Local MS Walk

I was recently away on vacation visiting my parents and aunt and uncle down in Florida, and I felt pretty good: I maintained a nice steady pace and I sorta kept up with the seniors!… Things have been about the same (healthwise) for a while now and I like to think that no news is GOOD news, hence the lapse in website writing and the increase in meeting the outside world with grace and gratitude. 

I’m falling into a pleasant groove here with some library and hospital volunteer work getting me out of the house and some freelance writing ventures keeping me employed and satisfied. I’m also in the process of applying for the Master’s of Social Work degree (MSW) through a couple of universities. My primary interest is in a college in Maine that offers an accredited– VERY RARE– distance education program with a part-time, in-person clinical component. I think I can handle this and conserve my energy until the final clinical rotation.

So things have been peaceful, steady, and sane here for the past few months. Whew!!

This past Sunday my husband Bill and I got out and volunteered at our local MS walk. We’ve been doing this for four years now, and the vibes and the camaraderie are always upbeat and supportive. I like to help run the registration table and assist participants with forms and donations and Bill finds himself getting shirts for the walkers who raise a certain level of money.

This year I also had the opportunity to meet a newly-diagnosed girl (she appeared to be in her twenties) who had a rough first attack. Her mom sat next to me at the registration table and she came over with her small walking group to talk. Jenni wasn’t participating in the walk herself because she was rebounding from leg paralysis and was happy to be out of a wheelchair and using a cane. Both mom and daughter marveled that I “looked so good” for someone who had battled MS for nearly 12 years. I had to confide that not everyone has a bad first attack and I was one of many patients with a LONNNNNNNG and winding road to the proper diagnosis. Even though Jenni and I had different stories, we both had similar symptoms– as do many MSers– and we related to one another. I then invited her to attend the next local in-person support group in our area. A guy from high school got me to it, and I wanted to “pay it forward” and get her to consider. So Jenni and I may hopefully meet again.

I Met Joan and Lisa and Sonia— What Fun!

What a great day yesterday! I ventured down to Delaware to meet Joan (from A Short in the Cord and Joan’s MS Chat Room), Lisa (from Brass and Ivory, MS Central, and The Carnival of MS Bloggers), and Sonia (one of Joan’s local MS buddies and a fellow chatter.)

Woo Hoo!!…… It was awesome to meet fellow MS writers and chatters in person, after nearly two years of online interactions. And we found that we had TONS to TALK ABOUT in person. Joan was a little concerned that we might have nothing to say when actually brought together in one room, but not so. We had lots of laughs, we shared more information, we learned more deeply about one another’s lives, and we also talked about NON-MS stuff!

An MS issue we did discuss: what did we feel were our greatest multiple sclerosis symptoms and did they greatly affect us? Joan and Sonia mentioned their stopped-in-their-tracks fatigue which altered both of their career paths. I mentioned my own embarrassing and VERY annoying bladder and bowel urgencies, and Lisa explained her right leg weakness and the compounding rheumatoid arthritis hand symptoms (although it was good to hear that her current RA med is helping BOTH of her conditions.)

We enjoyed food and some wine and we gazed at Joan’s adorable backyard with bird houses, feeders, and many visitors. Joan’s home actually backs to a water runoff area that has filled in since she moved there, giving her a serene small pond that she shares with other neighbors. SO COOL!…..We even met Joan’s husband Tedd and I got some better directions home, since I got thrown off course with MapQuest’s ambiguous information (SIGH…)

All in all: what a GREAT TIME!…. Thanks for such a splendid day, ladies, and I can’t wait to do it again soon. We hope to continue and make this a tradition, involving more MS ladies who’d like to gather and celebrate good food and good friendships and LIFE. We all ROCK n’ ROLL!……

NMSS Walk / Bike Events and Current Survey

Some of the current MS fundraisers sponsored by the National MS Society (U.S.) include the Walk MS event and the Bike MS event, which are both coming into full swing. Both raise many thousands of dollars towards MS Society programs and MS research. For the past several years I’ve volunteered at both of the events: I’m not much of a fundraiser but I definitely can donate my time to help the local events run smoothly. To find out about donating, fundraising, or volunteering for either of these national events visit:

There is also a current survey in which the NMSS asks for MS writers’ / bloggers’ input about online communications and information. If you are an online writer, feel free to have your say:

