Stress Management

“The $1 Million Question: What to Do?”

July 23, 2012

Stress has been analyzed for years to determine if stress affects the body. I roll my eyes at these analyses. Personal experience with MS and anyone with MS I have ever talked to knows stress has a direct impact on us in the short or long term. Or any other chronic disease for that matter.

It doesn’t take a rocket scientist for us to also know that ALL types of stress—physical, mental and emotional–has an impact on MS. While MS research hones in on triggers that bring on MS—viruses, vitamin D deficiency, genetic factors for instance—it seems that the final kicker to bring out the initial MS attack is often the result of an extremely stressful event such as:

*an accident, injury, or sickness

*a horrendous altering personal situation (for example, death, divorce, new  baby, job loss, etc.)

*long-term chronic fatigue from being overworked (such as simultaneouslyworking, raising a family, and running a household while neglecting one’s health…)

And these same long-term chronic stresses can be the precursor for more flare-ups or exacerbations as life goes on. These are serious events that require serious attention.

So let’s forget the “if” in the stress factor and focus on the “what to do about it” part, because that’s what really matters.

The goal? We want to prevent it, minimize it, and/or resolve stress. The buzz-words used today for this is stress management.

Unfortunately, stress is like anything else in today’s society. It comes in countless varieties—type, intensity, duration, onset, frequency—and there are always more than one to deal with. So for starters, one has to sort out what the stresses are and then what’s causing them. Then we can proceed with prioritizing them and finally managing them. It sounds complicated because many times it is. But going through a process to handle them lessens the overwhelming, impossible feeling they give us and helps us focus on the important ones first.

Let’s start with the first bullet above. Obviously, if we have an accident, injury or sickness, we take steps to get cured or better. During this process our symptoms are in the crazy zone from our defunct immune system, medications, fever, etc. So while we are recovering from our physical problem, we have to address the other associated stresses (pain, medication side effects, fatigue, undone domestic chores…).

It’s hard to be patient during this relapse, but it helps if you try to stay calm and focused on the fact that: when the injury/sickness is better, the symptoms will be better. The state of mind and a positive attitude is a powerful force on our well-being and healing process.

Furthermore, it’s important to takes measures to prevent these things from happening in the first place. For example, if you have a mobility problem from fatigue or balance issues, use walking aids to prevent falling and muscle strain; if someone has a cold or flu, don’t go near them…

In the other situations above, when things happen that are out of our control (death, job loss, overworked) stress can be minimized/resolved and here’s how:

    • First and foremost, take care of yourself and your health. Ensure that you eat and sleep. Self-control and mental/emotional effectiveness is enhanced while resistance to getting sick is maintained. Let’s face it, we know how we (re)act when we are tired or hungry. I freak out when I am tired and my husband is a beast when he is hungry; so I head for the bed and he heads for the frig.
    • Seek help and support from others to lessen the burden. Professional counseling, peers and support groups are invaluable for sharing, caring, problem-solving, finding connections and venting in a “safe” environment. Reach out and ask for help from friends, family, neighbors, your religious association, etc. for physical, financial, domestic issues. If you are concerned about humbling yourself or feeling ashamed, don’t be. You would do it for them; let them help you.
    • Learn to say “no” to anything that would overtax you, no matter what the circumstance. List your priorities, and review it frequently.
    • Figure out ways to change your lifestyle. Again, rely on others to help. I was a perfectionist, an independent person, and a constant doer. Therapy and unrelenting fatigue transformed me into a non-perfectionist (so what if the house didn’t get cleaned?), a more dependent person (I let others clean, cook and wash for me), and less of a doer (I made the time to rest in a quiet room at various intervals).

In contrast, short-term stress will cause a worsening of symptoms from an hour up to a day or two. The good news is however, that short-term stress can be remedied quickly and easily when identified.

This can include anything like lack of sleep, an argument, heat or allergies. Having an argument with my husband will frustrate me, causing me to drop things more and throw my legs into spasms. So I take a time-out and find ways to de-stress such as swim/exercise, take a walk around the block, read, phone a friend, read, shop on the internet, deep breathing….whatever works to calm down. Then I am better able to think and cope.

If I’m hot, I’ll cool myself down with ice water or ice packs. Showers and baths are definitely rejuvenating. When I start a new drug, I may have side effects; if the effects don’t reduce in a week or two, I might decide to stop them if the side effects are worse than the benefits I am receiving from them. If the monthly menses are causing too much havoc, it’s time to call the gynecologist. I personally was on a birth control pill for hormone management for years to help me with this problem.

