Fatigue in MS – and what to do about it

Fatigue – that horrible overwhelming inability to do another thing, sometimes even to think straight, is one of the most disabling invisible problems of MS. When I took a poll of the top symptoms that people wanted to troubleshoot in a holistic way, Fatigue was top. So here goes:
fatiguedWhy do people with MS experience fatigue?

Fatigue in MS is  of 2 types. Motor fatigue, or ‘short-circuiting’ fatigue, is when the difficulty of transmitting the electrical nerve signal down demyelinated, or damaged nerves, overwhelm the body’s ability to produce  ATP ( the energy molecule). Fatigued muscles just have to stop; you feel as if you’ve run a marathon, it’s like hitting ‘the wall’ for an athlete, and you have to sit down. After a short while, energy is replenished, and you can go again.

The second type of fatigue is more of a  widespread, overwhelming all-over fatigue, described here by MS campaigner, Shoshana Pezaro in 2015:

“It’s an absolutely crushing physical and mental symptom that cannot be overcome through will-power. When fatigue hits, I feel like my plug has been pulled out. Physically my body suffers extreme weakness and heaviness and every tiny movement, even raising my hand, is like fighting through thick treacle. But the mental effects are worse. The world separates from my consciousness. My brain is shrouded in a deep fog. It is a dreamlike state where I can hear people and see people, but I somehow I cannot connect. Fatigue cannot be fought, only managed through rest and care.”

Lots of research and debate has been carried out about what causes this type of fatigue; an interesting study reported at this year’s ECTRIMS conference investigated whether fatigue was more strongly linked to lesions in the brain, or to inflammation. They found a strong correlation to inflammation as the driver of this type of fatigue.

So to address Fatigue, we need to address the MS itself, and take both a short and a long view. The good thing is, there is a lot you can do to address both MS itself, and the problem of fatigue.

Starting with the most simple, here’s my list:

  •  Obviously read all the MS Society  ( you can download here)

http://www.mssociety.org.uk/ms-resources/fatigue-ms-essentials-14  and

pace yourself, budget your energy, and:

  • Get your groceries delivered online
  • Call a family meeting, explain that fatigue is a physical problem in MS, and give the family information about it, set rules and boundaries and share out the chores!
  • Save your energy for the stuff that counts – if you can get a cleaner, do so!
  • Fluids – ensure you drink plenty of water
  • The drug  Amantadine can be tried for fatigue in MS but it only seems to help about 20% of people, and sometimes causes unpleasant side-effects

Sleep

Baby smiling in bed with eyes closed and arms out.

It seems obvious, but if your sleep is poor, you will have fatigue!

Sleep problems:

  • No caffeine drinks after 6pm
  • Consider having something to eat before bed to prevent low blood sugar
  • Try to get outside as early as possible (once the sun is up) in the day, and making sure you are outside for at least ½ an hour a day; this helps to set your body’s circadian rythm( wake-sleep cycle)
  • Address causes of waking if possible – eg bladder, worrying, spasm, pain
  • Consider natural sleep aids like ‘Nightall’ etc which are made from hops and valerian – check that its ok to take these with any medication you are on
  • Use the HeartMath technique, for 10 minutes every morning, plus whenever you experience negative or worrying thoughts, or mind is free, and when you’re going to sleep at night.

heartmath-pic

  • Lock into a positive emotion

  • Focus on heart area

  • Breathe in for 5 seconds and out for 5 seconds in one long continuous cycle

  • imagine blowing up a balloon in your belly as you breathe in – your abdomen should rise first, then abdomen squeezes in as you expel the last bits of air out.

HeartMath is wonderful – I can’t find a good website to make it simple; you can buy all kinds of gadgets to allow yourself to see how you’re doing and coach yourself further, but the basic technique is this simple, and it has powerful and far-reaching effects on your resilience to stress, amongst other things.

Additional extras to consider.

mitochondria-2

Energy is created in our bodies by mitochondria, the ‘powerhouse’ of the cell. Each cell contains up to a thousand mitochondria. Mitochondria take fuel from the food we eat, and transform it into energy. They generate a chemical called ATP, which transports the energy for use by the body.

