Multiple Sclerosis For Dummies®

by Rosalind Kalb, PhD, Nancy Holland, EdD, RN, and Barbara Giesser, MD

Foreword by David L. Lander, Author of Fall Down Laughing: How Squiggy Caught Multiple Sclerosis and Didn’t Tell Nobody

Multiple Sclerosis For Dummies®

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Copyright © 2007 by Wiley Publishing, Inc., Indianapolis, Indiana

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Library of Congress Control Number: 2006939594

ISBN: 978-0-470-05592-2

Manufactured in the United States of America

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About the Authors

The authors’ shared commitment to multiple sclerosis (MS) began more than 25 years ago at the MS Care Center at the Albert Einstein College of Medicine, under the direction of Labe Scheinberg, MD, who is considered by many to be the father of MS comprehensive care.

Rosalind Kalb, PhD, is Associate Vice President of the Professional Resource Center at the National Multiple Sclerosis Society in New York City. After receiving her doctorate in clinical psychology from Fordham University in 1977, Dr. Kalb began her career at the MS Care Center, providing individual, group, and family therapy for people living with MS. Dr. Kalb is the author of the National MS Society’s Knowledge is Power series for individuals newly diagnosed with MS and is an editor of Keep S’myelin, the newsletter for children who have a parent with MS. Dr. Kalb has edited two books on MS — Multiple Sclerosis: The Questions You Have, The Answers You Need, 3rd Edition (Demos Medical Publishing, 2004), and Multiple Sclerosis: A Guide for Families, 3rd Edition (Demos Medical Publishing, 2006). She is also coauthor, along with Nicholas LaRocca, PhD, of the book Multiple Sclerosis: Understanding the Cognitive Challenges (Demos Medical Publishing, 2006).

Nancy Holland, EdD, RN, is Vice President of Clinical Programs at the National Multiple Sclerosis Society in New York City. Prior to joining the Society, Dr. Holland served as the MS Care Center’s Clinic Coordinator and Director of Training for 15 years. She is a founding director of the International Organization of MS Nurses. She is also author or editor of more than 60 MS-related articles, chapters, and books, including Comprehensive Nursing Care in Multiple Sclerosis, 2nd Edition (Demos Medical Publishing, 2002), Multiple Sclerosis: A Self-Care Guide for Wellness, 2nd Edition (Demos Medical Publishing, 2005), and Multiple Sclerosis: A Guide for the Newly Diagnosed, 3rd Edition (Demos Medical Publishing, 2007). Dr. Holland earned a doctorate in higher and adult education from Columbia University, and holds undergraduate and graduate degrees in nursing.

Barbara Giesser, MD, is an Associate Clinical Professor of Neurology and Clinical Director of the MS Program at the University of Los Angeles (UCLA) David Geffen School of Medicine. She also serves as the Medical Director of the UCLA Marilyn Hilton MS Achievement Center.

Dr. Giesser has specialized in the care of persons with MS since 1982, beginning with her training at the MS Care Center. She has been an invited lecturer to speak about MS in regional, national, and international venues, and has published research in the areas of cognition, gender issues, and rehabilitation strategies in persons with MS. Additionally, she has been active in developing educational materials about MS for medical students, residents, healthcare professionals, and people with MS for organizations including the NMSS and the American Academy of Neurology.

Dedication

We dedicate this book to our teachers — beginning with Labe Scheinberg, MD, who launched a generation of clinicians committed to the care of people with MS and their families and ending with our patients and colleagues who have taught us everything else we know about this disease.

Authors’ Acknowledgments

Okay, it’s time to admit that we didn’t do this all by ourselves. We need to thank quite a few people for their assistance along the way:

Stephen Reingold, PhD, for his ongoing encouragement, wealth of knowledge, and willingness to share the initial brainstorm.

Dorothy Northrop, MSW, ACSW, Kimberly Calder, MPS, and Steven Nissen, MS, CRC, from the National MS Society for their time, expertise, and commitment to helping people with MS develop and maintain their vocational and financial safety nets.

Nancy Reitman, RN, MA, for her ideas, behind-the-scenes research, and willingness to pitch in whenever and wherever.

