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PublicationsManagerTerrySchenkerEditorialCoordinatorChristopherPaineEditorialCommitteeKaseyMinnisNatalieBlakeAlissaAydenHildyBergerBrieaCuringtonJayHassContributingWritersDarylH.BryantLucilleCarrierePhDRebeccaFloydPhDJoanneFortunatoKimberlyLewisPhDFrancescoPagniniPhDMarcPetersDeborahPhillipsPhDLauraSteplemanPhDAmyMBSullivanPsyDBenThrowerMDTALKBACKTALKBACKWeWelcomeTopicSuggestionsforFutureIssues.Yourcommentsabouteachissueareimportanttous.Emailcommentstoeditormsfocus.orgorwritetoEditorMSFocus6520N.AndrewsAvenueFortLauderdaleFL33309TakeMSFocusontheroadwithMSFocusRadio.orgListenonyourPCormobiledeviceAvailable247 MSFocusispublishedquarterlyinenlargedtypeforthebenefitofourreaders.Audioversionsoffeaturedarticlesareavailableforlisteningordownloadonwww.msfocus.orgclickOnDemandAudio.Backissuesareavailableonlineatwww.msfocus.org.MSFocusisafreepublicationforindividualswithMStheirfamiliesandothersinterestedinMS.StatementofPurposeThepurposeoftheMultipleSclerosisFoundationspublicationsistoempowerthoseaffectedbyMSwiththeinformationnecessarytomakethemostcompleteandeducateddecisionsconcerningtheirhealthcare.Wedonotadvocateorendorseanyspecifictreatmentshealingmodalitiesorpractitioners.Thematerialpresentedinthispublicationisforinformationalpurposesonly.Forspecificadviceconsultahealthcareprofessional.MSFdoesbelievethateachpersonhastherighttochoosethetreatmentstheyfeelarebestandthereforeactsasasourceofinformationprovidingreferralstolocalresourcesandpartnershipinproblemsolving.VoicesOneWomanWinsHerBattleWithDepression44MSTech10146RegionalEvents48MenMS56MSFOnTheRoad58MSNews59QuestionsAnswers62FEATURESTheRelationshipBetweenDepressionandMS6DepressionandMSTheRoadtoRecovery13HOPEAPositivePsychologyGuidetoCopingWithDepression16DepressionWarningSignsforMSCaregiverstoWatch18ThreeHerbsandSupplementsThatMayHelpWithMS20MSFBrighterTomorrowGrantProgramMakesLifeBrighterforMany28NMSEAM2015ThemeInitativeandSuperheroApplication36AmbassadorandCoolingProgramApplications39ProjectPutstheWindinTheirSails54CONTINUINGTOPICSAsWeSeeIt4MSFMailbox5FromtheLibrary22FacebookFeedback27SupportGroupSpotlight32PSWhatsNew35UncleSamsHelpingHand42 4MSFocusWinter2015Generallyspeakingmanypeopleperceivethemainpurposeofdisease-relatedcharitableorganizationstoberaisingfundstohelpfindacure.Ofcoursewhenitcomestomultiplesclerosisandsimilarchronicdiseasesthecriticalimportanceofresearchcanneverbeoverstated.Fromourperspectivethegoodnewsisthatresearchiscapablybeingconductedorfundedbyuniversitiesprivateindustrygovernmentandanumberofourfellownonprofitorganizations.Equallyencouragingisthegrowingarrayofavailabletreatmentoptionsforsymptommanagement.Howeveronethingwehavelearnedfromourconstituentsearlyonisthatwhiletheyarehopefulforacureonedaymanyofthemfaceissuesandbarriersthataffecttheirdailylives.Theseneedscanhavefinancialemotionalmedicalorsocialimplications.PeopleandfamiliesaffectedbyMSareinneedofimmediatesolutionsandthatiswheretheMSFsstarshinesbrightest.Ourconstituentssimilartoafocusgroupsharedtheirconcernsandneedsmanyyearsago.Weinturntooknotebydevelopingamissiontailoredtofulfillingmanyofthoseunmetneeds.Todaywereceivenumerousinquiriesonadailybasisandprovideinformationonthescopeofournationallyaccessibleprogramsandserviceswhichareallavailableatnocost.Amongtheseareshort-termhomecareassistancegrantscrisisinterventionassistivetechnologygrantspatienttransportationhealthandwellnessinitiativesanationalnetworkof170asoflastcountsupportgroupsaswellasacaringstaffservingasafirstcallfromthosenewlydiagnosed.Sometimeswearecontactedbypersonswhoseneedsaresuchthattheycannotbefulfilledbyanyofourprogramsandservices.HoweveritdoesntnecessarilyendthereasourdedicatedstaffstrivestoresearchandidentifyalternateresourcesbeyondtheMSFsdomain.Thoseresourcescanincludeprogramsprovidedbylocalsocialservicesorhealthcareagenciesfinancialassistancefrompharmaceuticalcompaniesorprogramsfromothernon-profitorganizations.SoregardlessofwhatissuesyoufacewithMSweencourageyoutoreachouttoourstaff.Togetherletsstrivetoidentifysolutions.Whilewecannotguaranteesuccesstoallwecanassureyouofempathydedicationandproperfollowthrough.Ifyouareaprospectivedonororareinthemidstofincorporatingaworthyorganizationintoyourestateplanningweencourageyoutoconsiderouraccomplishmentsinpatientservices.Wecanprovideopportunitiesforyourgenerositytohavealastingpositiveaffectonpeopleslivesbyexpandingourprogramsoutreach.JulesKuperbergAlanR.SegaloffCo-ExecutiveDirectorCo-ExecutiveDirectorTheMSFYourPersonalPortaltoEssentialResourcesTheMSFYourPersonalPortaltoEssentialResources Iamveryluckytogetthispublication.IlivedinNorthMiamiFla.forsixyearsduringthewintermonths.WewereNYCsnowbirdsforsixyears.WhenIwasthereIgotintouchwiththeMultipleSclerosisFoundationinFortLauderdale.WegaveupourapartmentforfinancialreasonsandhavecontinuedtogetthismagazineeversinceItishelpfulandinteresting.Iamlucky.Iamstillmobileandsuffermostfromincontinencefatigueandincreasingage.IfeelawfulallthetimebutIdogetprofessionaltreatmentfordepressionandotherrelatedproblems.ItsagreatpublicationYourstrulyElisabethReiterStatenIslandN.Y.IreceivedmyfallissueofMSFocusmagazineandcouldnotputitdown.Thesebooksaremystressreliefandhelpmewithdepressionjustbyreadingthem.SometimesitshardformetoreadthewritingduetomyeyesbutIstillsee.Withthreegrandchildrenalldisabledplusmyhusbandwhohascanceritgetstoughforme.MSpeopledontwantpity.Wejustcannotdothethingsweusedtodo.Wedidntaskforthisdisease.IthankGodfortheMSFformailingmethesebooks.Pleasekeepmailingthemout.Theyareinspirationaltome.Thankyou.NinaFayeJonesLakeViewS.C.EditorsNoteWeresogladthatMSFocushelpsrelieveyourstress.Whenreadingistoughrememberthatmostarticlesareavailableonlinewhereyoucanadjustthetypesizeorlistentoanaudioversion.Visitwww.msfocusmagazine.org.TomembersoftheMSFThankyouforyourdonationtohelpmefundmyhand-heldcontrolsfordriving.MShadprettymuchsentencedmetobeingahomebodyandridemoocher.NowIamfreetodrivemyselftoappointmentsandgoshopping.Iamindependent.HereisapictureofmeinmycarwithmyservicedogWally.Hehelpsmewithbalanceandwalkingnowthatmylegshavestoppedworking.Healsothanksyouforyourgenerositywegotothedogparkalotmoreoften.Iappreciatetheworkyoudo.Theresultsofyoureffortmoveddirectlytometogreatlyimprovemylife.Iamhumbledandoverwhelmedbythepowerofsuchgivingandreceiving.SincerelyJeanneBaselEdmondsWash.MSFocusWinter20155IfyouhaveanycommentsorquestionsfortheMSFtheycanbeemailedtoeditormsfocus.orgorwrittentoEditorMSFocus6520N.AndrewsAve.Ft.LauderdaleFL33309 MSFocusWinter20156Depressionisacommonconditionthatappearssimultaneouslyinthemultiplesclerosispopulation.Itaffectsqualityoflifeandislinkedtoworseneddiseaseoutcome.InlargepopulationstudiesofindividualsdiagnosedwithMSthelikelihoodofmajordepressionvariesbetween26and51percent.ThefindingsonthefrequencyofdepressioninthesestudiesvarydependingonthepopulationexaminedthemeasureusedandthetimeframeevaluatedbuttherehavebeenconsistentresultsshowingaveryhighprevalenceintheMSpopulation.Bestestimatesofthe30-dayprevalenceofmajordepressioninthegeneralpopulationareabout3percentandinrheumatoidarthritispatientsdepressionappearsinabout15percent.IncomparisontoMSpatientsdepressionisthreetofourtimesashighasinthegeneralpopulation.ThusdepressionisquitecommonandofsignificantinterestinpatientswithMS.SymptomsandOriginsDepressionisstronglylinkedtothequalityoflifeintheMSpopulation.DepressioncanhaveasignificantandnegativeeffectonfunctioninginthosewithMSparticularlyasitoftenstrikesindividualsinmiddleadulthood20-40yearsofagewhentheymaybepursuingcollegeacareerorraisingafamily.SymptomsofdepressioncanoftenoverlapwithcommonsymptomsassociatedwithMSandthereforecanbedifficulttodifferentiate.SignsandsymptomsofdepressioncanincludeSadnesssubjectivereportofdepressedmoodmostofthedaytearfulnessAngerirritabilityworryanddiscouragementInterestdiminishedinterestinpleasurableactivitiesGuiltfeelingsofworthlessnessorguiltEnergyfatigueorlossofenergyConcentrationdiminishedabilitytoconcentrateorindecisivenessAppetiteweightlossgainincreasedecreaseinappetitePsychomotorpsychomotoragitationrestlessnessfeelingsloweddownSleepfragmentedinitialinsomniamiddleinsomniaandSuicidethoughtsofdeathideationintentplan.denotesoverlappingsymptomsofMSDepressionhasbeencategorizedaseitherprimaryorsecondaryinorigintoaidinunderstandingthepossiblesourceofthesymptoms.InprimarydepressionthereisnoidentifiablecauseoreventtoByAmyMBSullivanPsyDandLucilleCarrierePhD linktotheonsetofthesymptomssuchsymptomsmayappearwithoutwarningandinabsenceofanyenvironmentalfactors.Ontheotherhanddepressionidentifiedassecondaryinnaturemayhavemoreclearphysicalorpsychologicalcausessuchasadeathinthefamilydivorceorjobloss.CausesofsecondarydepressivesymptomsmayalsobebiologicalinoriginsuchasintheautoimmunemechanismsassociatedwithMSforexample.Thepreciseoriginorcauseofdepressionformostpeopleisoftendifficulttoidentifyassymptomsaremostlikelytheresultofacomplexinterplaybetweengeneticpsychologicalandenvironmentalfactors.Regardlessofthesourcerecognitionofdepressivesymptomsandearlytreatmentisimportanttolessenthenegativeeffectondailyfunctioninganddiseasesymptoms.InfactresearchhasidentifiedthepresenceofdepressivesymptomsduringthecourseofanMSrelapseasthebiggestpredictorofdepressivesymptomsattwoandsixmonthsfollowingarelapseregardlessofimprovementindisabilitystatus.TheconsequencesofuntreateddepressioncanbesignificantforindividualsdiagnosedwithMSasbothqualityoflifeandadherencetoMSmedicationshavebeenfoundtobelower.ScreeningandRiskAssessmentAsacomprehensivecarecenterforMSthehealthpsychologyteamattheMellenCenterscreensfordepressioninavarietyofwaysincludingself-reportobjectivepsychologicalmeasuresstructuredinterviewandreportsfrompatientslovedones.SeekingpsychologicalservicesatcomprehensiveMS-focusedcentersinwhichmedicalrehabilitativeandpsychosocialneedsarealladdressedcanbehelpfulinoverallcare.ComprehensivecarecentersaremorelikelytofacilitatecollaborationacrossprovidersneurologistspsychologistssocialworkersPTOTetc.toimprovepatientcareandalsoincreaseaccessibilitytoothertypesofprovidersasneeded.OtherneurologicalconditionscanalsolooksimilartodepressioninthosewithMS.TheseincludepseudobulbaraffectchronicpainfrontallobeirritabilitydementiaabuliaandsevereMS-relatedfatigue.Theseotherconditionsneedtobeconsideredandruledout.Whenthediagnosisisunclearweconsiderneuro-psychologicalassessmenttoassistus.ThereisalsoahighprevalenceofanxietydisordersintheMSpopulationaswellasthepresenceofadjustmentdisorderbothofwhichmayneedtobeaddressed.InadditiontothehighratesofdepressionandanxietythereisalsoanelevatedriskforsuicideintheMSpopulation.Infactresearchsuggeststhatthereisa7.5timesgreaterrateofsuicideintheMSpopulationthaninanage-matchedpopulation.Thisnumberisslightlyhigherduringthefirstyearofdiagnosisandstartstodeclineaftertheindividualreaches40yearsold.TheRoleofHealthPsychologyBecauseoftheincreasedriskofmentalhealthdisordersandspecificallydepressionhealthpsychologyisanimportantpartoftreatmentforapersonwithMS.HealthpsychologyservicesattheMellenCenteraremostactivelyusedinthefollowingsituations1adjustmentandcopingwiththediagnosisandassociatedfears2familyandcouplesadjustmentissuesincludingcaregiverburnoutandcommunicationissuesMSFocusWinter20157 MSFocusWinter201583noncompliancetotreatmentregiment4needleanxietyorphobia5painmanagementrelatedtoMS6wellnessprinciples7fatigueandenergyconservation8MS-relatedmooddisorders9andrelaxationskillstraining.Depressionisachallengingconditionthatshouldnotgountreated.Inthestoriesthatfollowyoucanfindwaystoaddressthecondition.Whileitwasstigmatizedinthepastitisnowsomethingcoveredbymosthealthcareplans.Ifyouneedtoreachoutbecauseofdepressionherearesomekeynumbers800273-8255...1-800-273-TALKNationalSuicidePreventionLifeline877838-2838...1-877-Vet2VetVeteransPeerSupportLine800784-2432...1-800-SUICIDASpanishSpeakingSuicideHotlineand877968-8454...1-877-YOUTHLINETeentoTeenPeerCounselingHotline.AmyMBSullivanPsyDisstaffclinicalpsychologistandtheDirectorofBehavioralMedicineattheMellenCenterforMSTreatmentandResearchattheClevelandClinic.Dr.SullivanreceivedherdoctoratedegreeatArgosyUniversity-AtlantaherinternshipattheUniversityofCincinnatiandherfellowshipattheClevelandClinicinPainMedicine.PriortohergraduatestudiesshewasaDivision1basketballplayeratSt.BonaventureUniversitywhereshereceivedherdegreeinpsychologyandchemistry.LucilleCarrierePhDisapostdoctoralfellowatMellenCenterforMSattheClevelandClinic.ExploresomeofthemostexcitingandscenicareasinNorthAmericaonboardCelebrityCruiseLinesSolsticewhileattendingoneofourmanymotivatingeducatingandempoweringprogramspresentedbyMSexperts.TaketheopportunitytovisitwitholdfriendsandmakenewonesaswenavigatetheTracyArmFjord.SeetheAlaskanwildlifeaswevisitJuneau.InSkagwaytakearideontheWhitePassandYukonRouteRailway.StrollthroughKetchikanAlaskasfirstcityandthesalmoncapitaloftheworld.Bookearlytoassureastatroomofchoice.FormoreinformationortomakeareservationcontactGabrielaAragonat800-659-0081or954-322-1030InordertoparticipateintheMultipleSclerosisFoundationsprogramaboardtheshipyourstateroommustbookthroughtheMSFattheabovenumbers. 