When Ms Cheryl Tan was 23 years old and first felt a tingling sensation in her right leg, she dismissed it as unimportant.
It certainly did not certainly register as the first sign of multiple sclerosis, a neurological disease that would severely affect her ability to walk.
As a baker, she was used to the physical strain of hauling 30kg to 40kg loads of flour and sugar. Even the doctors she saw suspected a slipped disc (a condition of the spine). It seemed like an occupational hazard, perhaps, from long hours on her feet.
However, the numbness and weakness began to spread until her legs gave way completely.
Ms Tan, now 33, recounted: “One evening, I couldn’t hold myself up anymore and I was rushed to the emergency department.”
What followed was a barrage of tests, including a lumbar puncture – where a needle is inserted into the lower back to collect cerebrospinal fluid.
It was a “traumatic” procedure she shuddered to recall even some 10 years later when she spoke with me this month.
The fluid drawn from a lumbar puncture is typically analysed for whether there is an increased count of white blood cells and certain proteins, which can be indicative of multiple sclerosis.
It was only after she suffered a relapse of symptoms that doctors confirmed she was now living with a condition she had never heard of: Multiple sclerosis.
This is when the immune system attacks the protective layer surrounding nerve cells known as myelin.
“After I was diagnosed in 2015, I realised I could not work in the F&B (food-and-beverage) industry anymore because of the long hours of standing and laborious work. I had to leave.”
Hearing this, I thought about how I am now in my mid-20s and in my second job, as Ms Tan was at the time of her diagnosis. I tried to imagine what it would be like to have my life and career rewritten overnight.
Where would I even begin? Would I feel that I should I stop working? How would I afford the medical bills sure to come, without the income of a full-time job and the insurance?
For Ms Tan, losing the prospect of pursuing her passion to be a baker was just the beginning of the upending of her life.
When she was finally ready to return to work after frequent hospital visits and taking time off to recover, she found that most employers had never heard of multiple sclerosis.
Many were hesitant to take the risk of hiring her, while others were simply unable to accommodate her needs.
The condition, which is far more common in Europe and North America, is rare in Singapore, affecting just more than 300 people here, the website of public healthcare cluster SingHealth states.
Worldwide, an estimated 2.9 million people have multiple sclerosis. Several studies have found that the disease tends to affect people who live further from the equator.
That is, the closer one is to the equator, or the greater one’s exposure to sunlight and vitamin D, the lower one’s risk of developing multiple sclerosis.
DENIAL, DEBT AND DARKER TIMES
Multiple sclerosis is often diagnosed in young adulthood, typically between the ages of 20 and 40.
For Ms Tan and her family, they had never heard of the condition.
This lack of awareness was the calm before a tempest of questions about her own future came with her diagnosis.
How would this condition shape her medical needs, finances and career, just as her working life was taking off?
“When they gave me the diagnosis, I was so confused. I had no idea what this condition is about, what is to come,” Ms Tan said.
“Even after more than a year, I wasn’t fully accepting of my own condition, I was still in denial. How can this be? There’s no history of anyone in my family with this condition.”