MS: Online Grocery Shopping & Home Delivery

One of my biggest obstacles and annoyances is grocery shopping. I have to admit that when it’s a small order I don’t mind trekking to the A & P for some things, but when I have to do a big run I get very stressed. I don’t enjoy grocery shopping to begin with: all the decisions, navigating the crowded parking lot (I don’t yet have a handicapped parking placard, but it’s getting very tempting..), navigating the crowds in the store, trekking everywhere for items– oh my goodness! Just talking about all of it is making me tired! Worst is the lugging of heavy bags from the cart into the car and then into the house. I HATE it. I’ve tried to accomplish this during bad stretches with a cane in hand. UGH. I can only imagine using one of the store’s scooters with the ridiculously small basket attached to the front. Nobody moves for me now as I lurch through the aisles, often trying to keep my balance and not crash into someone like what would appear be a drunken sailor. LOL. I can only imagine the added annoyance of a scooter. So the discovery of grocery store home delivery systems has been a sanity-saver for larger orders.

I’ve been utilizing Peapod online shopping as of late. It delivers from Stop n’ Shop, which is one of my local stores. The delivery fees are reasonable: $9.95 for a $60+ order and $6.95 for a $100+ order. The website is easy to navigate and weekly specials are listed. I can also create a bare bones list of regular items that I can continually refer back to in order to save time. Other grocery delivery programs abound. Below is a small list of regional chains (the U.S.) and their programs. Some provide online shopping and home delivery while others allow you to pick up your online order from the store. For your own area of the world, consider calling or looking up local and regional stores online and learning about their online shopping / delivery programs. I find myself much more at ease because of this fantastic concept:

Peadpod
Shoprite
AUL Superstore
Schwan’s
Safeway
Homeland Delivery
Giant Food Stores
Acme Food Stores

MS Awareness Week: March 8 – 14, 2010

It’s multiple sclerosis awareness week again and time to spread knowledge and news about this life-altering condition. Living with it can range from being a small nuisance to being a great daily challenge. No two cases are alike and no one patient presents the entire scope of the disease. Those looking in may assume that a mild case represents the case for everyone, or that a severe case– such as Annette Funicello’s— is the norm. Not so. We are all different in terms of physical symptoms, although we are all united in our general feelings, fears, hopes, and knowledge about multiple sclerosis. Please take the time this week to become aware of what multiple sclerosis means and how it impacts patients. Althought the ideal is to be aware YEAR-ROUND.

*For information on MS Awareness Week, visit the National MS Society.
*For more information about multiple sclerosis, read MS Defined.

Thanks.

Jen


MS News: February 2010

I’ve been busy with some new contract work and so I’m just dropping a note to report a few of the latest happenings in the month of February. Be well and please hope for an early spring!

Jen


Joan’s MS Chat Room this Friday, February 22nd:

Join Joan’s MS chat room this Friday, February 26th, from 7 – 9 pm Eastern Standard Time. Log into the chat from Joan’s blog A Short in the Cord by clicking on the coffee cup in the right margin of the homepage. Always fun and not always reverent, the chat is for anyone who would like to join (not just Delaware area MSers.) The topic this session will be “information exchange”, so if you have any news, tips, or happenings you’d like to offer (or receive), come out and join the discussion. All from the comfort of your home.

Latest about Prospective Oral MS Disease-Modifying med Fingolimod, now called Gilenia®:

Novartis International AG, the pharmaceutical company who created FTY720 or fingolimod, an initial oral disease-modifying MS medication, has been given priority review from the U.S. Food and Drug Administration, due to the drug’s potential for multiple sclerosis. Novartis petitioned for FDA approval in December of 2009, and priority review speeds up the process– if the drug is seen to be safe for use– to six months or less. At the same time the FDA will carefully evaluate whether FTY720 or fingolimod should require a risk management program to coincide with drug usage. For more information about this oral medication, see the National MS Society’s news piece.

First American Study of Venous Insufficiency (CCSVI) in Multiple Sclerosis Patients Intrigues and Spawns Further Research:

This topic I find fascinating: the idea that MS patients have an insufficient flow of blood leading away from the brain, causing abnormal flow patterns and neuron damage within the brain. My thoughts are still murky about this topic and I’m not completely convinced of the validity of the idea, but I’m happy to see that the University of Buffalo has and is continuing to study the topic. They’ve performed a large study with MS patients and healthy control patients. Ultrasound venous Doppler tests were performed and a significant amount- over 55%- of MS patients were seen to have the vascular anomaly compared with about 22% of healthy individuals. These findings are prompting more research into this CCSVI phenomenon. The U of Buffalo has had the first large study after the idea was initially tested by Dr. Paolo Zamboni in Italy. For more information about this cutting-edge research, see the University of Buffalo’s news release.

