Monthly Archives: September 2017

Walking the Dog, An MS Adventure Story

It’s 7 in the morning and it’s raining cats and dogs. I need to walk our dog and the thought of it is not very appealing. We live in a condo, so this activity requires getting dressed, squatting down to feed Joey, squatting again to get him hooked up with his leash, getting my rain gear on and going down the elevator. Not a big deal for most folks, but a little bit of a bigger deal for someone like me, who has MS.Joey and scooter 1

I don’t actually walk Joey. He trots alongside me as I ride my scooter. We’ve gotten pretty good at doing this, but the elevator can be a bit of a challenge, as can meeting up with most other dogs. Joey, who is a Cocker Spaniel, likes people more than he likes most dogs. (If you’re a certain age, you may appreciate the Joe Cocker connection.) He also likes to be the boss. (Not to be confused with The Boss.)

In the rain, it’s a bit of a challenge to get off the scooter with my cane, have his leash in one hand and the poop bag in the other – especially if there’s another dog around. I give myself extra points for completing the poop pickup if the wind is strong, which it often is here at the ocean.

Anyway, it’s not easy having a dog or, for that matter, a cat (more about the cat shortly). So I was surprised when I was contacted by a writer for another website who was putting together an article about the benefits that accrue to someone with a disability who lives with a pet. Benefits? Let me think about that and get back to you.

Meanwhile, let me introduce you to TJ. TJ. is a retired grand champion show cat, and he knows it. Like most cats, TJ thinks it’s great fun to plop down in front of me as I’m walking – not such a good thing to do to a guy who walks with two canes. He tries to nibble my ankles when I’m sitting – a dangerous thing to do to a guy who has a cane. I accidentally stepped on his tail one day with my bad leg. For a very long five seconds I couldn’t move and he couldn’t move, but we each managed to escape uninjured. Of course, as with all cats, there’s also kitty litter. Need I say more?

Yes, I eventually told that writer, there are benefits to having a pet for someone with a disability. There’s never-ending companionship, at least with the dog. There’s that friendly greeting when you get home (dog only) and the piercing howl when you leave. There’s the warm body curled up next to you at night, leaving you about two feet of room in a king-sized bed (mostly dog, but the cat can get pushy).

And, if you put Joey and TJ together, the result can sometimes be some great entertainment:

So, back to the original question. What are the benefits of someone with a disability having a pet? As far as I can see, the benefits are no different from the benefits for someone who’s healthy! And, they’re usually worth an occasional walk in the rain.

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When Do MS Symptoms Become a Relapse?

Am I having an MS relapse?

I saw that question asked the other day on one of the social sites I follow. At first, I thought, “Gee, doesn’t everyone with MS know when they’re having a relapse?” Then I realized that for several years after I was diagnosed, I was never sure if what was happening to me was technically a relapse and worth a call to the doctor. I’d wind up in the hospital being treated for a relapse, but only after my wife would spot a symptom getting worse and tell me that I needed to see my neurologist. It rarely dawned on me that what was happening was what we used to call an “exacerbation.” But I always walked better after getting treated with a course of steroids.

There’s a guide that can helpMSAA-Relapse-Tool-Kit

So, how can you know that you’re having a relapse? There’s now a really useful booklet that can help. It’s called, appropriately, the “MS Relapse Toolkit,” and it’s just been published by the Multiple Sclerosis Association of America. The booklet can be read online, downloaded as a PDF file, or ordered as a hard copy at the MSAA website. Here’s a thumbnail of what’s in it:

What’s a relapse?

  • Existing symptoms have worsened temporarily or recurred, or …
  • New symptoms have appeared
  • The symptoms have lasted for at least one or two days with no sign of a fever or infection (e.g. a UTI)
  • Tests show your myelin or nerves have been damaged or inflamed

When to call your neurologist?

The MSAA booklet, written by Aaron Boster, MD, and Jacqueline A. Nicholas, MD, MPH, suggests you call your doctor if:

  • The new or recurring symptom(s) has been present for at least 24 to 48 hours, or …
  • It’s been less than 24 hours, but your symptoms are severe and could affect your health or safety

As long as…

  • You don’t have a fever or any other signs of infection
  • Your body isn’t overheated, which might have resulted from the temperature around you, exercise, etc.
  • You didn’t overexert yourself
  • You aren’t having an unusually stressful day

The idea seems to be that the trigger for your problem should be medical and not the result of some external stimulus.