Joyce Nelson, CEO of the National MS Society, John Richert, MD, Executive Vice President of Research and Clinical Programs at the National MS Society, and Adrienne Glasgow, Chief Financial Officer of the National MS Society, for their dedication to people affected by MS and their enthusiastic support of this project and its authors.

And thank you to the amazing group at Wiley:

Lindsay Lefevere — the Acquisitions Editor who paved the way and got us all fired up.

Alissa Schwipps — our Senior Project Editor who patiently provided invaluable guidance and assistance every step of the way.

Jessica Smith — the Copy Editor who made sure you could read what we wrote.

The Composition team — this team turned our thoughts into the book you’re holding.

We also want to thank David Mattson, MD, PhD, for his very thoughtful and valuable technical review of the material.

Publisher’s Acknowledgments

We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/.

Some of the people who helped bring this book to market include the following:

Acquisitions, Editorial, and Media Development

Senior Project Editor: Alissa Schwipps

Acquisitions Editor: Lindsay Lefevere

Copy Editor: Jessica Smith

Technical Editor: David H. Mattson, MD, PhD

Senior Editorial Manager: Jennifer Ehrlich

Editorial Assistants: Erin Calligan Mooney, Joe Niesen, David Lutton, Leeann Harney

Cover Photo: © National Multiple Sclerosis Society

Cartoons: Rich Tennant (www.the5thwave.com)

Composition Services

Project Coordinator: Erin Smith

Layout and Graphics: Carl Byers, Carrie Foster, Shane Johnson, Stephanie D. Jumper, Laura Pence

Special Art: Kathryn Born, Medical Illustrator

Proofreaders: John Greenough, Aptara

Indexer: Aptara

Anniversary Logo Design: Richard Pacifico

Publishing and Editorial for Consumer Dummies

Diane Graves Steele, Vice President and Publisher, Consumer Dummies

Joyce Pepple, Acquisitions Director, Consumer Dummies

Kristin A. Cocks, Product Development Director, Consumer Dummies

Michael Spring, Vice President and Publisher, Travel

Kelly Regan, Editorial Director, Travel

Publishing for Technology Dummies

Andy Cummings, Vice President and Publisher, Dummies Technology/General User

Composition Services

Gerry Fahey, Vice President of Production Services

Debbie Stailey, Director of Composition Services

Foreword

I t was twenty-some years ago when I first realized that my body was trying to tell me that there was something wrong. I had no idea what was happening nor would I know what to do about it if I did.

First there were the problems with my legs, then my arms, then my balance. With all the changing symptoms and the doctors not knowing what I had, I thought I had contracted hypochondria. I knew I had something, but what? I asked myself, “What is this? Does it have a name?”

When I found out I had multiple sclerosis, other than finally having a label for my problem, I still had no idea what to do with it. It was complicated. It was unpredictable. And there was no cure!

I was lost and had no idea which way to go.

Had I had a wonderful book as simple to navigate, yet as comprehensive as Multiple Sclerosis For Dummies, my family and I would have saved a lot of time and aggravation.

It took me years to realize that the most constructive way to deal with my MS was by playing an active role as part of my health care team. While you won’t be able to be a doctor after reading Multiple Sclerosis For Dummies, you will be much more capable of asking your doctor the right questions, and that makes you an effective component of your own treatment.

While getting MS is no joke, Multiple Sclerosis For Dummies offers humor as another essential element for understanding and facing your MS. MS can take a lot of things away from you, but it cannot take away your sense of humor.

Multiple Sclerosis For Dummies is like a global positioning system for your condition; it’ll keep you from feeling lost.

David L. Lander (“Squiggy”)
Proud Member of the MS Community

Contents

Title

Introduction

About This Book

Conventions Used in This Book

What You’re Not to Read

Foolish Assumptions

How This Book Is Organized

Icons Used in This Book

Where to Go from Here

Part I : When MS Becomes Part of Your Life

Chapter 1: Meeting MS Face to Face

Introducing the Roles Your Immune and Nervous Systems Play in MS

Exploring Possible MS Triggers

Understanding Why Your MS is as Unique as Your Fingerprint

Perusing the MS Treatment Menu

Recognizing How Your MS Affects Your Loved Ones

Minimizing the Impact of MS on Work and Play

Taking Steps to Protect Your Quality of Life

Chapter 2: So, What Is it, Doc? Getting a Diagnosis

Clarifying the Diagnostic Criteria

Getting Familiar with the Neurologist’s Diagnostic Tools

Understanding Why the Road to Diagnosis Can Be Full of Twists and Turns

Chapter 3: You’ve Been Diagnosed — So What’s Next?