13MSFocusWinter2015WhyhaveIfeltsodownlatelyLivingwithMScanbestressful.Feelingsadorirritablewantingtobeleftaloneanddifficultyconcentratingorsleepingarecommonreactionstostress.ButwhatifyounoticethattheseexperiencesoccurmoreoftenorworsenovertimeMightyoubesufferingfromdepressionBecausestressMSanddepressionhaveoverlappingsymptomse.g.sleepdifficultiesandpoorconcentrationtryingtouncoverthesourceofyourfeelingscanbetough.Ausefulfirststepistodocumentthewaysinwhichyouarefeelingthinkingorbehavingdifferentlyparticularlythosechangesmostnoticeableordistressing.Thepeoplearoundyoue.g.spousechildrenfriendsandcoworkerscanprovideadditionalinsight.TheymaybethefirsttonotechangesinyouandexpressconcernslikeYouhaventseemedyourselflately.Seekingoutahealthcareprovidertoevaluateyourphysicalandemotionalwell-nessisacrucialnextstep.RegardlessofwhetheryouareexperiencingdepressionMSrelapsestressorsomethingelseitisessentialtotrustyourinstinctsadvocateforyourselfandtakeaction.WithoutinterventiondepressioncanworsenandmayaffectMSbyinterferingwithyourabilitytoadheretoMStreatments.HowdoesadoctorevaluatemefordepressionDuringyourvisityourphysicianmaystartbylisteningtoyourspecificconcernsaskingquestionsrelatedtoyoursymptomsincludingdurationandeffectondailylife.ThedoctormayalsodoaphysicalexamororderadditionaltestsespeciallyifMSrelapseisaconcern.Itisimportanttobehonestandforthcomingwhenreportingonsymptoms.Thestigmaofmentalillnessmaytemptyoutominimizedepressivesymptomsbydenyingthepresenceorseverityofsymptomsortheneedfortreatment.Havingacaregiverpresenttoprovidesupportandconfirminformationisfrequentlyagoodidea.Ifyoursymptomsareconsistentwithdepressionyourproviderwillcollaboratewithyouondecidingthebestinterventionsforyourindividualcircumstances.YourprovidermayconsiderIndividualpreferencesabouttreatmentDepressionseverityandspecificsymptomsPasthistoryofdepressionandresponsetointerventionsincludingmedicationandcounselingOtherhealthconditionsandCurrentmedicationregimen.InterveninginDepressionWithTherapyTherapywithamentalhealthprovidersometimescalledpsychotherapycounselingortalktherapyisoneavailableavenueforlearningeffectivewaystogainreliefduringadepressiveByLaraSteplemanPhDRebeccaFloydPhDandKimberlyLewisPhD episode.Therapistscomefromavarietyofeducationalbackgroundssuchaspsychologypsychiatrysocialworkcounselingormarriageandfamilytherapywillhaveamasterordoctoraldegreeandarelicensedbytheirstateofpractice.Therapycanbedoneinindividualfamilyandgroupformats.Althoughmanypeopleinitiallypreferindividualtherapygrouptherapycanbeessentialforrelievingisolationexperiencedduringdepressionreceivingsupportfromothersexperiencingsimilarcircumstancesandlearningadditionaldepressionmanage-mentstrategiesthatothersareutilizingsuccessfully.Aneffectiveandwidely-practicedtypeoftherapyiscognitive-behavioraltherapyCBT.ResearchhasfoundCBTisbeneficialforavarietyofMS-relatedconcernsincludingdepressionanxietygriefandpain.ThebasicpremiseofCBTisthatemotionsareinfluencedbycognitionsorthoughts.WhenindividualshavenegativethoughtssuchasItismyfaultthatIamdepressedorNoonecanlovemebecauseofMStheytendtoexperiencegreaterdespairthanindividualswithfewerofthesethoughts.Whenpeoplelearnwaystobalancetheirperspectivetheyoftenfeelhappiermorehopefulandlessdepressedevenwhentheirsituationremainsunchanged.SimilarlyCBTteachesthatemotionsarealsoinfluencedbybehaviors.Engaginginbehaviorsthatmakeusfeelgoodsuchasexercisingsocializingwithfriendsorenjoyingahobbydecreasesnegativethinkingandincreasesparticipationinpositiveactivitieswhichcanalleviatedepressivesymptoms.Similarlywefeelbetterwhenwereducebehaviorsthatmakeusfeelpoorlysuchasovereatingbeinginactiveortakingmedicationsincorrectly.Workingasateamwithyourtherapisttochallengeandchangeproblematicthinkingandtotryoutnewbehaviorsallowsyoutofeelbetterandaccomplishnewgoalsforyourself.CBTisarelativelytime-limitedtreatmentoften12sessionsorlessaugmentedbyhomeworkassignmentsthatallowyoutopracticetheskillslearnedinsessions.Oncelearnedyoucanapplythesetechniqueswheneveryouarefacingemotionallychallengingsituations.InterveninginDepressionWithMedicationYourMSphysicianprimarycaredoctororpsychiatristcanprescribeandmonitormedicationtotreatdepression.Factorsincludingconveniencevisitfrequencyandseverityofdepressionmaybeconsiderationsfordeterminingthemostappropriateproviderforofferingdepressioncare.Sometimesreferraltoanotherproviderwithexpertiseinaddressingyouruniqueneedsisneeded.Numerousmedicationsareeffectivefortreatingdepressioninfacttherearesomanyitisimpossibletoreviewthemallhere.Ingeneralmedicationsfordepressionmaybeespeciallyhelpfulforregulatingphysicalaspectsofdepressionsuchassleepenergyandappetitechanges.Forseveredepressionmedicationsmaybeessentialtoincreaseyourabilitytoengageinadditionaldepressiontreatmentsliketherapy.SomepeopleworryaboutmedicationsideeffectssuchasweightgainsexualdysfunctionanddrowsinessoraboutaddingnewmedicationtoalreadycomplexMStreatmentregimens.Theseconcernsarelegitimateandshouldbediscussedexplicitlyduringhealthcarevisits.Ofnotesomemedicationsusedfordepression14MSFocusWinter2015 canactuallyhelpmanageMSsymptoms.ForexamplesomemedicationsareeffectiveatdecreasingnervepaincommoninMS.Andwhilesomedepressionmedicationsfacilitatesleepinthosesufferinginsomniaotherscanassistinpromotingwakefulnessandstamina.Againhonestcommunicationwithyourprovidercanhelpwithidentifyingthebestmedicationsforyou.AswithMSmedicationsalwaystakedepressionmedicationsasprescribedandinformahealthcareproviderifproblemsdevelop.Ittypicallytakesseveralweeksorlongertodetermineamedicationseffectivenessdoseadjustmentsandchangesinmedicationmaybeneededtoprovidethemostsymptomrelief.Patiencecanbedifficultwhenyouwantdesperatelytofeelbetter.Becausedepressioniscomplexmadeupofphysicalpsychologicalandenvironmentalfactorslikedistressinglifeeventstreatmentmedicationtherapyoracombinationofbothcantaketimetowork.Practicingself-managementtechniquesincludinggoodnutritionphysicalactivityrelaxationrecreationengagementinsocialactivitiesandspiritualinvolvementmaymorequicklyandenjoyablymaximizeeffectivenessofthesetreatments.AFinalWordonDepressionTreatmentAlthoughsomepeopleimprovewithouttreatmentitisusuallynotthesimplepassingoftimethatbringshealingbutratherchangesincircumstancethatcomewithtimespassing.Youcanawaitthesechangesrealizingthatchangesmaytakeconsiderabletimeinoccurringorturnouttobenegative.Alternativelyyoucanovercomedepressionbybeingactive.Depressiontreatmentcanbeahumblingrewardingandlife-alteringexperience.Itcanbechallengingevenfrustratingmostjourneysareiftheyleadtolastingchange.Noteveryonereceivingtreatmentfullyrecoversbutmostpeoplewhoadheretotreatmentwillgetsignificantlybetter.Ifyouhavegoodhealthcareprovidersassistingyoumaintaintreatmentevenwhenitistoughpracticetheskillsyoulearnateveryopportunityandtakemedicationsasprescribedyoumayfindyourselffeelinglessdepressedandmorecontentwithyourselfyourrelationshipsandyourlife.15MSFocusWinter2015RebeccaFloydPhDisapostdoctoralhealthpsychologyfellow.FloydservesastheClinicCoordinatorfortheMSCenterwhereshealsofacilitatesamonthlyMSsupportgroupandsupervisespsychologyresidentsintheprovisionofMSclinicalservices.LaraSteplemanPhDisaprofessorofpsychiatryandhealthbehaviorandDirectorofMSPsychologicalServicesintheMSCenteratGeorgiaRegentsUniversity.ShespecializesinassistingthosewithchronicmedicalconditionslikeMStolivetheirbestlives.KimberlyLewisspecializesinprovidingpsychologicalservicestoindividualswithchronichealthconcernsincludingMS.SheprovidesclinicalservicesintheMSCenteratGRU. 16MSFocusWinter2015Thereisnomedicinelikehopenoincentivesogreatandnotonicsopowerfulasexpectationofsomethingtomorrow.OrisonSwettMardenConventionaldepressiontreatmentstypicallyfocusonreducingnegativebehaviorsthoughtsandfeelings.Positivepsychologypromotesdailypracticeofself-managementstrategiesthatincreasepositivemoodandthinking.Thesestrategiesempoweryoutofeelhappierbychangingperceptionsandcapitalizingonyourpositivequalities.ByidentifyingandincorporatingyourpositivequalitiesintodailyroutineyouarelesslikelytofeelworthlessanddamagedbyMSandmorelikelytofeelgoodaboutyourself.FindingandrecognizingopportunitiesforapplyingthepositivequalitiesyoulikeaboutyourselfandretaininspiteofMSevenifnowexpressedindifferentwaysfostersHOPEwhichisoftenabsentindepression.Happiness-buildingactivitiesarethecoreofpositivepsychology.Increasinghappinessdoesnotmeandenyingtherealityofyoursituation.Byincreasingpositiveexperiencesyoubroadenyourperspectiveinwaysthatpromoteconstructivechangeandadaptivecopingorpreventworseningasituation.Threebasictechniquesforbuildingpositivesintoyourlifeincludepracticingoptimismmindfulnessandgratitude.Optimismisthetendencytohavepositiveexpectations.Optimistspayattentiontothethingsthatgowellandanticipatepotentialforpositiveoutcomesfosteringhopeandapositivemood.Indepressionindividualstendtoexpectabadsituationtoremainthesameorworsenpessimismandbecomehighlyattunedtothingsthatwentwrongduringtheirdayfailingtonoticethemanythingsthatwentright.Pessimismfostersfeelingsofsadnesshopelessnessanddespair.Whilesomepeoplearenaturallymoreoptimisticthanothersoptimismcanbealearnedperspective.HowThiscanbedonebyshiftingattentiontofocusonthepositivesofasituation.OptimismactivityReflectontheeventsofthedayidentifyingwhatwentright.Initiallyitmaybechallengingtoidentifythesepositiveeventsbecausewetakeforgrantedthethingsthatwentrighttheyescapeournoticeanddontreceivepropercredit.Forexamplewemaytakeforgrantedandfailtoappreciategettingoutofbedfindingagoodparkingspaceormakingittoanappointmentontime.WhatwentrightforyouByRebeccaFloydPhDKimberlyLewisPhDandLaraSteplemanPhD MSFocusWinter201517Present-focusednonjudgmentalattentiontothoughtsfeelingsandsensationsunderliesmindfulness.Indepressionitmayfeelthatyouredrowninginnegativethoughtsorthatyourerunningonautopilot.Mindfulnessskillsteachustopresspauseandpayattentiontothepresentmomenteffectivelyendingthestreamofnegativethoughts.Thepurposeisnttochangethoughtsbutsimplytoacceptthoughtsasjustthoughtsnotfactswhichhavenopoweroveryourlife.Thegoalofmindfulnessisawarenessandacceptanceofexperienceswhichleadstofreedomandchoicetoengageinpurposefulactivities.MindfulnessactivityMindfulnessbreathingisasimplestrategytobegindevelopingmindfulnessskills.Theactofpracticingmindfulnesscanbechallengingthekeyispracticepracticepractice.Startbybringingyourattentiontoyourbreathing.Breatheinthroughyournoseallowingtheairtofillyourlowerbelly.Thenbreatheoutthroughyourmouth.Noticethesensationsofeachinhalationandexhalation.Continuethebreathingexerciseforawhile.Thenbegintobroadenyourfocusbynoticingthoughtsfeelingsandsensationsthatariseinthemoment.Noticeeachthoughtorsensationasitariseswithoutjudgingitgoodorbadandwithoutpursuingiti.e.lettingitbecomeacenterfocus.Ifyoubecomedistractedreturnfocustoyourbreathingandthenexpandyourawarenessagain.Expressinggratitudeorbeingthankfulisanotherimportantskilltodevelop.Gratitudedevelopsappreciationoflifespositiveaspectsencouragingalastingsenseofsatisfactionwhichisessentialtohappiness.Depressioncreatestunnelvisionnarrowingfocustothethingsthatarefelttobewronginlife.Thisblindsustoourblessingsorthingswefeelfortunateaboutsuchaspeopleactivitiesthingsorpersonalqualitiesleadingtoadeepdissatisfactionwithlife.Chronicillnesscanbecomethesolesourceoffocusblindingindividualstootheraspectsoftheiridentityorcircum-stancesthatremainpositivedespiteillness.Wemaybegratefulforessentialthingsinourlivessuchasaspouseoroneshomebutexpressinggratitudeincludesfindingthesmallthingseachdayforwhichtofeelgrateful.GratitudeactivityIdentifyatleastthreethingsforwhichyouarethankful.Becarefulnottodiscountthesmallstuffsuchasenjoyingafavoritesmellorthetasteofafavoritefood.Expressinggratitudetoasmanypeopleaspossiblecanalsoincreaseyourpositivity.HOPEHappinessOptimismPresent-focusandExpressingGratitudeisessentialtocopingwithachronicillnessovercomingdepressionandlivinglifeasyouchoose.Positivepsychologyfocusesonaccumulatingpositiveexperiencesthroughavarietyofpracticessuchasmindfulnessoptimismandgratitudethatcomplementconventionaldepressiontreatments.LetusknowwhatyouthoughtofthisorotherarticlesEmailyourcommentstoeditormsfocus.orgormailtotheaddressonthebackcoverAttnMSFocusLettersColumn. MSFocusWinter201518Mostpeoplearefamiliarwiththeconceptofdepression.Itisacommonlyusedwordassociatedwithfeelingblueorsimplyfeelingsad.SometimespeoplesayIfeeldepressedmeaningthattheirmoodislow.Everybodyexperiencesthistypeofmoodfluctuationwhichispartoflifesnaturalchanges.Howevertheconceptofmajordepressionreferstosomethingdifferentonethatsignifiesamoreseveremoodextendedintime.Itisamongthemorepainfulofhumanexperiencescharacterizedbyapersistentfeelingofsadnessanddisengagementfromlifesevents.Depressivefeaturescaninterferewitheveryaspectoflifeincludingsocialrelationshipsworkemotionalstabilityandphysicalhealth.Depressionisademocraticexperienceexperiencedbymanypeoplewithoutregardtoonessocio-economicstatuseducationandgeneralhealth.Statisticssuggestthathavingadiagnosisofmultiplesclerosisincreasestheoddsofadiagnosisofmajordepression.MS-relatedchangesinthebrainandimmunesystemoftenpromotedepressivesymptomsandcanariseasasideeffectofcertaindrugs.Itmaybeusefultoidentifythemainfeaturesofadepressedconditionandthemainpredictors.Depressionischaracterizedbysadmoodandoralossofinterestindailyactivitiesforatimeframeofseveraldaysgenerallyaroundtwoweeks.Thereiscommonlyadecreaseinpleasureinactivityandanincreaseinirritability.Notinfrequentlytherearechangesinappetiteeitherincreasingordecreasingandinsleeppatternsinsomniaorhypersomnia.OtherphysicalsymptomssuchaslossofenergypsychomotorretardationaslowingofthoughtorreductionofphysicalmovementoragitationaredifficulttointerpretbecauseofotherMSsymptoms.Additionalelementsthatcharacterizeadepressiveepisodeincludetheexpressionoffeelingsofworthlessnessorguiltaswellasdifficultyconcentrating.Inthemostseveresituationspersistentthoughtsofdeathorsuicidearepresenteitherexpressedorenacted.Itisnotalwayseasytodistinguishdepressionfromsadmoodorgrief.ForexampleconsequencesofMSsymptomssuchasphysicalimpairmentcanleadtoexperiencingastatesimilartodepressionareactivedepressionoraformofgriefprecipitatedbyeventssuchasthediagnosisorthelossofajob.Thatrequiressometimetoresolveitself.Thedifferenceisnotcategoricali.e.thereisnodepressionvs.griefratherthereisacontinuumbetweenthem.Thetwoimportantelementstounderstandwhetherthedepressiveconditionrequiresaspecificinterventionaretimingandseverity.Timingreferstotheevolutionday-by-dayofthepersonsmood.Mostpeopleexperiencefluctua-tionsintheirmoodsuchthataverysaddaymaybefollowedbyamoresereneone.Iftherearefewerfluctua-tionswithinsomeperiodse.g.aweekByFrancescoPagniniPhDandDeborahPhillipsPhD