Sheila DeMelle was diagnosed at age 17 with multiple sclerosis. For most of her life, her MS didn’t slow her down too much. “My disability was invisible. I knew I had it; I knew the symptoms,” but her symptoms weren’t readily apparent.

It’s taken almost 20 years, but the search for a widely usable, blood-based biomarker of multiple sclerosis (MS) disease activity is finally yielding results.

At first, Seattle-area resident Kellen Prouse blamed himself when sex became an ordeal after he was diagnosed with primary progressive multiple sclerosis. “I’m 27, and I’m saying, ‘What is wrong?’ It was hard to admit it was part of MS at first.”

Patient engagement in one’s disease management has long been hailed across specialties and chronic disease states as a key to better outcomes and care experiences. But what does it mean for multiple sclerosis specifically?