About Angel

I am a Client Services Specialist here at MSAA. I hold both a Bachelor's and Master's Degree in Counseling from schools outside the Philadelphia area. I love reading, movies, going to concerts and traveling. Favorite place I've been so far---Disney World!

Talk About Something You’re Grateful for…

Gratitude is a beautiful concept. Feelings of appreciation can really fill the heart and help to create a more positive outlook on things. When I was in graduate school I had a counseling seminar course and one day my professor asked us to go around the room and talk about something we were grateful for. Now the idea of this was great, however, it happened to be a very difficult time period for me. I had just lost my grandmother and it was my first class coming back, so the exercise was not very appreciated in that moment. I think I said I was grateful I made it to class and that was it. It’s beyond challenging to try to think of things to be grateful for in dark moments, but since then I’ve tried to learn how to look at the things that are still immersed in the light. Gratitude does not always have to be an extravagant or grandiose notion in order to feel it, actually most of the time it’s felt in the simplest of moments. We just have to allow ourselves to embrace it.

A stranger holding a door open. Someone else making dinner. A note of thanks for something you did. Having a day off. It doesn’t matter the action or words but the feelings behind it. Being thankful for things, big and small, can help to improve well-being and attitude. They study gratitude in the research area of positive psychology nowadays and have found that it helps to increase happiness and optimism. Many individuals use gratitude journals each day/week to note specific things they’re thankful for, which can really help to change one’s perspective and views. The world can sometimes be a very dark place with very unfortunate moments, but if you choose to see the light that still lives just as strong as this darkness, that generates hope, and hope is what keeps us all moving forward.

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You Are Your Own Best Advocate

Recently I went to my primary care doctor for an annual flu vaccine and physical exam to make sure everything was in check. I paid my copay when I arrived at my appointment per usual protocol, but after reviewing the Explanation of Benefits (EOB) from my insurance company that came in recently, I realized the appointment was considered preventative and I should not have had to pay my copay amount. After noticing this I called my doctor’s office and they told me that in fact there was now a credit on my account of the copay amount that I had paid. They asked me if I wanted it to stay on my account as a credit or if I wanted to be refunded the amount. This made me scratch my head in perplexity, because I realized if I hadn’t reviewed my EOB from the insurance company and contacted my doctor’s office myself, I would’ve essentially been left in the dark about this copay credit until maybe I’d gone to my primary care doctor next year and was surprised with the copay credit on my account.

I feel like this happens often to individuals who are just trying to follow up with and maintain their medical care. I think this is why it’s so vital to be your own advocate when it comes to reviewing insurance information and benefits because there are not many on the other side that will do this for you, be it insurance companies or medical offices. Now don’t get me wrong, there may be some representatives who are diligent and careful in their work and do their best to ensure accuracy, however, this may not always be the case so it’s good to check and re-check things on your own as well. Human error can occur and mistakes can happen, but if you’re not aware of your own benefits and coverage this can slip under the radar and you could be paying for things out of pocket that you didn’t have to.

Insurance benefits and coverage can be a tricky thing to try to understand, so it’s important to take one thing at a time and to make contacts when you have questions. Calling the insurance company can sometimes be challenging so set aside time you know you can dedicate to this, or maybe your doctor’s office can help you navigate and understand your benefits. Sometimes you can use online customer support services to contact your insurance or connect to patient portals through your doctor’s office too. A relative, friend, neighbor or other resources in your community may also be able to help you decipher your insurance coverage. Again, you are your own best advocate when it comes to your care so being thorough and asking questions and reviewing your benefits is an essential part of the process.

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Medicare Open Enrollment is Coming!

On October 15th Medicare’s open enrollment period begins and lasts until December 7th. It’s during this time period that you can review your current Medicare plan and make changes if needed. You do not need to sign up for Medicare each year, but this is an important time when you should review your coverage to make adjustments if necessary, to ensure your health insurance needs are being met. And with the government currently discussing change that could potentially impact different parts of the healthcare system, it’s also a good time to stay up-to-date on this news as it unfolds.

Medicare beneficiaries who have a Medicare Advantage plan or Part D plan should receive paperwork called “Evidence of Coverage” or “Annual Notice of Change” letters from your health plan showing coverage outlines and any changes that will occur. It’s very important to review these materials to make sure of any changes in the plan’s costs, providers, benefits, drug formularies, etc. so that if something is changing with your plan, you are aware of it and can make changes to your coverage, if needed. These plans can change their benefits so it’s crucial to review your policy and any upcoming changes.

