FIRST My House Is Your House, 1, 
SECOND What MS Is from a Neurological Point of View, 5, 
THIRD A Day and a Night in an MS Life, 14, 
FOURTH Immune Systems from a Neurological Point of View, 38, 
FIFTH With or without You, 46, 
SIXTH The Neurological Examination from a Neurological Point of View, 63, 
SEVENTH Neurological Exam in the Round, 83, 
EIGHTH MRIs and MS from a Neurological Point of View, 114, 
NINTH Mind, Meet Brain, 125, 
TENTH What MRIs Look Like from a Neurological Point of View, 133, 
ELEVENTH What I Heard the Doctor Say, 141, 
TWELFTH Neurocognitive Testing from a Neurological Point of View, 145, 
THIRTEENTH Imagined — Wished — Possible, 157, 
FOURTEENTH The MS Therapies from a Neurological Point of View, 160, 
FIFTEENTH My Life with You, 185, 
SIXTEENTH The MS ICE from Both Sides of the Desk, 241, 
SEVENTEENTH Sex from a Neurological Point of View, 292, 
EIGHTEENTH A Love Letter, 322, 
NINETEENTH How Stephen Colbert Has Helped Me to Understand MS Better, 324, 
TWENTIETH Family and MS from a Neurological Point of View, 329, 
TWENTY-FIRST, 
EPILOGUE The Breakup, 343,

CHAPTER 1

Each friend represents a world in us, a world possibly not born until they arrive, and it is only by this meeting that a new world is born.

— Anais Nin, author 1903–1977

My House Is Your House

Welcome. This is my life. My life consists of my family and friends, being a doctor, comedy, multiple sclerosis, teaching, religion, computing, woodworking, writing , jogging, nookie, thinning hair, the Yankees , reading Spenser novels , and thinking about God.

These are all things that are parts of my life. They're things that came into my life, and I treasure all of them because they're what make my life unique. This is Vincent Macaluso's life. I do not live with any of them. They live with me.

It's my house. It is up to me to keep the things that I have control of in balance. I value my family beyond all else in this world. My wife is the axis of my existence. We are blessed with two beautiful children. The four of us work through life together. We are a close family, in a cozy house. This allows us to create a tremendous home.

I love laughing. I love it when I laugh so hard it hurts and I can't catch my breath. Sometimes I get lucky and I laugh so hard that I can't catch my breath, and I start to black out, and I fall down. Then, when I'm lying on the floor, I start to think about how funny it must have looked when I keeled over. For me, that's a win-win-win situation.

I like watching The Colbert Report because it makes me think about the things going on in the world around me. Dr. Colbert's character brings up the absurdity of a situation or creates absurdity when there is none just to be a nudge. He goes fast, and you have to look and read and listen and think all at the same time. Stephen Colbert is smart. He challenges us. He has hair that does not move.

On the topic of hair, mine started an exodus several years ago. I didn't worry about it because I realized that I was getting older and it was a natural part of life. But as it grew thinner, I saw some pictures of myself and thought I would look better with hair — at least for a few more years. I started medication to keep my hair, and it had been working pretty well to slow down the loss. Unfortunately, the numbers continue to dwindle despite the medication. The countless many are becoming the cherished few. Well, I did what I could, but if this is my lot, so be it. I know I could get hair transplants done, but my two children are approaching the launch pad for college, and I think the money would be better spent maximizing what's inside their heads instead of maximizing what's on top of mine. I think of the hair loss situation the same way I think about Joe Torre and the Yankees. They had a good time together, but once they no longer benefitted from being together, they parted ways.

Multiple sclerosis entered my life over twenty-seven years ago. At first I didn't know what was happening. It was like some unwanted houseguest had arrived. My life was going on as usual, but suddenly I started to have strange feelings. Tingling here, decreased sensation there. I had trouble concentrating. Learning wasn't as easy as it had always been. This flighty guest came and went with neither rhyme nor reason. At first, I didn't know its name, but after diagnosis, I found out what it really was — an unruly guest. Sometimes with unruly guests, guidelines have to be set down. I had to find out what MS was all about. I had to find out what I could do to keep it in control. I also had to realize that some things I did not have control over. I decided to forget about that part so I could focus on the things that I could control in dealing with this morbus non grata. It was a big house I was running. Just because I found a chink in the foundation, I was not going to let the rest of what I had built get torn down.

