. To read his story, go to bit.ly/cavuto-NN.]

“When I told Neil that I had MS, he calmed me down and promised I would be okay,” Dean says. “He reminded me that I was working at a great company that would support us, and he also told me that every person's experience with MS is unique and that having MS today is different than it was in the past.”

Cavuto confided that he, too, had felt discouraged upon his initial diagnosis of MS, but had made a point of reading everything he could about the disease. He also found hope when doctors said his symptoms could be improved with medications and by maintaining a regular diet and exercise program.

When Cavuto decided to go public with his disease, he received the full support of Roger Ailes, president of the FOX News Channel. When Ailes asked Cavuto about the worst case scenario for his MS prognosis, Cavuto said he might someday need a wheelchair. Ailes calmly replied, “Then we'll build a ramp for the set.”

“Here was Neil, who at the time was anchoring two daily news shows on two different networks, including the top-rated cable news program in its time slot,” Dean says. “He was doing well despite having MS symptoms, and that gave me hope.”

Feeling more optimistic after Cavuto's encouragement, Dean became determined to learn all she could about MS, and to find the right doctor.

“I wanted to find a neurologist with a thorough knowledge of the disease and a good bedside manner, who could offer me reassurance and hope,” she says. “I also began reading about other people [in the public eye] who had been diagnosed with MS, such as Montel Williams, Teri Garr, Richard Cohen [Meredith Vieira's husband], and others. It helped me to put faces to the illness and to hear about people who were not only surviving, but also thriving.”

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A DREAM ACHIEVED

In 2007, Dean married her longtime boyfriend, Sean, a New York City firefighter who had supported her unconditionally through her diagnosis. That same year, Dean decided to go public with her diagnosis in the hopes of helping others who had been newly diagnosed.

“I never wanted to be the poster girl for MS, but I felt as though I could help others identify and live with the disease,” Dean says, adding that friends and colleagues often ask if she will speak to a friend or family member recently diagnosed with MS.

She always says yes. Those newly diagnosed with MS share many of the questions that she initially had about the disease, such as how having children will affect its progression and whether or not the condition is hereditary.

Dean learned that many studies show that pregnancy is actually protective for some women with MS, and that most women experience relief from their MS symptoms during pregnancy. Evidence also shows there is a less than 2 percent chance that a child born to a woman with MS will ever develop the condition.

In 2009, Dean gave birth to a son, Matthew, followed by Theodore in 2011.

Prior to her pregnancies, Dean had been managing her MS with a disease-modifying drug, glatiramer acetate (brand name Copaxone), that prevented her relapses. She consulted her neurologist and decided to halt the treatment during her pregnancies. This is a common practice, as many studies have shown that MS goes into remission during pregnancy, especially in the second and third trimesters.

“I had such wonderful pregnancies and I temporarily forgot that I even had MS,” Dean says. “I truly believe my boys saved my life and gave me purpose. Before I had them, I thought my career would be the biggest source of joy in my life, but I was wrong. My sons give me stability and peace, and never fail to make me feel good.”

Since the birth of her second son, Dean hasn't resumed taking injections of glatiramer acetate. She prefers instead to treat her MS through changes in diet and lifestyle.

“The injections gave me some unpleasant side effects, and since I haven't had any relapses and the MRIs that I do twice a year haven't shown any new lesions, I asked my doctor if we could closely monitor my condition,” says Dean. She sees her neurologist every three months.

However, she is considering giving MS drugs another try. “My doctor would like me to go back on medication and we've been discussing the new oral drugs that are being used to treat MS,” she says.

In fact, says Dr. Coyle, the three months postpartum are recognized as a risk period for MS attacks. “As long as my patients aren't breast-feeding, I recommend resuming their disease-modifying drugs as soon as possible.”

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Where You Can Find Support

Talking to another person who has MS and can share common life experiences is helpful to most patients. “It's important to find someone who has the same diagnosis and who has a similar outlook,” says Dr. Coyle.

The National MS Society can help you find accurate information about your diagnosis and a peer counselor who is at the same stage in the disease. “Just as MS symptoms can vary from one individual to another, so can the individual concerns and questions of each patient,” Dr. Coyle says. Some women, like Dean, may have questions about juggling young children with work responsibilities, while others may wonder if they should reveal their diagnosis to their employer.

While Dean chose to go public with her diagnosis, others feel that it might hurt their career or affect their chances of promotion. “Telling your employer you have MS is a very individual decision that should be weighed carefully,” Dr. Coyle says.

While the Americans with Disabilities Act prohibits on-the-job discrimination against those with disabilities, some people with chronic conditions continue to report feeling slighted at work.

