-Multiple sclerosis is a chronic and potentially disabling disease that impacts the central nervous system.

The National MS Society estimates nearly 1 million Americans are living with it.

A notable Nevadan who died from MS complications is Las Vegas native and former Raiders quarterback David Humm.

Senate Bill 286, the David Humm commemorative bill, designates the third week of March as Multiple Sclerosis Awareness Week in Nevada and also requires the Department of Health and Human Services to provide information about MS on its website.

Sometimes described as an invisible illness, knowing the signs and symptoms is critical.

For more, we spoke with Dr. Carrie Hersh, Director of the Multiple Sclerosis Health and Wellness program at the Cleveland Clinic Lou Ruvo Center for Brain Health, as well as patients Lori Scharar and Raul Hernandez.

Scharer is also David Humm's sister.

Lori, I'd like to start with you.

You are David Humm's sister.

You have also been diagnosed with MS yourself.

When did that happen, and how did you respond?

(Lori Scharar) I was diagnosed in 1985.

Luckily, I guess, I had vertigo traveling, and I went to my primary care physician just to make sure everything was okay.

He suggested because of my history having a brother with MS and an uncle with MS to do an MRI.

And after two MRIs, I was diagnosed with MS. -And how did you choose to respond?

And I say "choose to respond" because your choice was different than your brother's.

-It was very different.

I pretty much got on medication right away.

And I was, again, lucky enough that the first medication I went on, I responded very well to.

-How did David respond when he was diagnosed, and when was he diagnosed?

-He was diagnosed in 1985, and there were not a lot of different options for him at that time.

He chose not to go the medication route.

He was a professional athlete and in excellent shape.

And so we chose very different paths in our medical journey.

-Why do you think he chose not to take medicine?

-Because he was a strong, tough guy, to be perfectly honest.

He was a very strong guy.

And I think he just thought he could outwork it and do right by it, but it definitely caught up with him.

-And, Raul, this is something you identify with, that tough man's story.

How was it that you were diagnosed, and how did you respond?

(Raul Hernandes) I also had vertigo from the onset, and I credit my wife for pushing me to do something about it.

Otherwise, I probably would have just ignored it or, you know, not tried to pay attention to it.

But she insisted, and I was fortunate to have gone to a great doctor at the time who diagnosed it very quickly.

And soon thereafter, I started treatment.

So I feel very fortunate to have had that situation where I was, you know, really went to a great doctor that put me on medication at that time.

This was 30 years ago.

-And, Doctor, this is where the problem lies, though, right?

The early diagnosis, what makes that so difficult?

(Dr. Carrie Hersh) The early accurate diagnosis piece is so crucial.

So that way we can improve the opportunity of starting an early effective therapy as soon as we can.

So that way we can improve long-term outcomes.

What makes it so difficult is that MS is not the same for everyone.

There are so many nuanced pieces.

And not one individual who is living with MS has the same presentation, the same symptoms, the same background as anyone else who is living with the diagnosis as well.

And because of the complexities around this, this is where it can make the initial accurate diagnosis challenging.

-Lori, your brother joined us today, Tom, and he gave us some insight that when you did first have symptoms, you happened to mention to the doctor that you also had a numb toe.

-I did.

-And that made a difference too?

-It did make a difference.

And I'll-- I used to walk the park with a friend a few years before, and I thought I hurt my foot.

I went to an orthopedic surgeon who put me in a boot.

Six weeks later he said, you're good to go.

I'm pretty sure that was MS. -Okay.

So symptoms like that, I mean, what do people need to be looking out for, Doctor?

-Sure.

So with Lori's story, there were two different neurological symptoms that were coming from two different areas of the central nervous system.

So they were different.

And because of the difference, superimposed on the fact that there was a very strong family history of multiple sclerosis, that led to the acknowledgment earlier that, hmm, we may need to start looking into this a little bit more deeply, even though a numb toe to any other individual who doesn't have that background, doesn't have the same family history, it may go unnoticed or unacknowledged by a healthcare provider.

-Tell us the symptoms and signs people need to be watching for.