In order to function properly, mitochondria need the fuel of excellent nutrition and oxygen.

Dietary factors

  • Everything that we put in our mouths can either be pro-inflammatory or anti-inflammatory; what we eat has an impact on inflammation.
  • A study published in July 2016 showed improvements in fatigue over the course of one year,  in people with MS who adopted a low fat, plant-based diet

plant-based-diet

  • See www.overcomingmulstiplesclerosis.org  for this type of diet, which could be expected to reduce inflammation, www.fatfreevegan.com for recipes.
  • Also  have a look at the work of Terry Wahls, a medical doctor who reversed her own secondary progressive MS with advanced nutrition,  online. I prefer the overcomingms diet as above, but Terry’s extras like green smoothies and intense nutrition make sense to add in.
  • Be aware of food intolerances. More people with MS have full blown celiac disease than in the general population, but you can also have a milder food intolerance that is not picked up by clinical allergy testing. Experiment to find out if some foods worsen your fatigue, by excluding them for 3 weeks and then bringing them in and noticing. Common irritating foods are bread, cheese, dairy products, gluten grains, sugar, and sometimes beans, but many people have individual things that they don’t tolerate.
  • Vitamin D3 at least 5000 IU daily & consider minimal erythmal dose sunbed. Some people may need more to get into the optimal range of 150-200nmol per litre; you can get your blood checked at http://www.vitamindbloodtest.org.uk
  • A study published this year found a significant reduction in fatigue in people with MS who took 500mg of Co-enzyme Q10 daily.
  • Omega 3 fatty acids are found in oily fish, nuts, seeds and whole grains, and help to calm down and prevent inflammation, aswell as helping to store and retain energy. 20g daily can be supplied by 2 dessert spoons of cold pressed flax seed oil used cold, and make sure it’s fresh; one example; www.flaxfarm.co.uk
  • B vitamins – some people are deficient in these, which can mimic symptoms of MS; some people report these help with fatigue; probably when there has been some deficiency present.
  • Probiotics & fermented foods– very important to restore health of gut, especially after antibiotics, which contributes to health/ energy

Exercise  &  Oxygenation hyperbaric-chamber-10-person

  • Many people report that hyperbaric oxygen improves MS fatigue; if this isn’t possible, at least do deep breathing!
  • Just had great comment in response to this post by Frank:
  • “The very best thing for me has been taking Oxygen Therapy at the MS Centre. There are 56 centres to choose from so there’s almost bound to be one near you – unless you live in Northumberland or Cumbria. 
    With Oxygen Therapy and MS, lots of us find there there is an optimum pressure. The ascending protocol suggests that people should start at 1.5 ATA, move to 1.75 ATA and then try 2 ATA. After each session note down how you feel immediately afterwards and then again about 24 hours later. Once you’ve tried all three pressures you should know the one that suits you best.
    As you say, Miranda, it does not work for everyone, but then neither do any of the drug or dietary therapies – we are all different – however, I’ve found it great for reducing my fatigue and if I miss my weekly session, I certainly feel the impact. Some of my colleagues find they are really tired after the Oxygen Therapy but then feel full of energy the next day, others, like myself, feel the benefit within a few hours. Whatever your views, it’s definitely worth giving it a go.”
  • Regular cardiovascular exercise can help to raise oxygen and energy levels, in your own zone of tolerance. Exercise has been shown to be strongly anti-inflammatory – make it part of your daily routine in one form or another.
  • Some people with fatigue have reported improvement to fatigue by raising the head of their bed by 6 inches. Called ITB or inclined bed therapy – See New Pathways issue 62

APS Therapy

At the MS Therapy Centre where I work we have now had many cases of people’s MS fatigue, including post relapse, responding very well to APS Therapy. This makes sense as the treatment stimulates production of ATP, and is a replica of the wave-form of action potentials ( the electrical nerve signal.)active-nerve-cells-29027134 It hasn’t worked for everyone that’s tried it; it seems to be more effecitve for fatigue in relapsing remitting, rather than progressive MS, and we are still collecting data about this, but the therapy is available privately ( see ‘my other work’ button)  and at 7 MS Therapy Centres:

Bedford, Portsmouth, Kent, Sutton & Croydon, Leicester, Berkshire and Hertfordshire and MS-UK’s Wellbeing centre, Joseph’s Court in Colchester.