MSFocusWinter201519sothatoneretainsthesadmoodthereisagreaterchancethatthemoodisintheareaofdepression.Severityistheotherimportantelement.Deepandcon-stantsadnessindicatesomethingdifferentthanoccasionalmomentsofemotionaldistressordiscomfort.Apracticalsuggestiontosubstantiatethedifferencebetweenaperiodofsadnessandacaseofdepressionistoproposeoneormoreactivitiesthatthepersonusedtoenjoye.g.cookingaparticularlyappreciateddishorwatchingamovie.Thiscouldhelpinunderstandingtheseverityofthegriefanditcanalsohelpprovideanewpointofviewi.e.youcanhavepositiveexperience.Alackofinterestinthingsthatwerepreviouslyexcitingforthepersoncouldrepresentadepressivefeature.Furthermorethedisengagementfromactivitiesmayhaveafurthernegativeeffectinmoodalongwithadownwardspiral.Severesadnessaswellasotheremotionshaveahaloeffectoverthefabricofsocialrelationships.Inparticularpeopleclosetothepersonfacingadepressiveepisodemayexperiencesimilarfeelingsanexpressionoftheirownempathy.Empathymeansfeelingtheothersfeelingsasiftheywereyourown.Thereisastrongvariabilityinempathyacrosspeoplebutitisnotuncommonthatthemaincaregiverfeelswhattheotherpersonfeelsintermsofemotionsandsensations.Thereforeacaregiverssubjectivefeelingsofseveresadnesssenseofguilthelplessnessorworthlessnessexperiencedwhenclosetothepossiblydepressedpersoncouldrepresentanalarm.Nowadaysitispossibletofaceevenseveredepressionwithinnovativeandintegratedapproaches.Psychotherapyandmedicationsareavailableandareabletosupporttheexitfromthedepressiveepisode.SometimesthepersonwithMSespeciallywhenhesheisfacingdepressionisnottheonlyonewhocanbenefitfromprofessionalsupport.Professionalsupportcanhelpthecaregivercopingwithadversities.Andsometimesitcanremindusthateveryonehastheirownneedscaregiversincluded.FrancescoPagniniPhDisamemberoftheDepartmentofPsychologyHarvardUniversityCambridgeMass.andtheDepartmentofPsychologyCatholicUniversityofMilanMilanItaly.DeborahPhillipsPhDisamemberoftheDepartmentofPsychologyCatholicUniversityofMilanMilanItaly. 20MSFocusWinter2015Addinghealthyherbsandsupplementstoanydietcanimproveoverallmotorandcognitivefunctioningbutforthosewithmultiplesclerosisthesenaturaladditivescanbeespeciallyhelpful.ManydoctorssuggestnaturallyoccurringherbsandmineralstohelppatientscounteractcommonMSsymptoms.AlthoughtheyshouldnotreplaceprescribedmedicationstakingthesefollowingherbscanhelpyoumanageyourMSsymptomsbyreducinginflammationandstrengtheningtheimmunesystem.GingerGingerGingerisasweetsubstituteforhoneythatcanhelpalleviatemusclemuscleandjointpain.Asanaturallyoccurringanti-inflammatoryitcanreducetheinflammationaroundthenervesandmusclesthatcausesthestiffnessandphysicalpaincommonwithMS.Cuttingupgingerrootandaddingittosomeofyourfavoritemealsorchoosingtomakeawarmcupofteaoutofitcanbringdeliciousandhealthyimprovementstoyourdailylifestyle.ChamomileChamomileLikegingerchamomilecaneasetensionandrelaxmusclesbyreducinginflammation.Becauseofitsrelaxingtendenciesmanypatientschoosetodrinkitinatea.Thiscanprovetobeespeciallyeffectiveatnightifphysicalpainpreventsyoufromgettingafullnightssleep.Itssweettastealsomakesforadeliciouscakeorglazewhichcanbepairedwithfreshfruitforarefreshingsummertimesnack.DandelionDandelionDandelionisafinesubstituteforcaffeineandcanhelpalleviatethefatiguethatisbroughtonbythephysicalpaincausedbyMSsymptoms.Dandelioncomesinsupplementformforthosewaryofeatingaweedbutifyourewillingtotaketheriskdrinkingitinateaisahealthyoption.DandeliongreensarealsopopularByDarylH.Bryant 21MSFocusWinter2015DarylH.BryanthasbeensuccessfullymanaginghisMSfor14yearsandistheauthorofMSLivingSymptomFreeTheTrueStoryofanMSPatientabookthatcoverseveryaspectoflivingwithmultiplesclerosisfromcommonMSsymptomstothethingsdoctorsdonttellyouaboutMS.TodayDarylislivingahappyhealthyandsuccessfullifedespitehisMSandhewritesaweeklyblogonhowtomanageMSsymptoms.SOMETIMESYOUJUSTWANTTOTALKTOPEOPLEWHOGETITOurliveWebeventsfeaturemedicalexpertsandpeopletakingGILENYA.Askthemyourquestionsandhearwhattheyhavetosayinrealtimefromwhereveryoucanlogin.WeretalkingaboutthefactsonlineeveryTuesdayat400PMPT700PMETandThursdayat700PMPT1000PMET.Jointhediscussionandreserveyourspotatgilenyapatientprograms.comNovartisPharmaceuticalsCorporationEastHanoverNewJersey07936-10802014NovartisPrintedinUSA914T-GYA-1308467GILENYAisaregisteredtrademarkofNovartisAG.InaScottandRehshettaarepeoplewhotakeGILENYA.Theyarecompensatedfortheirtime.insaladsastheyarerichinirontohelpstrengthentheimmunesystemandprovideenergy.Youcanevenmixthemintohummusorpesto.WouldyouuseherbstohelpyoumanageyourMSThelistofherbsandsupplementsavailabletoMSpatientsisextensivebutremembertomoderateyourconsumptionoftheseplantsandvitaminsuntilyouarecertainofhowyourbodywillreacttothem.Theycanneveractasreplacementsforregularlyprescribedmedicationbutcanbeaddedtohelpalleviatetensionfatigueandotherconditionsthatarecausedbyorexacerbatesymptoms.Checkwithyourdoctorbeforeyoumakeanychangestoyourdietandremembertostopeatingsomethingifitmakesyoufeelill.Howeverifyourdoctorgivesyouthegreenlightherbscanbeagreatalternativeremedytohelpingyoureduceinflammationinyourbodyandultimatelymanageyoursymptoms. 22MSFocusWinter2015ADIRTYLITTLESECRETByKevinA.PorrecoADirtyLittleSecretprovidesagrippingpersonaltaleofhardshipstruggleandthefeelingofabandonmentasauthorKevinPorrecocomestotermswithbeinggivenupforadoptionbyhisbirthmotherlivinginadysfunctionalhomeenvironmentandlaterbeingdiagnosedwithmultiplesclerosisattheageof36.InAugustof1997Kevinwasanewlymarriedbusinessmanwithafast-growingcareerbutitallcametoahaltwhenageneralpractitionerandneurologistconfirmedthattheconstantnumbnessandtinglinginhislegsweresymptomsofMS.HavinghadMSsymptomsforatleasttwoyearsbeforebeingdiagnosedhegivesaglimpseintohiseverydaylifeandsharestheupsanddownsofhavingtodealwiththediseaseonset.Hecreditshisdiagnosisforhelpinghimcometotermswithhischaoticupbringingbringinghimclosertodiscoveringhistrueidentityandsolidifyinghisfaithinahigherbeing.Thisbookisforthosewhoarehopingtofindpeaceastheytransitionintothenextphaseoftheirlifewithachronicillnessorlovedoneswhowanttobetterunderstandtheillnessfromafirsthandaccount.Kevinsstoryalsogivesencouragingadviceoncopingthrivingandnotlettingyourlifecircumstancesdictatewhereyouultimatelyendup.OptimalHealthWithMultipleSclerosisAGuidetoIntegratingLifestyleAlternativeandConventionalMedicineByAllenC.BowlingMDPhDWithacomprehensiveapproachtolivingwellwithmultiplesclerosisOptimalHealthWithMultipleSclerosisAGuidetoIntegratingLifestyleAlternativeandConventionalMedicineprovidesdetailedinformationonconventionalmedicinealternativelifestyletreatmentsforthoselivingwithMSandhowsuchtreatmentsmayhelpalteronesdiseasecourse. 23MSFocusWinter2015ToborrowthisandothertitlescalltheMSFLendingLibraryat888-MSFocus673-6287orvisitwww.msfocus.org.ClickonLendingLibraryundertheProgramsandActivitiesheading.ThebookincludesaSeven-StepApproachtosuccessfullycreatingyourowntreatmentplanhelpfulstrategiesformakingdietaryandlifestylechangesandwaystocopewithcommonMSsymptomsincludingdepressionfatigueandanxietyusingcomplementaryandalternativemedicinetreatmentssuchasbiofeedbackhomeopathyyogaandothers.SomeofthesemethodsempowerpeoplebyallowingthemtousetheirbodysownresourcesfortherapeuticeffectssaidDr.AllenBowling.Throughreliabledatalessonsandresearchmethodologyreaderswillbenefitfromanunbiasedperspectiveastheymakeresponsibledecisionsregardingthemosteffectivetreatmentoptionsfortheirhealthandwell-being.LIGHTWEIGHTDISCREETCOMFORTABLEPOLARProducts1.800.763.8423www.polarproducts.comPolarProductsPolarProductsFashionablyCoolPolarProductsisaleadingworldwidemanufacturerofbodycoolingsystemsforMSandaproudsupplierfortheMSFCoolingProgramPolarsFashionCoolingVestsforMenandWomenareavailableinKhakiorBlackinsizesSmall-XXXLwithyourchoiceofKoolMaxPacksorCool58Packs.Decidewhichisbestforyouatwww.polarproducts.com.Iliveinthedesert.AnyonewithMScanrelatethateachsummermonthgetsmoredifficulttomanage.SoIfinallybrokedownanddecidedtogetaPolarfashioncoolingvest...BoyamIgladIdidIwaspleasantlysurprisedhowdiscreetthecoolinginsertswereandhowmuchbetterIfeltafterward.Trustme-itwontcrampyourstyleDontputitoff.Youllloveit.-TerriinCAsince1984 PERSPECTIVEonrelapsingMSChangeyour 2014BiogenIdec.Allrightsreserved.1214TEC-US-0074225BinneyStreetCambridgeMA021421-800-456-2255Tecfidera.comPRESCRIBEDPILLTHEforrelapsingMSintheUSsinceSeptember2013.1VisitTakeTecfidera.comorcall1-844-TalkTec1-844-825-5832TECFIDERAdimethylfumarateisaprescriptionmedicineusedtotreatpeoplewithrelapsingformsofmultiplesclerosis.ImportantSafetyInformationDonotuseTECFIDERAifyouhavehadanallergicreactionsuchasweltshivesswellingofthefacelipsmouthortongueordifficultybreathingtoTECFIDERAoranyofitsingredients.BeforetakingandwhileyoutakeTECFIDERAtellyourdoctoraboutanylowwhitebloodcellcountsorinfectionsoranyothermedicalconditions.WhatarethepossiblesideeffectsofTECFIDERATECFIDERAmaycauseserioussideeffectsincludingallergicreactionsPMLwhichisararebraininfectionthatusuallyleadstodeathorseveredisabilityanddecreasesinyourwhitebloodcellcount.YourdoctormaycheckyourwhitebloodcellcountbeforeyoutakeTECFIDERAandfromtimetotimeduringtreatment.ThemostcommonsideeffectsofTECFIDERAincludeflushingandstomachproblems.Thesecanhappenespeciallyatthestartoftreatmentandmaydecreaseovertime.TakingTECFIDERAwithfoodmayhelpreduceflushing.Callyourdoctorifthesesymptomsbotheryouordonotgoaway.AskyourdoctoriftakingaspirinbeforetakingTECFIDERAmayreduceflushing.ThesearenotallthepossiblesideeffectsofTECFIDERA.Callyourdoctorformedicaladviceaboutsideeffects.YoumayreportsideeffectstoFDAat1-800-FDA-1088.Formoreinformationgotodailymed.nlm.nih.gov.Tellyourdoctorifyouarepregnantorplantobecomepregnantorbreastfeedingorplantobreastfeed.ItisnotknownifTECFIDERAwillharmyourunbornbabyorifitpassesintoyourbreastmilk.Alsotellyourdoctorifyouaretakingprescriptionorover-the-countermedicinesvitaminsorherbalsupplements.ForadditionalimportantsafetyinformationpleaseseePatientInformationonthefollowingpage.Thisisnotintendedtoreplacediscussionswithyourdoctor.Duringa2-yearstudyTECFIDERAcutrelapsesinhalfreducingriskofrelapseby49comparedtoplacebo.BasedonnumberofprescriptionsfromIMSNPAWeeklyDataSeptember272013-September192014.TECFIDERAisanoraltreatmentforrelapsingmultiplesclerosisMS.Ithasbeenshowntonotonlycutrelapsesinhalfbutalsoslowthedevelopmentofbrainlesionsanddelaytheprogressionofphysicaldisability.ThousandsofpeoplearoundtheworldhavetakenTECFIDERA.Askyourdoctorifyoushouldtoo.ConsiderTECFIDERAapillthathasthestrengthtocutrelapsesinhalf. PatientInformationTECFIDERAtekderahdimethylfumaratedelayed-releasecapsulesWhatisTECFIDERATECFIDERAisaprescriptionmedicineusedtotreatpeoplewithrelapsingformsofmultiplesclerosisMSItisnotknownifTECFIDERAissafeandeffectiveinchildrenunder18yearsofageWhoshouldnottakeTECFIDERADonotuseTECFIDERAifyouhavehadanallergicreactionsuchasweltshivesswellingofthefacelipsmouthortongueordifcultybreathingtoTECFIDERAoranyofitsingredients.Seebelowforacompletelistofingredients.BeforetakingandwhileyoutakeTECFIDERAtellyourdoctorifyouhaveorhavehadlowwhitebloodcellcountsoraninfectionanyothermedicalconditionsTellyourdoctorifyouarepregnantorplantobecomepregnant.ItisnotknownifTECFIDERAwillharmyourunbornbaby.IfyoubecomepregnantwhiletakingTECFIDERAtalktoyourdoctoraboutenrollingintheTECFIDERAPregnancyRegistry.Youcanenrollinthisregistrybycalling1-866-810-1462orvisitingwww.tecderapregnancyregistry.com.Thepurposeofthisregistryistomonitorthehealthofyouandyourbaby.breastfeedingorplantobreastfeed.ItisnotknownifTECFIDERApassesintoyourbreastmilk.YouandyourdoctorshoulddecideifyouwilltakeTECFIDERAorbreastfeed.takingprescriptionorover-the-countermedicinesvitaminsorherbalsupplementsHowshouldItakeTECFIDERATakeTECFIDERAexactlyasyourdoctortellsyoutotakeitTherecommendedstartingdoseisone120mgcapsuletakenbymouth2timesadayfor7daysTherecommendeddoseafter7daysisone240mgcapsuletakenbymouth2timesadayTECFIDERAcanbetakenwithorwithoutfoodSwallowTECFIDERAwhole.Donotcrushcheworsprinklecapsulecontentsonfood.ProtectTECFIDERAfromlight.Youcandothisbystoringthecapsulesintheiroriginalcontainer.ThrowawayopenedTECFIDERAafter90days.WhatarethepossiblesideeffectsofTECFIDERATECFIDERAmaycauseserioussideeffectsincludingallergicreactionssuchasweltshivesswellingofthefacelipsmouthortongueordifcultybreathingPMLararebraininfectionthatusuallyleadstodeathorseveredisabilitydecreasesinyourwhitebloodcellcount.YourdoctorshoulddoabloodtestbeforeyoustarttreatmentwithTECFIDERAandwhileontherapy.ThemostcommonsideeffectsofTECFIDERAincludeushingrednessitchingorrashnauseavomitingdiarrheastomachpainorindigestionFlushingandstomachproblemsarethemostcommonreactionsespeciallyatthestartoftherapyandmaydecreaseovertime.TakingTECFIDERAwithfoodmayhelpreduceushing.Callyourdoctorifyouhaveanyofthesesymptomsandtheybotheryouordonotgoaway.AskyourdoctoriftakingaspirinbeforetakingTECFIDERAmayreduceushing.ThesearenotallthepossiblesideeffectsofTECFIDERA.Callyourdoctorformedicaladviceaboutsideeffects.YoumayreportsideeffectstoFDAat1-800-FDA-1088.Formoreinformationgotodailymed.nlm.nih.gov.GeneralinformationaboutthesafeandeffectiveuseofTECFIDERAMedicinesaresometimesprescribedforpurposesotherthanthoselistedinthisPatientInformation.DonotuseTECFIDERAforaconditionforwhichitwasnotprescribed.DonotgiveTECFIDERAtootherpeopleeveniftheyhavethesamesymptomsthatyouhave.Itmayharmthem.Ifyouwouldlikemoreinformationtalktoyourdoctororpharmacist.YoucanaskyourdoctororpharmacistforinformationaboutTECFIDERAthatiswrittenforhealthcareprofessionals.WhataretheingredientsinTECFIDERAActiveingredientdimethylfumarateInactiveingredientsmicrocrystallinecellulosesiliciedmicrocrystallinecellulosecroscarmellosesodiumtalcsilicacolloidalsilicondioxidemagnesiumstearatetriethylcitratemethacrylicacidcopolymer-TypeAmethacrylicacidcopolymerdispersionsimethicone30emulsionsodiumlaurylsulphateandpolysorbate80.CapsuleShellgelatintitaniumdioxideFDCblue1brilliantblueFCFyellowironoxideandblackironoxide.ManufacturedbyBiogenIdecInc.CambridgeMA02142www.TECFIDERA.comorcall1-800-456-2255ThisPatientInformationhasbeenapprovedbytheU.S.FoodandDrugAdministrationIssued122014 DeniseMullerIhavecopedwithmilddepression.Ihavechronicimbalance247.Itwearsonyou.Myattitudeisgreatgetthehelpyouneedandbethebestyoucanbe.Howeverattimesitcanbeverydaunting.VickieMartinYesIhavecopedwithdepressionseveraltimesovertheyearsdiagnosedin1986.OnceIwasoutofworkforsixmonthsduetodepression.ThereweretimesthatIwantedtokillmyselfbecauseofmyissueswithMS.ItalkedmyselfoutofharmingmyselfbecauseIknewnooneelsewouldtakecareofmykids.Imfinenowbutthedepressiondemoncanstrikeagain.JamesMonaPrescriptionmedsKathyCrudeleIusearomatherapyalongwithyogaforMS.Alwaysremembertosurroundyourselfwiththepositive.MarissaBenniTranscendentalMeditation.WorthatryKirstinBsecretIjustmoveon.DepressionIthinkistellingmesomething.Listenandthenfeelituntilitgoes.Trytotakeactionasneeded.Thatisit.AmyFarrahFowlerVegaThedepressionaspectofitscaresmesomuch.TherewasatimeaboutayearandahalfagothatIwouldntallowmyselftodriveoverbridgesthatwerenearmebecausethedesiretodriveoffofonewasjusttoogreat.Iwouldliterallydrive30minutesoutofmywaytogetaroundgoingovercertainbridgesandinthatactionIrealizedthatIreallydidntwanttodiebutthatdepressionhadastronggriponme.WhenIamfeelingthiswayIvoiceittofriendsandfamilysothattheyareawareandIcanholdontothemjustalittlebittighter.DonnaMartyPadulaTheBibleandprayer.Lotsofprayer.PennyMcBlaneAkeIhavelearnedtousethelawofattractionusingapositiveattitudebychoicenotchance.Ihavetrainedmybraintoseegoodevenwhenthereisbad.Itworksifyoupracticeitlongenough.Itsnoteasyanditisntquick.IsufferedfromdepressionlongbeforemydiagnosiswithMSsoIknowthestruggleisreal.MSFocusWinter201527FacebookFeedbackisyourchancetoshareinadvanceyourexperiencesrelatedtotopicscoveredintheMSFocus.LikeourFacebookpageatwww.facebook.comMultipleSclerosisFoundationandwatchforournextFacebookFeedbackpost.OurquestionforthiseditionwasHowhaveyouorsomeoneyoucareforcopedwiththeeffectsofdepressionConnectwithus.ShareyourthoughtsandinsightswiththeMScommunityonourFacebookpages.Likeusatwww.facebook.comMultipleSclerosisFoundationandwww.facebook.comgroupsmsfocus. MSFocusWinter201528TheMSFBrighterTomorrowGrantProgrammakesdreamscometrueforindividualswithmultiplesclerosisthroughoutthecountry.Thegoalofthegrantistoprovideanitemorservicevaluedbetween1and1000perrecipienttoimprovequalityoflifebyenhancingsafetyself-sufficiencycomfortorwell-being.Applicantsareaskedtoprovidebasicpersonalandfinancialinformationandtowriteabriefessayof100wordsorlesstodescribehowthegrantwouldhelpthemhaveABrighterTomorrow.Forsomequalityoflifeisimprovedwithitemsthatarefunctionalforothersitisachievedwithrecreationalactivitiesorhobbiesthatenhanceasenseofwell-being.ThisyeartheMultipleSclerosisFoundationspentatotalofjustmorethan31000tomaketomorrowbrighterfor71MSpatients.Appliancesandfurniturewerethetopneedstobefulfilledwithmanyseekingtoreplaceagingmattresses.Electronicsexerciseitemshobbysuppliesandgiftcertificateswerenextonthelistofneeds.Andthentherewereanumberofitemssuchastiresandatelescopethatdidntfitneatlyintoanycategory.Thefollowingstoriesof2014grantrecipientsillustratethevarietyofusesforthegrantthoughalltheseusesledtoabrightertomorrowfortherecipients.Manyofustakebeingabletodobasicmundanethingsforgrantedsuchaslaundryandcooking.Washingmachinesanddryersweregreatlyinneedaswerefreezersrefrigeratorsandovens.Formanyapplicantssomethingassimpleasnewapplianceswasenoughtomaketheirtomorrowsbrighter.IntheWashMichaelJ.VarinoofKennerLa.wasadrillingfluidsengineerintheoilindustrybeforebeingdiagnosedwithMSinFebruary2000.Whilethefirstthreeyearswerereallyroughhecontinuedtobeamanofstrongfaithandexperiencedaperiodofremissionfrom2003-13.Howeveralotofthingshappenedrecentlyatriplewhammyashelikestodescribeit.HiswashingmachinebrokedownhewasattackedbyadogandanMRIfoundanewlesion.Itwasverydifficultduringthatperiodduringthesummer.Gettinganewfront-loadwashingmachinemadeadifference.Itbrightenedupmytomorrow.Itboostedmyconfidenceandoutlookthattherearegoodpeopleoutthere.Itisallowingmetotakecontrolratherthanletthediseasecontrolme. MSFocusWinter201529GettingtheWashingDoneAlisonScofieldswashingmachinediedfouryearsago.AlltheStratfordConn.nativecouldaffordtowashatalaundromatweretwoloadsweekly.Manyofherclothesandlinensneededtobereplacedsincetheyremainedunwashedinherspareroom.Alisonwasawardedatoploadwasher.AfteraboutfouryearswithoutoneandstrugglingtodraglaundrytothelaundromatorafriendshousetheMSFgrantedmyapplicationandIgotmynewwasheraboutthreemonthsagoshesaid.ItssomucheasiertodomywashathomewhereIcanrestwhenIneedtoandfoldthematmyleisure.Muchlessstruggle.InTimefortheHolidayOntheeveofThanksgivingAnthonyDotteryandhiswifeof36yearsSheliawereputtingtheirnewKenmoregaswalloventhroughitspaces.Theywerepreparingtoservemanyfamilymembersfortheholiday.ItsdoingitsjobaswespeakSheliasaid.Itsmellsgoodinhereandhejustcantwait.UntilrecentlytheDotterysofAtlantadidnthaveaproperlyworkingovenanddidnothavethefundstogetitrepaired.TheBrighterTomorrowGrantchangedallofthatanditmadeadifferencejustintimefortheholiday.AccordingtoSheliaTheoventookabigcloudoffofmeandhimworryingabouthowweweregoingtomanagewithoutoneinthehouse.Ithaseasedsomeoftheburdenswevebeenhaving.Afewapplicantsneededconsumerelectronics.Forsomethismeantlarge-screentelevisionsthatwouldallowthemtoseemoreeasily.ForothersthistranslatedintoiPadsandtabletsthatwouldallowthemtobettercommunicate.JordanClevelandwasoneofthelatter.IPadACommunicationToolJordanClevelandofPortageInd.wasdiagnosedwithMSin2009.Theprogressionofthediseasetookawayhisabilitytospeak.HiscurrenthighschoolallowstheuseofaniPadbutwhenhegraduatesthatwillhavetobegivenbacktotheschool.WithouttheiPadhehasnorealwaytocommunicatewithothers.ButthatallchangedwhentheMSFawardedJordanathirdgenerationiPad.HenowhashisowniPadsaidJordansmotherKelleeWaters.HeusesittotalkbyusinganAppleappwhichinvolvestypingontheiPadandconvertingwhathetypesintoavoice.Jordansdeviceismountedonhiswheelchairandhehasalsobeenusingittoshootphotos.Hewenttothemilitaryballandsnappedupabunchofphotossheadded. MSFocusWinter201530Exerciseisanimportantcomponenttocopingwithmultiplesclerosis.Runningshoesmassageandequipmentgoalongwaytostayinghealthy.Forsomeitisapartoftheprescribedcopingregime.Butnoteveryonecanaffordthenecessitiestostayfit.StepbyStepForCynthiaHodgesofNorthLittleRockArk.atreadmillwouldallowhertoexerciseathomesincesheisunabletoattendoraffordanexerciseprogramnorthecopayforphysicaltherapyservices.Ibelievethebenefitofexerciseonatreadmillwouldimprovemyhealthandprovideweightcontrolshesaid.Cynthiawasawardedatreadmill.Noteveryrequestfellintoaclearcategory.Somerequestswerehobby-related.Otherswereabitfartherafield.Theseincludedaseptictankelectronickeyboardcartiresandawig.WithStringsAttachedPriortobeingdiagnosedwithMSinJanuary1995LouiseCurtisSeidlofAshevilleN.C.wasengagedinpart-timesingingandstorytellingtochildreninprimaryschoolsandlibrariesinadditiontoteaching.AsherMSsymptomsworsenedshehadtolimitherperformances.Shewaseventuallyforcedtogiveupherteachingjobandstopdriving.Playingtheguitarandsettingupheramplifiersoonbecametoounwieldy.Practicingwithafriendsukuleleshediscoveredshecouldplayitfromherwheelchair.HowgreatitwouldbeifIcouldpurchaseagoodqualityukulelewithapick-up.ThenIcouldresumeperformingshesaid.LouisewasnotifiedthatherwishforaMartinC1KConcertUkulelewasgranted.Itsabeautifulukulele.Itssmallenoughtoplayfrommywheelchairshesaid.TheinstrumenthasmadeLouiseslifebrighter.IabsolutelyloveitTheArtofCraftingSusanSilverofThorntonColo.usedtomakecraftsforherfamilyfriendsandhome.BecauseofherMSsheisnotabletocraftasoften.Cuttingandstampingisdifficultbecauseofshakinessandfatigue.SheaskedfortheCricutExplorerMachineSet.Thismachineandsetwillhelpmegetcraftingagain.ThemachinewillcutformeandIwillnothavetostampasoftenshesaid.TheFoundationgrantedherBrighterTomorrowrequest.ThankyousomuchfortheCricutExplorermachineandstarterpack.NowIcangetbacktodoingmoreofthecraftsIloveThankyouagainforgivingmeabrightertomorrow 31MSFocusWinter2015SittingontheDockAt58yearsoldRandyL.WoodofAlbanyGa.ledaveryhealthylifeuntiltheonsetofMSinNovember2000.Aloverofallkindsofnaturehecurrentlylivesonalakewithadockwherehiswifefishesalmosteveryday.Theproblemisthatsincebecomingwheelchairboundhecouldonlywatchherfromadistancebecauseofagrassyandsandyareanearthedock.Hedreamedofhavingarampbuilttotheexistingdocksohecouldenjoytimewithhiswifeonceagainnotjustwatchingfromfaraway.TheMSFgranthelpedRandymakethehomemodificationhesought.Thatmadeitrealniceforbothofus.TheinstallationtookaweekandprovidedRandyandhiswifeanopportunitytodosomefishingbeforetheannuallakeloweringinOctoberfordockmaintenance.OneWomansBestFriendBeforebeingdiagnosedwithMSLauraTendlerofSeminoleFla.wasaworkingpsychologistandshewasveryactive.HavingMShaschangedLauraslifebutadognamedBellachangeditagain.DescribingherasaGermanShepherdontheoutsidebutaGoldenRetrieverontheinsideBellaisLaurasservicedogintrainingwiththeNewHorizonsServiceDogInc.sownertrainerprograminFlorida.Afteroneyearoftrainingtheyhavebeenapprovedtoattendthetwoweekcertificationtestclasswhichcosts500andisrequiredtobecomeastaterecertifiedservicedoginFlorida.Bellagraduatedatthetopofherclassfromthecertificationclass.HavingBellahasallowedLauratobemoremobile.Imexcitedtogooutnow.Imlessworriedaboutfallingnow.Usingherforthelastyeareveryonecanseethedifference.Ihavebetterstrengthbetterbalance.Itsverylife-changing.ImjustsothankfulandappreciativethattheMSFevenofferstheopportunityforpeoplelikemetogetassistance.ApplicationsfortheBrighterTomorrowGrantareacceptedfromJune1toSept.1ofeachyear.ForfurtherinformationontheBrighterTomorrowGrantcallourProgramServicesDepartmentat888-MSFOCUS673-6287.Youcanalsocontactusbyemailatsupportmsfocus.orgorvisitourwebsiteatwww.msfocus.orgBrighter-Tomorrow-Grant.aspx. 32MSFocusWinter2015ByAlissaAydenTheMultipleSclerosisFoundationIndependentSupportGroupNetworkisgrowingPleasewelcomethefollowingnewly-affiliatedgroupsHuntleyMSSupportGroupHuntleyIll.MSSupportGroupofPensacolaPensacolaFla.MSSurvivorsofthePeeDeeAreaSupportGroupHartsvilleS.C.NewGenerationofMSNassauSupportGroupLevittownN.Y.NewGenerationofMSSuffolkSupportGroupMelvilleN.Y.TalkingtoInspirePeopleMSSupportGroupVeroBeachFla.WestBrowardMSSupportGroupWestonFla.Pleasevisitourwebsiteatwww.msfocus.orgsupport-groups.aspxforthemeetingdatestimesandlocationsoftheabovelistedsupportgroupsortofindthesupportgroupclosesttoyou.AswebeginthenewyearIencourageallofyoutogetconnectedwithyourlocalMSF-affiliatedsupportgroupevenifyouarentsureyoullbeabletoattendeverymeeting.MostofthemagichappenswhenagroupofpeoplewithMSgathertogethertoshareMSexperiencessympathizewitheachothersfrustrationsandcelebrateeachotherstriumphs.HowevertheresstillagreatdealofmagicthatcanhappenbymakingconnectionswithotherpeoplewithMSinyourareaviaemailorphonein-betweenmeetings.Iurgeyoutoreachouttoyourlocalsupportgroupleaderandintroduceyourself.AsktobeaddedtohisorhergroupsemaillistandsignedupfortheMSFsmailinglistsothatyoucanstayinformedofthesupportgroupshappenings.Manysupportgroupleadersalsosharenewsarticleslocaleventsinterestinginformationandhelpfulresourceswiththeirmembersviaemailthroughoutthemonth.SupportgroupsalsoserveasawaytoforgefriendshipswithotherpeoplewithMSinyourareasothatyoullhavepeerstocalltextoremailwhenyouwanttotalkwithsomeonewhowillactuallyunderstandhowyourefeelingonanygivenday.ByconnectingwithanMSsupportgroupthisyearIbelieveyoullfindthatwereallstrongerinourjourneysthroughlifewithMSwhenweretravelingtogether.TolearnmoreabouttheMSFsSupportGroupProgramandhowyoucanapplytostartoraffiliateyoursupportgrouppleasecontactmeviaphoneat888-MSFOCUS673-6287orviaemailatalissamsfocus.org.Ilookforwardtohearingfromyou 