First Things First: Sorting Out Your Feelings

Deciding on the Next Steps

Facing the Longer-Term Challenges of a Chronic Illness

Making Treatment and Lifestyle Choices That Work for You

Chapter 4: Creating Your Healthcare Team

Working with Your Physician

Rounding Up Other Key Players

Considering Comprehensive MS Treatment Centers

Part II : Taking Charge of Your MS

Chapter 5: Developing Your Management Plan to Take Charge of Your MS

Using Multiple Strategies to Manage MS

Tapping Your Creativity and Flexibility

Creating Your Own Treatment Template

Chapter 6: Managing the Disease Course and Treating Relapses

Managing the Disease Course

Managing Relapses

Getting Comfortable with Your Treatment Decisions

Chapter 7: Managing Fatigue, Walking Problems, Visual Changes, and Tremor

Foiling Your Fatigue

Envisioning Solutions to Vision Problems

Getting Around Walking Problems

Taming Tremor

Chapter 8: Handling Problems with Bladder and Bowel Function, Pain, Sex, and Speech and Swallowing

Eliminating Elimination Problems

Sizing up Sexual Symptoms

Sidestepping Sensory Symptoms and Pain

Sorting out Speech and Swallowing Problems

Chapter 9: Getting Your Head around Problems with Thinking and Mood

Handling Problems with Thinking and Memory

Managing the Emotional Ups and Downs

Chapter 10: Considering Complementary and Alternative Medicine

Defining CAM

Understanding the Allure

Putting CAM to the Test

Identifying CAM Interventions That May Be Useful in Managing MS Symptoms

Becoming a Cautious CAM Consumer

Part III : Staying Healthy and Feeling Well

Chapter 11: Paying Attention to Your Health — It’s Not All about MS

Enhancing Your Wellness by Paying Attention to the Whole You

Scheduling Routine Checkups to Protect Your Health

Making Healthy Eating a Priority

Improving Your MS and Overall Wellness with Exercise

Increasing Your Chances of Success

Chapter 12: Handling Stress without Giving Up Your Life

Understanding the Relationship between Stress and MS

Recognizing Your Own Signs of Stress

Identifying the Major Stresses in Your Life

Developing Your Stress Management Plan

Chapter 13: Coping with Advanced MS

Scouting Out the Treatment Scene

Maintaining Your Quality of Life

Discovering Long-Term Care Services (Just In Case)

Important Tips for Caregivers

Part IV : Managing Lifestyle Issues

Chapter 14: Presenting Your MS Face to the World

Explaining Your MS to Others

Disclosing Your Diagnosis to a Prospective Partner

Communicating Your Needs

Chapter 15: Making MS a Part of the Family

Addressing Your Family Members’ Feelings about Your Diagnosis

Communicating Effectively with Adult Family Members

Keeping the Family Rhythm Going so Your MS Doesn’t Steal the Show

Building and Maintaining Healthy Partner Relationships

When Your Child Has MS

Chapter 16: And Baby Makes Three, Four, or More: Planning a Family around Your MS

MS and Babies: Here’s the Good News!

Considering Key Issues when Making Family-Planning Decisions

Strategies for Smart Decision-Making

Chapter 17: Parenting: It Wasn’t Easy Before You Had MS!

Keeping the Communication Lines Open

Parenting around Your MS Symptoms

Employing Effective Parenting Strategies

Part V : Creating Your Safety Nets

Chapter 18: Keeping Your Place in the Workforce

Understanding the High Rate of Unemployment in MS

Counting the Reasons to Keep on Truckin’