MS Strength’s Fundraiser for the MS Society Scholarship Program is Soon to Hit $100 (AGAIN):

This is my own little project and if you glance to the upper right of the homepage here, you’ll see that the funds for the second donation are now over $95. Thanks for your help and for supporting a great cause: EDUCATION. You can read about recent recipients of the MS Scholarship fund by accessing the MS Society’s scholarship page.


I’ve Joined an In-Person MS Support Group

YES! It’s hard for me to believe it myself, but I was finally enticed by a fellow classmate from high school. I learned about our common disease through, of all places, FACEBOOK. YES!

I wasn’t sure if I’d ever join such a group: my long road to diagnosis made me settle slowly into the idea that I probably had multiple sclerosis. I wasn’t hit over the head with a drastic flare-up and suddenly changed: there was a slow progression with attacks increasing in severity and duration over the past 11 years. When I was actually diagnosed, I was going through a downward spiral of ever-decreasing employment and an uncertain future of disability benefits / no satisfying career. The last thing on my mind five years ago was to join people face-to-face and keep from bursting into tears.

My mom and I actually once attended a seminar (given by my honorable neuologist) for newly-diagnosed patients. I was in such a slump at the time and I could barely move my limbs as I shuffled, mid-relapse, into the meeting where pharmaceutical reps hawked their wares—pens, writing tablets, mouse pads, water bottles, fanny packs— and a nurse handed out a poem about what MS was akin to: believing you’re going to fast-paced, glamorous Paris and being rerouted to Bavaria. Both are great, but different. And the subtle beauty, slower pace, and depth of Bavaria becomes “the road less traveled.” Well then and there I burst into tears and made my mom get up so that we could leave. I think I might have frightened all the NEWBIES! I can laugh about it now, but at the time I was too neck-deep in my own concerns and depression and anger to want to share with others or be a source of comfort and understanding for the rest of the group.

Since being diagnosed, I’ve finalized my disability case and have found a steady– albeit slower– pace with satisfying volunteer hours, a class or two, and some freelance writing work. Things have stabilized both physically and mentally. I’ve gained insight from a social worker and have made strong bonds with online support networks. And yet I’ve had the ever-increasing need to meet others in person to support, be supported, educate, be educated, laugh with, and occasionally commiserate with. The craving to be in an ongoing group setting where I can steadily grow with other MSers. Little did I know that this need would be met with a local in-person support group through the MS Society. And that I would learn about it through a fellow classmate on Facebook. Life is STRANGE.

I joined the group in November of 2009 and we had a Tai Chi instructor (a patient’s mother) who gave us simple poses and breathing exercises to incorporate into our daily routines. We also spoke of Thanksgiving recipes and what we do for the holidays. In December the group met at a Chinese buffet and we spoke about the new concept of CCSVI. Was it a lark or would it get further research? And then this past January we met and just talked for two hours– no instructional demonstration or specific agenda. Just talk. NICE. And I have to tell you that because I’ve become emotionally and physically ready to face my fears, I have been met by a bunch of people laughing and kvetching and sharing and educating and not ONE moment of it has made me want to burst into tears.

*** For more information about MS support groups in the United States, visit the Nat’l MS Society and the Multiple Sclerosis Foundation.

The Circle of Ten


I was just visiting a great MS patient resource, About.com’s multiple sclerosis site, and I read about a fantastic way for people to simply and effectively raise money for MS research. The idea is called “The Circle of Ten”, created by a family who was touched by multiple sclerosis. The theory is quite simple (and ingenious): a person employs ten friends/family members to each collect $10 donations from 10 other people. So 10 people x 100 dollars in donations (each) = $1,000. What a great way to raise a cool grand! This idea is perfect for the coming MS Walk and MS Bike events.

To read more about this idea, visit Julie Stachowiak’s MS site at About.com.

AMPYRA: New MS Symptom Medication

I recently received the following press release about a new multiple sclerosis therapy (symptom-managing as opposed to disease-modifying) that is viewed to increase mobility. Given that we spoke a bit about it at my MS support group last night, I feel the need to share with you this information and to allow you to make your own decision as to whether to try it:

Hi Jen:

On January 22nd, the US FDA approved a new MS therapy called AMPYRA from Acorda Therapeutics. Ampyra is indicated to improve walking in people with MS as demonstrated by an increase in walking speed. As a leader in the effort to inform and inspire people with MS about the disease, we hope that you will want to share information about this important development with the people who follow your blog.