I found a nice neurologist who specialized in MS.

I learned as much as I could about MS.

I got on a therapy to slow down MS.

I let my neurologist know if something new came up so we could decide what intervention we should make — if any.

I kept my eyes and ears open for new therapies that were coming.

I did not fight MS.

I saw what the situation was, and I did what I could to continue to make my home beautiful.

I asked for help.

I had good people around me who helped me when I asked for help.

I had people around me who helped even when I did not ask for it.

Or know that I needed it.

I was lucky that I had been able to lay such a good foundation for my home so that it was rock solid and ready to withstand storms when they hit.

While MS initially appeared daunting and unwelcomed when it showed up at my door, it turned out to be a crucial guest in my life. It helped me realize that while it is my life, it is still just that.

    Life.

    In life, there are no certainties.
    There are joys.
    There are marriages.
    There are children.
    There are diseases.
    There are good people.
    There are deaths.
    There are challenges.
    There are jobs.
    There are careers.
    There are disappointments.
    There are successes.
    There is laughter.
    There are houses.
    There is your house.
    There is my house.

This book is written from both sides of the desk. The first half of most topics is written by me, Vincent Macaluso, MD, from a neurological point of view. In these sections, I'm writing to teach about the factual things in MS — what the disease is, how to treat it, and so on. The second half of most topics is written by me, Vincent Macaluso, a guy with a wife, two kids, a mortgage, a lawn mower that might or might not turn over after several pulls, and a burning desire to make people laugh. It is in these sections that I get creative. Everything written here is experiential. I write about how it feels to have MS, to take medications, to get a neurological examination, to receive life-changing news. The most important chapter, "The MS ICE," is where doctor and patient meet, put their thoughts together, and try to make a contribution to the worlds of patients, doctors, and anyone who wants to learn about MS.

All right. I'm gonna go exercise for a while, then make some nachos and watch some stand-up comedy and think about poetry and "fire and ice" and the nature of God, and maybe I'll have a beer.

The door to my world is open.

I hope you enjoy it.

CHAPTER 2

What MS Is from a Neurological Point of View

What we've got here is failure to communicate.

— Captain, Road Prison 36, Cool Hand Luke

We will begin our journey in the central nervous system (CNS), which is made of the brain and spinal cord (see figure 1). Of the two, the star is the brain. In fact, it's so special it's sequestered in its own private room — the skull. The fact that the brain is kept separate from the rest of the body makes it even more mysterious. Before CT and MRI imaging came along, the only way to see what it looked like was to cut open its protective case and take a look around. When seen up close, such as during surgery, it doesn't appear to be doing much. The surface glistens and pulses slightly with each heartbeat. At first glance, it appears to be similar to other organs, like the liver or kidneys. Upon closer inspection, however, its surface appears convoluted, like a walnut. How come it doesn't appear uniform like the other organs?

Unlike other organs, the brain does not do a fixed number of tasks, repeatedly, for the entire life of a person. It's the organ that has a new job each and every day. It has to be expandable but cannot grow any bigger. It does this by having its many different computer processors, called neurons, make new connections based upon the tasks that they're given. It upgrades continuously. Our brains are made of about one hundred billion neurons. They're organized into different functions, placed in different locations, set in a thin, gelatinous matrix, and then stuffed into an irregularly shaped carrying case. This is what gives it a walnut-like appearance.

Extending from the base of the brain is its partner, the spinal cord. It too has some nerves that have special functions, but its major function is to act as a conduit. It's the main highway carrying information from the brain to the body and from the body to the brain. Multiple sclerosis (MS) is a disease that affects the nerves that are in the brain and spinal cord.