45MSFocusSummer2014 35MSFocusWinter2015MSCoalitionReleasesNewConsensusPaperSummaryTheMSCoalitionreleaseditsnewconsensuspaperandsummaryTheUseofDisease-ModifyingTherapiesinMultipleSclerosisPrinciplesandCurrentEvidencetohelpmembersoftheMScommunitynavigatetheinformationthatexistsonavailabletreatments.ThepaperdescribeswhatiscurrentlyknownaboutdiseasemodificationandseekstobolsterpatientaccesstoFDA-approveddisease-modifyingtherapies.Thesummaryoffersinformationinabriefsynopsis.Theconsensuspapertreatstopicsindepth.BothversionsaredesignedaseducationandadvocacytoolswhenapproachingyourinsureronissuesoftherapiestomanageMS.DownloadthepaperandorsummaryfromtheResourcespageofwww.ms-coalition.org.TheMultipleSclerosisFoundationisafoundingmemberoftheMultipleSclerosisCoalition.ProgramHelpsYouKeepYourCoolManypeoplewithMSexperienceweak-nessfatiguevisualdisturbancesandothersymptomswhentheybecomeoverheated.TheMSFCoolingProgramoffersavarietyoffreeitemsincludingbandanasnecktieshatswristbandsandtwotypesofcoolingveststohelpyougainrelieffromheat-inducedsymptomsandmaintainyouractivelifestyle.ApplicationsareacceptedfromFeb.1toJune1.Seetheapplicationonpage41orapplyonlineatwww.msfocus.org.TheProgramServicesDepartmentcanmakeadditionalapplicationsavailableviaemailfaxormail.Call888-673-6287oremailsupportmsfocus.org.MakingSomeNoiseMSFocusRadiowillbebringingyouexcitingnewprogrammingintheweeksahead.BeginninginJanuaryMSFocusRadiowillbroadcastMSDiscoveryanewcollaborativeprogram.AdditionallytheBooksonRadiosegmentwillfeatureworksfromtheNewWorldLibraryauthorsEckhartTolleShaktiGawainandDanMillman.InOurOfficeTheProgramServicesDepartmentspotlightsindividualswhohelpbridgetheFoundationandourcommunity.InthiseditionwefocusonDebraForman.Debrahasbeenavolunteerfor30yearsinadditiontobeingemployedinthemedicalhighereducationandfuneralindustries.DebrahasbeenemployedbytheMSFforthepasttwoyears.SheistheEducationalProgramsCoordinatorandforthelastyearhasalsobeenthecoordinatorfortheAmbassadorprogram.DebradesignsandcoordinatestheeducationalprogramsthattheFoundationhoststhroughouttheU.S.andsheistheliaisonbetweentheMSFandits54volunteerambassadors.SheisagraduateofFloridaInternationalUniversity. MSFocusWinter201536TeamFearlessMSAdvocatesUniteisourthemeforthe2015NationalMultipleSclerosisEducationandAwarenessMonthNMSEAMinMarch.AreyoureadytouseyourvoicetomakeadifferenceforpeoplewithMSJointheMSFsgovernmentadvocacyinitiativesnowNospecialskillsorexperiencearerequiredjustaninterestinspeakingupabouttheMScausetoyourstateofficialsandlegislators.WhataresomewaystohelpHelptheMSFreachthegoalofnationwideobservanceofthiscampaignbyrequestingitberecognizedinyourstate.FormanadvocacyactioncommitteewithothersaffectedbyMSinyourcommunitytobereadytorespondquicklytocallsforactionfromtheMSFandpartneragencies.VisityourstatelegislatorstointroducesamplelegislationbenefitingthoseaffectedbyMS.Wellprovideyouwiththeinformationandtoolsyouneedandworkwithyoueachstepoftheway.ThereisstrengthinnumbersDuringthisAwarenessMonthandbeyondletsworktogether.TeamFearlessMSAdvocatesUniteTolearnmoreortoreceiveaMSAwarenessKitpleasecall888-MSFOCUS673-6287orvisitwww.msfocus.org.AdvocatesUnite2015NationalMultipleSclerosisEducationandAwarenessMonthWhatIsNationalMSEducationandAwarenessMonthNationalMSEducationandAwarenessMonthisaneffortbytheMultipleSclerosisFoundationMSFtoraisethepublicsawarenessofmultiplesclerosis.ThevitalgoalsofthiscampaignaretopromoteanunderstandingofthescopeofthisdiseaseandtoassistthosewithMSinmakingeducateddecisionsabouttheirhealthcare.EffortstoraiseawarenessofMStakeplaceacrossthecountry.AwarenesskitsandinstructionsareavailablefromtheMSFforthosewhowishtobecomeinvolvedintheeffort.AnyoneaffectedbyorinterestedinlearningmoreaboutMSisinvitedtoparticipateinactivitiesandtobroadentheirunderstandingofMSthroughoutthemonth.AllMSorganizationsareencouragedtoparticipate. ENTEROURMSSUPERHEROCONTESTAssembleyoursidekicksandsuitupforNationalMSEducationandAwarenessMonth.ThisyearsthemeisTeamFearlessMSAdvocatesUniteNosuperhumanpowersneededParticipateinourMSSuperheroContestAniPadwillbeawardedtothefirstplacewinnerineachcategory.WinnerswillalsobefeaturedinMSFocus.Nominateyourheroinonecategoryonly.Ifyouwishyoumaynominateadifferentheroineachcategory.ThecategoriesareTheMSSuperheroanypersondiagnosedwithMSwhodealsheroicallywiththeirdiseaseortakesheroicactiononthepartofothers.AnAdvocateofCaliberapersonwhoadvocatesforsomeonewithMS.TheymaybeaspecialfamilymemberorfriendwhohelpssomeonewithMSinanycapacity.OrtheymaybeapersonwhotakespersonalorpoliticalactiononbehalfofapersonswithMS.CaptainHealthcareanyhealthcareprofessionalwhoservesindividualswithMSandgoesaboveandbeyondthecallofduty.Applicantsareaskedtosubmitanessayof500wordsorlesstodescribetheirheroandwhytheyhavedecidedtonominatethem.OfficialGuidelinesEntriesmustmeetthefollowingcriteriaSendyourcompletedapplicationtoTheMultipleSclerosisFoundationAWARENESSCOMMITTEE6520NorthAndrewsAve.FortLauderdaleFL33309Applicationscanalsobesubmittedonlineatwww.msfocus.org.Additionalapplicationscanbeobtainedbycalling888-MSFOCUS673-6287.Applicantsmustnominatetheirheroinonecategoryonly.Howeverapplicantmaynominateadifferentheroineachcategory.ApplicantandheromustgranttheMSFtherighttousetheirnameandphotographforpromotionalpurposes.Applicantandheromustagreetosignadisclaimer.ApplicantandheromustbelegalresidentsoftheUnitedStates.Applicationmustbepostmarkedtime-stampedonorbefore03312015. NomineeinformationNAME______________________________________________________________________ADDRESS___________________________________________________________________CITY__________________________STATE_____ZIP________COUNTY_________DAYPHONE____________________ALTERNATEPHONE_____________________EMAILADDRESS___________________________________NominatedbyNAME______________________________________________________________________DAYPHONE____________________ALTERNATEPHONE_____________________EMAILADDRESS___________________________________In500wordsorlessexplainhowthepersonyouarenominatingisanMSSuperheroanAdvocateofCaliberorCaptainHealthcare.Additionalpapermaybeusedifneeded.Icertifythatthefactscontainedinthisentryaretrueandcompletetothebestofmyknowledge.Signature________________________________________________Date______________MSSUPERHEROENTRYFORM MSFocusWinter201539ThisspringtheMSFwillchoosepeoplewithMSfromaroundthecountrytoserveasambassadors.ThesepeoplewillbecomeleadersintheMScommunitybyRepresentingtheMSFintheirlocalcommunity.AttendinglocalandregionalMSFevents.Speakingatsupportgroupsandhealthfairs.ParticipatinginpublicoutreachandmoreSelecteeswillhavethechancetoparticipateinleadershiptrainingtohelpthembecomeadvocatesforMSawarenessandworkcloselywiththeMSFtohelpmeettheiradvocacygoals.SotellushowyouwouldgetthewordoutBecreativewriteanessayrecordavideoincludephotosordoaslideshowpresentation.Applicationscanincludeanessayvideoormixed-mediapresentation.Essaysmustbe1000wordsorless.Videosarelimitedtofiveminutes.PhotosvideosessaysandothermaterialssubmittedtotheMSFwillnotbereturned.Entriesmustbepostmarkedortime-stampedbyApril152015.AmbassadorsgranttheMSFtherighttousetheirnameandphotographinconnectionwiththisprogram.AmbassadorsmaybeaskedbutarenotobligatedtotravelwithintheirregiontoattendMSFprograms.AmbassadorsmaybeaskedbutarenotobligatedtospeakwithmembersofthemediaaboutMS.OfficialGuidelinesEntriesmustmeetthefollowingcriteria 40MSFocusWinter2015MSFAMBASSADORENTRYFORMName________________________________________________________________________Address______________________________________________________________________City_______________________________State__________________Zip______________DayPhone__________________________AlternatePhone_________________________EmailAddress________________________________________________________________AreyoucomfortabletalkingaboutyourpersonalexperiencewithMSKYesKNoAreyounoworhaveyoubeeninthepastaspokepersonforaKYesKNopharmaceuticalcompanyoranotherMSorganizationIfyespleaseindicateforwhomyouserved_____________________________________AreyouwillingtotraveltoattendMSFeventsanddoyouhaveKYesKNoaccesstotransportationtodosoPleaseattachthisformtoyourentry.YoucanenterthecontestthreewaysKEssayLimitof1000wordsorfewer.KVideoPresentationLimitoffiveminutesorless.KMultimediaPresentationSlideshowpresentationusingtextpicturesandorsound.BeascreativeasyoulikebutyourentrymustanswerthefollowingquestionsAWhydoyouwanttobeaMSFAmbassadorBHowhasMSaffectedyourlifeonadailybasisCWhatpastMSawarenessactivitieshaveyouparticipatedinDWhatisthemostimportantmessagetogetoutaboutMSandhowwouldyoudoitEntrieswillbeacceptedthroughthemailandonline.Bothmustbereceivedortime-stampedbyApril152015.Seewww.msfocus.orgforinstructionsforsubmittingyourapplicationonline.VideoentrieswillbeacceptedinvideoorDVDformatormaybeuploadedtotheMSFonwww.youtube.comuserMSFstaffasavideoresponsetothecallforentries.MultimediapresentationsmaybesubmittedasPowerPointfilesorauto-executablefilesonCDorDVD.SelecteeswillbenotifiedbyMay152015.MailtoTheMultipleSclerosisFoundationAwarenessCommittee6520NorthAndrewsAve.FortLauderdaleFL33309Additionalapplicationscanbeobtainedbycalling1-888-MSFOCUS673-6287. MSFocusFall201443COOLINGPROGRAMCOOLINGPROGRAMQUALIFICATIONAPPLICATIONPleasePrintLastName____________________________________FirstName_____________________________StreetnoPOboxes____________________________________________________Apt.___________City______________________________County_______________State________Zip___________Phone____________________Email________________________DateofBirth_______________AlternateContact_______________________Relationship____________Phone_____________PhysiciansName__________________________________________________Phone_____________WhenwereyoudiagnosedwithMS_____________Currentmajorsymptoms_____________________________________________________________________________________________________PleaseincludeawrittenconfirmationofdiagnosisofMSfromyourphysician.DoyouoryourspousehavemedicalinsuranceIMedicareIMedicaidIPrivatecarrierMonthlygrossincome_________Monthlyexpenses_________Disposableincome________ChooseOneOptionOnly____SteeleCoolingVestKitSizeIOnesizefitsall-ColorINavyITan____PolarCoolComfortEvaporativeKitfullvestnecktiewristbandsSizeISIMILIXLIXXLIXXXL-ColorIBlueITanHatIbuckethatIbaseballcapIstrawhat____PolarFashionVestKitfullvesthatnecktie-ColorIBlackITanIFemaleVestIMaleVest-SizeISIMILIXLIXXLTypeofCoolingPackIKoolMaxWater-BasedCoolingPackI58DegreeFPhaseChangePack____HeatReliefDepotAccessoryPackagehatnecktiewristbandsHatSizeISIMILIXL-ColorINavyIKhakiFOROFFICEUSEONLYIVHIVFIHINTBIPhnwIIherebyreleaseandholdtheMultipleSclerosisFoundationInc.harmlessfromagainstandinrespectofallclaimsinjuriesactionsdemandssuitslossesliabilityorotherdamagesthatmaybeincurredasaresultofacceptinggoodsorservices.PatientSignature____________________________________Date___________SendyourcompletedapplicationtoTheMultipleSclerosisFoundation6520NorthAndrewsAvenueFortLauderdaleFL33309 42MSFocusWinter2015Theever-changinglandscapeoffederalregulationsmedicaltechnologyandinsurancecoveragecanmakeonesheadspin.Thiscolumnspotlightsgovernmentresourcesavailabletoqualifyingpeoplewhohavemultiplesclerosisandotherchronicillnesses.VeteransAgenciesProvideHelpForAllYoumaybeawarethathealthservicesareavailableforveteransbutdidyouknowthereareanumberofservicesavailablespecificallyforveteranswithMSAndthatsomeofthoseservicesareavailabletonon-veteranstooTheU.S.DepartmentofVeteranAffairsrecognizesmultiplesclerosisasadevastatingcondition.TheMultipleSclerosisCentersofExcellencearededicatedtofurtheringunderstandingofmultiplesclerosisitseffectonveteransandpromotingeffectivetreat-mentstohelpmanageMSsymptoms.Theirwebsitewww.va.govmsoffersnewsandtopicsnotonlyforveteransbutanyonesufferingfromMS.TheParalyzedVeteransofAmericafoundedin1946isacongressionally-charteredveteransserviceorganization.VeteranswithMSareeligibleformanyservicesbeginningwiththeProstheticandSensoryAidsService.AlsoavailableistheHomeImprovementsandStructuralAlterationsprogramthatwillpayforhomealterationsforaservice-connecteddisabilityandisalifetimebenefitforotherveterans.TheSpeciallyAdaptiveHousinggrantassiststomakeapatientshomewheelchair-accessible.ForspecificlossesofhandmobilityandblindnessthereistheSpecialHousingAdaptationsgrant.Findinformationattheirwebsitewww.pva.orgorcall800-232-1782.NextthereistheNationalVACaregiverSupportHotlineforcaregiversandfamilymembersdealingwithchronicillness.Thetoll-freehotlinenumberis855-260-3274anditsopen8a.m.11p.m.ESTMondaythroughFridayand1030a.m.6p.m.onSaturday.AnyonewithMScanbenefitfromfreemonthlyconferencecallsandlearnfirst-handaboutMSfromMSexpertsandotherhealthcareprofessionals.Discussedareavarietyofeducationaltopics.ToparticipateonthefourthMondayofeverymonthcall800-767-1750accesscode43157.AnyoneinterestedinreceivingfreeDVDscancallatoll-freenumberandlearnaboutMSintheprivacyoftheirownhome.SomeofthetopicsofferedareModifiableRiskFactorsStayingMobileWithMSandMSCognitionandBrainImaging.Call800-463-6295ext.7133orsendanemailtoAngela.Young4va.gov.MedicalcareforeligibleveteranswithMSincludesdisease-modifyingtherapiesphysicalandoccupationaltherapyotherhealthcareservicesand 