Hot tubs can put MSers in the soup

  

Jumping in the Jacuzzi may sound appealing when muscles spasm and joints ache. Whiling away time in a steamy whirlpool can sound soothing.

 

 

  Lounging in a steamy hot tub may rejuvenate some folks, but it can utterly wipe out someone with MS.

 

Not so for anyone living with multiple sclerosis.

 The hot tub can be one of our worst enemies, when it comes to managing life with MS. It’s pretty much on par with a sit in the sauna, when it comes to triggering MS troubles.

 Heat is not our friend. (Actually, extreme temperatures in either direction can set off our symptoms.  But overheating is a big baddie for us.) 

 Is a sauna soothing for someone with MS? Not so much.

 Uhthoff’s Phenomenon (aka Uhthoff’s Sign) is a classic experience among MSers. When the body temperature goes up, our neurological symptoms generally increase too. That means a cozy dip in the hot tub can invite extra balance problems, blurred vision, confusion, dizziness, fatigue, numbness, pain, tingling, weakness, and other MS woes.

Once our bodies cool down again, some of those symptoms may subside, usually within 24 hours.

 Is it worth all that, just for a short jaunt in the jetted tub?

 

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Image/s:  Public domain photos, Pixabay

 

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MS can be a ticket to de-stress

 

Life with multiple sclerosis can be exhausting. Add the occasional (or frequent) sudden onslaught of MS-related fatigue of biblical proportions, and it’s almost unimaginable.

 High-energy people may find it difficult to empathize or understand what the MSer means, when he or she describes a titanic tiredness that saps all strength and sends energy and motivation limping away.

 Physicians may call this lassitude, and it's a hallmark of MS. It’s physical and mental weariness, a crippling sluggishness. And it can come on suddenly, seemingly without warning.

 One thing we know for sure – MS hits us the most when we are tired and stressed.

 

Maybe it’s time to let MS be our ticket to de-stress and recharge.

 Here are a few strategies for minimizing the stress that can aggravate and increase the fatigue that goes with MS (and that can leave the MSer extra vulnerable to a full-blown flare-up).

1. Clutter is confusing and chaotic. Simply clearing off a kitchen counter, putting away clean laundry, or tossing out junk mail helps remove stressors.
   

2. Multitasking can be unmanageable. Efficiency is lauded as a virtue, but too much multitasking can send our minds awhirl and our energy away.
   

3. Tackling to-do lists reduces stress. Sometimes it helps to make to-do lists and then knock off one task at a time. By listing even the smallest chores, we can gain satisfaction with each completion. At the end of the day, we can review what’s done and feel a bit of accomplishment. If MS has us homebound, sidelined, or otherwise restricted, this strategy can be extra important.
   

4. Realistic goals are our reality. Sure, we like to stretch ourselves, often past our own limits. But setting more reachable objectives can be rewarding and simplifying. The net result is often less stress. The tricky thing is, MS can change our energy resources spontaneously and unpredictability. (Ever heard of The Spoon Theory? We never know how many we’ll have in a day.)
   

5. Learning to say “no” is life-changing. Boundaries can be a new best friend to the MS warrior. They don’t come easily, because we tend to want to volunteer and participate and be active helpers. That’s one way we get worn out extra quickly, so we have to choose carefully when to say “Yes,” if someone asks.
   

6. Granting ourselves permission to rest is powerful. Stopping our self-expected activities isn’t easy. Who doesn’t want to feel productive and useful? Yet those living with MS may need more rest than those whose myelin isn’t threatened and compromised? We may need to curl up with a book, stretch out under a blanket, or even catch a catnap to regather ourselves and avoid the overdoing that can invite MS to wreak its havoc on us again.

 Self-management is tough, especially with the ever looming challenging that the MS MonSter brings to our lives. And it’s not like we want to cop out of life, escape all responsibilities, and sit idly by. But it’s critical to be deliberate about our mental and physical exertions, if we are to reduce stresses and build ourselves to battle the dreaded beast as best as we can.

 Preaching to the mirror here. I know. Remind me again … soon.

 

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Image/s:  Adapted from public domain image.

 

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Dizziness isn't always all-ears

 

Whirling vertigo often begins in the ears … but not always. Ask anyone with multiple sclerosis or migraines. Better yet, ask anyone with the double bonus of both. The combination abounds!

 Vertigo can be a symptom of migraine. And it’s extra special when it comes from an MS migraine, which is an entity (or agony?) all its own.

The American Speech-Language-Hearing Association put it this way:

 Specifically, vertigo, which is the sensation of perceived motion without actually moving, is reported by up to one third of people who have migraine, and general dizziness or unsteadiness is reported by up to three quarters of all patients with migraine.

The folks at Johns Hopkins Medicine point to vestibular migraine as a frequent source of vertigo and related symptoms:

 Migraine headaches are a common neurological condition. Although common migraines are characterized by a moderate to severe pounding or throbbing headache, vestibular migraine may or may not involve headaches in combination with vestibular symptoms such as vertigo, imbalance, nausea and vomiting.