The central nervous system (CNS) is what controls almost all the actions in the body. The nerves that make up the CNS send signals out along a part of the nerve called the axon. The axon has insulation around it called myelin. In MS, the myelin is destroyed by the body's immune system. No one knows exactly why this occurs, but starting in the 1970s, methods for understanding, diagnosing, and treating this disease have made enormous strides. In this chapter, you will learn more about the CNS and you will also be introduced to the immune system and multiple sclerosis.

The Central Nervous System

As mentioned, the brain and spinal cord make up what is called the central nervous system (CNS). There are two main cell types that make up the CNS — nerve cells (called neurons) and supporting cells (called glial cells). The glial cells, for the most part, make the skeleton that the nerves grow around. It is the structure and function of the nerve cells, however, that are the focus of the story. Figure 2 shows what a nerve looks like when you look at it very closely.

In total, there are about one hundred billion cells (nerve and glial cells combined) in your CNS. 4 Those one hundred billion cells are arranged into many different regions that have many different functions. Most of those different regions make multiple connections to other functional areas of the CNS via pathways (also called tracts, fasciculi, or projections). For example, some of the pathways go from your eyes to another part of your brain that tells you that you see your best friend coming. Other tracts go from the part of your brain that saw the shape of your best friend to another part of your brain that stored the memory that your best friend still owes you ten dollars. Other pathways contain the nerves that go from your brain all the way down to your hand that lets you put your hand out as you approach your friend. There are other pathways that go to the language center in another part of your brain to say something to your friend. And then there is yet another part of your brain that makes the final decision as to whether you say "Hi. How are you?" and shake your friend's hand or say, "Hey, you owe me ten bucks, and I want my money," and you put your hand out, palm side up, waiting for the ten dollars.

While learning all the different functional areas and discreet pathways that the one hundred billion nerves in your brain and spinal cord make, there is one easy thing to remember. All nerves essentially work the same way. The nerves are set up very much like the computer in your home. Let's say your computer has a fancy picture on it, and you want to send it to someone over the Internet (see figure 3).

The computer sends the bits of the digital file along a cable to your modem. Your modem then modulates the picture into bits of information that can be sent over the Internet to your friend's modem (see figure 4). Your friend's modem then demodulates the information into data that her computer can interpret and display as a picture. Each neuron in our brain plays all of these parts. A neuron is 1) a computer, 2) a cable, and 3) a modem. For our purposes, the Internet will be the space between the axon terminal of the first nerve and the dendrites on the cell body of the next nerve. This space is called the synapse. The body's "Internet" transmits information from the axon terminal of one nerve to the dendrites on the cell body of the next by using neurotransmitters.

In our analogy, the computer is the thinking part of the nerve, which is called the cell body. The dendrites on the cell body are the receivers of information — the "demodulating" half of your modem. The cell body is the central processing unit of the nerve. It integrates the input from the dendrites and then sends its message, through a cable called the axon, to the nerve terminal, which then acts like the "modulating" part described above.

In multiple sclerosis, the important part of the nerve is the cable coming off the cell body, which is called the axon. Like the insulation that surrounds the cable coming off your computer, there is an insulation that surrounds the axon. This insulation is called myelin. Myelin is the thing that is under attack in MS. Hold that thought. We'll get back to it after we talk about the immune system.

The Immune System

The other crucial element to know about in MS is the immune system. This is the system in your body that fights off the bugs that try to invade your body. If you cut your finger or someone sneezes on you, bugs (like viruses and bacteria) try to get inside you and take over. The thing that prevents the bug from taking over your body is the immune system.

Now, Let's Put These Two Ideas Together

In multiple sclerosis, the body's immune system, for unknown reasons, turns on itself. Instead of just fighting off bugs and other invaders, it starts to attack the myelin that surrounds the axons in the CNS (see figure 6). This is called demyelination. When an axon is demyelinated, it can no longer carry the information from the cell body to the axon terminal of the nerve. If the message cannot be transmitted, then whatever function the nerve was in charge of doing (like telling a muscle to contract or helping a person pay attention when reading about neurobiology) cannot be executed! This can cause a lot of trouble for a person with MS (as well as for the people around the person with MS).