Speed Bumps Ahead: Recognizing the Job-Related Challenges

Knowing Your Rights under the ADA

Thinking about Leaving Your Job

Chapter 19: Getting a Grip on Insurance

Considering Your Health Insurance Options — It’s All about Eligibility

Keeping a Tight Hold on Your Health Insurance

Understanding the Ins and Outs of Your Health Insurance Plan

Filing Successful Insurance Appeals

Replacing Your Income with Disability Insurance

A Brief Word about Life and Long-Term Care Insurance

Chapter 20: Planning for a Future with MS

Preparing for the Worst While Hoping for the Best

Navigating the Planning Process: It’s as Easy as One, Two, Three

Part VI : The Part of Tens

Chapter 21: Ten Must-Do’s for Living with MS

Educate Yourself about MS

Work with Your Neurologist

Start Treatment Early

Make MS a Part of the Family

Develop Your Support Network

Plan for the Future

Feel Healthy and Well

Create Your Tool Chest

Monitor Your Mood

Keep Your Sense of Humor Well-Oiled

Chapter 22: Ten MS Myths Debunked

MS is Fatal

Everyone Eventually Needs a Wheelchair

Because There’s No Cure, There’s Nothing You Can Do about Your MS

People with MS Can’t Handle Stress

People with MS Shouldn’t Have Children

“Natural” Treatments Are Safer

No One Can Understand How You Feel

Having a Relapse Means Your Medication Isn’t Working

Scientists Aren’t Making Any Progress

If You Can’t Walk, Your Life Is Over

Chapter 23: Ten Tips for Trouble-Free Travel

Tap the Right Resources

Calm Your Medical Concerns

Save Energy for the Fun Stuff

Check Ahead for Accessibility

Rent Accessible Vehicles

Keep Your Cool

Navigate Air Travel with Confidence

Safely Pack Your Prescriptions

Get Vaccinated

Look for Adventure

Part VII : Appendixes

Appendix A: Glossary

Appendix B: Additional Resources

Reading Other Books about MS

Finding Helpful Information Online

Appendix C: Medications Commonly Used in MS

: Further Reading

Introduction

Being diagnosed with multiple sclerosis (MS) is definitely a bummer, but living with it doesn’t have to be. This book is all about how to live your life with MS without making a full-time job of it. After diving in, you’ll be more informed and more prepared no matter how your MS behaves.

If you’ve never heard of MS before and you want to know what may be in store, this book is definitely for you. You also want to take a gander through this book if all you’ve ever heard about MS is the bad stuff. We suggest this because the fact is, you’ve probably met several people at work, at the gym, or in your neighborhood, who have MS and you didn’t even know it. And, even if the people you happen to know with MS don’t seem to have a symptom or care in the world, you now have another good reason to keep reading: Everyone’s MS is different and no one can predict exactly what yours will be like.

The three of us — a neurologist, a nurse, and a psychologist — have worked with, and learned from, people with MS for almost 30 years (actually it’s 82 years if you add our careers together end to end!). We wrote this book as a team effort so we could send a loud and clear message that you’re not alone. Health professionals trained in neurology, nursing, psychology, rehabilitation medicine, and a variety of other disciplines, as well as voluntary organizations, such as the National Multiple Sclerosis Society, are ready to help you every step of the way.

About This Book

Don’t worry: In this book, we’re not going to try and tell you everything there is to know about MS. Instead, we only give you what you need in order to make educated choices and comfortable decisions. We provide lots of information that’s easy to access and easy to swallow regarding what happens in MS — what kinds of symptoms it can cause, how it can affect your life at home and at work, what you can do to feel and function up to snuff, and how you can protect yourself and your family against the long-term unpredictability of the disease. We also throw in useful tips, introduce you to the members of your healthcare team, and point you in the direction of other useful resources. And we even promise to make you chuckle once or twice along the way.

Feel free to pick and choose what you want to read — you don’t have to take a cover-to-cover approach if you’re more comfortable with a hop, skip, and jump style. Each chapter tackles a different aspect of living with MS so that you can zero in on the stuff that’s most relevant to you.

Conventions Used in This Book

We used the following conventions throughout the text to make things consistent and easy to understand:

All Web addresses appear in monofont.

New terms appear in italics and are closely followed by an easy-to- understand definition.

Bold is used to highlight the action parts of numbered steps.

Because most people with MS receive their MS-related care from a neurologist (a physician who specializes in the diagnosis and treatment of diseases of the nervous system), we use the terms neurologist, doctor, and physician interchangeably whenever we’re referring to the person who’s treating your MS. When we’re talking about other medical specialists — such as internists, family practice doctors, urologists, gynecologists, physiatrists, psychiatrists — we refer to them by their specialty titles.

