How Do I Empower Myself to Deal with Multiple Sclerosis?

Eat Right

No specific diet has been proven to have a positive effect on MS. Choose a well-balanced diet with lots of fruits and vegetables for increased fiber. Plenty of water is important. Many people restrict water to prevent bladder accidents, but end up with worsening constipation and dehydration.

Low Vitamin D blood levels have been found to be a risk factor for the development of MS. In one study, individuals with MS who had high blood levels of Vitamin D were more likely relapse-free. In contrast, people with low levels of Vitamin D were more likely to have disability. Supplements have not yet been proven to help once you have MS, but these trials have had only a small number of patients.

Build Strength

Critical in MS! The saying "use it or lose it" definitely applies. Mild weakness can worsen if you avoid exercise. If your legs are weak, avoiding walking distances will result in further weakness. If you have no physical limitations, aerobic exercise is great. Avoid the heat of day or the end of the day which can limit your endurance. If you have some mobility challenges, consider swimming or yoga. Both are also good for people with balance issues. Swimming keeps your body temperature cool.

If you have trouble walking, try a recumbent bike with ten minutes episodes of alternating exercising and rest. People with physical disability should strongly consider a course of physical therapy. A physical therapist can frequently help you learn to walk better and more safely as well as develop a customized exercise plan for you.

Think Positively

Your attitude can make a tremendous impact on how you live with MS. A good mindset will help you focus on your goals in life and not let MS define you. A positive attitude will help you take your medication regularly, exercise, and eat well. Turn to family and friends for support. If you don't have much support, consider getting involved with the National Multiple Sclerosis Society to find local MS support groups. Connecting with someone else living with MS can help ease your own worries.

Depression is common in MS, affecting up to 50% of individuals. Depression may be due to the effect of MS on the brain, a reaction to having the disease, or even treatment side effects such as to interferon. Signs of depression include increased irritability, trouble sleeping, crying, more withdrawn, appetite change, feeling of worthlessness or suicidal. If you feel depressed, call your doctor as soon as possible. Anti-depressants generally work well. A psychiatrist or psychologist may need to be involved in a treatment plan.

Tackle Fatigue

Fatigue is a huge issue in MS, affecting 90% of people. Different types of fatigue can occur with MS such as reduced muscle endurance or an overwhelming tiredness despite a good night sleep. Exercise reduced fatigue in clinical trials. Short breaks or naps during the day can help. Plan physical activity in the morning and try not to over-schedule. Re-evaluate your sleep since many MS patients can have treatable general sleep problems like trouble falling asleep, restless legs, or airway problems. For example, some people, who snore during sleep, stop breathing multiple times at night. This is called obstructive sleep apnea and can be treated.

If the fatigue is significantly interfering in your life, there are some good medication options that can help. Provigil can be very effective for some people to stay more alert during the day. Amantadine, an antiviral medication, is another generic option that helps some people. Other people with MS get control of fatigue only with amphetamines such as Ritalin, but amphetamines have very small risks of heart attack and stroke.

Fix Bladder and Bowel Issues

The most common MS bladder symptom is the need to urinate right away called "bladder urgency." For some people, this can lead to a loss of urine accidentally or "urinary incontinence." Many moms often have leakage when they cough, sneeze and laugh called "stress incontinence" from pelvic muscle weakness from having babies. MS leakage is usually from not being able to make it to the bathroom in time when you have to urinate immediately. Mild bladder urgency can be controlled by relieving yourself regularly and before activities (especially before going for a drive). If the urgency or incontinence is problematic, there are numerous medications that work to help control your bladder sphincter.

Some people with MS have the opposite problem; they have trouble emptying their bladder. The inability to void completely is called "urinary retention." Sitting for a while on the toilet to urinate or having to go back to the bathroom in a few minutes to empty the rest of your bladder can be signs of urinary retention. Frequent bladder infections can be another sign since bacteria tends to grow in urine sitting in a partially-filled bladder. Usually a visit to a urologist is needed to test for urinary retention using either an ultrasound or catheterization after urinating. Treatment can be medication to relax the sphincter or sometimes catheterization 4-6 times a day using a clean technique.

