Continued Success after Therapy

Posted on October 20, 2014 by MSAA

By: Matt Cavallo

Earlier this month, I wrote a personal story of my positive outcomes with therapy. I utilized Physical and Occupational Therapy, along with Speech Language Pathology to aid in my recovery from neck surgery. This was a scary time in my life, and I was extremely thankful to have each line of therapy to help me overcome my deficits. My personal challenge became what to do once I no longer qualified for therapy visits?

The best way to relate my therapy experience is to talk about my gym membership. I have a family gym membership and make my annual gym appearance sometime in January. Then, I don’t go for the rest of the year. I offer any number of excuses to my wife and kids as I watch them drive off to the gym each Saturday.

The truth is that the only way I would utilize that gym membership would be if I had a personal trainer – someone to look over my shoulder as I exercised that I paid for. Paying for the service holds me accountable and forces me to keep my appointments. I also prefer to work out with a trained professional, who understands my limitations and can design a routine where I won’t hurt myself. The problem becomes I get on a good routine with the trainer, but as soon as I stop using a personal trainer, I stop working out.

This is my same relationship with therapy. While I am actively participating in therapy, I do great. As soon as they give me home exercises, I don’t follow through. I know that the homework given by a therapist is specifically designed to help me functionally, but I just don’t do well when left to my own devices. The problem is that my lack of follow through is detrimental to my health. My neck surgery forced me to change my behavior. Here are a couple of tips that helped me have continued success after being discharged from therapy:

Tips for Continued Success after Therapy:

1. Request clear, written discharge instructions. Your therapist will develop a plan of care that you can continue on your own after you finish all your therapy appointments. Make sure that you get a copy of those discharge instructions at your last appointment.

2. Get a copy of your Home Exercise Program (HEP). Your therapist can provide you home exercise instructions with pictures. These instructions provide a handy reminder of the therapist recommended exercises, as well as a visual reference for how to safely perform the exercise.

3. Make sure you get your questions answered. During your last appointment, make sure that you have a list of questions for your therapist. You will want to make sure that any concerns you have are addressed. There is truly no such thing as a stupid question when it comes to your health and well-being. Even if you think your question isn’t appropriate, you may have a legitimate concern that the therapist isn’t thinking of. I always have my questions written on a piece of paper and take detailed notes.

4. Follow through. Where I am lacking is in the follow through. For my neck, I still have my HEP and discharge instructions. When it tightens up, I know exactly the stretches that help and reference the pictures to make sure I am doing it right. The problem is that if I consistently followed through and strengthened and stretched my neck, then I probably would feel consistently better – just ask my wife!

Therapy is a great start for managing your MS symptoms. Continuing to follow through after you finish therapy is the key to success. Following these steps may help to ensure that you are prepared for life after therapy. Continuing your home exercise program post-discharge will put you in a better position for continued success.

*Matt Cavallo was diagnosed with multiple sclerosis in 2005. Matt is an MS blogger, author, patient advocate, and motivational speaker. Matt also has his Master’s degree in Public Health Administration. Matt is the proud father of his two sons, loving husband to his wife, Jocelyn, and best friend to his dog, Teddy. Originally from the Boston suburbs, Matt currently resides in Arizona with his family. To learn more about Matt, please visit him at : http://mattcavallo.com/blog/

What is an Occupational Therapist?

Posted on October 17, 2014 by Angel Blair

In the field of medicine there are many specialties that often work together to provide a comprehensive approach to patient care. For those dealing with MS, these specialties can oftentimes blend together, as the symptoms of the disease warrant concurrent methods of treatment. Trying to understand and recognize the responsibilities every specialist has in a patient’s care can be challenging, and in the rehabilitative treatment domain, the role of occupational therapy may be lesser known than other forms of therapy.