Therapies

Lots of therapies, including Shiatsu, Reflexology, Yoga and ‘EFT’ tapping are found by people to improve wellbeing, energy and sleep which may then help with fatigue.

Remember that Disease Modifying Therapies (DMTs) all aim to reduce inflammation and relapses, and by doing so, can have a marked impact on reducing fatigue and improving how you feel. If you are eligible, but not on a DMT, review and reconsider the situation. If you’re on a DMT but still having relapses, request a review, as per the the MS Brain Health Campaign. And when choosing a DMT, ask about the common side-effects, explore how other people have responded, and choose one that fits best with your needs and aims.

happy

In summary, with both long and short term strategies, there are lots of things you can do to beat fatigue and enhance your energy. Some of the long term strategies take longer to bear fruit – but keep going; many people with MS can remember a time when they were so much more fatigued than they are now.

All the best

Miranda

 

Weight loss on Overcoming MS Diet

Hell, Happy New Year!  Proud to be asked to blog for Overcoming MS recently, and replicate my blog  here. It’s inspired by my patients, of course, and the ups and downs you  experience in moderating your health by adjusting lifestyle factors to address the serious condition, MS, and this is the first in a series of 2!

OK, so one problem people worry about, is losing too much weight.

What is “too much” weight to lose? What is ‘normal’ ?

obesity www.mirandasmsblog.com

We know that the average weight keeps on rising, with the USA leading the way; the average weight for women in their 20s has increased by 13kg (29lb) since 1960 (1).

A recent Gallup poll found that the average American man’s weight was up 7kg (16lb) since 1980 to 88kg (196lb), and women’s up 6kg (14lb) to 70kg (156lb).

But the really interesting finding from that poll was that people’s perception of normal has also moved. The weights people stated as their ideal had shifted almost as much as their actual weights – men’s were up by 6kg (14lb) and women’s up by 4kg (11 lb). And despite being over their ideal weights by these figures, most people reported that their weight was ‘about right’. (2)

In our culture we’re used to seeing skinny models – in a weird stylised magazine world – but not skinny normal people, unless they’re unwell. But thin does not necessarily mean weak or unwell. In my 20s I spent quite a bit of time in India, and I remember being impressed at how incredibly strong the very skinny, but wiry, bicycle rickshaw drivers and train porters were…and feeling quite ashamed of my weak, chubby, western ways!

sleeping rickshaw driver www.mirandasmsblog.com

Perceptions aside, another thing to remember is that weight loss will probably stabilise.

 

 

 

 

Increase your good fats

Firstly, remember the OMS diet is not a low fat diet – it’s a low saturated fat diet. Here’s what George Jelinek kindly replied to me in an email one time:

“There is no real limit to the amount of fat we should be consuming. Remember it is not a low fat diet, but a low saturated fat diet. That said, if you eat a plant-based wholefood diet with seafood, it will be really hard to eat a high fat diet, almost impossible unless you eat bucket loads of avocados, nuts and oily fish every day. Most people just physically can’t eat that much of that sort of food because it fills you up so much.”

So it’s okay to double-up on the flax seed oil, increase your nuts, seeds, avocados and oily fish if you feel you are losing too much weight.

Eat protein-rich food

It’s obvious I know, but if you’ve been used to eating ‘meat and two veg’, it’s important not to slip into just two veg. For inspiration from a culture with a history of getting its protein from a plant based source, we can again look to India, which has around 500 miliion vegetarians, and perhaps the most sophisticated and ancient vegetarian cuisine, based on the ancient medical understanding of Ayurveda, and using anti-inflammatory spices and flavourings which complement the flavours of vegetables and grains.