43MSFocusWinter2015medicalequipment.TheVAhasledthewayinrehabilitationmedicineandtheseservicesareavailabletoveteranswithMS.Toenrollgotowww.va.govhealthbenefitsorcalltheVAat877-222-8387.VeteranswithsymptomsofMSinthemilitaryorwithinsevenyearsafterhonorabledischargemaybeeligibleforservice-connecteddisability.LetusknowwhatyouthoughtofthisarticleEmailyourcommentstoeditormsfocus.orgormailtotheaddressonthebackcoverAttnMSFocusLettersColumn.ListentotheSoundofOurVoicesonMaybeyouorsomeoneyoucareforhaveastorytotellanunforgettableexperiencelinkedtoMS.Maybethatstoryjustcriesouttobesharedwiththecommunity.OrperhapsyoursisasimpletaleofcopingwithMStowhichotherscanrelate.ThatiswhattheVoicesfeatureisallabout.Wesharethestoriesofpeoplejustlikeyouwithourlisteningaudience.MSFocusiscontinuallyseekingyourpersonalstoriesforbothprintandradio.Forprinttheyshouldbenomorethan800wordsinlength.Youmayalsosubmitapersonalheadshotphotoat300dpi.Youmaysubmitthesetochris.pmsfocus.orgforconsideration.Forradioyoushouldbeabletotellyourstoryclearlyandsuccinctlyinlessthaneightminutes.Segmentsarerecordedbyphonebyappointment.PleaseemailabriefoutlineordescriptionofthestorytoKaseyMinnisatkaseymsfocus.orgforconsideration. MSFocusWinter201544Thisistheworstsadnessyouveeverfelt.Noitismorethansadness.Itishopelessnessdespairandadisappointmentinyourselfandlifeingeneral.Youdontfeellikedoinganythingbathingdressingorcombingyourhair.Youjustwanttobeleftalone.Youwanttobebyyourself.Depressionmakesyoufeelmiserable.Ivebeenthere.Icriedeverydayfornothinginparticular.Ijustcried.Ineverleftthehouserefusedphonecallsandsatinmychairalldayallnightdayafterdayfocusingonmypain.Isufferedlikethisforalmostayear.IknewIcouldntlivetherestofmylifelikethis.Ifeltsorryformyselfandhadalongingtobefreefrompain.IthoughtthatIwasaburdentomyfamilyandwasuselesstoeveryoneincludingmyself.Ithoughtthattheworldwouldbeabetterplacewithoutme.Istartedtalkingaboutsuicideanditwasmyplantodoit.Ithoughtthatsuicidewouldendallmysuffering.Thedetailsoftheplandontmatterhere.WhatyouneedtoknowisthatIhadeveryintentionofgoingthroughwithit.ButbeforeIdidsomeonecalledmeandaskedmewhymyhusbandwasactingsostrange.Ihadntnoticedit.Iwastoofocusedonmetonoticeanyoneelse.Ifinallysawmyhusband.Helookedmiserableandconcernedaboutmeandmysuicidaltalk.Ialsoheardmybrothertryingtocheermeupwithhiscornyjokes.Isawmydaughterpreparingmyfavoritefoodstryingtomakemehappy.AndwhenIlookedatsomeoneelsebesidesmyselfIreallybegantocryNotformyselfbutforwhatIwasdoingtothem.HowcouldIdothistothemIrealizedthenthatsuicidewasaselfishact.IrealizedthatIwaslovedandIknewthatIdidntwantanyonethatlovedmetofindmydeadbody.Ichangedmymindandstoppedthinkingaboutme.IwasstilldepressedbutIchangedmyfocustosomeonebesidesmyself.ImheretotellyouthisbecauseIchangedmymind.IdidntchangehowIwasfeelingIchangedhowIwasthinking.Suicideisapermanentoutcomeforatemporarysituation.Ifyourethinkingaboutityoutoocanchangeyourmindbychangingyourconcentrationfromyoutoanythingelse.WhenIchangedmymindmylifealsobegantochange.Igotupoutofmychair.IwantedtodothingsandtogoplacesandIdid.WhenImovedIfeltlessdepressed.Myplanschanged.ImadesurethatIalwayshadsomethingtolookforwardtogoingtoaplaynextmonthorgoingonaweekendtripnextspring.Ihadbeenprescribedanantidepressantmedicationbymyneurologist.Iwasstilldepressed.Ihadbeengoingtoapsychologisteveryweek.Iwasstilldepressed.Idecidedtostopseeingthepsychologistformeitwasawasteoftimeandmoney.ButIdidntgiveup.Itookchargeof MSFocusWinter201545mylifeandwasdeterminedtogetcontrolovermydepression.Ithenmadeanappointmentwithapsychiatristbecauseunlikeapsychologisttheyarephysiciansandcanwriteprescriptions.ShedeterminedthatIwasgiventhewrongdosageforthemedicationthatIhadbeenprescribedandalsoIwasprescribedthewrongmedicationformydepression.WhenthemedicationsheprescribedmademefeelstrangeIaskedhertochangeit.Shealsoencouragedmetogointodepressiongrouptherapy.WhenIresistedshekepturgingmetoattend.Iwent.Ilistenedtotheirstories.Therearemanyreasonswhypeoplearedepressed.Wealltalkedwhileasocialworkerfacilitated.Wewerehelpingeachotherworkthroughourissues.Thiswasimportantbecauseyouknewthatyouweretalkingwithsome-onethatcouldcommiseratewithyousomeonewhoknewhowyoufelt.Wewereabletogiveeachotheranotherpointofviewregardingthesituationswefaced.Ithasnowbeenmorethan10yearssinceIwasgoingtocommitsuicideandthreeyearssincethechangeofmedicationandgrouptherapy.InsummaryIgotupoutofthatchaireventhoughIdidntfeellikeitatthatmoment.ItookchargeofmylifeandmadecertainthatIwasprescribedthecorrectmedication.Iwenttogrouptherapybeingwithothersisalsoimportant.MostimportantlyIchangedhowIwasthinkingandwhatIwasthinkingabout.Iamnowdepressionfree.IfIdidityoucantoo.PedraBlackwellwasfirstdiagnosedwithMSin1990.Shestartedwithrelapsing-remittingbutnowhassecondary-progressive.MULTIPLESCLEROSISIfyouoralovedonehavebeendiagnosedwithmultiplesclerosisandareexperiencingrelapsesconsidertheRadianceStudy.VisitRadianceStudy.com.LifeisaboutsomuchmorethanMULTIPLEADVENTURESMULTIPLESMILESMULTIPLECELEBRATIONS 46MSFocusWinter2015GettingdigitalentertainmentsuchaseBooksandaudiobooksisrelativelysimple.AllyouneedisanInternetconnectionandamobiledevicesuchasaphoneortablet.Thereareseveralwaystogetdigitalentertainment.Howeveroneofthemostoverlookedsitesthatdeliversmaterialisyourlocallibrary.ThereisnofeeandtheamountoftimethatyoucanaccesseBooksaudiobooksandvideosissimilartothelibraryshard-copypolicies.Thisprocesshasbecomestandardized.Someonefromyourlocallibrarywilloftenteachpatronshowtousetheirsystem.Evenifyouaretrainedbythelibrarythisarticlecanserveasareviewoftheprocedure.TheappneededtoaccomplishthisiscalledOverdriveafreedownloadforbothAndroidandAppledevices.ObtaintheOverdriveProgramDownloadthefreeOverdriveappfromGooglePlayAndroidoriTunesApple.IfyouneedhelpchecktheGooglePlayorApplewebsiteandsearchthesupportpageforinstructions.RegisterforanAdobeOverdriveAccountOverdrivewascreatedbyAdobeandinordertousetheappyouwillneedanAdobeOverdriveaccount.WhenyouopentheOverdriveappforthefirsttimeyouaregivenachancetocreateanaccount.Makesuretoremembertheemailaccountyouusedandyourpassword.Ifyouhavemorethanonedeviceyoucanloginwiththisaccounttosyncthedevices.Makesuretodownloadtheappandtitlesontoeachdevice.UsingOverdriveOverdrivetakespracticetouse.Afirst-timeusershouldgetinstructionatthelibraryorwatchtutorialsgotohttphelp.overdrive.comvideosandchooseyourdeviceoperatingsystem.ConnectingtotheLibraryYouneedtobeconnectedtotheInternetforthisstep.OpentheOverdriveappandpressonAddaLibrary.Followinstructionstoaddyourlocallibrary.Onceyouhaveloadedyourlibrarysignintoaccessthedigitalmaterial.ThisisnotthesameprocedureyouusedforyourOverdriveaccount.Youneedalibraryaccesscodewhichcanbefoundonthebarcodeofyourlibrarycard.Ifyouarehavingtroublewiththisstepordonothavealibrarycardcallthelibrary.CheckRememberEbooksandVideosFromYourLocalLibraryByJoanneFortunato 47MSFocusWinter2015myloginsoyoudonothavetoretypetheaccesscodeeachtimeyousignin.GettingTitlestoYourDeviceYouneedtobeconnectedtotheInternettosearchforlibrarymaterials.Whenyoufindatitleyouwanttosignoutyouhaveseveraloptions.Ifthetitleisavailableyoucanborrowitimmediately.YouwillbeaskedtodownloadtheEPUBeBookorreadinyourbrowser.IfyouwantaccesstothetitlewhenWi-FiisnotavailableyouneedtodownloadtheEPUBformat.Ifthetitleisnotavailableforcheckoutyoucanaddittoyourholdslist.Youwillbeemailedwhenthetitlebecomesavailable.Onceyoudownloadatitleitisonyourdevicefortheallowedcheckouttime.Toaccessthetitlepressthemenuoptionthethreebarsintheupperleftcorner.Choosebookshelftoseeyourlistofsigned-outtitlesandpressonthetitleyouwanttouse.UsingtheeBookReaderTheOverdriveeBookreaderiseasytouse.ChoosetheeBookiconandatopicfromthelist.TolearnhowtouseeBookschooseReadingeBooks.TipsandTricksYoudonothavetodownloadatitle.YoucanreadlistenandwatchontheInternet.HowevertheadvantageofdownloadingatitleisyoudonotneedanInternetconnectiontousedigitalmaterial.ThismakesitpossibletousemediaatdoctorsofficesandotherlocationswithoutWi-Fi.Overdriveallowsvideostreaming.YouneedanInternetconnectiontodothis.Internetconnectionsatpubliclocationssuchascoffeeshopsareoftennotstrongenoughtostreamcontent.Manylibrariesoffervideotitles.AsimplesearchofyourlibraryOverdrivesitewillshowyouwhatisavailable.MostdeviceswillhookuptoyourHDtelevision.Checkyourdevicessupportpageformoreinformation.Theadvancesearchfeaturesareveryhelpful.Youcansearchbysubjectauthortitleandpublisher.SearchingfortitlesthatareAvailableNowallowsyoutofindtitlesthatcanbesignedoutimmediately.Otherwiseyoucanputtitlesonholdandyouwillbeemailedwhenthattitleisavailable.IfyouareunabletovisityourlocallibraryusingAdobeOverdriveisagreatwaytobringlibrarycontenttoyouathomeatthedoctorsofficeorwhenyouareonvacation.WhiletheOverdriveprogramcanbeoverwhelmingthereareexcellentresourcesavailabletolearnitsmanyfeatures.Enjoyyourfavoritebookorvideoonyourschedulenotthelibrarys.JoanneFortunatoBSMAisaretiredcomputertechnologyteacherinTroyN.Y.Shehasamastersdegreeineducationandhasbeenteachingtechnologytoteachersandstudentsfor30years.ShehaspublishedseveralarticlesandbooksoneducationalcomputertechnologyincludingseveralarticleswiththeInternationalSocietyforTechnologyinEducationISTE.ShewasdiagnosedwithMSin2006andusestechnologytoaidincopingwiththemanydifficultiesthatMScanpresent.Sheisexcitedtosharethisinformationwithothersthatdealwiththesameandmanyotherissuesonadailybasis. 48MSFocusWinter2015WellsFargoCommunitySupportCampaignAProudTraditionofCaringandAccomplishmentEachSeptemberWellsFargoemployeesdonatefinanciallytononprofitsoftheirchoiceduringtheCommunitySupportandUnitedWayCampaign.ThisAugustBusinessTrainingConsultantJohnL.BerryJr.contactedMSFFundDevelopmenttoannouncethattheMSFwouldbearecipientofthe2014WellsFargoCommunitySupportfundraisinginitiativecoordinatedbytheWellsFargoTeamMemberPhilanthropyGroup.EmployeesintheMiamiandMaitlandFla.officeswantedtodonatetotheMScauseinmemoryoftheircoworkerLindaJ.Morganwhopassedawaythispastsummer.LindaisaherotousasshedemonstratedheramazingfaitheverydayinthefaceofthisdiseasewroteJohn.FundraisersincludedanofficeBlueJeanDayanauctionandabakesaleinMaitlandthatraisedmorethan300.Attheendofthemonth1993wasraisedfortheMSFinhonoroftheircolleague.TheMSFisproudtobeapartnerinWellsFargosoutstandingphilanthropiceffortsandweextendoursincerestappreciationtoallwhoparticipatedtohelpthosewithMS.VolunteerSpecialEventsInthepastfewmonthstheMSFhasreceivedproceedsanddonationsfromeventscoordinatedbyfriendsoftheMSFaroundthecountryincludingMSsupportgroupleadersandoneofourambassadorstrainedvolunteerswithMSwhospeakonbehalfoftheFoundation.AriseandWalkforHopeThe2ndannualAriseandWalkforHopeWalkathontookplaceonSept.6.HostedbyMt.PleasantMissionaryBaptistChurchMinistriesinClintonN.C.theeventwasorganizedbyDorcasDeeBeattywhohasMSandlostasistertocomplicationsfromMS.BeattysaidTheMSFhasbeenablessingtomehelpingmetodealwiththisdisease.Thewalkbroughtin500thisyearandDeespassionatededicationtothecausetheFoundationandtoothersthroughherchurchistrulyinspirational.CourageHopeandFaithWalkathonOrganizedbySupportGroupLeaderKevinCodeSr.theCourageHopeandFaithWalkathonwasKevinsfirstforayintocoordinatingafundraisingevent.ThewalktookplaceonSept.20attheDowntownCourthouseSquareinWarrenByHildyBerger 