Occupational therapy (OT) focuses on treatments used to rehabilitate activities of daily living for individuals with physical, mental or developmental conditions. Working to develop and improve the skills needed to maintain day-to-day living and work habits are the goals of this therapy, with the client being at the forefront of treatment. Things like bathing, eating, dressing, job performance, driving and financial management are some of the areas of focus OT can impact with intervention. OTs work closely with the client, and many times with the family also to create an environment that’s conducive to the client’s needs; this can include the home, workplace, school, or other settings. Making changes that help modify particular tasks and teaching new skills helps clients regain control over their daily functioning and aids in maintaining their independence.

OTs help to create personalized interventions and treatment plans to help clients achieve personal goals of what they ultimately want to perform in their daily routine. Education is a major component of OT, as therapists and clients alike work together to learn what activities need modifying and how these changes can happen. The OT specialty often works in conjunction with other treatment specialists including physical, speech, and language therapists, in addition to other healthcare and social work professionals to develop an inclusive plan for client care.

If you are experiencing challenges with daily living and work activities, ask your doctor about OT to see if an evaluation is appropriate for you. Your doctor may be able to provide further information about this therapy and if it could benefit your needs. For additional information about occupational therapy, visit The American Occupational Therapy Association, Inc.

Feeling SAD: Seasonal Affective Disorder

Posted on October 15, 2014 by MSAA

It is commonly known that MS can impact mood and can cause an increased risk for developing depression and anxiety which MSAA detailed in the Winter/Spring 2014 issue of The Motivator. However, you may be unfamiliar with another condition – Seasonal Affective Disorder (SAD) – which may be something to pay attention to as the seasons change.

SAD is a type of depression which is hallmarked by its “seasonality” generally beginning in the fall and lasting through the winter months. SAD typically tends to creep up as the daylight hours get shorter and the weather gets cooler and the impacts on mood may become more severe as the season goes on. Like other forms of depression, individuals who experience SAD may experience low energy (fatigue), may lose enjoyment in activities they once enjoyed, may experience changes in eating or sleeping habits, may have persistent sad or depressed thoughts, and may even think of engaging in self-harm. As with other forms of depression, individuals with SAD may benefit from the use of medications and/or talk therapy to help address this issue. One major difference with teasing out SAD from other forms of depression is that individuals with SAD may also benefit from using “phototherapy” or specialized light therapy; a person may even be assigned a specific amount time in their day to sit under the specialized light or lamp to help improve their symptoms.

If you have noticed that the fall and winter seasons tend to impact your mood, or if you have noticed a lower overall mood, please discuss the issue with your treating physician…sometimes just shedding some “light” on a situation can make a world of difference.

Swim for MS: Give me a T-E-A-M!

Posted on October 13, 2014 by MSAA

With the start of the new school year and a new swim team season, MSAA’s Swim for MS has seen tremendous support. All over the country, swim teams are working together raising money to improve the lives of those living with MS.

Swim for MS encourages volunteers to create their own challenge, such as swimming laps or set distances over a chosen period of time while collecting donations for their personal fundraising goal. These challenges can be done individually or through group swims by teams of young and old alike. The NCMP Aquagirls, a Girls’ High School Swim Team from Iowa, created an event that would push them into swim shape early while creating awareness and raising funds. Their team captain, Rachel, challenged the team to swimming 50,000 total laps during the month of September. They collected pledges in August and September to raise over $1,000 for Swim for MS.

NCMP Aquagirls

Lexie & Team at her Swim for MS event

Volunteers also raise funds through a variety of unique one-day events such as pool parties, water-volleyball tournaments, and cannonball challenges. Unlike more traditional MS fundraising activities, Swim for MS allows individuals with MS at any stage in their journey – from the recently diagnosed to those with limited mobility – to benefit from water exercise and assist in raising donated funds for a vital cause. Lexi and her Swim for MS Team participated in a one day Swim for MS event held at her high school in Indianapolis and raised over $2,800 in September.

Just because October, November, and December are filled with back-to-back holiday parties, doesn’t mean you can’t organize a successful fundraiser! Stay on top of your game by encouraging a team effort for this fun event. Gather your Swim Team for a fundraising event everyone can do together. Show your school spirit by having a friendly competition between team colors, pick a side, and swim your heart out. Winning team gets bragging rights for the swim season!