Constipation is common with MS. Regular bowel movements are daily. For constipation, first try increased water and fiber in your diet. Eat lots of fruits and vegetables. If these options do not work, consider over-the-counter medications such as Miralax. Sometimes enemas are required to have a bowel movement. Some people living with MS have very little warning before having a bowel movement called "bowel urgency" or sometimes accidents called "bowel incontinence." Frequently, bladder medications that help tighten the sphincters for bladders work for bowel urgency and incontinence.

Improve Sex

A healthy sex life is important to many of you living with MS. MS can lead to sexual dysfunction, especially when the spinal cord is significantly attacked. A new change in genital sensitivity, erection ability or the ability to have an orgasm may be due to an acute MS relapse, which can be treated like other attacks with I.V. steroids. For women, extra stimulation is sometimes needed to overcome reduced sensitivity. Many men respond to medications for erectile dysfunction such as Cialis, Levitra and Viagra. Be aware that many medications such as anti-depressants can cause sexual dysfunction, especially a delay in orgasm.

Physical limitations from MS can be addressed by trying new positions. The morning is generally better since you can have more physical energy and less fatigue. Be creative in satisfying your partner. You may need to explore options you had not previously considered such as using sexual aids. Have an open discussion regarding your needs and listen to your partners desires and concerns. Especially deal with emotional issues for not having sex, but physically able.

Relieve Painful Sensations

MS can sometimes be very painful. Pins and needles and burning sensations are common. Some people have electric bolts of pain in their face called trigeminal neuralgia. Electric shock-like sensations down the spine with neck movements is called "L'Hermitte's sign." To help relieve nerve pain such as burning and pins-needles, medications used for nerve pain frequently work. Neurontin, Lyrica, Cymbalta and amitriptyline are often used "off-label" since they are not FDA-approved for MS pain. For trigeminal neuralgia, carbamazepine (Tegretol) or oxcarbazepine (Trileptal) are also options.

Spasms and cramps, especially in the legs, can be severe. Muscle relaxants such as baclofen and tizandine can help reduce stiffness or "spasticity." Sometimes these medications cause drowsiness and are taken only at night. Stretching exercises can help. Botox injections are another potential treatment option.

Restore Balance

New onset of balance problems should be treated as a relapse with I.V. steroids. Frequently, imbalance walking is associated with other symptoms such as spinning sensations (vertigo), hand tremor, coordination problems, ringing in the ears (tinnitus) and double vision (diplopia). Prevention of falls is key so assessing your needs to get around is important. Some people need a cane or walker, at least temporarily.

A physical therapist can address ways to compensate for imbalance and help you come up with exercises to try to improve your balance. Yoga can be useful to learn how to better try to control imbalance. MS yoga classes are available even if you have a fair amount of disability. Sometimes a medicine called primidone can help with balance.

Boost Memory

Short-term memory loss and trouble performing multiple tasks at the same time can occur in about half of people with multiple sclerosis. These cognitive problems can lead to difficulties at work and home. Controlling your disease with the available MS medications is the best way to prevent progression. A new change in thinking abilities may be a relapse that can be treated with I.V. steroids. The amount of MRI activity may correspond to the amount of cognitive problems.

To fight short-term memory loss and multi-tasking problems, get organized! Take more notes, buy an electronic organizer, and use emails so you can go back and retrieve information. Have a large family calendar on the refrigerator. Have family members and co-workers give you "To Do" lists rather than verbally tell you things to be done. Minimize distractions when trying to focus on a specific task. The medications for dementia such as Alzheimer's have not yet been proven to work in MS. Hopefully, new research will lead to ways of repairing memory.