The National MS Society offers these resources to help you navigate the road ahead:

* bit.ly/peers-MS: The Peer Connections program matches people with MS with others who have a similar condition and can offer one-on-one advice, tips, and emotional support.

* bit.ly/MS-supportgrps: Find a support group in your area.

* bit.ly/shoulditell: Resources to help you decide how, when, and who to disclose your condition to at work.

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MEDICATIONS & LIFESTYLE FACTORS MATTER

Dr. Coyle notes that the best treatment plan for MS involves both lifestyle modifications and a medication regimen. “There is very interesting long-term data demonstrating that MS patients who are treated as soon as possible after a diagnosis of MS do better and have less disability in the long term,” she says.

Although she is not currently on medication, Dean says she has found relief from her relapses by eating a balanced diet and avoiding gluten. “I eat fish and chicken rather than red meat and try to focus on meals that are high in fiber and low in fat,” she says. “I also drink lots of water and avoid soda.”

Staying away from salty foods may also help manage the condition. “Recent research suggests that a diet high in salt may worsen MS symptoms,” Dr. Coyle says.

In addition, a study presented by Oregon Health and Science University researchers at the 2014 AAN Annual Meeting found that people with MS who followed a plant-based diet very low in saturated fat for one year had much less MS-related fatigue.

Dean has found that stress and lack of sleep can aggravate her MS symptoms, so she makes a point of getting a full eight hours of sleep each night. “I try to not let the stresses of everyday life get to me,” she says. “I do breathing exercises and get in 20 minutes of walking every day. I've found that walking isn't just good exercise, it's also a great stress reducer.”

She also takes a multivitamin and an extra vitamin D supplement prescribed by her doctor, since some research has shown vitamin D may lessen the frequency and severity of MS symptoms.

“We know that vitamin D deficiency is a significant factor for the development of MS,” says Dr. Coyle. Studies have shown that regions with high sunlight exposure, and thus more exposure to vitamin D, have a lower prevalence of MS, she says. The reverse is also true: In regions with low sunlight exposure, there appears to be a relatively high prevalence of MS.

Dr. Coyle checks her patients' vitamin D levels regularly and says she often recommends that patients supplement their vitamin D levels.

“Research has shown that vitamin D can help regulate the immune system and may affect the onset and progression of MS,” Dr. Coyle says. “Depending on the results of a patient's vitamin D blood test, I often recommend that they take a vitamin D supplement of 2,000 to 5,000 International Units (IU) of vitamin D daily.”

Dean has also discovered that being outside for long periods of time in extreme heat can lead to an MS flare-up, so when her family vacations, they often visit amusement parks and other tourist destinations in the morning hours.

Dr. Coyle says she recommends that MS patients also quit smoking, eat a low-salt diet, and optimize their sleep to maintain good health.

“It's also important to treat any other underlying health issues such as pre-diabetes (when fasting blood sugar levels are 100–125 mg/dL) and high blood pressure,” she says. “If these other medical conditions aren't addressed, it can lead to poorer outcomes and possible disability for MS patients.”

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ASK FOR HELP

Once the kind of person who had to do everything by herself, Dean has also learned the importance of asking for help, and now feels comfortable asking a friend or neighbor for favors such as dropping her oldest son off at the bus stop.

“I'm fortunate to have a very supportive husband with a flexible schedule that allows him to help out with our family,” Dean says. “We also have a babysitter to help care for our two boys when we're both working, and she's an important part of our family.”

Dean has also aligned herself with the National MS Society and recently emceed their annual Climb to the Top fundraiser in New York City, where more than a thousand people climbed 66 flights of stairs from the ground floor to the observation deck at Rockefeller Center.

“It's important for me to raise awareness of MS because there is still a stigma attached to the disease,” Dean says. “Many people are afraid to reveal their diagnosis at work, and I'd like to see more awareness and support of MS in the workplace. Just because someone has an autoimmune disease doesn't mean they can't do a great job.”

Dean has also taken on a second career as a children's author with her two books, Freddy the Frogcaster (2013) and Freddy the Frogcaster and the Big Blizzard (2014). She is currently completing the third book in the series, which is about hurricanes, and hopes to publish more of Freddy's adventures.

“I've had a lot of great feedback on the series,” Dean says. “The books explain different weather conditions to children in a way that educates without scaring them.”

And Dean believes her personal forecast, and that for others with MS, is bright.

“I feel very hopeful, since there have been a lot of advances in MS research and treatment over the last several decades,” Dean says. “I'm confident the future will bring even more treatments and answers.”

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FOR MORE INFORMATION:

* Go to Multiple Sclerosis: The Basics bit.ly/Basics-MS

© 2014 American Academy of Neurology