Health care is an issue with life-or-death consequences that affects every person in America. It's foundational to a productive, satisfying life. But so far, it has been neglected this election cycle. Immigration, inflation, abortion restrictions, and wars in Gaza and Ukraine have drowned out discussions of expanding Medicare and shoring up public health in the wake of the COVID-19 pandemic...
Read more at The Progressive Magazine
The websites are tantalizing: "You can catch conditions before they become crises," reads one. Another promises to make cancer "easier to beat" and claims it can detect "over 500 other conditions in up to 13 organs." Full-body scans are attracting celebrity promoters, tech mogul investors and long waiting lists of people hoping to identify life-threatening conditions, usually more treatable in early stages...
Read more at NPR.org
In the summer of 2019, Karson Lewis, then 23, was hiking with friends around Belton Lake, north of Austin, Texas when her legs suddenly stopped working. "It felt like I was stuck in quicksand, like my shoes were full of lead," she recalled. She staggered over to a fence, where she steadied herself and caught her breath, blaming her symptoms on heat exhaustion. When other gait changes prompted a visit to an orthopedic surgeon in subsequent weeks, she received a diagnosis of bursitis and a steroid shot in the hip...
The headlines are compelling, with phrases like, "The Obesity Revolution," and "A new 'miracle' weight-loss drug really works." The before-and-after pictures are inspiring. People who have struggled for decades to shed pounds are finally finding an effective strategy.
The last few years saw breakthroughs in treatments for obesity, with new weight-loss medicines dominating recent news reports. The medicines, semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), work by slowing stomach-emptying and decreasing appetite. They're usually administered by weekly injection...
Read the rest at NPR.org
Having MS can sometimes feel like a full-time job. Over the last few weeks, I had to establish care with a new clinic and MS neurologist (my long-time neurologist just retired from patient care), get biannual labs, get an MRI and make arrangements for my next infusion.
As usual, it wasn't a smooth process. This time, the hospital where I went for the MRI was under construction — I was late because the old parking garage had been demolished. Then the lab orders contained a nonexistent code that took way too long to sort out. I had to call my new doctor's office and hand over my cell phone to the lab staff person so the nurse could explain what was needed.
And I'm still not done. My next order of business is one of the most important — get recommended fall vaccines...
Keep reading in Momentum magazine.
Uncertainty is one of life's inevitabilities. And we all cope with it and accept it – more or less. But a chronic disease like MS can raise that level of uncertainty to a new level - to scary, unfamiliar territory. MS is especially unpredictable with a wide range of symptoms and rates of progression. My diagnosis left me reeling. I didn't know how to get on with my life with the added uncertainty of MS...
(To continue reading, see the article as published by InnerSelf.com.)
I was recently asked by Shepherd - an amazing website for discovering new books - to share 5 of my favorite books in a category of my choice. I made up a very cool category: The best medical memoirs with an inspirational female narrator. As the author of my own new memoir, Up the Down Escalator, I enjoyed writing about some of the incredible books that inspired me. Check out the books I picked and tell me about your favorites in the comments below.
"You have MS."
What?!? That can't be right…seriously?… NO! I'm fine. You're mixing me up with someone else… At least it's not a brain tumor… but what the hell?.. that just can't be right…
That mishmash of thoughts at the time of an MS diagnosis, as with many other serious or chronic diseases, can be so loud and alarming that everything else is shut out. The analogies are endless – you're being sucked into a tornado, sinking to the bottom of the ocean, suffocated under an avalanche. I remember feeling numb, dizzy, confused, and horrified all at once...
(To continue reading, see the article as published by New York Weekly.)
The young man was in his mid-20s when he came to see me for severe abdominal pain at my small community clinic. The pain, worse than any he'd ever experienced, had persisted for weeks and was getting worse. He cried out when I examined him.
I didn't know the cause of his pain, but I could think of possibilities, including a ruptured appendix, a perforated ulcer or pancreatitis. He needed an urgent CT scan and a surgical consult. The fastest way to get both was to send him to the emergency room.
But the man said he couldn't go. He was uninsured...
(To continue reading, see the article as published by NPR news and Public Health Watch.)
"What the hell are you doing?"
"Oh, my God. I am SO sorry." I was mortified. I had been trying to fit my daughter's suitcase into an overhead bin on an early morning international flight, but in the process, it slipped out and knocked a woman on the head.