On our SwimForMS.org website, you can read the profiles of some of our swimmers. They can inspire you and give you great ideas for your own Swim for MS challenge. We would like to thank everyone who has or will participate in Swim for MS!

Planning for a Doctor’s Visit When You Have MS

Posted on October 8, 2014 by Samantha Schech

Being prepared and asking questions may assist in the overall care you receive at your doctor’s appointment. Taking control of your medical care by finding your voice and advocating for your health will help you to feel more involved in your health care decisions.

Well before your appointment, get in the practice of writing down questions you wish to address with your doctor. A journal or binder can be used to keep track of these appointments. Sometimes it is helpful to have one binder for all medical professionals so that you can review notes from all appointments. Dividers or clips can help organize one doctor or specialist from the next. If questions come up for your primary care while you are visiting with the neurologist, you can add them to the section for the primary care.

Before the appointment, prioritize the questions that are more important at that time. Often appointment time is limited, so by prioritizing the questions, you will assure that what is most important to you at that time is what gets addressed.

It can be a challenge to manage the patient-doctor relationship, especially if your doctor is not used to you asking questions. You certainly do not want to come across as aggressive by demanding the doctor answer questions. Before the appointment, make the doctor aware that you would like to discuss some concerns. By being upfront with the doctor, he or she can make sure there is enough time. Some doctors may prefer to follow-up and discuss questions through a phone call or e-mail.

Asking questions is important but so is making sure you hear and understand the answers you get. Taking notes during an appointment can help to clarify things after you have left the office. Having a care partner or family member at the appointment may also help in remembering some of the details of what you heard. If writing is a challenge, perhaps try using a voice recorder (with the doctor’s permission) to help re-play what was said during the appointment.

If you are having trouble understanding or are confused, ask your doctor to explain again. Ending your appointments with a summary can help to ensure that the doctor hears that you have understood the directions or information provided to you.

If there is something you are not sure about, ask for more information. Many doctors’ offices provide brochures, or educational materials that can describe a treatment or symptom. If the office does not provide these things, ask where you may find them. Perhaps you can reach out to one of the MS organizations to learn more about a particular treatment or symptom, or ask for information to be mailed to you.

By taking a more active role in your health care planning and decisions, you may feel more positive about the control you have over the disease.

How do you plan for your trip to the doctor or specialist?

Adjusting to Change

Posted on October 6, 2014 by Angel Blair

Change is something that continually occurs throughout life for all people and to different degrees. Change may have very mild, subtle effects, or very significant effects depending on what’s being altered. Sometimes change can be a good thing, and sometimes not. One of the most difficult concepts to accept about change is that at times you have no control over it. In our individualized society we try to live by the mantra that we control our lives and what happens to us day-by-day, but this is not always the case. Sometimes the unexpected arises and we play no part in its occurrence. An unexpected illness, a loss, or other unforeseen situations are some of the incidences that can transpire due to no control of our own. When the unexpected occurs, what can you do to help adjust and cope with this new-found circumstance, that wasn’t necessarily welcome or planned for?

Talk to others about the changes that have occurred. Communicating to trusted loved ones, friends or your healthcare team can help you explore ways to adjust by receiving outside perspectives.
Reflect on what the change has affected. By recognizing what’s different you can make your own adjustments that will work for you in your day to day.
Explore your support resources. If change has had emotional, physical, or social impacts for you, it’s important to know who you can reach out to for help.
Bring focus to things that you enjoy and that you can control in your day-to-day. Make decisions that help to ensure that changes are modified to fit your needs.

Change can take some getting used to, especially if it’s something unpredictable. Though some things are uncontrollable and unforeseen at times, individuals do hold influence over the way they can approach change and react to it. It’s how you make the change work for you that’s significant.