49MSFocusWinter2015Ohio.Morethan70peoplecametowalkvolunteersupportandhavefun.Theeventraised1900fromwalkproceedsandindividualdonations.IntheSwingTheMSFbenefitedfromtwogolfeventsduringthesummer.OnAug.4golfersparticipatinginthe8thannualLaVitaCigarsGolfOutingteedoffattheRoyalHawkCountryClubinSt.CharlesIll.HostedbyTylerClaypoolandDrewGorlewskitheeventraised885forourprogramsandservices.ThankyouTylerDrewandallwhocameouttoplayitforwardforagreatcauseOnAug.26MSFAmbassadorSheriPaulsonhostedacontestonthegreentobenefittheMSFduringtheFarmersInsuranceGolfforMStournamentinMapletonN.D.HeldforanotherMSorganizationourambassadorwasabletoarrangeaMSFfundraiserononespecialstoponthecourse.GolferswereencouragedtoteeofffromascooterandputtwithglassesthatblurredtheirvisiontodemonstratetheeffectMShasonsomanypeople.TheresultMSawarenessmadetheroundsalongwithagreatgolfexperienceand520wasdonatedtoourCoolingProgram.GreatworkSheriTheShoesFitProbablythemostmultifacetedfundraisersofarthisyearwascoordinatedbyWestPascoMSSupportGroupLeaderNewPortRicheyFla.SusanStruder.AfterfindingtheFunds2orgssiteonlineSusanandLarryDispartiorganizedtheShoes4MSshoedrive.RunningJunetoSeptemberthecollectionraised400fortheMSFandofferedopportunitiesthroughthedeliveryofgentlywornshoesforpeopleinimpoverishednationstostartandexpandavitalmicroenterprisetosustaintheirfamilies.ThankyoutoSusanandvolunteersfordevotingsomuchtimeandefforttohelpthoseinneed.MSFEventsKickinItCountryWithJulieRobertsandBonBonBootsCountrymusicartistJulieRobertsperformedabenefitconcertfortheMSFonSept.27atRenegadesCountryBarGrillinWestPalmBeachFla.PatronsweretreatedtogreatmusicandlinedancingforonerowdybootscootinSaturdaynight.SignedtoMercuryNashvillein2003JuliemadeherdebutwiththeTop20BillboardHotCountrySingleshitBreakDownHere.SincebeingdiagnosedwithMSshesbecomeafearlessMSadvocatesharingpersonalstoriesthroughhermusicandraisingawarenesseverywhereshegoes.AlsosharingthespotlightwasBonBonBootswww.bootoutdisease.comfounderBonnieMurphystandingtallwithherMarcusbootsalesofwhichbenefittheMSF.ItcouldntbemorefittingHildyBergeristheMSFsFundDevelopmentCoordinator.IfyouareinterestedinplanningafundraisingeventorwouldlikemoreinformationcontacttheMSFFundDevelopmentDepartmentat800-225-6495orsendanemailtohildymsfocus.org. 50MSFocusWinter2015GatheringPartyHostedbyAlpineJaguarandTDBankDonatinganauctionitemwasthetickettoattendanditemscollectedincludedspabasketsartworkuniquejewelryspecialtyvodkaandwineandotherhigh-endgoods.HeldatAlpineJaguarinFortLauderdaleFla.insupportofour2014GalacelebrationguestsweretreatedtowinemicrobrewbeersandhorsdoeuvresfromIIIForksofPalmBeachGardensFla.AppearancesbyMissMotorsportsUSAEstherDollarandDJentertainmentfromLoriMcQuestiona.k.a.TwoStoryLoriwerealsopartoftheevent.SpecialthankstoDamianPolgarofAlpineJaguarandHermesAlvarezofTDBankforpartneringwiththeMSFforthispreludetoourHatsOffGala.TheMultipleSclerosisFoundationdidmorethantipourhattohonoreesandadmiredguestsduringourHatsOffGalawhichtookplaceonDec.6atFortLauderdalesHyattRegencyPierSixty-Six.TheMSFrolledouttheredcarpetformorethan250guestsalltheretosupportandgivebacktotheMScause.Theyear-endfundraiserandawardsceremonyraisesmoneyforoursupportprogramscontinuingeducationandnationalMSawarenessinitiativesandoutreach.InadditiontothedinneranddancingtakingplaceonthatmildandmoonlitSaturdaynighttheeventhonoredseveralmoversandshakersandsailorsDanielKantorMDaneurologistMSFadvisorandprominentfigureintheMScommunitywaspresentedwiththeMSFsLeadershipinCareaward.Drs.IraandMariettaGlazerweretherecipientsoftheVolunteeroftheYearawardfortheirdedicationtoservice.InadditionaspecialBeaconofLightawardwaspresentedtothenine-membercrewofOceansofHope.AninitiativeoftheMSFCo-ExecutiveDirectorJulesKuperbergandwifeHelenewithDr.DanielKantorandwifeCrystal.Drs.IraandMariettaGlazer NovartisPharmaceuticalsBiogenIdecI.LorraineThomasGenzymeEMDSeronoATTBayerHealthcareTevaPharmaceuticalsMallinckrodtPharmaceuticalsToshibaBusinessSolutionsCBIZMHMLLCMDWInsuranceGroupNeuroscienceCentersofFloridaFoundationAlpineJaguarAllstarCupcakesTheColonnadeOutletsatSawgrassMillsSouthFloridaOpulenceMagazinePalmBeachBroadcasting97.9WRMFX102.3Sunny107.9and103.1WIRK.AspecialthankstobothLynneandRalphMcGrathforonceagainco-chairingafabulouseventandtothenightsemceeChanelfromMega94.9and93.9fordonatinghertimetomakethisgalasurelymemorable.51MSFocusWinter2015SailingSclerosisFoundationtheinternationalcrewoftheOceansofHopevesseliscomprisedprimarilyofpersonswithMSwhoseprojectistocircumnavigatetheglobeaboarda67-footsail-boat.AstheycircletheglobetheyofferlocalMSpatientstheopportunitytosailwiththecrew.Attendeessupportersandsponsorshelpedraisemorethan100000forMSFssupportprogramsandservices.Wehopetoseeyouallagainin2016tocelebrateandmarktheMSFs30thanniversaryMikkelAnthonisenFounderofOceansofHopeandMSFCo-ExecutiveDirectorJulesKuperbergGalaCommitteeChairsLynneandRalphMcGrathGinnyValenzeandJackBurksMDMariettaGlazerJoAnneLewisandLynneMcGrathWithsinceregratitudetooursponsors FREEEDUCATIONALPROGRAMSBYPHONEJoinusfortheMSFocusRadiomonthlyteleconferenceseries.WednesdayFeb.25830p.m.Eastern530PacificUsingExercisetoImproveWalkingandBalanceinMSPresentedbyHerbKarpatkinPTDScNCSMSCSAnMSFocusRadioteleconferenceWednesdayApril22830p.m.Eastern530p.m.PacificAskaNeurologistPresentedbyAaronBosterMDAnMSFocusRadioteleconferenceOurNationalMSEducationAwarenessMonthschedulewillbeannouncedsoonforMarch.Keepaneyeonyourmailandonourwebsiteforupdatesandchangestoourteleconferenceschedule.Tojoinanyoftheseeducationalteleconferencescall888-550-5602andenter23441168uptofiveminutesbeforethescheduledstarttime.Youwillbeplacedonholduntiltheconferencebegins.Toviewthepresentationduringthecallconnecttohttpsccc.spiderphone.com23441168.WouldyouliketoreceiveareminderbeforeeachteleconferenceSignupfortheMSFAnnouncementsemaillist.Emailsubscribetoannouncementsmsfocus.org.52MSFocusWinter2015 53MSFocusWinter2015PartnerwiththeWhenyoushopatAmazonSmileAmazonwilldonatetotheMSFOfferingeightcontacthoursofcontinuingnurseseducationthisprogramisco-providedbytheInternationalOrganizationofMultipleSclerosisNursesandNursePractitionerAlternatives.InordertoparticipateinourprogramyourreservationmustbebookedthroughtheMSFatthenumbersbelow.FormoreinformationaboutpricesandstateroomavailabilitycontactGabrielaAragonat800-659-0081or954-322-1030ortheMultipleSclerosisFoundationatMScruisemsfocus.org.JoinusNov.592015forthisuniquefour-nightfunandsunNursesAccreditedContinuingEducationProgramatSeaaboardCarnivalsElationsailingfromNewOrleansLa.toCozumelMexico.ITINERARYThursdayNov.5NewOrleansLA-Depart4p.m.FridayNov.6EducationProgramFunDayatSeaSaturdayNov.7CozumelMexicoArrive9a.m.-Depart6p.m.SundayNov.8EducationProgramFunDayatSeaMondayNov.9NewOrleansLA-Arrive8a.m. 54MSFocusWinter2015UnderfairwindsandsunnyskiestheshipandcrewoftheOceansofHopepulledintoportonthemorningofDec.3inFortLauderdale.Thevisitwaspartofa17-monthvoyagearoundtheworldthatbeganinJuneinCopenhagenandwillincludestopsatthePanamaCanaltheGalapagosIslandsAustraliaandeventuallybacktoCopenhagen.MembersoftheMultipleSclerosisFoundationwereonhandtogreettheinternationalcrewdocksideattheBahiaMarYachtingCenter.ThemajorityofpeopleontheninemembercrewhaveMSandincluderepresentativesfromtheU.S.theU.K.CanadaandDenmark.AlanSegaloffCo-ExecutiveDirectoroftheMSFexchangedgiftswithJensAlsAndersenBoatManageroftheOceansofHope.AlanpresentedaDolphinsfootball MSFocusWinter201555jerseyandreceivedaSailingSclerosisflag.Thecrewofferedtwotwo-hoursailingexcursionsonDec.6forpeoplewithMS.NosailingexperiencewasnecessaryandmembersoflocalMSsupportgroupsboardedthevesselforthemorningandafternoontrips.TheshipsnextdestinationisthePanamaCanal.ThegoalsofOceansofHopeaSailingSclerosisFoundationProjectaretochangeperceptionsofmultiplesclerosisandtoinspirepeoplewiththediseasetoovercometheirownchallengesbytellingthestoriesofthosetakingpartinthefirstevercircumnavigationoftheworldbyayachtcrewedbypeoplewithMS.TheOceansofHopeisa67-feet-longyachtbuiltin1996fortheBTGlobalChallenge.Thesteel-hulledsailingshipwasoriginallynamedPakeaBizkaiaandwasbasedinBilboaSpainwheresheconductedscientificexpeditionsaroundtheworld.Theshiphastocarryenoughsuppliestolastuntilthecrewreachesitsnextport.Duringthetriparoundtheworldthecrewwillpreparenearly13500mealsanduse900rollsoftoiletpaper.OnthejourneythecrewwillcrosstheequatortwiceandwillloseadaywhentheytravelwestacrosstheInternationalDateLine.TheSailingSclerosisFoundationwasfoundedbyDr.MikkelAnthonisenaspecialistatCopenhagenUniversityHospitalRigshopitaletinDenmark.AdoctorpsychotherapistandsailorMikkelhasbeenworkingwithmultiplesclerosispatientssince2010.Aconversationwithapatientsparkedtheidea.ItsanaturalprogressionandtheultimatedreamafterwesetupareallysuccessfulsailingprograminDenmarkforpeoplewithMS.ItstartedquitesmallgrewbiggerasmorepeoplegotinvolvedandrealizedtheirMSdidntmeantheyhadtostopcompletelydoingsomethingtheyloveditsjustaquestionofdoingitabitdifferentlyMikkelsaid.BiogenIdecistheofficialpartneroftheSailingSclerosisFoundationandtheOceansofHopecampaign.TheFoundationhascrewspacesavailableforthosewithMSwhohavesailingexperienceonthemanyupcomingoffshorelegsofthevoyageacrossPacificOcean.Toapplyforoneofthese2-3weeklonglegsvisitwww.sailing-sclerosis.orgoceans-of-hopeabout-oceans-of-hopeapplication-form.Visitourwebsitewww.msfocus.orgtowatchexclusivevideofromtheevent. 56MSFocusWinter2015TransformingMSPainIntoMusicArtByMarcPetersMynameisMarcandIamabeatmakerandgraphicdesignerfromRichmondVa.MystorybeginsonDec.182009thelastdayoffallfinalsatJamesMadisonUniversityinHarrisonburgVa.AllofmyclassmatesandIwereintheWRTClabpushingtofinishacodingfinalthatwasduethatday.AlthoughwewerehardatworkIhadoneofthebesttimesIeverhadincollegeinthatroomsurroundedbyfriendsImadeduringthepastthreeyears.Iarrivedhomethateveningsogratefultobeonwinterbreaksleepinmyownbedandbehomewithmymother.IdidntknowDec.19wouldbethedaythatchangedmylifeforever.Iwokeuptoamassivesinusinfectionthatnoamountofmedicationwouldcure.ThecolddriftedawayinthebeginningofJanuarybutthesicknesscamebackafewweekslater.ThistimeIlostvisioninmylefteye.AweeklaterIexperiencedlossofbalanceandmemory.JMUHealthCenterdoctorswerenotsurewhatwaswrongwithmeandthoughtIhadanearinfectionorsomeformofvertigo.Over-the-countervertigomedicationssuchasDramaminemademefeelworse.IfeltlikeIdidnthavemyfinalsemesterofcollegenorecreationpartiesoranythingoutsideofmydorm.MostofmyprofessorsdidntunderstandwhyIemailedthatIwassickeveryotherday.TheonlyprofessorthatreallyunderstoodwasmyWTRCcounselorandprofessorLucyBednar.Shemademylifesomucheasier.ThereweresomanyissuesIhadduringthelastthreemonthsofschool.Ilostalotofpersonalitytraits.Itwashardtowalkspeakandjustfeelnormal.ItfeltlikeonedayIwokeupandwasacompletelydifferentperson.Ihadtorememberhowtowalktalkandholdconversationswithpeopleagain.IknewIhadmyworkcutoutbutjustcouldntunderstandwhatwaswrongwithme.IjustmadethebestofeverydayanddidmybesttorelearnthingswhiletryingtoearnmyfinalcoursecreditssoIcouldgraduateontime.IcherishedmylastdaysatJMUandmadethebestofwhatIhadthere.ImadeittograduationonMay82010andwalkedacrossthestagetoreceivemydiploma.IwassohappythatIgraduatedfromamajoruniversity.WhenIcamehometoRichmondforthesummerIhadchestpainsandwenttothelocalER.EverythingtestedfineyetIstillhadnoideawhatwaswrongwithme.TheER MSFocusWinter201557referredmetotheearnoseandthroatdoctorandthentheENTreferredmetotheneurologistwhoreferredmetogetanMRIinSeptember2010.ThatsummertheriseofRapmusicianDrakehadaseriousaffectonmylife.In2010withpromoforhisfirstalbumThankMeLaterMTVdidadocumentaryBetterThanGoodEnough.DrakesaidhewouldquitmusicifNoah40ShebibdiedbecauseofhisMS.IusedGoogletounderstandwhatMSstoodforandfoundthetermmultiplesclerosis.IrealizedIhadeverybeginningsymptomforMSblurryvisioninoneeyevertigotirednessandsoon.InOctober2010whenmyfirstneurologistDr.WhitecalledmeinforthediagnosisIfinallyfoundoutwhatwaswrongwithme.From20102014IhavebeenonthemedicationRebifwhichisaself-injectionIperformthreetimesaweek.Thepainthresholdgetsbetterasthemonthspass.IvebeendeniedpartialsocialsecuritythreeorfourtimesinthepastthreeyearssoIlivetocreatemyownfuturethroughmusicandart.Ivebeenmakingmusicsince2005andbloggingsince2008.From2010to2012IproducedanddesignedmyartworkformyinstrumentalmixtapesandcreatedawebsitecalledChampionSince.IalwaystrytousemyMSsituationandturnthatpainintoapositivedigitalform.Relapsing-remittingmultiplesclerosisformemeansIcanlosetheuseofanylimbforafewsecondsorpermanently.Beingpositiveandcreativeismywayoffightingthroughallthenegativity.IputmypainandeverythingIhaveintomymusicanddesignsandcreatewhatwasoncenegativeintoapositive.Iwanttoinspirepeopletounderstandthattheytoocanmakeitthroughtheirtoughsituationsaslongastheyremainpositiveandstaytruetowhattheybelievein.Ihopemystorycanhelpthosethatneedhelpthemselves.Sometimestheinspirationyouneedisrightinfrontofyourface.Dontgiveup.Youreyeswillnoticethesignswhenthetimingisright.T-ShirtsSweatshirtsBearsCoolingItemsJewelryOrangeRibbonAwarenessItemsCarMagnetsandsomuchmore.Seeouronlinecatalogatwww.themsshoppe.com920238-5138infothemsshoppe.comAportionofallproceedsgoestotheMSF