When Jennifer Leon Hill walked down the aisle in October, she didn't feel clumsy, didn't limp and didn't use her cane for support.
Sure, the excitement of her wedding helped. But so have the lifestyle changes she has made since her diagnosis with multiple sclerosis, and the medication she has been taking for it.
Three years ago, when Hill, 42, of Chandler, Ariz., was diagnosed with MS, there were only a few treatments available -- and none was very appealing. The drugs were delivered by daily or weekly injection, often didn't help much, and had potentially devastating side effects.
Hill's neurologist enrolled her in a research study testing a once-a-day pill that promised fewer side effects and equal or better effectiveness.
That drug, Aubagio, was approved in September for general use -- the second of a new generation of medications. For the first time, doctors and MS patients have a range of drugs from which to choose.
Twenty years ago, there were no drugs for MS, a disease in which the immune system attacks nerve cells in the brain and spinal cord, robbing people of physical coordination and mental sharpness. Now there are nine, with more on the way.
"This has been the field that has seen the most dramatic therapeutic changes in all of neurology, perhaps all of medicine, for the last 15 years, accelerating in the last few years," says Aaron Miller, medical director of Mount Sinai School of Medicine's MS center in New York.
Basic research has helped scientists better understand how the immune system damages the insulation that speeds signals from one nerve cell to another. The newer drugs block that damage -- and though data are still thin, there is hope that this will make a huge difference for patients in the long term, says Gordon Francis, a vice president at Novartis, which makes the MS drug Gilenya.
But life with MS is still a challenge, and drugs are far from a cure.
Hill had a relapse last March -- about the same time as America's most famous MS patient, Ann Romney, wife of former presidential candidate Mitt Romney, relapsed. Ann Romney has said she overdid it in the days before the Super Tuesday primaries. She recovered after rest.
Hill, who has three teen boys, ended up in the hospital but has improved since. With the changes in diet -- no more junk food to trigger immune flare-ups -- a dedicated exercise routine, a break from her teaching job and her new drug regimen, she feels much better. The fatigue that used to make it a challenge to get out of bed four or five days a week is now down to one or two days.
For patients discouraged by the previous generation of drugs, now is a good time to check out treatment options again, says Bill Sibold of Genzyme, the maker of Aubagio.
Each drug ($30,000-$50,000 a year) has strengths and weaknesses, says Ellen Lathi, director of the Multiple Sclerosis Center at St. Elizabeth's Medical Center in Boston.
A number of drug companies are interested in MS, suggesting more options will be out soon, doctors say.
So far, the focus has been on the 85% of patients who have the remitting-relapsing form of MS. Scientists still need to figure out how to provide relief to the other 15%, whose disease either skipped that stage or has advanced beyond it, says Timothy Coetzee, chief research officer for the National Multiple Sclerosis Society.
For Hill, the biggest symptoms remain the fatigue, plus the diarrhea and nausea that are occasional side effects of her medication.
Still, she's feeling optimistic."MS is not a death sentence," she says. "It is a struggle. It will wear on you. But the future is bright."
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