We talk about a lot of medications in this book, which you may or may not ever need. In case you do, we always give the brand name first, because that’s the one you’re most likely to see in advertisements or hear other people talk about, followed by the chemical name in parentheses.

What You’re Not to Read

Even though we poured heart and soul into every page of this book, we know that you won’t want to read it all — and most likely you won’t need to. So, we make it easy for you to identify “skippable” material by sticking it into sidebars. This is the stuff in the gray boxes that’s interesting and related to the topic at hand, but not essential for your health and well-being.

Foolish Assumptions

Even though no two people have MS in exactly the same way, we assume that you — our readers — still have quite a few things in common. We’ve written this book with these thoughts about you in mind:

You have MS or care about someone who does.

However much you already know about MS, you want to know more — in language that’s easy to access and easy to understand.

You’re looking for ways to manage your MS and the symptoms it can cause.

You want to be healthy, active, and productive in spite of whatever challenges MS is throwing your way.

You wish you had a crystal ball, but you’re willing to settle for some helpful suggestions on how to deal with the unpredictability of MS.

How This Book Is Organized

This book is divided into seven parts to help you gather all the information you need about MS. However, every part can stand alone, so you don’t have to read one before another. In fact, if you’re looking for only a few things in particular, just check out the table of contents or the index and skip directly to those topics. The following is a rundown of the seven parts.

Part I: When MS Becomes Part of Your Life

Whether MS has entered your life with a bang or a whimper, you need to know what it’s all about. So, in this part, we fill you in on the basic facts as well as the big mysteries that remain to be solved. We show you the usual steps involved in getting a diagnosis and suggest ways to handle any reactions that you may have during those early days (as well as those that may crop up as the realities of the disease begin to sink in). This part also gives you good ideas on how to begin making room in your life for a chronic, unpredictable illness — without giving it more of your attention than it needs.

It’s always good to know that you don’t have to deal with tough stuff on your own — so, in this part, we also spend some time introducing you to the healthcare professionals who are going to help you manage your MS.

Part II: Taking Charge of Your MS

The best way to feel more confident in the face of any new challenge is to come up with a game plan. And you’re in luck because this part of the book is designed to do just that. It helps you get started with the planning process and gives you tips on how to work with your healthcare team to make the treatment choices that best meet your needs.

Each chapter describes a part of the MS treatment package — including all the immediate and longer-term strategies for slowing disease activity, dealing with pesky relapses, and managing symptoms. We talk about the importance of early treatment and describe the available options. And, we zero in on ways to manage the physical symptoms that can pop up along the way, as well as the ones that can mess with your head, such as mood changes and problems with memory and thinking.

Alternative medicine is a hot topic for people with MS, so in this part, we also give you pointers on how to sift through the available products and services to find those that are safe and effective for people with MS.

Part III: Staying Healthy and Feeling Well

You can be healthy with MS — in fact, the healthier you are the better you’re going to feel. So, this part is all about how to take care of yourself with a healthy, balanced diet, the right kind of exercise, restful sleep, and some good stress management strategies.

Throughout the chapters of this part, we emphasize the importance of looking beyond your MS (or your family member’s MS) to develop an overall wellness plan involving regular checkups by your family doctor and dentist and the preventive health screens recommended for your age group.

In this part, we also give you an idea of what to do when your MS isn’t behaving very nicely. When the disease progresses in spite of available treatments, it’s important to know how to manage your symptoms, avoid messy complications, and keep your life on track.

Part IV: Managing Lifestyle Issues

The key to coping well with your MS is finding ways to fit it into your life. So, in this part, we begin with a reminder that people’s responses to your MS are going to depend in large part on how you present it to them. We then go on to give you lots of strategies for helping others understand what your MS is all about.

We also include a chapter that shows how to make MS part of the family. This chapter describes the ways in which families are affected when someone they love gets MS, and it also shares tips to help family members communicate and problem-solve more comfortably.

Because MS is diagnosed most often during early adulthood, when people are busy starting or adding to their families, this part fills you in on all the good news for prospective parents (yes, people with MS can have happy, healthy kids!). It gives you lots of parenting tips to help you deal with those bundles of joy that quickly grow into toddlers and teens.