No one knows exactly why a person's immune system decides to turn on itself. There are many ideas about why this happens. It could be that a person is exposed to something in the environment, such as a virus or some other foreign substance, which looks like myelin on a molecular level. Normally, when the immune system sees a virus, it makes antibodies based upon the molecular structure of the virus. By doing this, if and when the antibody sees the same molecular structure again, it will be ready to immediately launch an attack and prevent a full-blown infection. 8 Possibly, in MS, if an invading virus has a molecular structure similar to the molecular structure of myelin, the antibodies that were made for the virus could then start to attack the myelin.

There is good evidence that our genetic makeup plays a role in having our immune system start attacking tissues within our own body. 9, 10 Most MS experts believe that the cause of MS is almost certain to be multifactorial (a combination of genes and something in the environment). In their paper, Genetics of Multiple Sclerosis: Swimming in an Ocean of Data, Sergio E. Baranzini and Dorothee Nickles put together the results of the largest genome-wide association study for MS, as of 2011. 11 Their synthesis confirmed the association of twenty-three genes with MS and reported about twenty-one other suspect genes. They also report on the data implicating the CYP27B1 gene variant as a heritable factor that prevents proper conversion of vitamin D from its inactive 25-hydroxyvitamin D form to its active 1,25 dihydroxyvitamin D form. The paper goes on to describe other statistically valid and reliable data, including the "brother and sister" relationship of MS with other autoimmune diseases like Crohn's disease , diabetes mellitus type I, asthma, psoriasis, celiac disease, rheumatoid arthritis, and Grave's disease. The number of newly discovered genes and gene variants associated with MS increases on a regular basis. At an MS consortium meeting in 2014, it was announced that the number of genes associated with MS was up to 159. Other potential causes of MS will be discussed again in the chapter dedicated to the immune system.

Conclusion

So there you have the essence of MS. After a nerve is demyelinated, it cannot transmit the message from the cell body, along the axon, to the axon terminal and allow for neurotransmitter release to communicate with the next cell. If it affects a visual pathway, a person might have trouble with vision. If it affects a coordination tract, movements can become clumsy. If it affects a behavior fasciculus, initiative can be impaired or lost. 14 We don't know the exact causes of MS, but we have many clues. The next chapter will discuss more of the specifics about how the immune system causes demyelination. Then, in subsequent chapters, we will discuss how to slow this whole process down.

(Continues...)

Excerpted from Multiple Sclerosis from Both Sides of the Desk by Vincent F. Macaluso. Copyright © 2015 Vincent F. Macaluso, MD. Excerpted by permission of iUniverse.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

“Acerca de” puede pertenecer a otra edición de este título.

PBShop.store US

Wood Dale, IL, Estados Unidos de America

Vendedor de 5 estrellas

Vendedor de IberLibro desde 7 de abril de 2005

Tarifas de envío en Estados Unidos de America

Artículo	De 7 a 14 días hábiles	De 7 a 14 días hábiles
Primer artículo	EUR 0,00	EUR 0,00

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Métodos de pago

Descripción de la tienda

We first started out as “The Paperback Exchange,” a chain of physical bookstores where we would part exchange your beloved books for new stories to transport you to faraway places. However, as shopping started to evolve to online shops and marketplaces, we bid our stores goodbye to become “PBShop.” This transition has only allowed us to blossom as we now ship thousands of titles to book lovers across the globe. We pride ourselves in being a community of local book lovers which allows our passion and devotion to shine in everything we do. In 2020 we not only celebrated our 20th birthday but our 1st birthday as being completely employee owned after becoming an E.O.T in September 2019. We are proud to be different and embrace standing apart on a book mountain by working from a virtual inventory which allows us to provide thousands of books that may be difficult to get for your bookshelf or your studies. Working with a number of different suppliers allows us to explore other avenues such as puzzles, sheet music and even stationery so we really do have something for everyone. Life is about being versatile in all realms of existence. If this is your first visit or you are a returning customer, we would like to welcome you to the PBShop family, for there is no friend as loyal as a book. We are a company who put our customers at the centre of everything we do as we understand the importance of reading because once you learn to read, you will forever be free. There are a whole lot of things in this world of ours that we are yet to explore, which is why we will forever inspire curious minds.…

Especialidad

Hardbacks, Paperbacks

Información empresarial del vendedor

Pbshop.co.uk Ltd

Unit 22 Horcott Industrial Estate, Horcott Road
Fairford, Reino Unido GL7 4BX

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Condiciones de venta

Returns Policy
We ask all customers to contact us for authorisation should they wish to return their order. Orders returned without authorisation may not be credited.
If you wish to return, please contact us within 14 days of receiving your order to obtain authorisation.