In the past, I have talked to my physicians about different medications to try to help with the stresses/effects of things like depression, anxiety, or insomnia. These are very common issues with MS, and there is nothing wrong with taking something to help us cope. I have successfully used antidepressants, anxiety pills and sleeping aids intermittently over the years.

There is a lot of merit in new alternative therapies such a deep breathing, yoga, pilates, and tai chi to name a few. I have tried them all, and they provide great benefit for relaxation as well as aiding problems associated with symptoms such as weakness, balance, endurance and fatigue. These can be learned from videos, online resources, and local clubs/associations/ MS chapter programs.

There are ways these techniques can be incorporated into daily activities. For instance, deep breathing can be done while showering. Standing on one leg while doing dishes can help with balance.

Whatever it is that can help—medications, alternative therapies, therapy/self help groups etc.—it never hurts to try it out and see if it works for you. As with anything, what works for one person may not work for someone else. And I always say—“Two heads are better than one” in figuring out a problem or solution.

If there is no clear-cut problem or solution, find a peer to talk to. It’s comforting to just unload stresses, secrets and complaints to get it off your chest. There is no one better than a peer or a good, loyal friend to “dump” on. They would do it for you as you would do it for them. And, yes–“misery loves company.”

Finally, it’s okay to just go ahead and vent! Go into a room alone, close the door, and let it out. Scream, yell, cry, swear, or throw pillows. Most of the time I do very well, but then that moment arrives. I give myself a break to let go and lose control. Like a pressure cooker. I earned that right, and so have you. It doesn’t solve anything, but it sure feels good.

P.S. You can always take a stress management class. I never have, but it’s worth a try!

www.debbiems.com

Feet Care, Massage & Reflexology

“Sole & Soul Therapy”

July 16, 2012

It’s time for a pedicure. I like pretty toes and feet. But I love the therapeutic benefits I get from getting a pedicure.

I never had a pedicure when I lived in Pittsburgh. Shoes were always worn and I thought getting my toes painted was frivolous. Then I moved to Arizona, where the state shoe is a flip flop. That’s lucky for me since I don’t have to wrestle putting on socks and shoes too often. It’s not an easy task for someone who has stiff hands and spastic legs.

Bare feet, also a standard here, also has its benefits besides not having to struggle with footwear. It’s cooler and more comfortable, especially when my feet swell from sitting too long. I can grip the floor better when I stand or take a step or two.

Arizona is a very casual-dressing state; the oppressive desert heat in the summer probably has much to do with it. Yet, most girls and women have their feet all gussied up with color and design—even the sloppiest-looking people.

I like looking nice. Maybe that comes from my upbringing, or Eastern roots. It makes me feel good. I like to match my outfits with my earrings, purse, and footwear when I go out, even if it’s to a grocery store. Finding comfortable and stylish footwear had always been a challenge to me ever since I started having walking problems. It was great when I didn’t have to buy matching footwear anymore, but I still had to have nice-looking feet.

So it didn’t take me long after I settled in to my new home to go to a salon and get a pedicure. That’s when I discovered that a pedicure provides more besides just pretty toes. The therapeutic benefits are enormous.

For me, who has advanced MS, cutting my own toenails and polishing them is quite a challenge. I felt like Dorothy in the Emerald City that first day sitting in a massaging chair, as I watched the gal carefully scrub the bottom of my feet. It was embarrassing that my big toes were stiff like two soldiers when she got started, but she told me to just sit back and relax.

And wow, did I ever! As she cleaned and clipped, I became immersed in the chatter going on in the shop. It was fun looking at what everyone else was choosing to do with their nails—the colors, designs, and sparkles. It was a great escape and mood elevator. Where have I been all these years?

After the girl cleaned up my feet and nails, she asked if I wanted extra massage for my feet. I giggled and said “Go for it!” That is when my eyes really opened wide. I couldn’t believe how good it felt as she skillfully massaged ever toe, every part of my foot, ankles and shins. My stiff, soldier-toes were gone, my feet were aligned perfectly–not inward–and my whole body was relaxed and rejuvenated.

What was going on? Where did my back, feet and shoulder pain go? I knew how beneficial a regular body massage was for my sore neck, shoulder and back muscles, but I never expected in a million years what a foot massage would do for me.

I started researching on the internet and found out that I wasn’t getting just a foot massage; I was actually getting reflexology. I was (and still am) going to a Vietnamese-run shop where the girls were trained to do this. I just didn’t know it because of the language gap—they speak very little English.