So, what can be done during the open enrollment period? According to Medicare, you can do the following:

Something else to keep in mind is that if you are not satisfied with your Medicare Advantage Plan, you can disenroll from that plan and join Original Medicare during the Medicare Advantage Disenrollment Period. This disenrollment period is open from January 1st to February 14th.

The Medicare website offers a Medicare Plan Finder where you can search for and compare health plans, benefits, coverage and estimated costs. You can also contact Medicare directly at 1-800-MEDICARE (1-800-633-4227) for information and questions.

For additional help, you can receive individualized assistance and guidance in choosing coverage through your State Health Insurance Assistance Program (SHIP). This resource provides one-on-one insurance counseling and support, visit https://www.shiptacenter.org/ to find your local office.

MSAA’s My Health Insurance Guide is a helpful source for the MS community to find more information about insurance options and resources, in addition to the Medicare Planning and Multiple Sclerosis brochure that helps to outline important parts and questions about Medicare coverage.

This is an important time to review your plan’s policy and make changes if needed to ensure that you have the appropriate coverage for your healthcare needs.

Resources:

http://www.medicareinteractive.org/get-answers/overview-of-medicare-health-coverage-options/changing-medicare-health-coverage/6-things-to-know-about-fall-open-enrollment

https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/when-can-i-join-a-health-or-drug-plan.html#collapse-3190

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Employment Changes

For this month’s MS Conversations blog we wanted to focus on the topic of changes in routine, but with this thought, it was important to highlight employment changes as well, as this is something that comes up often when talking with clients. The timing is appropriate, as Fall always marks a time of change in the year itself, not only in the season’s colors and temperatures but with the familiar sights of back to school and holiday displays (because of course stores are already doing this!).

There are many individuals within the workforce living with MS, and oftentimes its symptoms can impact one’s work routine and abilities in their position. This can be very frustrating and challenging for those affected because with it comes the added stress over job security, self-worth and independence. Because of how our society views work and the roles we fulfill, many people identify themselves by their job and what they do for a living—so if this changes, one’s self-perception can change too. But it’s important to know that there are resources available to help accommodate changing needs in the workplace or help to find another position if an overall change is needed. Separating one’s self-worth and perception from one’s job role is going to be a continuous feat that society as a whole must work on, because individuals are and should be defined by more than just the work they do.

For those who have human resource representatives in their workplace sometimes it’s a good idea to start the discussion with this department if you need something modified in your role; whether it is your schedule, job location/environment or something else, there may be procedures in place for how to ask for these in the workplace. The Job Accommodation Network is a helpful source of information on employment accommodations as well. And for additional help receiving workplace accommodations or finding employment, a Vocational Rehabilitation office is a resource throughout each state that assists those living with disabilities on information and resources regarding employment needs and changes. Working with one’s doctor/healthcare team may be another avenue to assist with employment matters too, especially when discussing symptom issues and their (potential) impact.

Change can be difficult to encounter at times so it’s important to know what resources are in place that could help. Being aware of MS symptoms and how they could impact needs in the workplace can be a good starting point.

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The Not So Good Relationship

Keeping with the theme of relationships on this month’s blog inspired me to do a little Googling into different relationship topics and recent news to see what’s been trending lately. I actually found several pieces on toxic relationships and help in how to recognize these. Usually when people think about relationships the mind doesn’t tend to go towards the dark side necessarily, but the truth is there can be a lot of toxic parts to a relationship that some people don’t even notice sometimes. Often, people believe their relationships look like other’s relationships; everyone has their ups and downs and not-so-fluffy cloudlike days and this is normal. This is true, but when the relationship is in that darker side of the clouds more often than not, it’s something to address.

Psychology Today recently posted about how to recognize toxic people and relationships, and it’s not always easy. In a relationship, sometimes the people involved have blinders on in order to see what they want or need to see in the other person; it’s only natural. Everyone has flaws and no one is perfect, but there are some toxic traits that can’t and shouldn’t be overlooked. Things like selfishness, disrespect, and arrogance are all signs that point towards a potentially harmful toxic relationship. The post also mentions these other red flags as potential signs of a toxic bond:

  • Lying
  • Being unapologetic
  • Manipulative
  • Abusive
  • Narcissistic
  • Spiteful

Examining one’s relationship and trying to recognize red flags is not easy. It can be overwhelming and sometimes shocking to realize that the relationship is causing more harm than good and if it’s contributing to stress and negativity. Sometimes these bonds are ones that can’t be severed so easily either, especially if they’re with family and loved ones. This is why it’s so important to surround yourself with positive energy and loving relationships whenever possible, and taking a step back from the ones that aren’t is sometimes necessary. Reaching out to others for support, seeking therapy, taking time for self-care and self-love are actions that can help combat toxicity. Everyone deserves to be respected and to be in relationships that nurture love and support; anything else is unnecessary distress.