Vegetarian Indian meals will always include a dhal or pulse dish, rice, a vegetable dish, and a chapati or pure. I don’t worry about making so much each time, but I always try to include a source of protein. Pulses are a cheap and filling way to do this, and my next post will be on the best way to cook pulses for optimum digestion, and digestion in general!

Eating enough

Need I say more?

Exercising for muscle mass

This subject deserves it’s own post I think. I’m going to direct you to a great blog I found called ‘No Meat Athlete’ by a vegan athlete Matt Frazier. Here he talks about the method he found effective to incerase muscle mass as a vegan, managing to put on 7kg (17lb) in six weeks. www.nomeatathlete.com/gain-weight-vegan

For the time being, all the best!

 

1)  Centre for Disease Prevention and Control USA

2)http://www.gallup.com/poll/150947/Self-Reported-Weight-Nearly-Pounds-1990.aspx

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MS Frontiers intro and OMS newsletter

I was proud to present this poster at the MS Frontiers conference – Fantastic findings re Flax seed oil – 49% less relapses in people with MS that took it, research by http://www.overcomingms.org just been accepted for publication.. Will post more info asap.

Also coming up – and important to know about if you have RRMS -Campath/alemtuzimab/lemtrada trials

and – interesting stuff from MS Frontiers conference

MS Nurse Miranda Olding presenting our poster at the MS Frontiers Conference

It has been a busy few weeks for Miranda Olding, MS Specialist Nurse, based at the MS Therapy Centre in Bedford. She was recently nominated by her patients for an award of ‘My MS Super Nurse, a competition run by the MS Trust. Click here to hear how Miranda describes her work with the MS Community.

With her holistic approach to patient care, she is a keen advocate of the OMS Recovery program and has represented us on a number of occasions, most recent of which was the MS Frontiers Conference at the Sofitel, Heathrow where she presented a poster on the current research work being undertaken by Professor Jelinek’s team at St. Vincent’s in Melbourne.

Photo: MS Specialist Nurse Miranda Olding presenting our research work in London

Recovering from Multiple Sclerosis: turning evidence into reality

Everyone knows about AMEX day by now, surely? Presented by Professor Jelinek and Dr Craig Hassed this day-long event will lay before you the recovery program and outline the evidence base that led Professor Jelinek to developing the program. The price includes all refreshments, a wonderful lunch and a copy of the book Overcoming Multiple Sclerosis: an evidence based guide to recovery to take home with you. The newly built AMEX Stadium, home of Brighton and Hove Albion Football Club is a wonderful venue with superb facilities. Ticket sales have been strong, and bookings have come in from as far afield as central Europe, but at the time of writing there are still some places left. Don’t leave it until the last minute. This event will not be repeated until the end of 2014 at the earliest. Tickets are obtainable from here

New OMS app for smartphones released!

The new OMS app for smartphones has been released. Download free from the App Store!

Our trusty team has been working away behind the scenes to bring you OMS on your smartphone.

Go to the App Store in iTunes or Google play if you have an android phone and use the keywords ‘overcoming multiple sclerosis’ and you will find the new OMS app, which you can download for free!

From podcasts at your fingertips, to recipes, and even a place to send your photos of the surprised expression of your neurologist when he sees how well you are doing! All there on the new OMS app….

Letter from Dad about diet and MS

One of my clients with MS forwarded me this email from his dad.  It’s really nice, and I have permission to share it ( and then I replied) Thanks XXXXXX and ‘Dad’ !

Dear XXXXXXX,

There are two significant surveys reported today. They should give you some comfort that the changes to diet you took aboard a year ago were absolutely the right thing to do. 

The first one about processed meat is from a massive study over a long period of time. Although it is not directly about MS it is a reminder of the other significant risks you have significantly reduced as a result of your diet changes. There is one figure that jumps out – people with very differing diets had a 44% different chances of dying over a thirteen year period.