What else is in the Relapse Toolkit?

The booklet has another half-dozen chapters that include a list of questions to ask your neurologist about relapses, some handy, fill-in-the-blank forms for contact information and the drugs that you use, what to tell your doctor when you call, details of various treatment options, and some really useful ideas about planning, at home and at work, for a possible relapse. It even includes a crossword puzzle that uses relapse-related words.

The price is right

Did I mention that the “MS Relapse Toolkit” is free? As we used to say when I was growing up in New York City: “Such a deal!”

(This post first appeared on www.multiplesclerosisnewstoday.com)

Questions About Health Insurance for Your MS?

A lot of people on the various MS social media groups that I follow are worried about their health and drug insurance…losing it, not being able to afford it, etc.

The National MS Society and Can-Do MS have scheduled an insurance webinar this coming Tuesday and it looks like it will provide some good info. You can register by clicking the “RSVP” tab below:

Common Health Insurance Problems in MS: Solutions, Resources, and Strategies
Can Do MS and National MS Society Webinar & Telelearning Series
Learn more about common areas of confusion around health insurance affecting people with MS, how to resolve issues, and resources and tips for getting the most out of health insurance coverage.

September 12
Online and/or by phone

RSVP

Is Medical Marijuana Right for My MS?

The state where I live has legalized medical marijuana (MMJ) and it’s getting ready to open state-licensed marijuana dispensaries. So, I’ve been thinking about using MMJ to treat some of my MS symptoms.

How can MMJ help MS patients?

A 2012 study by researchers at the University of Plymouth in the U.K. reported improvement in the muscle spasms and pain of MS patients. There have been other reports of reduced bladder urgency, faster and better sleep, improved vision, and fewer abdominal problems.

As I’ve considered marijuana, I’ve discovered there are a lot of choices to make and some things that I should know before I’d feel comfortable using MMJ for my MS.

For example, I wanted to know the difference between cannabidiol (CBD) and tetrahydrocannabinol (THC). Both are cannabinoids, compounds that are found in the marijuana (cannabis) plant. And the balance between the two has a major impact on the effect of the marijuana.

What are CBD and THC?

THC is the main active ingredient in cannabis. It’s the part of the plant that provides the “high.” According to the National Institute on Drug Abuse (NIDA), “THC can increase appetite and reduce nausea. THC may also decrease pain, inflammation (swelling and redness), and muscle control problems.” And, there can be a wide range of THC potency between cannabis strains.

CBD doesn’t give you a “high.” In fact, scientists report that CBD has anti-anxiety effects and lessens the intensity of the “high” produced by THC. According to NIDA, CBD “may be useful in reducing pain and inflammation, controlling epileptic seizures, and possibly even treating mental illness and addictions.” It’s said that it promotes calmness without causing you to feel unusual.

The website “Learn About Marijuana,” published by the Alcohol and Drug Abuse Institute at the University of Washington, is a great source of more information about this.

What strain should I use?

There are a lot of marijuana “strains” with all sorts of colorful names like “Blackberry Rhino” and “Girl Scout Cookies.” Many are available for sale in the dispensaries that states have set up to sell medical marijuana products.

On the various MS social media sites, people have lots of favorites. One friend even keeps a list of ratings for those that she’s sampled.

MMJ scorecard

 

An article on the www.leafly.com website tells the story of how one MS patient uses different strains and different ways of consuming it, depending on the time of day.

“In the evening, he enjoys an indica-infused brownie to help him sleep. During the day, he’ll add a high-CBD infused butter to his omelet or vaporize strains that alleviate fatigue and give him energy.”

Balancing CBD and THC

The difference between strains is due mostly to the ratio between CBD and THC, but how do you determine what that ratio is, or should be, for what you need? The website Green Rush Daily has tried to help with that decision by creating a “10 best” list of marijuana strains for several diseases, including multiple sclerosis. Leafly.com actually rates strains and, like Yelp, offers customer reviews. I can’t vouch for any of this information, but it’s good to look at it just to help you understand how different strains of marijuana may affect you.

One other suggestion: Several of the MMJ users I’ve contacted suggest asking the “budtender” at the dispensary where you buy your MMJ which strain would best serve your needs. Just like asking a sommelier to suggest a wine, I guess.

(This post first appeared as my column on Multiple Sclerosis News Today website).