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Someone Has to be Excited…

In talking about relationships this month on the blog it’s impossible not to think of the bonds I have with the people in my life and how impactful they are in shaping who I am, and in turn, what I am to others.  Sometimes we don’t realize how much we’re touched and influenced by other people. But all it can take is just one conversation, one tiny fraction of an entire day to make an impression on someone else. I had an occasion recently that I wasn’t really feeling up to celebrating much. My husband on the other hand, was very happy and wanted to share his elation; he has a special knack for being positive and optimistic. His exact words were “someone has to be excited for you.”  The sentiment didn’t resonate in that precise moment but afterwards it was all I could think about. That this man knew that I wasn’t able to feel joy in that particular moment but still wanted to mark the occasion and celebrate for me. That is a remarkable relationship trait.

There are going to be times when a day is gloomy, a mood is sour, or chaos arises. It’s a roll of the dice sometimes in how a day will play out — but what matters is who is there with you at the end of that day, being your cheerleader and light in the darkness. It’s difficult trying to be happy and positive 24/7, we’re only human; it’s part of our wiring to experience other moods and emotions. But if you have or can find that other person who can champion for you when you can’t for yourself, find gratitude in that because it’s a truly special trait. Being your own champion is of course ideal, but in those moments where this isn’t possible, having that piece in your relationship with someone else is truly significant.

Unfortunately many people experience toxic relationships that are one-sided and selfish where the other person wouldn’t think to imitate this selfless behavior. That is why self-love and self-respect are necessary in your pursuit of finding relationships that will help foster encouraging aspects and positively influence you. You deserve to be loved and supported and knowing this makes all the difference in what you want or are looking for in others. Being that hopeful light for someone else and having them be the same for you when needed signifies a healthy bond; and a relationship where one person can be excited for the other if and when they can’t be for themselves.

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Caregiver Wellness

Caregivers are some of the most important people in the world. They dedicate themselves to caring for someone else with their time, commitment, sacrifice, and compassion. Being a caregiver to someone else means they don’t always have the time to care for themselves. But everyone’s wellness and care are important, especially for those who need to be there for another person. Caregiving is an enormous task that can stretch people thin and make it difficult to carry out or even think about one’s own wellness. It’s no one’s fault – there is only so much time in the day and when the majority of that time is focused on someone else’s care, a caregiver’s own wellness and physical well-being are often just put on the back burner. The same is true of parenting/family roles and helping professions; others needs are simply put first, without question or expectation.

Caregiving doesn’t necessarily mean that person has to do everything themselves either. Knowing when and how to ask for help is a great strength, and for caregivers there are resources that can help. Oftentimes these resources are geared towards those caring for someone elderly, but it’s these same types of contacts that can help those caring for disabled individuals too. Communication is vital in the caregiver role; being able to talk about what is needed or what’s currently going on is essential to maintaining balance and stability. One key element to caregiver support is respite; a period of rest and relief for those carrying out this role. It’s also a significant piece to wellness – taking a break to focus on one’s own needs and having the peace of mind to know that the person they care for is safe in that moment too. It’s not a selfish act by any means; it’s a necessity of life. You have to take care of yourself in order to be able to take care of someone else. Selflessness is an admirable quality but self-care is equally important.

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Physical Wellness: One Part of the Sphere

We’ve talked about different aspects of wellness here on the MS Conversations blog in the past, and this month as we’ve covered topics related to depression we also wanted to touch on factors of physical wellness too, because all of the elements of wellness can intertwine and are equally important. Living with a chronic illness like MS can make it difficult at times to have control over one’s physical health because of how unpredictable and unknowing the disease course can be. However, there are pieces of physical wellness that a person can try to maintain influence over, even though MS may have other plans in mind.

Daily habits and behaviors can have great influence over one’s physical health and can include things like diet, exercise and sleep practices. With a disease like MS that can affect physical body function, maintaining consistent sleep or exercise routines can be challenging at times. It’s in these cases where people may need to get a little creative and modify/adjust practices to make things work for them. Working with healthcare professionals on symptom management strategies can help with this. Applying good habits to daily routines may improve physical health needs, especially with sleep practices. And though at this time there is no one specific diet known to influence MS and they continue to research this, maintaining healthy eating habits and a well-balanced diet can have positive effects on one’s physical nutrition. Each person is unique and what works for one’s physical health may not for another, so it’s important to evaluate behaviors and choices that can apply to your situation and what your needs are.