Below please find a press release with more details about Ampyra and Acorda. Please feel free to contact us with any questions.

Best,

Agnes Cao

Berry & Company Public Relations

57 East 11th Street

Sixth Floor

New York, NY 10003

Acorda Therapeutics Announces FDA Approval of

AMPYRA™ (dalfampridine) to Improve Walking in People with

Multiple Sclerosis – Demonstrated by Increases in Walking Speeds


HAWTHORNE, N.Y., January 22, 2010 – Acorda Therapeutics, Inc. (Nasdaq: ACOR) today announced that it has received marketing approval from the U.S. Food and Drug Administration (FDA) for AMPYRA™ (dalfampridine), an oral treatment to improve walking in patients with multiple sclerosis (MS). This was demonstrated by an increase in walking speed. AMPYRA demonstrated efficacy in people with all four major types of MS (relapsing remitting, secondary progressive, progressive relapsing and primary progressive). AMPYRA can be used alone or with existing MS therapies, including immunomodulator drugs.

“The approval of AMPYRA marks an important milestone for the many people with MS who suffer walking impairment. Difficulty walking is often cited by those with MS as one of the most pervasive and challenging aspects of their disease,” said Ron Cohen, M.D., President and CEO of Acorda Therapeutics, adding “We are enormously gratified to have achieved approval for the only medication indicated to improve walking in people with MS, and we thank all of the clinicians, people living with MS and medical and patient support organizations who joined in this effort over the past decade. Reaching this milestone underscores Acorda’s ongoing commitment to develop innovative therapies for people with neurological diseases.”

“Walking impairment affects a large majority of people with MS, and we are very pleased that the FDA has approved a new treatment that addresses this aspect of the disease,” said John Richert, M.D., Executive Vice President for Research & Clinical Programs at the National Multiple Sclerosis Society. “Continuing to advance clinical research and expand the range of therapeutic options for people with MS, including treatments for the most debilitating symptoms and challenges associated with the disease, is critical to helping people with MS.”

AMPYRA, which was previously referred to as Fampridine-SR, is an extended release tablet formulation of dalfampridine (4-aminopyridine, 4-AP), which was previously called fampridine. The FDA granted AMPYRA orphan drug status, which will provide seven years of market exclusivity for the drug. In addition, Acorda has several issued patents that cover the formulation and use of AMPYRA.

AMPYRA is administered as a 10 mg tablet twice daily, approximately 12 hours apart. The primary measure of efficacy in its two Phase 3 MS trials was walking speed (in feet per second) as measured by the Timed 25-foot Walk (T25FW), using a responder analysis. A responder was defined as a patient who showed faster walking speed for at least three visits out of a possible four during the double-blind period than the maximum speed achieved in the five non-double-blind, no treatment visits (four before the double-blind period and one after).

A significantly greater proportion of patients taking AMPYRA 10 mg twice daily were responders compared to patients taking placebo, as measured by the T25FW (Trial 1: 34.8% vs. 8.3%; Trial 2: 42.9% vs. 9.3%). The increased response rate in the AMPYRA group was observed across all four major types of MS.

During the double-blind treatment period, a significantly greater proportion of patients taking AMPYRA 10 mg twice daily had increases in walking speed of at least 10%, 20%, or 30% from baseline, compared to placebo. In both trials, the consistent improvements in walking speed were shown to be associated with improvements on a patient self-assessment of ambulatory disability, the 12-item Multiple Sclerosis Walking Scale (MSWS-12), for both drug and placebo treated patients. However, a drug-placebo difference was not established for that outcome measure.

“Walking impairment makes life more difficult for many of my patients,” said Dr. Andrew Goodman, M.D., Director of the Multiple Sclerosis Center at the University of Rochester. “With the approval of AMPYRA, we will have the first treatment option shown to improve walking speed in people with MS.”

Acorda expects AMPYRA to be commercially available in the United States in March 2010. AMPYRA will be distributed exclusively through a network of specialty pharmacies and coordinated by AMPYRA Patient Support Services. Dedicated and experienced customer care agents will be available to help healthcare professionals process prescriptions, work with insurance carriers to facilitate coverage, and help patients to access benefits available through reimbursement assistance and patient assistance programs.

AMPYRA Patient Support Services can be reached at 888-881-1918 for more information about AMPYRA.

The FDA approved AMPYRA with a risk evaluation and mitigation strategy (REMS) program comprising a medication guide and communication plan. The goals of the communication plan are to inform patients about the serious risks, including seizures, associated with use of higher than recommended doses of AMPYRA therapy, and the change of the established name from fampridine to dalfampridine.