Her partner was not amused. "WHAT were you thinking? Why didn't you ask for help?" he snarled. I was afraid he might bite me...
(Please see the rest of this piece as published by Momentum Magazine online.)
Living in Texas, I dread the summer. Don't get me wrong. I love my hometown of Austin. But by early June when temperatures rise above 95 degrees nearly every day, the heat is so oppressive that I start fantasizing about a move to the mountains.
As many as 60-80% of people living with MS experience heat sensitivity. Heat exposure saps our energy and can exacerbate symptoms. High summer temperatures can make us downright miserable. . .
(Please see the rest of this piece as published by Momentum magazine.)
One morning in November 2009, I woke up dizzy – a cloudy feeling I couldn't explain. I ignored it and continued my routine, seeing patients at a clinic in central Austin, carting my daughters to preschool. But when I developed double vision and taste changes, I started to worry...
(To read the full story, please go to Public Health Watch or The Dallas Morning News.)
I can hardly believe a new year is upon us! As we celebrate the start of 2023, I hope you'll join me in making a New Year's resolution to prioritize personal health. For those of us with MS, I think one chronic condition is more than enough. Let's do everything we can this year to stay healthy! Are you seeing your healthcare provider regularly? Getting enough sleep? Eating a healthy diet? Exercising most days of the week?
The beginning of the year is a time to reflect on our lives and make changes, big and small, to improve. Here are some suggestions:
1) Get a check-up with your primary care provider. Your PCP can talk to you about any health issues, bothersome symptoms, depression or mood concerns, and help you catch up on screening tests for chronic disease and cancer.
2) Make sure you've had all recommended immunizations. In addition to COVID and flu vaccines, everyone needs an updated tetanus shot every 10 years. Depending on your age and risk factors, you might also qualify for a shingles vaccine, pneumococcal vaccine, and/or other immunizations.
3) Make a plan to exercise. Adults should get at least 150 minutes of moderate-intensity physical activity each week + 2 days of muscle strengthening activity. Find an exercise buddy, make a workout mix of favorite songs, or find another way to make it fun. Pick a time that makes sense for your schedule and make a commitment to yourself to stick with the plan.
You might also consider resolutions to better manage stress, sleep 7-8 hours a night, eat more fruits and vegetables, start a meditation practice, write in a journal. Write down your resolutions as "SMART" goals: something that is Specific, Measurable, Achievable, Relevant, and Time-bound. I also encourage you to share your resolution with a friend or family member who can provide encouragement and help hold you accountable.
Here's to a happy, healthy new year!
Everyone is getting sick. Our hospitals (and hospital doctors like my husband, Don) are overwhelmed. What can you do to stay healthy?
Nothing is 100% protective, but I wanted to share these 6 self-care strategies to help keep you well during this busy time of year:
1) Get enough sleep: For most adults, 7-8 hours a day are recommended. Follow sleep hygiene recommendations:
2) Stay Active: Getting at least 20-30 minutes of exercise a day will help you feel and sleep better, in addition to physical health benefits.
3) Don't drink too much: Alcohol is often a central part of holiday parties, but it can lead to accidents, impair judgement, and interfere with sleep. The effects of alcohol impact short and long-term health. In general, women should limit alcohol to one drink/day (or less), and men can have up to two.
4) Follow a healthy diet: It's tempting to overeat when you're surrounded by seasonal treats. Aim for 5+ servings of fruits and veggies a day and limit snacks, desserts, and sugar-sweetened beverages. Harvard Health has more on avoiding holiday weight gain.
5) Stay up to date with COVID and flu vaccines: Flu cases are rising in many areas, and COVID cases are starting to climb in many places too. Vaccines significantly reduce the risk of severe illness, hospitalization and death from COVID and flu. Keep a close eye on disease activity in your community, and consider wearing masks and avoiding crowds, especially if case rates creep up.
6) Breathe: The holidays are fun… but can be stressful. Take time to pause, take deep breaths, meditate.
Make sure self-care is one of your top priorities!
Please add your thoughts and your own tips below! Also, check out my monthly columns with Public Health Watch (and sign up for their thoughtful and informative newsletter).
"These lesions here and here pretty much confirm the diagnosis of MS," the neuroradiologist said, pointing to fuzzy white spots on my MRI.