Another part of this physical piece includes maintenance and follow-ups when it comes to one’s care. I don’t know anyone who necessarily “enjoys” going to the doctor or hospital, but it’s one of those things that has to be done sometimes. Making sure to see your doctor regularly, notifying them if you’re having an issue or experiencing changes in symptoms are all good habits to try to enforce when it comes to your health. It’s not always an enjoyable experience having to go to the doctor or having medical tests/procedures done, but it’s a way to ensure that you’re doing all you can to keep your care in check and to maintain control over this aspect of your health. There are even tools and resources to help keep communication flowing between you and your medical team for your physical care needs. Though physicality is merely one aspect of the entire wellness sphere, it remains a vital part that contributes to all of the other elements of wellness and to one’s overall care.

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Cognitive Changes

This month we’ve been talking about MS symptoms that aren’t spoken about or mentioned as often as other symptoms within the MS community. Some of the symptoms highlighted so far have been issues with incontinence and bowel and bladder challenges. On the My MSAA Community peer-to-peer forum, we recently asked a poll question about which commonly overlooked MS symptoms individuals would like to learn more about, and one of the results has been cognition. Though many individuals are experiencing this issue, it’s still not one discussed very often, and it’s hard not to wonder why.

With the multitude of research that has been – and continues to be – done on MS, issues with cognition are still questioned and sometimes aren’t even associated with the disease itself. Individuals often ask if MS can affect their cognition and thinking when they notice certain changes, and the answer is unfortunately yes – this, too, is another area that MS can influence. If parts of the brain that control judgement, memory, thinking, and reason are affected by MS disease activity and inflammation, then symptoms can manifest and cognitive changes can occur. Sometimes individuals do not know that cognitive changes can be a symptom of MS and they ask if there is something else going on, or is it due to getting older/the aging process itself, or stress, etc. Bringing this and other types of symptoms that aren’t discussed as frequently to the forefront will help increase awareness of them being related to MS, and in turn, start conversations on how to address them.

There are several types of feelings that can be provoked by cognition changes due to MS, and embarrassment is a feeling that oftentimes accompanies this symptom. Individuals can feel self-conscious and uncomfortable if they’re experiencing issues with their memory and thinking—especially when interacting with others or trying to fulfill work or relationship roles. Shame and guilt can be other feelings associated with cognitive difficulties too. People feel they should still be able to do certain things and not have to ask for help or admit they can’t do what they once did. It’s very common for these types of feelings to emerge when it comes to such an impactful symptom that can effect day to day situations so easily. But knowing that you don’t have to feel ashamed or guilty if it does occur is key – and so is knowing that you can talk about it with others who are supportive and can identify with you, as you are not alone in this symptom issue.

MS sets out to be a thief not only of physical body functions, but also of mind operation as well, and it’s to no fault of those affected. It’s important to recognize if you are experiencing cognitive changes or challenges, and to bring it to a healthcare professional’s attention so you can work together to try and address it. MS may have its own agenda, but you can show your power with proactive steps in symptom management and self-care and awareness.

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If You’re Not Staycationing…

Earlier this month I talked about considering a staycation in regards to planning and preparing for the upcoming summer months. Not everyone may be staycationing around their home this summer so I wanted to talk about travel preparations if summer is going to take you out of your backyard. In a prior post about summer traveling, we reviewed some things to think about and prepare for when creating your travel itineraries. Considering things like accessible accommodations, materials needed for the trip, and who you can work with for assistance were some of the discussed topics. It’s important to do what you can when making travel arrangements so you can be prepared as best as possible, especially when dealing with an unpredictable disease like MS that makes its own plans a lot of the time.

While the planning piece of the trip is significant, let’s circle back to the beginning when you’re thinking about your destination. What’s important to you when deciding where to travel? What does the decision process look like? Everyone has their own needs and wishes when contemplating journey destinations; many even have a ‘bucket list’ of desires that they wish to accomplish at certain points of their life. Some individuals may have a random selection method they use to pinpoint their vacation spot—pick a point on the map and go. Others are very methodical in their decision making because there may be multiple factors that need to be taken into account to plan the journey. Either way, it’s good practice to be mindful and considerate of what your needs and wishes are and to not be afraid to fulfill them. Half the fun is in the planning so enjoy even these smallest of moments along the way.

What are some of your plans for the upcoming summer months?

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