The foot has more than 7,200 nerve endings that connect to specific organs, according to the Reflexology Association of America. The top of the foot corresponds to the chest, the Achilles corresponds to the side of the hip, and the big toe links to the brain. Massage and reflexology techniques bring comfort and restore proper nerve flow. Hm– is this the reason why my big toes weren’t standing at attention anymore?

It is a form of alternative medicine. It doesn’t reduce my need for baclofen that I take for spasticity, but it definitely helps my spasticity and is a complementary approach for my bothersome MS symptoms.

I wish I could get a pedicure every week, but our budget won’t allow it. And unfortunately, other forms of alternative medicine such as massage, acupuncture, or yoga are not covered by insurance. But I consider it enough of a necessity to get one (with massage/reflexology) once a month. Fortunately, the shop where I go only charges $25 (plus tip). And gift certificates for birthdays and Christmas are always appreciated.

Relaxation, good company, energized well-being, less pain and pretty toes–all for $25-30 and an hour of time. I think it is a great bang for the buck.

P.S. I should mention that although the shop is filled mostly with women, it’s not unusual to see a guy or two in there as well :).

www.DebbieMS.com

Using Mobility Scooters and Other Assistive Devices

“Move Forward–not Backward or Not at All!”

One of the National MS Society’s famous phrases is “MS stops people from moving”. Not me! MS may have stopped my legs from moving but it didn’t stop me from moving. And it shouldn’t stop you either.

I never hesitated to use any assistive device and actually sought them out on my own. This is what I say:

Goodbye fatigue and mobility problems. Hello freedom and happiness!

Recently I mentioned to a person with MS that I was getting ready to go do some leisurely shopping at the Mall. She said, “I am so envious that you can go shopping in this heat.” I told her it was time to think about using a scooter. Buy one, rent one, or borrow one.

Through the years, assistive devices have allowed me to be less fatigued, elevating my moods and enabling me to do more. I didn’t overheat as fast since I struggled less in trying to walk. Since I was walking better using the devises, I experienced less muscle and bone stress on my body parts.

Twenty-five years ago when my son was only four years old, I got my first scooter (insurance covered 80% of it). I was still able to walk, but only for short distances. Wanting to keep active, live life and enjoy my son, the scooter enabled me to go to zoos, amusement parks, Disneyworld, shopping malls, etc.

Goodbye danger. Hello safety.

Weakness, poor balance, fatigue, incoordination, foot drop, spasticity…. These symptoms increase your probability of falling and suffering an injury—risking a flare-up and residual damage. Not to mention the pain and inconvenience while you heal if you fall.

Goodbye pride. Hello common sense.

Most people at some in their lives have to use corrective lenses for their vision problems. They don’t think twice about getting them. Eyeglasses are so fashionable these days, and people love the styles and colors available. Others prefer contact lenses instead of glasses for personal reasons; plus, it gives them the ability to have several pair of designer sunglasses to wear.

So what’s the difference if you need to use a device for mobility? In the days when I started using a cane, I had four of them in different colors and styles to match my outfits.

In addition, in today’s world, the stigma of using wheelchairs is going away. The attitude and awareness about using medical devices has changed since the eighties when I first had to use them. People of all ages are often seen in movies and advertising brochures using a wheelchair. You see more people out and about using them. Grocery and retail stores like Target or WalMart have scooters available now for their customers to use. Many places like amusement parks rent wheelchairs and scooters.

Besides, who cares what people think? I do what is best for me. Sometimes I just look at the way people dress, look, and act today….and I should worry about how they look at me?!

And added bonus? People—family and strangers alike—treated me differently when I started using a mobility devise. I looked disabled and received many more offers for help!

A word of caution, however. When you find how relieving it is to use a scooter or wheelchair, never stop your exercise regime. The old saying that “if you don’t use it, you will lose it” has truth to it. I’m a full-time power chair/scooter user, but I still do my daily stretching, balance and strengthening exercises. I use a pool regularly to practice standing and walking—things that I can’t do on land.

So technically, the Society’s phrase is correct in the sense that MS does stop people from moving in the physical sense. But MS shouldn’t stop people from moving forward in life. If you look hard enough, there is a solution to almost everything.

P.S. See my video “Mobility Scooters: Tips on How to Buy” http://youtu.be/TfLtgb2ybb8

www.DebbieMS.com

MS: What is Causing What?