While this study lent massive support to the ever growing consensus on healthy eating, the second report about salt intake is specifically relevant to MS. It appears to be a significant study which seems to being well received as providing a new insight into the triggers for the disease. It also seems to reinforce the part that the microbiome might play in MS (I think I sent you an Economist article on this topic but if not I will dig it out). Although as always there is a long way to go before it can all be validated, and will not cure MS it seems reasonable to hope that it may moderate it. The author of the report says quite clearly in his final sentence:

If I had MS, I would think very much about not eating processed foods and really cutting down my salt intake,”

It may give you some encouragement, that you have inadvertently been doing this in following your new diet. Although it is not yet proven, it is one of those low cost, low risk, high potential gain actions that are worth a punt.

Love

Dad

(This guy has taken on the OMS dietary approach. here’s my reply)

Hello!

Nice to read such an articulate email! I did read the meat one, but hadn’t seen the salt!

Another biggy ( huge, really) is The China Study – copied here from wikipedia:
The China Study (2005) is a book by T. Colin Campbell, Jacob Gould Schurman Professor Emeritus of Nutritional Biochemistry at Cornell University, and his son Thomas M. Campbell II, a physician. It examines the relationship between the consumption of animal products and a variety of chronic illnesses, such as coronary heart disease, diabetes, and cancers of the breast, prostate and bowel.[2] The book had sold 750,000 copies as of January 2013.[3] It is one of America’s best-selling books about nutrition.[4]

…The authors conclude that people who eat a plant-based/vegan diet—avoiding animal products such as beef, pork, poultry, fish, eggs, cheese, and milk, and reducing their intake of processed foods and refined carbohydrates—will escape, reduce or reverse the development of chronic diseases. They also recommend adequate amounts of sunshine to maintain sufficient levels of vitamin D, and supplements of vitamin B12 in case of complete avoidance of animal products.

All the best! 🙂 Miranda

Specialist Study Presentation – July 2013

From the OMS website

Specialist Study Presentation – July 2013

Primary, secondary and tertiary prevention of multiple sclerosis: theory and clinical evidence

In 2012 an Australian research team led by Professor George Jelinek (Founder of Overcoming MS, http://www.overcomingms.org) published research in Neurological Sciences, a major international neurology journal, looking at the health related quality of life outcomes at 1 and 5 years after an intensive MS lifestyle intervention. The evidence presented showed an average of 20% improvement on MS quality of life scores across physical, mental and emotional domains for people with MS following a preventive risk factor modification approach to MS over a 5-year period.

Additionally, Professor Jelinekʼs team has also commenced a major international study of PwMS looking at the various factors in their diets and lifestyles, and their disease activity and disability. This will produce strong evidence about the effect of these factors in MS disease activity and progression. The respondents represent the widest possible range of ages, geographical regions, and with different types of MS. The outcomes of this research will be published in a series of papers during 2013 and Prof. Jelinek will discuss these findings at this seminar.

This presentation will be held on Thursday 4th July 2013 at The Belmont Hotel, De Montfort Street, Leicester, UK.

via Specialist Study Presentation – July 2013.

Old posts: 2012: diet, supplements, Epstein Barr, detox, urine infections

2012

Supplements

The Therapy Centre is going to stock the supplements that I recommend most, at a discount of 15% off the RRP (which is fantastic news). So soon you will be able to buy Vitamin D3 5000 IUs, cold pressed flax seed oil 1000mg (Omega 3), and 2 varieties of an iron-free multi vitamin, mineral and nutrient supplement made from whole foods.  I got mixed up with a discount code previously, so if anyone used it and didn’t get the 20% discount, massive apologies, it went direct to the Centre, if you want to claim it back, see me!

Food

For people who’re eating food without saturated fat, but struggling with what to eat, I found a great website, www.fatfreevegan.com. Also, the OMS site is collecting more recipes that you can see when you log in. I too am collecting recipes, tips and ideas, so anyone out who has some good ones, please email or bring them in!