MSFocusWinter201558Oureducationalprogramspresentedthroughthefallandintoearlywinterhigh-lightedthelatestnewsandresearchtohelpyoulivewellwithMS.HerearesomeofourmostrecentstopsOct.1415PanamaCityandTallahasseeFla.BuildingaStrongerMSCommunityYouAreYourOwnBestAdvocateCourtneyCoxarepresentativeforPatientAccessforFloridaspoketoguestsregardingpendinglegislationthatwouldincreaseaccesstocareandmedicationsinthestateofFlorida.ShespokeofhowtheMScommunitycouldjoinotherstohelpstrengthenpatientprotectionsinFloridaspecificallyintheareasofcontinuityofcareformularyrequirementsaccesstomedicinesstreamliningpriorauthorizationandsteptherapyfailfirstrestrictions.SupportforthisprogramwasprovidedthroughagrantfromNovartis.Oct.21TheVillagesFla.ManagingYourMSSymptomsPresentedbyKalinaSandersMDassociateprofessorofneurologyattheUniversityofFloridasShandsJacksonvilleMSCenterthisprogramwassupportedwithhelpfromTevaPharmaceuticals.Nov.11SeattleWash.BuildingaStrongerMSCommunityYouAreYourOwnBestAdvocateItwasachillydayforourSouthFloridastaffwhichrepresentedMSFataliveeducationalprograminSeattle.TheprogramwaspresentedbyAlanD.WittenbergMSWwhoisaSocialWorkerRCattheSwedishMSCenterSeattle.InthispresentationhediscussedNavigatingtheworldofhealthcarewhichincludedthebenefitsanddisadvantagesofMedicarepartAandBplansThevarioustiersofmedicationandhowMSdrugsareintier5thehighestandPatientassistanceprogramsformedication.JustincasetheItalianbuffetandyummydessertswerentenoughtoeatAlanhandedoutapageofkeywordstoeachguestandiftheyheardhimsayoneofthewordsandbroughtittohisattentionhewouldrewardtheguestwithachocolatekiss.SupportforthisprogramwasprovidedthroughagrantfromNovartis.MEEITSALLABOUTMotivatingEducatingEmpoweringMULTIPLESCLEROSISFOUNDATIONMEEITSALLABOUTMotivatingEducatingEmpoweringMULTIPLESCLEROSISFOUNDATIONTofindoutiftheMSFwillbevisitingyourlocalcommunitystayconnectedthroughourFacebookpageatwww.facebook.comMultipleSclerosisFoundation. MSFocusWinter201559PilotStudyFindsStemCellTreatmentSafeforMSPatientsResearchersfoundthatstemcelltransplantationmaybesafeandfeasibleforMSpatients.UsingstemcellsharvestedfromthebonemarrowofthetestsubjectsthePhaseIstudysuggeststhattheproceduredeservesfurtherstudy.Followinguponpriorstudiesthatfoundthatstemcellsweresafeandeffectiveinthetreatmentofotherdiseases24participantswithrelapsingformsofMSwereinvolvedinastudythattestedtheuseofbone-marrow-derivedculture-expandedmesenchymalstemcellsMSCs.LedbyDr.JeffreyCohenoftheClevelandClinicresearchersinjected16womenandeightmen10withrelapsing-remittingand14withsecondary-progressiveMSwithMSCsandfoundthatcellinfusionwaswell-toleratedandtherewerenotreatment-relatedsevereorseriousadverseevents.Whileneitherdiseaseactivationnorsignificantimprovementwasobservedresearcherssaidthatfuturetrialstoassessefficacymoredefinitivelyarewarranted.CohensresearchwaspresentedattheACTRIMS-ECTRIMSMSBoston2014.Dr.ThrowerMSmanagementhastraditionallyfocusedonthreeareastreatingrelapsesmanagingsymptomsandpreventingfurtherprogression.Hopefullywewillbeabletoaddafourthgoalinthenearfuturereversingdisability.Whileneuralrepairwasconsideredanunattainablegoalinthepastresearchersarenowattackingtheproblemonmultiplefronts.Adultmesenchymalstemcellsmaybeanoption.Advantagesofthesecellsaretheirreadyavailabilityandthefactthattheycomedirectlyfromthepersoneliminatingtheriskofrejection.ThisreportfromClevelandClinicshowsthattheirapproachwassafe.Asstatedthenextstepwillbeshowingthatthesestemcellscanactuallyrepairdamageinthebrainandspinalcordandreversedisability.StudySleepDisordersUndiagnosedinMSPatientsTheresultsofanewstudysuggestthatsleepdisordersareundiagnosedinmultiplesclerosispatients.ResearchersfoundthatthesleepdisordersmaylieattherootofTheMSNewscolumnincludesanalysisfromMSFSeniorMedicalAdvisorBenThrowerMD.DrawingfromthetopMSnewsstoriesofthequarterDr.ThrowerwillassesswhatthenewsmeanstoyouthepersonwithMS.MSNEWSandWhatItMeanstoYou MSFocusWinter201560fatiguethataffectsMSpatients.TheUniversityofCaliforniaDavismedicalresearcherssurveyed2375MSpatientsandfoundthatofthem37.8percentreportedsymptomsconsistentwithobstructivesleepapnea31.6percentmoderatetosevereinsomniaand36.8percentrestlesslegssyndrome.Bycomparisononly4percent11percentand12percentoftherespondentsreportedbeingformallydiagnosedwithobstructivesleepapneainsomniaandrestlesslegssyndrome.Ofthoseinthesurvey81percentoftheMSpatientswerewomenand88percentwereCaucasian.Theaverageageofparticipantswas54.ThisstudyshowsthatsleepdisorderfrequencysleeppatternsandcomplaintsofexcessivedaytimesleepinesssuggestthatsleepproblemsmaybeahiddenepidemicintheMSpopulationseparatefromMSfatiguesaidleadauthorStevenBrassassociateclinicalprofessorandDirectoroftheNeurologySleepClinicalProgramandCo-MedicalDirectoroftheUCDavisSleepMedicineLaboratory.ThestudywaspublishedonlineintheJournalofClinicalSleepMedicine.Dr.ThrowerAreyoutiredofbeingtiredFatigueisthemostcommonsymptomseeninMSandformanythemostbothersome.WhilefatiguecanbeadirectresultoftheMSitselfotherfactorssuchasmedicationsanddisruptedsleepmayalsocontribute.ThisstudyshowshowcommonsleepdisordersareinMS.Clinicalcluestoanunderlyingsleepdis-orderincludefeelingfatigueuponfirstawakeningorahistoryofsnoringfromthefamilyspouseorpartner.Ifasleepdisorderissuspectedthenextstepshouldbeareferraltoasleepclinicforasleepstudy.NewDrugCandidateShowsPromiseinTreatingMSTheresultsofanewdrugcandidateshowedareducedrelapserateandlowerlevelsofnewbraindamageinMSpatients.Thedrugalsoshowedhigherlevelsofsafetyforpatients.ThedrugcandidateRPC1063firstdiscoveredandsynthesizedattheScrippsResearchInstitutewastestedduringasix-monthPhase2studyof258multiplesclerosispatients.Theresultsofthedrugcandidateshowedareductionintherelapseratebyupto53percentandadecreaseinnewbraindamagebymorethan90percentinMSpatients.Thedrugalsoshowedastrongsafetyprofilewithnearlyallparticipantsstayingonthedrugregimenduringthetrialperiod.ReceptosabiopharmaceuticalcompanyinSanDiegoisdevelopingRPC1063forapprovalbytheU.S.FoodandDrugAdministration.ThedrugcandidateiscurrentlyinaPhase3randomizeddouble-blindstudyinvolving1200relapsingmultiplesclerosispatients.Thetrialisexpectedtobecompletedin2017.ThesedatasupportourlabsapproachatTSRIthatdiscoveryoffundamentalmechanismsinchemicalbiologyprovidesthefoundationforintelligentinterventionindiseaseprocessessaidEdRosenScrippsCalifornia.ThenewRPC1063findingswerepresentedattheMSBoston2014meeting.Dr.ThrowerRPC1063isasphingosine1-phosphate1receptormodulatorS1P1RthatworkssimilarlytoGilenyafingolimod.Thereareseveraltypesofsphingosinereceptorsinthehumanbodyincludingintheheart.Apotentialsideeffectoffingolimodisaloweringoftheheartrateduetothedrugsactionsonthesecardiac 61MSFocusWinter2015receptors.Thissideeffectisgenerallytransientandmanageable.ThereisthehopethatbyhavingadrugthatdoesnotaffectthosecardiacreceptorslikeRPC1063thatthissideeffectcouldbeeliminatedcompletely.TheeffectofRPC1063onrelapseratesandnewMRIlesionsappearspromisingaswell.StudyFindsProcessingSpeedCognitiveDeficitLinkKesslerFoundationresearchersfoundthatslowprocessingspeedexplainsexecutivedeficitsinmultiplesclerosispatients.Researchersexaminedtwokeyvariablesexecutivefunctionandprocessingspeed.Thebrainsfrontallobecoordinatesthementalskillsthatmakeupexecutivefunction.Examplesincludebutarenotlimitedtotheabilitytomanagetimeandattentionswitchfocusplanandorganizeandrememberdetails.Processingspeedistheabilitytoquicklyandefficientlyrespondtobasicstimuliandisoftendefinedasspeedofcompletionofataskwithreasonableaccuracy.Thestudymeasuredexecutivefunctioningtasksin50MSpatientscomparingthemto28healthyindividuals.ResearchersfoundthatontimedtasksofexecutivefunctionMSpatientsperformedworsethanhealthyindividuals.Whenthescientistscontrolledforspeedperformancedeficitsdisappeared.Theyalsofoundnolinkbetweenatrophyandperformancewhenspeedwascontrolledfor.OurresultspointtoslowedprocessingspeedasthemechanismunderlyingdeficitsinexecutivefunctionsaidNancyChiaravallotiPhDaco-authoroftheKesslerFoundationstudy.Under-standingthisassociationisanimportantsteptowardthedevelopmentofeffectivecognitiverehabilitationstrategiesforindividualswithMS.Weshouldfocusoureffortsontwokeydomainsprocessingspeedandmemory.ThestudywaspublishedonlineinthejournalRehabilitationPsychology.Dr.ThrowerCognitivedysfunctioniscommoninMSandisaleadingcauseofvocationaldisability.WhatthisstudyshowsisthatsomeofthecognitivechallengesfacedbypeoplewithMSmightbepartiallyaddressedbyallowingmoretimetocompletethetask.Therealworldimplicationsaresignificant.HealthcareprovidersmayneedtoaskformoretimeforstudentswithMStocompleteanexamination.Employersmayneedtoconsideradaptiverequeststoaccommodateslowedprocessingspeed.CognitivesymptomsinapersonwithMSmaybemagnifiedbyfatigueandordepression.Comprehensiveneuro-psychologicaltestingremainsthebestwayofsortingouttherootcausesofcognitivesymptoms.ShowYourSupportfortheT-shirtsmousepadskeychainsandmore.Visitwww.msfstore.com 62MSFocusWinter2015Q.Q.CanstresscausemultiplesclerosissymptomsA.A.Lifecanbestressful.Addthediagnosisofachronicunpredictablediseaselikemultiplesclerosisandthestresscanbecomeoverwhelming.ManypeoplebelievealinkexistsbetweenstressandMS.Whilethislinkhasyettobescientificallyprovenorfullyunderstoodanexacerbationduringaperiodofseverestressishardlyrare.Howevermostpeoplefailtocareforthemselvesproperlywhileexperiencingseverestress.Theymaynoteatwellorgetenoughrest.Theymayabandontheirusualfitnessroutineandturntoalcoholorcigarettestoalleviatetheirstress.Allofthesebehaviorscouldcontributetotheworseningofsymptoms.Q.Q.HowcommonarespeechandvoicedisordersinpeoplewithMSA.A.Thebodyofresearchinvestigatingphysicalandsensorydisordersinindividualswithmultiplesclerosisisimmensewhilecognitive-communicationdeficitsassociatedwithMShavereceivedlittleattention.ThelackofresearchforcommunicationdisordersandMSisshockinggiventhatbetween45percentand65percentofindividualslivingwithMSexperiencedifficultieswithmemoryattentiondistractibilityproblem-solvingword-findingandothercognitivefunctionsassymptomsofthedisease.InadditionavarietyofspeechandvoicedisordershavebeenidentifiedinindividualswithMS.AresearchquestionnaireinvestigatingspeechandcommunicationskillsassociatedwithMSindicatesthatapproximately45percentofrespondentsreportedchangesinspeechclaritywhile33percentreportedimpairmentsofvoiceandswallowingskills.DespitetheseoverwhelmingfiguresonlyasmallnumberofpeoplewithMS2percentareappropriatelyreferredfortreatment.Understandingthedifferenttypesofcognitive-communicationspeechandvoicedifficultiesassociatedwithMSisthefirststeptowardsmanagingthesesymptomseffectively.Q.Q.WhatsensoryproblemsmightpeoplewithmultiplesclerosisexperienceA.A.Sensoryproblemsordisturbancesinfeelingareoftenoneoftheearliestsymptomsofmultiplesclerosisandoccurin20to50percentofindividualsThisQuestionsandAnswerscolumnfeaturesquestionsthathavebeenansweredbytheMSFforSharecareacompanydedicatedtoprovidingthebesthealthandwellnessinformationonline.TheMSFhaspartneredwithSharecaretohelpspreadvitalinformationaboutthediseasetotheglobalMScommunity.VisittheMSFspageonSharecare.comathttpwww.sharecare.comgroupmultiple-sclerosis-foundation. Winter2015MSFocus63withthedisease.Paresthesiasmaybecausedbyanumberofotherfactorsincludingsittingorstandinginonepositionfortoolongcertainmedicationsorlackofbloodsupplytotheaffectedarea.ItchingalsoknownaspruritismayoccurasasensorysymptomofMS.Whilesuchitchingcausesthedesiretoscratchthescratchingcanoftenintensifytheitchingandcausefurtherdamagetotheskin.Feelingsoftinglingburningornumbnesswhicharecausedbylesionsinthecentralnervoussystemareknownasdysesthesias.LiterallytranslatedfromtheGreekthismeansbadsensation.Q.Q.HowcanmultiplesclerosisaffectmyeyesightA.A.Movementsofthehumaneyearecoordinatedthroughsmallmusclesattachedtotheeyeitself.Thesemusclesarecontrolledbythebrain.Areasofdemyelinationfrommultiplesclerosiscanresultinuncoordinatedmovementsoftheeyes.Onepossiblesymptomofthisisdoublevisionordiplopia.LikemanyMSsymptomsitshouldimproveovertime.Howeveritmaytakemonthsandthereisalwaysthechancethatitcouldbepermanent.Yourneurologistneedstobeawareofthissymptomandmayalsoreferyoutoanophthalmologist.Q.Q.WhatismyokymiainpeoplewithmultiplesclerosisA.A.Myokymiaisanannoyingtwitchingorflutteringoftheeyelidmuscles.Itmaycomeandgoinmanypeoplewithmultiplesclerosis.Visionitselfisnotactuallyaffected.MyokymiacanbeseeninsomepeoplewithoutMSaswell.Stresssleepdeprivationandcaffeinemaymakeitactupinsome.Q.Q.HowcommonisnumbnessduetomultiplesclerosisA.A.Oneofthemostcommonsensoryproblemsassociatedwithmultiplesclerosisisnumbness.Numbnessoccurswhenthenervesthattransmitsensationsdonotconductinformationproperly.Asaresultsensationsinthatparticularareaareeitherlackingornonexistent.Q.Q.HowdoesmultiplesclerosiscauseshortnessofbreathA.A.Multiplesclerosissometimescausessomethingcalledrestrictiveventilatorydefectwheretightnessinthemusclesbetweentheribslimitshowmuchtheribcagecanmovewhenyoutakeabreath.Whileyouractualbloodoxygenlevelsareusuallynotaffectedthedefectdoesgiveaverydistinctfeelingofshortnessofbreathorchesttightnessandsometimesboth.Questionscanbealsobeemailedtosupportmsfocus.orgormailedtoMSFocus6520NorthAndrewsAvenueFortLauderdaleFL33309.VisitOurWebsitetwww.HeatReliefDepot.comReceivea10DiscountUseCouponCodeMSFWarmingVestsHandFootWarmersWarmingCushionsHerbalWrapsHeatPacksMoreCoolingVestsNeckWristCoolersFansSunscreensHatsCapsVisorsMistingProductsMoreYourPlaceForPersonalCoolingWarminProductsHEATRELIEFDEPOTOrCallUsTollFree877-879-1450 NONPROFITORG.U.S.POSTAGEPAIDFT.LAUDERDALEFLPERMITNO.2698AreyoumovingPleasenotifyusofyourchangeofaddress.Call888-MSFOCUS673-6287orEmailsupportmsfocus.orgChangeServiceRequested6520NorthAndrewsAvenueFortLauderdaleFlorida33309-2132RAND-SCOTIncorporatedMakeanEasytransferwiththeEasyPivotTheEasyPivotPatientLiftisthepatientliftofchoice-EasyPivotEasyPivot401LindenCenterDriveFortCollinsCO80524800-467-7967970-484-7967inforandscot.com2012Rand-ScotInc.ManufacturersofEasyPivotLiftsBye-ByeDecubitiCushionsSaratogaFitnessProductsSpiritCycleFeelbetterforlifewithSpiritCyclewww.RandScot.comSaratogaSpirit690-