Measuring Success

Posted on October 1, 2014 by MSAA

Sometimes life can be tough, and we may have to hear feedback that we don’t want to receive or work through challenging situations we don’t want to encounter. Like when the school says that your child is just not able to do what other kids can, or when your boss says that you are not keeping up to the standards the workplace requires, and if something doesn’t change soon, they’re going to have to let you go.

It is never easy or pleasant to deal with times where your “actions” or a loved one’s “actions“ are not “measuring up” to the expectations of what is required in a situation. This may occur when a real issue arises, i.e. if you are a nurse you need to have the ability to properly measure medications, and not doing this in a proper way can lead to major harm, or if your child needs a specific educational plan of action and you don’t get them help, it could be a big disservice.

Alternately, these types of situations can occur when the other person has a different “measuring stick” than you do, like if your old boss understood that you needed to take an afternoon break to be recharged and on your game for the rest of the day, but a new boss is inflexible and slams your work performance for taking a break. This type of situation can lead to major frustration and anger on both sides of the coin. The new boss has a different measurement they are using for success.

So, when it is not just a situation you have to own up to or seek support to overcome, how do you get the other party who is using a different measuring stick to see reason? First, check your own thought process by bouncing the situation off of a trusted friend, family member, or co-worker. Do they agree that you are being reasonable, or do they bring up good counterpoints for you to consider? Second, check for any formal supports or avenues for recourse. This might include documenting this situation and your concerns, or seeking out formal supports. In this workplace scenario, it might include talking with HR and asking for a formal workplace accommodation. It may also include you documenting your work actions more carefully or capturing feedback from clients or co-workers about your work to allay concerns presented by the new boss.

Not every difficult situation can be resolved, especially if neither person can compromise or shift how they are measuring success. You can do your part by being proactive in trying to see how the other person is viewing the situation, and trying to present your own views and insights in a clear and rational manner. Sometimes even simply acknowledging that you are looking at the situation from two different vantage points can allow enough of a bridge to achieve some type of workable solution.

Inside My Bubble, Prepared for Anything

Posted on September 26, 2014 by MSAA

By: Jeri Burtchell

I like to think of myself as a planner. Now, before those of you who know me collapse into uncontrollable laughter, let me explain. I don’t plan as in “wedding planner” or even use a “day planner.” In truth, I’m a perfect candidate for one of those intervention reality shows.

I never said I plan in a structured, well thought-out manner. No, I’m motivated by more of a panic-driven, deeply troubled, “what-if” thought process I learned from my mother. I have cultivated an emergency response for every possible scenario that could come along in life. I have prepared for catastrophic events that may or may not ever happen.

Mom and I have our fire season evacuation box, our hurricane season supply stash, and when I travel I have a whole suitcase packing ritual designed to make life easier in the event that things go wrong. When connections are missed or there are bathroom emergencies, I know I can count on the contents of my purse or roller bag to rescue me.

I like to think of this as part of my MS Bubble. Since I was diagnosed in 1999 and have come to realize how unpredictable it can be, one small thing that gives me solace is having my MS Bubble.

It’s a sort of invisible force field I’ve visualized that surrounds me. Inside I have everything I might need to deal with unpredictable events. Things that define my comfort or bring me joy are always close at hand.

Others might say my bubble is nothing more than my “comfort zone,” and in the classic sense, I guess it is. When I’m working, it’s right here at my desk. In my bubble/comfort zone, I keep the necessities of life. I have everything from a box of tissues to device charging cables.

While others look at my workstation and see a chaotic mess, I see a symphony of bubble-friendly instruments, each playing a part in bringing me comfort. I choose to forgo the aesthetic appeal of minimalism. I’d rather have clutter, as long as it’s purposeful clutter. Who can say I won’t need that thermometer mere inches from my keyboard?

My sweater stays on the back of my chair, always at hand in case I get chilled. Slippers are close by.

My smartphone is the most indispensable tool in my bubble. It connects me socially, delivers my mail, reminds me to take medications, tells me what the weather is like outside, and will distract me with games if I let it.