Stanford Medicine agrees:

 Unlike the classic migraine, which is described as severe, throbbing headache, vestibular migraine has no pain associated with it 50% of the time. Vestibular migraine causes episodes of dizziness described as rocking, spinning, floating, swaying, internal motion and lightheadedness. They most often occur spontaneously, but can be triggered by stress, sleep problems, skipping meals, dehydration, other illnesses.

 Wow. So it’s possible (and not even unlikely) to have a migraine without suffering a severe headache.

Finally, someone’s talking my language!

 After years of going around and around (See what I did there?) with my primary care physician, in which he insisted that my frequent and severe vertigo / lightheadedness / dizzy / off-balance symptoms were caused by inner-ear crystals (including multiple physical therapy sessions for this diagnosis, which proved unfruitful and actually aggravated my symptoms, I found this migraine-related information to be a complete game changer.

OK, for the vast majority of vertigo sufferers, a simple physical therapy maneuver can work miracles. (Got vertigo? Try this first!)  But for the MSer (or anyone with central vertigo, rather than benign positional vertigo) or the migraineur, it generally proves a bust.

 I’ve had migraines since my Junior High years. But they always used to include major headaches. And apparently vestibular migraines (and the frequently associated vertigo) are most common among those who were particularly susceptible to motion sickness, especially as children. Bingo! That was me.

 Enter MS. Within the past few years (especially since hormonal changes kicked in with a vengeance), my migraines have evolved. Sure, I occasionally have the head-in-a-vise pounding variety. But more often, I battle a dull headache behind the agonizing whirling and unsteadiness of vertigo.

 Thankfully, my MS doctor affirmed my description of symptoms and flat-out said the frequent (sometimes daily) vertigo I face is related to migraines, which are common with MS. As such, she recommended avoiding food-related migraine triggers (as I already do), getting much-needed rest, drinking plenty of water, and taking travel-sickness medication when vertigo strikes. (See Simple OTC product helps vertigo?)

 That means no more neck twisting, which only aggravated some of my existing MS demyelination and didn’t fix the lightheaded spinning problem anyway.

 

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 Image/s: Excruciating Headache, M. Egerton, 1827, public domain

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Self-advocacy: When therapy is not therapeutic

 

Multiple sclerosis pits a person against his or her own body – and sometimes against medical experts.

 Ask any of us who battle MS daily, and you’ll likely hear about how our own bodies betray us, as our central nervous systems mutiny against our limbs, eyes, and countless other components. Maybe that’s why it seems extra frustrating when we have to combat false assumptions and unhelpful advice, particularly when it comes from medical professionals we have enlisted to help us.

 

Ouch.

 Recently, my physician sent me for vestibular therapy, explaining that my recurrent (and increasingly severe) vertigo episodes might be traced to benign paroxysmal positional vertigo. Simply described, that’s a condition that arises when inner-ear crystals slip out of place, causing dizziness.

 

That’s not what’s caused my vertigo.

 More than a decade ago, my (now-retired) neurologist/MS specialist attempted the Epley Maneuver on me, simply to rule out BPPV. This little trick involved lying flat (supine) on the exam table, while the practitioner bends and turns my head to one side and then the other.

 

The Epley Maneuver can work wonders for someone with BPPV. But for the MSer, it can wreak havoc.

 Way back when (and again recently), this technique sent me spiraling into vertigo hell for hours.

 

Fast-forward to last week.

 The young physical therapist, apparently specializing in vestibular issues, put me through a full battery of balancing, rolling, and head-turning trials. She set me supine on the flat exam table and tipped the top (head) section downwards by 30 degrees. Adapting the popular 1-10 pain scale, my vertigo went from a 3 to an 8.

 In our initial discussion, I had already explained to her that I needed to elevate my head at least 30 degrees whenever on my back (as for an exam, fitness class floor exercises, or a yoga class). I mentioned that I sleep with two pillows. All of these allowances are vertigo-preventative, as I have demyelination in my cervical spine area.

 Ever determined, however, she put me through the paces.

 Then she concluded that my vertigo was not vestibular-related, but only after I’d endured her full checklist of tests and potentially therapeutic head positions and movements. Even so, she said she recommended repeating the same exercises, intentionally precipitating vertigo, on the chance that might retrain my brain to adjust to vertigo.

 

Um, what?

 Afterwards, I contacted my physician and reported on the experience. I told him I was not inclined (no pun intended) to continue the vestibular therapy, as it only triggered and increased my symptoms and as my vertigo clearly was not vestibular in nature.

 Holy moley. My head is still spinning over this ordeal. But I had to find my way to standing on my own two feet (literally and figuratively) to avert repeat occurrences.

 Phew! They don’t call us MS Warriors for nothing. (At least, perhaps they should.)

 

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Image/s: 3 Wise Monkeys at Tosho-gu Shrine, Nikko, Japan, by Ray in Manila - CCA lic.

 

 

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