I stood there in the dark room, staring at the MRI films. I didn't know how to read an MRI, but I could see the spots he was talking about. I couldn't believe it. Maybe these weren't my MRI films. Maybe the machine was broken. He had to be wrong. He had made a mistake.
Continue reading on the National MS Society's Momentum Blog.
When have you found silver linings in your own life? Please share your experiences in the comments below.
Don't wear a mask… actually, wear a mask. Spray your groceries with bleach… no, that's silly and unnecessary. Boosters are for everyone… no, boosters are only for older adults and those with chronic condition. No, we were right the first time—boosters are for everyone (age 16+).
I already struggle with dizziness related to MS. But keeping up with the ever-changing COVID-19 guidance really makes my head spin...
Continue reading this article on the National MS Society's Momentum Blog and please share your comments below.
Summer is not my favorite season: HEAT (especially in Texas). Over-air-conditioning in any indoor public space. No school = no structure and bored kids. Friends, doctors, and colleagues (including that person who really needs to weigh in on a big decision) are out of town.
But summer doesn't have to be the worst time of the year.
Perhaps, maybe, it can even be the best.
Although Covid-19 is still out there, the vaccine is safe for nearly everyone--even if you have MS or another chronic condition, even if you're pregnant or breastfeeding. Once fully immunized, you can enjoy a return to many of the pre-Covid pleasures of life. Some limitations remain, especially for those of us on immunosuppressant medications that might make us more susceptible to infection. But as case rates continue to decline, we can all feel safer to venture out, reunite with loved ones, and lead a normal life.
Here are some ideas to plan and experience your best summer yet:
1) Make a To-Do list of fun activities: My personal To-Do list usually consists of items like Change the oil, Water the plants, Pick up meds, Clean the rabbit cage, De-shed the rabbit, Vacuum the rabbit fur from my office, and Consider a less messy pet. But why not make a different list of fun stuff? You might make a shared list with family or friends, and then prioritize each item and get them on your calendar. My new list might include: Swim at Barton Springs, Go to an outdoor evening concert, and Go tubing in the San Marcos River.
2) Stay cool: Heat is a major inconvenience in many parts of the country, and it can even pose a health risk. For those of us with MS, heat can trigger symptoms and add to fatigue. To cope, stay well hydrated with ice water/cold drinks. Go outside in the early morning and evening, and stay inside during the middle of the day. Dress appropriately, and use fans to cut down on high AC bills.
3) Get out of town: Just the act of planning a vacation can improve quality of life for up to eight weeks. Declining rates of Covid-19 mean that most travel, with reasonable precautions, is safe again for people who are vaccinated. Try to find a spot near water – pool, lake, ocean – or a place that allows you to escape to a cooler climate. If your budget is tight, look for a nearby state or national park where you can camp for a weekend, or visit friends or family who can host you. See my prior blog post on lessons learned from air travel.
4) Indulge in seasonal produce: This is the best time of year to enjoy cherries, peaches, tomatoes, cucumbers, blackberries, and so much more. Visit a new farmers market, make smoothies, and try new recipes (like this excellent gazpacho recipe.)
5) Enjoy live music and entertainment: With rates of Covid-19 falling fast, live entertainment is coming back. Search on-line for local options, like a free symphony concert or Shakespeare in the Park.
6) Set a goal and start to work on it: Always having a goal is a key strategy for coping with a chronic condition and for anyone who wants to feel a sense of purpose and accomplishment. Think of a new skill you'd like to learn or a house or professional project to tackle. Set a new fitness or health goal (maybe join a Walk MS or MS150 event this fall). Choose something attainable, map out the steps to get there, and go for it!
7) Read some great books: Escaping into a good book is the next best thing to embarking on your own adventure. Visit a local bookstore for inspiration. Follow friends (and me!) on Goodreads. Get a free trial on Audible. For more ideas, the New York Times publishes a fun list of summer reads. Share what you're reading in the comments below.
And while you're having fun, take good care of your health:
What other ideas do you have for a great summer? Please add them to the comments below.
Get up now and exercise! Lying in bed is lazy. And what's up with this messy house? Shameful. You need to clean this weekend. Speaking of messes and inefficiency, can't you get your email under control? Your inbox is going to explode. You better deal with those emails while you're working out on the Stairmaster... or read some medical journals. You do realize you aren't doing enough to keep up with the medical literature, right?
On and on she goes.