-Sure.

So with MS there are so many different signs and symptoms that can develop: vision loss in one eye, numbness and tingling in an arm or a leg, weakness in a foot or the fingers, bladder and bowel dysfunction.

So really just trouble using the facilities, the bathroom.

And because there are so many different symptoms, it's the presentation.

How does it present?

Where does it present?

That is so key when we are listening for some of those aspects that can raise the suspicion, this might be MS. -Is there an age group?

I believe I had read that.

-Yeah.

So the typical age range where folks are actually presenting with their initial symptoms tends to be anywhere from 20s throughout the 40s.

However, there is a very strong pediatric population as well.

We have individuals who are coming to see us at the Cleveland Clinic who are younger than the typical onset age group.

And we have also seen older individuals as well who have come in to see us who are in their 50s and 60s who are presenting with symptoms.

-When you talked about getting diagnosed, you used the word "fortunate."

And I think you used the word "lucky."

Why does luck and fortune have any role in diagnosis, besides that it's difficult to diagnose?

But what else?

-Lack of awareness at that time.

30 years ago, I don't think people were knowledgeable enough to understand that MS was a real possibility in the symptoms that I was getting.

So, yes, fortunate to have gone to a doctor that saw through all the problem and was able to give me an MRI really quickly, which showed, yes, by process of elimination, you have MS. -Why do you think luck is involved in this?

-Well, I mean, to have a primary care physician that looked at all of my symptoms and my signs and my brother and my uncle's history, my family history, I didn't think I had it, because I had none of the same symptoms as David.

Ours were completely different.

So when you talk about awareness and MS awareness, really, everybody's different.

So it is hard to diagnose, and you have to be lucky enough to get in there early.

I watched David's progression on his illness, and MS is not kind.

It's not a kind disease.

And so I knew once I was diagnosed, I was gonna get on something immediately.

-What was his progression like?

-It was very rough.

It was wheelchair bound.

He went from being a professional athlete to, sorry, wheelchair bound, and he lost his life to it.

-I mean, from when he retired to when he was wheelchair bound?

-His daughter helped him very much.

I would say, I would say within 10 years, he was using a cane, using a walker, using a wheelchair, and it just progressively grew and grew.

-There is danger in a delay in diagnosis.

But there is a delay that we have talked about off camera, Doctor.

There was also a woman who testified at the legislature that she started showing signs of MS at 23 years old, didn't get the diagnosis until 27.

There was a senator who was also a physician who said there are people who come in, they show symptoms, but then getting them into a neurologist can take a long time.

Why is that, and what can be done to help that?

-This is one of the core challenges that we all face in the MS community.

And at the Cleveland Clinic, we have been investigating this barrier quite extensively.

So we have a researcher at the Cleveland Clinic who investigated how long it typically takes for an individual to get diagnosed, in addition to looking at some of the geographic barriers of getting to an MS specialist.

And on average, individuals living with MS live at least 60 miles away from their closest MS subspecialty center.

And we have very strong data showing that an individual with MS seeing a specialist in multiple sclerosis leads to better short- and long-term outcomes.

This is something that we take very seriously.

And while it is a very large and intrusive problem for the individuals who are at risk of developing MS or who are starting to manifest symptoms of MS, we are doing our best to understand what are these barriers to care.

And at the Cleveland Clinic Lou Ruvo Center for Brain Health right here in Las Vegas, we are initiating programs in order to help bridge those barriers to care.

So with generous offerings from Gloria and Emilio Estefan through the Fajardo grant, we are able to assist our patients with transportation.

So that way, our patients who want to establish care with us are able to do so, and it's not because they can't physically get to see us.

We're able to support patient services that go beyond just the medical care.

So that's education.

That's health and wellness programs.

That's yoga.

So that way we can better help serve our patients earlier and more effectively.

-For someone who is at home watching and says I may have some of those symptoms, I'm going to go to the doctor, and then that doctor says, well, let's get you to a neurologist, and they are having trouble getting that appointment, they're on a waiting list, what do you tell them to do?

-It's advocacy.