Hot topics

A hot topic for me this past year has been Epstein Barr (glandular  fever) virus and herpes virus (mainly herpes, cold sores and shingles in adults). Since I started asking people if they had these viruses, I’ve been shocked at how many MS people have one of these.  Recent research showing Epstein Barr still alive in MS lesions at post mortem, and    discussion around the fact that the virus lives on and may drive       inflammatory processes, got me wondering whether there could be a natural or herbal way of killing off the virus, and whether this would have any effect on the MS. So watch this space for the results of this latest     quest – natural viral detox!

Got a great tip the other day – did you know that the Kindle (£150 version) can read your books to you?  And for some people with    vision problems, the iPad is a revelation, so keep your eye on how technology can make life easier!

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 December 2011

As an MS Nurse, I’m always looking for the best advice to give to my clients about being and stayingwell…..  MS is a disease with a genetic component, but our environment – the food we eat, the climate,     exposure to various    viruses, and stress, – have an impact on activating or suppressing our genetic susceptibilities. I often talk with people about their lifestyle and diet, and   depending on what I find out, I may recommend that they look at the work of Terry Wahls,  Ashton       Embrey, Ann Boroch or Sawyer & Bachrach , or get an overview and understanding of the different considerations and approaches by reading Judy Graham’s book.

But at the moment, if I had to choose just one piece of advice to give to    people with MS  who want to know what they can do to help their health, it would be to go to the http://www.overcomingms.org/website, and immerse themselves in the evidence based information there.

George Jelinek is the author of the book and website ‘OvercomingMS’ . He  is a medical doctor, and professor of emergency medicine in Australia, whose mother had MS and became very disabled, and who was diagnosed himself in 1999. Since that time, he  invested a vast amount of time and energy into examining the research on the various dietary, nutritional and lifestyle factors that have a  documented effect on MS, found evidence of the profound difference they can make, put the recommendations into practice and stayed symptom and relapse free, and has put this together into a simple to follow approach.

The work that Professor Jelinek has done in compiling and explaining, in simple language, the research on dietary fats and vitamin D is      incredibly helpful, and the fact that it’s all in one place, on the web or in his book,

Overcoming MS, an Evidence Based Guide to Recovery’ means that the   information stays cohesive and doesn’t become overwhelming

The cornerstones of the OMS approach are:

Diet and supplements

· Omega-3 fatty acid: 20g /mls  a day of flaxseed oil or fish oil, or the equivalent amount of fish

· Optional B group vitamins or B12 supplement if needed

Meditation – 30 minutes daily

Vitamin D

Sunlight 15 minutes daily 3-5 times a week as close to all over as  practical

Vitamin D3 supplement of at least 5 000IU daily, adjusted to blood level

Aim to keep blood level of vitamin D high, that is between150-225nmol/L (may require up to 10 000IU daily)

Exercise  –   20-30 minutes around 5 times a week preferably outdoors

 Medication

·    In consultation with your doctor, if a wait and see approach is not

appropriate, take one of the disease-modifying drugs (many may not need

a drug, and drug selection should be carefully weighed against side effects)

·   Steroids for any acute relapse that is distressing

·   One of the more potent drugs if the disease is rapidly progressive

The down side to the evidence-based approach, is that if anything – be it a therapy, foodstuff, supplement, drug, or approach, has not been      researched, or not researched to an adequate standard, then it can’t be counted. The evidence based approach prevents us from wasting money or time on useless therapies, but as Carl Sagan, famous America

astronomer, writer and scientist, famously said, ‘absence of evidence is not evidence of absence’.   So I’m still happy to suggest a person, for   example, who has extreme fatigue, might try Terry Wahl’s green   smoothies, or that someone might try hyperbaric oxygen, or even some of the commonly used symptom management drugs ( for instance for muscle spasm and stiffness) which don’t necessarily have a body of      scientific evidence for effectiveness behind them, but are used due to the effects that people report.

Recently I was really excited to see a research paper from the Australian Journal ‘Quality in Primary Care’, following up people who attended an OMS retreat and took on the recommended dietary and lifestyle changes. This study showed ‘ongoing improvements in health related quality of life after an intensive lifestyle modification course’, over 2 ½ years, that ‘ could potentially make a significant difference to the lives of many people with this condition’, and ‘contribute to the growing body of evidence that health promotion programmes and non-drug therapies for MS     patients have a beneficial effect.’