The “Chicken or the Egg” dilemma

July 2, 2012

The numbness and tingling is spreading.  The muscles are more spastic, stiffer and tighter.  Legs are weaker; coordination and balance are worse.  Walking endurance is lessoned and the fatigue is escalating.

Figuring out what is going on and what to do about it is frustrating and confusing.  And there’s always the chicken-and-the-egg question of trying to figure out what is causing what.  Is my depression (fatigue, etc.) causing a bad day or flareup, or is the bad day/flareup causing the depression (or fatigue, etc.)???

The MS acts.  But wait–or is it reacting?

It’s very easy to blame what the symptoms are doing and how we are feeling on the MS itself.  However, more often than not, the MS is actually reacting to something else.

So how do you know, and what do you do about it?

MS is highly sensitive to an endless list of things, and existing symptoms intensify due to things like:

• weather changes and types of weather (barometer, heat, humidity, storms)
• sickness (colds, allergies…)
• lack of food, water, rest, sleep…
• medication
• stress (temporary physical/emotional/mental, not chronic)
• monthly menses

For example, a fever can immobilize a person with MS.  When the body is cooled down and the fever is gone, the symptoms will subside.  Spending two hours on the phone trying to resolve an insurance problem can escalate fatigue enormously; taking a nap afterward or venting in some way will ease that stress and help calm down those symptoms.

Or, maybe those intensified symptoms are the result of what I refer to as a ‘pay day’.  For example, if I wake up one day feeling great, I might push myself too hard to do extra things.  Then I ‘pay’ for it the next day and can do only half of my normal daily activities.

In situations like these, the worsening of symptoms can last from several hours, to a full day to perhaps several days depending on what the cause is.  Think carefully about things like this relative to recent or that day’s events:  What happened or didn’t happen?  What changed or didn’t change?

When you figure out what the culprit is, it can then be remedied and the symptoms will calm down.  Things go back to their normal state, whatever ‘normal’ is to you. No residual damage.

So when would the MS itself directly cause intensified symptoms or new symptoms that do NOT go away after a few days?  Now we may be talking about an attack, relapse, or flare-up…i.e. when we come out of remission.  It can just happen on its own, but often will be triggered by any major event, such as:

• falls, accidents, sicknesses, infections
• chronic physical, mental or emotional fatigue/stress
• major life occurrences (death, divorce, new baby, abuse…)

In these situations, or in the case when symptoms don’t calm down after a week, when the cold/infection is over, and rest does improve anything, it’s time to put a call into your neurologist to discuss the situation/ask for some help.  The MS may be relapsing and steroids (like Solu-medrol) may be needed to shorten the duration and severity of the relapse.

Over time, being in-tune with your body will help you figure out if it is the chicken or the egg.

www.DebbieMS.com

MS Support: Know thy Neighbors

“My Eleventh Commandment”

If you have read my book Managing MS: Straight Talk…, you know about my own ten commandments I follow to manage my MS. I’m adding another one. As I was walking my dog around the neighborhood today, I reflected on how important my neighbors are to me. When I moved from Pittsburgh to Arizona in 2001, I lived alone for several years since my husband couldn’t join me until he retired. Being a planner and organizer, the first thing I did after settling in was become a co-director of our volunteer neighborhood block-watch program. I hosted the committee meetings and arranged quarterly weekend social events. The result? I immediately met and got to know everyone living around me. I made good friends, I found professionals (a mechanic, an a/c and heating technician, a computer guru, a lawyer…) and I felt safe. My dog and I have walked and patrolled the neighborhood daily for all these years, and if people don’t see me for a few days, they’re wondering why.

When a new neighbor moves in, I want to meet them. Recently, a new neighbor was putting the finishing touches on a new paint job for his new house. I introduced myself and told him how much I liked the color. It was instant rapport!

I love my neighbors, and can count on them if I/we need something, and vice versa. One terribly hot summer morning, my air conditioner stopped working. My a/c technician neighbor came to fix it within the hour I called. Another time when my husband was back East, I accidently pulled my Christmas tree over with my power chair at ten o’clock in the evening. I was surrounded by broken bulbs and lights! My girlfriend across the street came over immediately and picked it all up for me. If I’m home alone and I need assistance, I have a phone around me at all times so that I can call someone for help. They can get into my house by using the security-code keypad on my garage door. Many of our neighbors now are not only friends; they are like family to us and to each other. They are invaluable to me.

www.DebbieMS.com
Author, MS Counselor, Living with MS