Returns requested beyond this time will not be authorised.

Our team will provide full instructions on how to return your order and once received our returns department will process your refund.
Please note the cost to return any unwanted order to us is borne by the buyer.

Should your order arrive damaged, not as advertised or faulty, we must be advised of this within 14 days of delivery. Please contact us so we can find the best solution for you.

Our Customer Care Team can be contacted via emailing paperback-us@paperbackshop.co.uk, or by calling our UK Office on +441285 712 917. We are available 9:00am till 5:30pm GMT weekdays and 9:00am till 1:00pm GMT on Saturdays.

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Información sobre el derecho de desistimiento

Derecho legal de desistimiento

Tiene derecho a rescindir este contrato en un plazo de 14 días sin dar ningún motivo.

El periodo de desistimiento vencerá a los 14 días desde que usted, o un tercero que no sea el transportista e indicado por usted, adquiera la posesión física del último bien o del último lote o pieza.

Para ejercer el derecho de desistimiento, complete de forma electrónica y envíe una declaración clara en nuestro sitio web, desde "Mis compras" en "Mi cuenta". Le enviaremos sin demora un acuse de recibo de dicho desistimiento a través de un soporte duradero (por ejemplo, por correo electrónico).

Para cumplir con el plazo de desistimiento, basta con que envíe su comunicación relativa al ejercicio del derecho de desistimiento antes de que venza el periodo de desistimiento.

Efectos del desistimiento

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Podemos hacer una deducción del reembolso por la pérdida de valor de cualquier bien suministrado, si la pérdida es el resultado de una manipulación innecesaria por su parte.

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Podremos retener el reembolso hasta que hayamos recibido los bienes o hasta que nos haya presentado una prueba de que los ha devuelto, lo que ocurra primero.

Deberá devolver los bienes o entregarlos a PBShop.store US, Springfield Gardens, New York, U.S.A., +44 1285 712917, sin demoras indebidas y, en cualquier caso, en un plazo máximo de 14 días a partir del día en que nos comunique su desistimiento del presente contrato. El plazo se cumple si devuelve la mercancía antes de que venza el periodo de 14 días. Tendrá que asumir los gastos directos de devolución de los bienes. Usted solo es responsable de la disminución del valor de los bienes como resultado de una manipulación distinta a la necesaria para establecer la naturaleza, las características y el funcionamiento de los bienes.

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El derecho de desistimiento no se aplica a lo siguiente:

La entrega de periódicos, diarios o revistas, con la excepción de los contratos de suscripción; y
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Condiciones de envío

Books are shipped from our US or UK warehouses. Delivery estimates allow for delivery from either location.

Privacidad y seguridad

We are committed to protecting the privacy and security of personal data. This policy tells you how we will collect and use your personal data, and what you should expect in respect of the personal information about you that we have collected.

We are PBShop.co.uk Limited (registered in England & Wales with Company No: 9366362). Our registered office is at Swatton Barn, Badbury, Swindon, SN4 0EU, United Kingdom.

The person with responsibility for our data protection compliance is the Managing Director and they can be contacted via email at help@pbshop.store.

We are the data controller of the personal data that we keep and use, and we are therefore responsible for making sure that our systems, processes and people comply with the relevant data protection laws in respect of that personal data.

We will act in respect of personal data to comply with the six principles of the General Data Protection Regulation (“GDPR”), which are:

Lawfulness, fairness and transparency;
Purpose limitation;
Data minimisation;
Accuracy;
Storage limitation;
Integrity and confidentiality.
You have rights in respect of how your personal data can be processed; these include the right to request:

a copy of your personal data;
that inaccurate data is rectified; and
that your personal data is, in certain circumstances, erased or restricted.
You have the right to complain to the Information Commissioner, which you can do by contacting the Information Commissioner’s Office (ICO) directly. Full contact details, including a helpline number, can be found on the ICO website (www.ico.org.uk). This website also has useful information on your rights and our obligations. However, please raise any concerns or issues with us first so that we may deal with this as quickly as possible for you.