We hope to get Professor Jelinek over to the UK for a retreat in summer 2013, but you don’t need to do a retreat to take on this approach –all the research and recommendations are outlined on the website and in his book. Recently I met up with Lisa, the moderator from the website, and  two English women who  have done the OMS retreat, follow its recommendations, and enjoy good  health, and introduced them to the MS Trust. Now they are going to be introducing the work  to the MS specialist practitioners at the annual MS Trust conference for healthcare professionals in November. The goal of this is to help to promote the work of OMS in the UK – so that everyone who gets diagnosed with MS has the chance to find out about it, research it for themselves, and make their own decision.

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spring 2011

 This month I am mainly focussing on Urinary tract Infections (UTIs),   because they can really set you back when you have MS, and Prevention is better than cure!One cause of UTIs   with MS is the bladder not emptying properly. Not being able to start passing urine,  feeling there’s some left afterwards, passing a fair amount again quite soon after, ‘urgency’ and UTIs  can all be signs of incomplete emptying. This needs to be identified by ultrasound scan, which is done during an assessment by the continence service. For    Bedfordshire, Melanie  runs a clinic here once a month, or for Beds and Northants you can be seen in a local clinic , or have a home visit. Speak to me, a nurse or your GP to be referred

Be prepared! Burning, cloudiness or unusual smelling urine are classic signs of a UTI, but you can also dipstick test your urine at home. Buy Multistix or Uristix which include Leukocytes and nitrites,.Also dipstick if you have a relapse, as UTIs can be symptom free. It’s a good idea to help your GP understand how a UTI can cause MS to flare up, and be ready to prescribe an antibiotic at the first sign of infection. Get a sample taken in too, and the antibiotic can be changed lagter if necessary.

If you use a catheter, either a permanent or intermittent type, this also can introduce a route for infection. Obviously scrupulous hygiene is a must. People who get recurrent infections can try having antibiotics for the three days around a catheter change, or may even need to use a daily low dose antibiotic. For intermittent catheters, the type can make a difference – it’s important to use something that you don’t have to touch the tip of at all, and there are a couple out now which have a protective ‘introducer’( Hollister ‘Vapro’ is one), so the tip does not even touch the outer part of the urethra. Talk to your continence adviser.

if you get a UTI.

Don’t take any chances – Get a prescription of antibiotics!  If you take a course, top up with probiotics during and afterwards to help protect your digestion and health. Always finish a prescribed course of antibiotics, as stopping early can cause      antibiotic resistant bugs.

Drink plenty of water and pee frequently. Begin as soon as you feel the first signs and symptoms. Doing this can actually flush the bacteria out and wash it away. Avoid alcohol, caffeine, fizzy drinks, spicy foods,  and bubble baths etc, which can worsen symptoms. Cut out sugar to help your immune system fight back.

The most common bug causing UTIs is E coli, which lives in the bowel, but can cause persistent problems once it enters the urinary tract. So – what else can you do to help get rid of RECURRENT UTIs, especially if antibiotics are not working?

You may want to consider using Colloidal Silver  – silver particles suspended in water, which is a natural antibiotic.  Go to http://www.ukcolloidalsilver.co.uk/

“Citricidal’ from Higher Nature is a safe, natural antibiotic you can try at home.

Cranberry helps to acidify urine, and may help stop the bacteria form sticking to the bladder walls. Concentrated tablet form is best.

Some people have found D-Mannose to be effective in the same way – this is a simple sugar that E coli tends to latch on to. It’s available online but is quite     expensive.

All these remedies can be taken both in a higher dose for infection, and at a low dose as a preventative.

Be aware:

· Some sexually transmitted diseases have symptoms similar to urinary tract infections. See a doctor if you suspect that you may have an STD.

· See a doctor if you have a fever, chills, pain in the flank area, nausea or vomiting – especially if the symptoms develop rapidly. Also see a doctor if symptoms do not improve after 24 hours of self-care, or if you are unable to urinate at all.