Part V: Creating Your Safety Nets

The hallmark of MS is its unpredictability. Because everyone’s MS is different and no one has a crystal ball, anxiety about the future is pretty common. To reduce that anxiety as much as possible, this part is all about making sure that you’re armed and ready to deal with whatever comes along.

We give you tips on how to stay in the work force as long as you’re interested and able, strategies for getting and maintaining insurance coverage, and recommendations for how to plan effectively for the unpredictable future. When you’re living with MS, developing these kinds of safety nets can help you feel less vulnerable and more in control.

Part VI: The Part of Tens

In this part, we give you some key suggestions in a handy top-ten format. One chapter lists ten tips to live by when you have MS and another lists the mistaken notions about MS that you can finally put to rest. We round out this part with ten strategies to make traveling with MS as trouble-free as possible.

Part VII: Appendixes

This is the last-but-definitely-not-least part. We start with a glossary so you can look up any of those technical words that trip you up when you’re reading about MS, attending an educational meeting, or even talking to your doctor. Then we point you toward some important resources that you may want to tap along the way — including other books that zero in on some of the issues covered here, Web sites with accurate, up-to-date information, and community agencies and organizations that you can tap for information or assistance if the need arises.

Icons Used in This Book

To make this book easier to read and simpler to use, we include some icons that can help you pick out the key ideas and points of information throughout the book.

This icon highlights shortcuts that help you conserve valuable resources, such as energy, time, and money.

When you see this icon, it tells you that the information that follows is essential and that you should keep it in mind as you deal with your MS.

This icon flags dangers to your health, safety, or general well-being.

This icon reminds you when it’s time to check in with your neurologist or another specialist on your healthcare team.

Where to Go from Here

This book is organized so that all you need to do is shut your eyes and point in order to find complete information about one aspect of MS or another. If you prefer the eyes-open method but aren’t sure where you want to start, we recommend Part I. It gives you basic info about MS and how it’s diagnosed, as well as some tips for sorting out all of the feelings that an MS diagnosis can stir up. If you’ve already been there and done that, you may want to check out specific treatment strategies in Part II, or discover ways to feel more bright-eyed and bushy-tailed in Part III. If you’re wondering how MS may affect your relationships with the important people in your life, you can focus on Part IV. And if you’re someone who likes to get all your ducks in a row from the get-go (and even if you’re not), you can check out Part V for suggestions on how to feel securely prepared in spite of the unpredictability of MS.

No matter where you choose to begin, begin now. Make it your priority to educate yourself about MS and the strategies you and your family members can use to live well in spite of it.

Part I

When MS Becomes Part of Your Life

In this part . . .

W e’re guessing that multiple sclerosis (MS) has become part of your life recently. Either you or someone you care about has been diagnosed with MS and you’re wondering what it’s all about. This part gives you the big picture, starting with an overview of what doctors know — and don’t know — about this chronic, unpredictable disease and what you can do to live comfortably and productively in spite of it. The good news is that you aren’t ever alone in your efforts to overcome the challenges of MS — your healthcare team, which we introduce to you in this part, will always be right beside you.

Chapter 1

Meeting MS Face to Face

In This Chapter

Exploring how MS affects your body

Determining what triggers MS

Recognizing the uniqueness of your MS

Taking a peek at the available MS treatments

Understanding the impact of MS on your family and work life

Gearing up to keep your life on track

Because you’ve picked up this book, we’re assuming that your doctor has delivered the news that you have multiple sclerosis (MS). Or, perhaps he or she said that you may have this disease, or that you probably have this disease (which makes you wonder why you can’t get a clear answer). Whether you got the news yesterday or several months ago, you’re probably trying to figure out what it means for you, for your future, and for your family. In other words, you have about a zillion questions about what’s in store.

Chances are, the answers you’ve received so far haven’t been all that satisfying — mostly because MS still can’t be cured, no one knows what causes it, and no doctor can predict with any certainty how your MS is going to behave in the future. However, the good news is that the treatment options are expanding, and people with MS are busy getting on with their lives — and you will too.

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!

Lesen Sie weiter in der vollständigen Ausgabe!