COLLECTION, USE AND DISCLOSURE OF PERSONAL DATA
We collect and process data for the following reasons:

personal data collected and created in relation to our selling books and other items; and
personal data relating to our people (which means those people working for our company, or providing services to us, or potentially working or providing services to us, including employees, consultants, temporary or casual workers and contractors).
All of our people are required to abide by our Privacy Policy when handling personal data, and are provided with appropriate data protection training. Any breach of data protection will be taken seriously, and may result in disciplinary action.

Selling books and other items
COLLECTION:
We will collect personal information which may include names, addresses and other information for our customers. This will be done for the management of the commercial relationship with our customers.

We may collect this personal data from you directly, and also from third parties, including publicly available third party sources. Additional personal data will be collected as it is created by or supplied to us in the course of anything we do for you.

USE:
We will use the personal data in the course of making sales and to comply with requirements that we are required to undertake.

We will only use your personal data when the law allows us to. Most commonly, we will use your personal data in the following circumstances:

in performance of a contract (the agreement to sell books and other items); and/or
compliance with a legal obligation; and/or
vital interests of the data subject; and/or
where it is necessary for our legitimate interests (or those of a third party) and your interests and fundamental rights do not override those interests.
We may also use your personal data in the following situations, which are likely to be far less common:

where we need to protect your interests (or someone else’s interests);
where it is needed in the public interest or for official purposes.
DISCLOSURE:
We may share personal data with third parties as is necessary in the sale of books and other items, including to third party providers who deliver services to support the operation of our company.

In respect of all disclosures of personal data, we will only share the personal information which is necessary for the particular purpose for which it is provided, or where we have another legitimate interest in doing so, and we will ensure that the personal data is appropriately protected.

RETENTION PERIOD:
We will keep personal data only for as long as is necessary to fulfil the purposes for which we collected it, including for the purposes of satisfying any legal, accounting or reporting requirements. Normally, our retention period for personal data collected for this purpose is a minimum of 6 years after the end of the period that we are selling books and other items.

Our people
COLLECTION:
We will collect names, addresses, contact details, education and employment history, identity and other background checks (which may include appropriate criminal and financial checks and confirmation of the right to work in the UK), marital status and information on next of kin and dependents, financial information (such as bank details and NI numbers), date of birth, gender, a copy of your passport and driving licence, performance information and compensation history, recruitment information (including references), salary, benefits, pension and annual leave information, disciplinary and grievance information, photographs, information about your use of our information and communications systems and CCTV footage or other information obtained through electronic means.

We may collect and use special categories of personal data as required in the carrying out of obligations and exercising specific rights of us or the data subject in the field of employment. This may include information relating to matters such as health, racial origin, religious belief and offences or alleged offences.

Personal data may be collected from you during the selection process (for example via your application form and CV) and during your employment (including holiday forms, expense claims, performance reviews, any disciplinary or grievance processes), or from third parties, including referees, health service providers, background check providers.

USE:
Personal data of our people will be used for HR administration and management, both in respect of the selection of people to work for us (including suitability, eligibility and/or fitness to work), and those who do work for us, to include learning and development, disciplinary and security (of people, offices and data) requirements, providing and liaising with benefits providers, business management and planning (including accounting and auditing), paying you and dealing with tax and NI deductions, assessing and deciding on salary reviews and compensation, conducting performance reviews and managing performance, dealing with legal disputes involving you or others, preventing fraud, monitoring your use of our information and communications systems, ensuring compliance with our policies, and equal opportunities monitoring.