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December 2010

I hope everyone is reading the MS Resource Centre’s New Pathways (available to read at the MS Centre) at this exciting time in the world of MS treatments. The July/August edition updates us on the CCSVI debate, and lists all the places worldwide where you can be screened and treated. To learn more, I am attending the first International conference on CSSVI in Glasgow, in October, so I’ll be sure to report back.

The same New Pathways reports on a couple of fascinating small studies which fit in with this theory of poor circulation from the brain, and have worked for most of the people on the trial.

Inclined Bed Therapy

This involves raising the head of your bed by 6 inches. It’s certainly a lot cheaper than a private operation in Poland, as bed raisers, risers, or ‘elephant feet’ can be bought online for 12.99. Since CSSVI hit the headlines, this research has attracted fresh attention, and the author is carrying out a larger survey. You can get involved by going to www.thisisms.com/ftopicp-118378.html#118378

Update on Vitamin D

Thank you to the lady who came to let me know that she’s been feeling much better since she started on it. It is always good to get feedback; good or bad! D3 is still coming up as good, but newest research suggests it’s not just the vitamin D component that’s so important, it’s also the ultraviolet light, so more reasons to get outside as  much as possible. Had a good question regarding the vitamin D Should you take CALCIUM with it? I discussed this with the technical advisers at Nutri, who supply quality supplements to practitioners. Their view was YES, if you are on a dairy free diet, but not if not. Also, if you quote MSRC New Pathways when you make an order on the phone at      NutriCentre, you get 20% off.

My little break from clinic afforded me some reading time, and I’ve just finished ‘Healing Multiple Sclerosis’ by Ann Boroch. I’d recommend this to anyone who has taken lots of antibiotics in their life before    having MS, or has had recurrent yeast or fungal infections (like thrush or athlete’s foot) It’s main drive is about the association between chronic candida and MS; this isn’t a new theory, and most natural health    practitioners understand all about it. Getting rid of candida overgrowth is a long slog, but worth it if it applies to you, and I’m also happy to help anyone with this 3 pronged attack – kill yeast, don’t feed yeast, put good bacteria back! The author’s attitude to illness is a bit over the top at times, but the candida bit is good.

MS Centre Dietitian Bernice Chiswell adds

‘However, it should be born in mind that there is no scientific       evidence behind this. The diet is very restrictive and for the majority could prove more harmful than beneficial due to inadequate macro and micro nutrient intake’

Me:  The next book was ‘The MS Recovery diet’ The theory behind this is that food intolerances can initiate inflammatory reactions in the body, and it makes excellent and logical reading. It’s a similar approach to the Best Bet diet, but assumes that your intolerances are likely to be     individual,  explains how to find out, and has a large recipe selection to help get started. I recommend this to anyone with MS in the family.

Bernice Chiswell adds;

‘It should be born in mind that, although people with MS can have food intolerances, the only sure way to test for this is by food        exclusion and re introduction. Again, unnecessary exclusion can lead to unbalanced diets, plus be an added life burden to people who are already coping with disability and fatigue. The best bet diet is again not evidenced base.’

Me:  It’s a great month for books, too, as 3 new publications are out which all deserve reading – I have been waiting for ages for 2 of them:

Terry Wahls’ ‘Minding my mitochondria – How I Overcame       Secondary Progressive MS and Got Out of my Wheelchair’, which promises to be very scientific and convince everyone to eat loads of greens; ‘Overcoming Multiple Sclerosis; An Evidenced Guide To     Recovery’ by George Jelinek. Check out his approach on his website of the same name. Basically, super low fat Swank diet, a disease    modifying drug and meditation, and Judy Graham’s ‘Managing Multiple Sclerosis Naturally’. I haven’t read these yet but I will be doing and will report back!

Dietary approaches vary a bit, but some things remain constant – the less saturated fat, and the more brightly coloured veg & omega 3 fatty acids you eat, the more good you’ll be doing yourself.

Remember, if you’re taking something out of your diet, make sure you balance your nutritional needs. Our expert dietician, Bernice, can advise you.