The point is, I have made my life as comfortable as I can, given the unpredictability of MS (and of life itself!). Although my bubble does not appear to be in any semblance of order to the untrained eye, it works for me.

I haven’t “planned” my bubble this way as in planning-a la-Martha-Stewart. It is only an ever-evolving collection of habits and things that aid me in everyday life. So I am soothed by the knowledge that, even when my MS symptoms are acting up, my MS bubble is always there, ready to comfort me.

Perhaps it’s eccentric of me to imagine this “bubble,” but visualization is a coping mechanism that works for me. I once got through the claustrophobia of an unmedicated MRI by imagining I was at the beach. My “vacation” was so enjoyable I was almost sad when the MRI ended. The protective “bubble” just works for me.

If you can develop coping strategies – whether or not they involve visualizing your own bubble – whatever works to keep you calm, centered, comfortable, and in a joyful state of mind is all that matters. So think about your situation and what things bother you the most. Then go about “planning” to deal with them ahead of time.

Create your own comfort zone, your own MS Bubble.

And if you’re a friend or family member of someone coping with MS, you might want to consider memorizing these 12 things you should never say to someone with a chronic condition.

But please add one more: Never say, “I took the liberty of cleaning up your desk. Hope you don’t mind – it was a real MESS!”

Why, that would just burst my bubble!

References:
Photo credit: Jeff Kubina, used with permission under the Creative Commons License
http://www.healthline.com/health-news/ms-12-things-not-to-say-022814#1

*Jeri Burtchell was diagnosed with multiple sclerosis in 1999. She has spoken from a patient perspective at conferences around the country, addressing social media and the role it plays in designing clinical trials. Jeri is a MS blogger, patient activist, and freelance writer for the MS News Beat of Healthline.com. She lives in northeast Florida with her youngest son and elderly mother. When not writing or speaking, she enjoys crafting and photography.

National Day of Gratitude

Posted on September 19, 2014 by Samantha Schech

“Feeling gratitude and not expressing it is like wrapping a present and not giving it.”
― William Arthur Ward

Recently on Facebook, a trend has emerged where individuals are challenged to list three things that they are thankful for and re-post three new things for five days in a row. At the end of the five days, they are to nominate other friends to complete the five-day challenge.

Although sharing feelings of appreciation or value can occur on any day, sometimes it takes a nomination from a friend, or a national “holiday” to remind us to share those thoughts with others. The expression of personal emotions and feelings are often the most difficult to convey. Assumptions are made that the other party understands our feelings without ever discussing them. But as the quote at the top illustrates, having gratitude means nothing without sharing it with others.

So while it is important to personally remind ourselves of the things we feel grateful for, it is also important to share it. Writing a letter, posting to Facebook, or making a phone call are some of the ways to reach out to someone to say that you are grateful for them.

This Sunday, September 21st is the National Day of Gratitude. In what ways will you show your gratitude? Leave a message in the comments section to share your appreciation and gratefulness.

It’s beginning to look a lot like fall….

Posted on September 17, 2014 by Angel Blair

Cooler temps forecast across parts of the country this week remind us that the fall season is approaching. Cooler nights, falling leaves and seasonal colors like orange and yellow are some of the trademarks of this festive time of year. Though some areas are still consumed by warm temperatures and strong sun rays, it is the time of year where the seasons start to evolve.

For those affected by the heat, fall is a welcomed time of the year that brings with it opportunities to enjoy the outdoors in a more comfortable manner. Sports activities, ball games, gardening and festive fall events are some ways to embrace the season’s change by spending time outside, and to perhaps ‘escape’ from hibernating methods used during the summer months when the unbearable heat was avoided.

Some look at the season change as a way to start new ventures, set new goals, or make plans for the rest of the year. New beginnings can create feelings of excitement and hope as new memories are made and added to those past. Though change can be difficult at times, it’s how you embrace it and make it work for you that matters. How the journey is spent experiencing something new is as important as the destination.

What are you looking forward to this fall?

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