We will only use your personal data when the law allows us to. Most commonly, we will use your personal data in the following circumstances:

In performance of a contract with you; and/or
compliance with a legal obligation; and/or
vital interests of the data subject; and/or
where it is necessary for our legitimate interests (or those of a third party) and your interests and fundamental rights do not override those interests.
We may also use your personal data in the following situations, which are likely to be less common:

where we need to protect your interests (or someone else’s interests);
where it is needed in the public interest or for official purposes.
In respect of all disclosures of personal data, we will only share the personal information which is necessary for the particular purpose for which it is provided, or where we have another legitimate interest in doing so, and we will ensure that the personal data is appropriately protected.

In respect of special categories of personal data, we may process this in the following circumstances:

in limited circumstances with your explicit written consent; and/or
where we need to carry out our legal obligations and in line with our policies; and/or
where it is needed in the public interest (such as for equal opportunities monitoring or in relation to our occupational pension scheme), and in line with our policies; and/or
where it is needed to assess your working capacity on health grounds, subject to appropriate confidentiality safeguards.
Less commonly, we may process this type of information where it is needed in relation to legal claims or where it is needed to protect your (or someone else’s) interests and you are not capable of giving your consent, or where you have already made the information public. We may also process such information about our people (or former people) in the course of our legitimate business activities with the appropriate safeguards.

The special categories of personal data may be used in the following ways:

in relation to leaves of absence, to comply with employment and other laws;
in relation to your physical or mental health, or disability status, to ensure your health and safety in the workplace and to assess your fitness to work, to monitor, manage and administer benefits and absences;
in relation to your race, national or ethnic origin, religious, philosophical or moral beliefs, or your sexual life or sexual orientation, to ensure meaningful equal opportunity monitoring and reporting.
DISCLOSURE:
Personal data may be transferred to service providers who support the operation of our business (such as payroll service providers), to other third parties reasonably necessary in the conduct of our business (including insurers, professional advisors, regulators). These third parties may be acting as processor, or controller of personal data in their own right.

RETENTION PERIOD:
We will keep personal data only for as long as is necessary to fulfil the purposes for which we collected it, including for the purposes of satisfying any legal, accounting or reporting requirements. We will normally keep personal data of applicants who we do not employ for six months after we receive it.

We will keep personal data of employees throughout your employment and normally for a minimum of six years after your employment ends.

Changes to your personal data
It is very important that the personal information that we hold about you is accurate and current. Please tell us if your personal information changes during your relationship with us.

Data Security
We have put in place measures to prevent your personal data from being accidentally lost, used or accessed in an unauthorised way, altered or disclosed. In addition, we limit access to your personal data to those of our people and other third parties who have a business need to know. They will only process your personal data on our instructions and where they have agreed to treat the information confidentially and to keep it secure. We have put in place procedures to deal with any suspected data security breach and will notify you and the ICO of a suspected breach where we are legally required to do so.

Where we store your personal data
We principally store data, both electronically and on file, at our office.

Personal data may be transferred outside of the EEA by processors acting on our behalf. For transfers to countries not considered adequate by the EC, we will ensure that personal data is adequately protected, as required by the GDPR. This would include by use of the Standard Contractual Clauses adopted by the EC to protect personal data.

Your rights
Under certain circumstances, you have the right by law to request:

access to your personal data. This enables you to ask to receive a copy of the personal data that we hold about you and to check that we are lawfully processing it.
correction of the personal data that we hold about you.
erasure of your personal data.
object to processing of your personal data where we are relying on our legitimate interest and there is something about your particular situation which makes you want to object to processing on this ground. You also have the right to object where we are processing your personal information for direct marketing purposes.
restriction of processing of your personal data.
transfer of your personal data to another party.
Links from our website
Our website may, from time to time, contain links to and from the websites of third parties that we permit to make such links. If you follow a link to any of these websites, please note that these websites have their own privacy policies and that we do not accept any responsibility or liability for these policies. We recommend that you check these policies before you submit any personal data to these websites.

CHANGES TO THIS PRIVACY POLICY
Any changes we may make to our privacy policy in the future will be posted on our website, so please ensure that you are viewing the correct version.

Please contact us if you have any questions, comments or requests regarding this Privacy Policy.

Last amended May 2021.

Multiple Sclerosis from Both Sides of the Desk

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