Believe it or not, she has chilled out over the years. Having MS has helped me to suppress the drill sergeant and sometimes have a little self-compassion. But I'm still a work-in-progress.
I reviewed a section of my upcoming memoir with my editor recently. I had written about how my return to work after my MS diagnosis 11 years ago helped me stop my "self-absorbed wallowing."
"What? 'Self-absorbed wallowing?' You're being way too hard on yourself," my editor said. "You had just been diagnosed with MS… You wouldn't treat a patient that way – or a friend."
Of course not. I hadn't even realized I was being harsh. But she was right. After my MS diagnosis, I should have allowed myself to feel disappointment, despair, even to "wallow" without this hypercritical inner judge telling me to hurry up and get over it.
I'm not going to psychoanalyze myself to get at the root cause of my commandant mentality. My drive to work hard has helped me achieve important goals and feel a sense of purpose. But I am learning to gently push back against regular self-criticism. MS is an extra good reason to cut myself some slack. I can befriend and cheer myself on with a more congenial tone:
- I can only do what I can do.
- I'm doing the best I can.
- I'm doing enough, I have enough, I am enough.
Self-compassion does not need to mean self-indulgence. Even when I want to, I don't skip my workouts or binge on Ben and Jerry's. But it's a new mindset, and it's helped me create small rituals that brighten my day: I light a candle at my desk. I take short walks around the block or to the community garden between conference calls. On Wednesdays after my run, I go to Caffe Medici for a chai latte, and I pick up tacos for my kids. On afternoons packed with meetings, I treat myself to dark chocolate. With rare exceptions, I don't work on weekends. On infusion days, I pack snacks, listen to good music, and wear fuzzy socks.
I still spend too much time in my home office, on Zoom/Skype/Teams calls, reviewing reports and spreadsheets, or plowing through email. I feel guilty that I'm not working hard enough and then guilty that I'm not spending enough time with my family. But like everyone, I'm stuck with a 24-hour day. It is OK. I'm doing enough, I have enough, I am enough.
Please share your thoughts on self-compassion in the Comments below and any recommendations you have for me and others.
I am high maintenance when it comes to sleep. Conditions have to be perfect: dark, quiet, not too hot, not too cold. If I stay up too late, I may miss my bedtime window and not be able to sleep. If I go to bed too early, I may be awake for hours. Interruptions provoke an unfiltered rage because I know I may not be able to get back to sleep, meaning I'll be tired in the morning, grumpy and volatile all day, and unproductive at work. Sleep is key to my wellbeing and relationships, but getting a good night sleep can be a major challenge.
Studies show I'm not alone. Insomnia affects nearly 1/3 of adults, and stress (think Covid-19) and chronic disease can make it worse.
Poor sleep can also contribute to health problems, increasing the risk for weight gain, diabetes, and possibly mood disorders, reduced immune function, heart problems and even decreased life expectancy. Adequate, restful sleep is important.
So, what's an insomniac to do? Here's the lowdown on treatment options and sleep meds:
Before turning to medication, make sure you practice good sleep hygiene:
Try meditation. Try breathing or relaxation exercises. This guided meditation was recommended by a physician friend.
Talk to your doctor if you take medications that can impact sleep (stimulants, some antidepressants, some blood pressure medications, steroids, and others).
Know that most sleep meds only increase sleep by 15-30 minutes.
Weigh risks and costs of medications:
Consider supplements (but have realistic expectations)
I also wear ear plugs and use a white noise app – both help a lot.
Finally, emerging evidence shows diet and sleep are intimately connected. Studies show sugar, saturated fat, and processed carbs can interfere with sleep. Plants, fiber, unsaturated fat may improve sleep.
Here's to sleeping better in 2021! Hopefully we won't have as much to keep us up worrying. Please add your own suggestions in the Comments section below.
I woke up dizzy on a Monday morning in November, 11 years ago. I didn't think much of it, and I went to work, as usual, at my small community clinic in Central Austin. But as the week wore on and my symptoms persisted, without any explanation, I began to worry. When I started to have mild diplopia and taste changes, I needed to seek care. A neurologist examined me and told me I was probably okay, but my dizziness continued. A few days later, after noting subtle nystagmus during my otherwise normal exam, a savvy ENT doctor ordered the MRI, revealing my diagnosis: multiple sclerosis...
Continue reading on the Texas Academy of Family Physicians blog: https://www.tafp.org/blog/ms-resources