It is all about self-advocacy.

It's just pushing the grind and not accepting no for an answer.

The typical place where individuals are going to when they first have these symptoms are their primary care provider.

And this is why it's so important to raise awareness about what MS is.

So that way we can decrease that barrier to getting in with a neurologist and, more importantly, an MS specialist.

So that way we can make that early, accurate diagnosis, just like Raul had and was so fortunate to have so early on in his disease course.

-And we have talked about the signs and the symptoms and the awareness, but then this is considered an invisible illness.

I mean, how do you battle that when-- what does that even mean to you, Lori?

-Oh, it's an invisible illness.

People tell me how great I look and how could I possibly be that sick?

It's very difficult to look as good as Raul and myself and know that we're battling a disease that can be sometimes hard to deal with on a day-to-day basis.

-Do you identify with that description?

-I do.

And it's just something that you work through.

In my case, I live pretty much a normal life, very few limitations.

But what can I say?

It's just great to have a doctor like Dr. Hersh to take care of me.

-Thank you, Raul.

And I will add that the term "invisible," it has these nuances that are very challenging, because even though it's, it may be invisible to other people, it's definitely not invisible to the person who is struggling with MS. And I will say that it is the invisible symptoms, cognitive impairment and fatigue and depression, that actually can be much more disabling than some of the more visible symptoms.

For example, when it comes to employment, fatigue and cognitive impairment are some of the number one and number two reasons why folks are going on disability and are unable to continue gainful employment for themselves and their families.

So while these symptoms are called "invisible," they are absolutely not invisible to the individual who is struggling.

-They are very real.

And that's why, you know, I use a handicap placard because I can't walk long, long distances.

But when I get out of my car, I look okay.

So it is hard to deal with those kinds of things.

Again, fatigue.

Sometimes I look and I go, well, I'm getting a little older.

And other times I go, well, that's MS.

I mean, so it is hard to live with some of those symptoms.

-Back to diagnosis.

Doctor, there are some advancements in that area, correct?

-Among all of the neurological diseases that exist, MS is one of the most rapidly evolving neurological conditions in terms of diagnostics and therapeutics, so medicines and other complementary strategies to help our patients live life to their fullest.

-How far are we from a cure?

-There are global efforts at looking to a pathway to a cure.

And the National MS Society is at the forefront of this, bringing together important key stakeholders from across the MS community, coming together and discussing, what does a cure mean?

And this very importantly includes the individual living with MS. What does a cure mean to the person who is living with the disease, so it's not just coming from other individuals who are not living with it.

-Lori, Raul, do you think there will be a cure in your lifetimes?

Lori?

-I do, and I think we really need to talk about Cleveland Clinic and the amount of new medications and therapies they have had breakthroughs with.

-Five of the latest drugs to be approved for the treatment of MS were all tested at the Lou Ruvo Center for Brain Health.

-That is not something to overlook, because that is such an amazing thing they have accomplished.

I do think there is going to be a cure.

-Raul?

-When I moved to Las Vegas four years ago, I never expected to find the Cleveland Clinic and Dr. Hersh.

What a blessing it has been.

And, yes, it's given me optimism.

It's given me hope.

What I see happening there really makes me believe that there is going to be a cure soon.

-And then last thing for all of you, with this bill that is now law, it requires the Department of Health and Human Services to post information about MS on its website, as well as the resources that are available.

That's law, and it's required.

What does that mean to you, Lori?

-Well, when I was diagnosed, it was very, you know, other than talking to my brother, David, it was talking to my doctors, and that was it.

So this is huge, going online and finding out different information that you need to suit you and to learn about what your particular circumstances are.

-It's fantastic.

It's great awareness.

As we have said many times here, anything that we can do to raise awareness and make people act as quickly as possible.

And I think this, this is a good step forward in terms of doing that.

-Knowledge is power.

So the more information that is out there for individuals who may even be experiencing the symptoms and to the healthcare community at large, this can only assist us in achieving what we need to achieve for individuals who are living with the disease.

-Thank you all for your time.

-Thank you.