AMPYRA will be marketed in the United States by Acorda’s established commercial organization, which successfully launched ZANAFLEX CAPSULES® (tizanidine hydrochloride). The Company plans to double the number of field- based sales professionals to approximately 100 by the time of commercial availability in March.

Under Acorda’s existing license and supply agreement with Elan Pharma International Limited, a subsidiary of Elan Corporation, plc (NYSE: ELN), AMPYRA will be manufactured by Elan Drug Technologies using one of their Oral Controlled Release Technologies, the MXDAS™ (MatriX Drug Absorption System) technology.

“We are delighted that AMPRYA will now be available to help people with MS. This approval represents another significant milestone in our successful collaboration with Acorda Therapeutics,” announced Shane Cooke, Executive Vice President and Head of Elan Drug Technologies. “The approval is the culmination of an enormous amount of work and effort over many years and is the second product in which we have collaborated with Acorda. We hope to find additional opportunities to work together in the future.”

Important Safety Information

AMPYRA can cause seizures; the risk of seizures increases with increasing AMPYRA doses. AMPYRA is contraindicated in patients with a prior history of seizure. Discontinue AMPYRA use if seizure occurs.

AMPYRA is contraindicated in patients with moderate to severe renal impairment (CrCl≤50 mL/min); the risk of seizures in patients with mild renal impairment (CrCl 51–80 mL/min) is unknown, but AMPYRA plasma levels in these patients may approach those seen at a dose of 15 mg twice daily, a dose that may be associated with an increased risk of seizures; estimated CrCl should be known before initiating treatment with AMPYRA.

AMPYRA should not be taken with other forms of 4-aminopyridine (4-AP, fampridine), since the active ingredient is the same.

Urinary tract infections were reported more frequently as adverse reactions in patients receiving AMPYRA 10 mg twice daily compared to placebo

The most common adverse events (incidence ≥2% and at a rate greater than the placebo rate) for AMPYRA in MS patients were urinary tract infection, insomnia, dizziness, headache, nausea, asthenia, back pain, balance disorder, multiple sclerosis relapse, paresthesia, nasopharyngitis, constipation, dyspepsia, and pharyngolaryngeal pain.

*For full prescribing information, please visit: www.AMPYRA.com

About AMPYRA (dalfampridine)

AMPYRA is a potassium channel blocker approved as a treatment to improve walking in patients with multiple sclerosis (MS). This was demonstrated by an increase in walking speed. AMPYRA, which was previously referred to as Fampridine-SR, is an extended release tablet formulation of dalfampridine (4-aminopyridine, 4-AP), which was previously called fampridine. In laboratory studies, dalfampridine has been found to improve impulse conduction in nerve fibers in which the insulating layer, called myelin, has been damaged. AMPYRA is being developed and commercialized in the United States by Acorda Therapeutics, and by Biogen Idec in markets outside the U.S. based on a licensing agreement with Acorda. AMPYRA is manufactured globally by Elan based on an existing supply agreement with Acorda.

About Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, usually progressive disease in which the immune system attacks and degrades the function of nerve fibers in the brain and spinal cord. More than 400,000 Americans have MS. Most people living with MS are diagnosed between the ages of 20 and 50, and women are affected two to three times more often than men. Worldwide, MS may affect an estimated 2.5 million people.

Research indicates 64%-85% of people with MS have difficulty walking, and 70% of people with MS who have difficulty walking report it to be the most challenging aspect of their MS. Within 15 years of an MS diagnosis, 50% of people with MS often require assistance walking and, in later stages, up to a one third are unable to walk.

About Acorda Therapeutics

Acorda Therapeutics is a biotechnology company developing therapies for multiple sclerosis, spinal cord injury and related nervous system disorders. The Company’s marketed products include AMPYRA™ (dalfampridine), a potassium channel blocker approved as a treatment to improve walking in patients with multiple sclerosis (MS), as demonstrated by an improvement in walking speed; and ZANAFLEX CAPSULES® (tizanidine hydrochloride), a short-acting drug for the management of spasticity. The Company’s pipeline includes a number of products in development for the treatment, regeneration and repair of the spinal cord and brain.

About Elan Drug Technologies

Elan Drug Technologies (EDT) is the world’s leading drug delivery company and is a business unit of Elan (NYSE:ELN). EDT developed dalfampridine, using one of their proprietary Oral Controlled Release Technologies, the MXDAS™ (MatriX Drug Absorption System) technology. EDT aim to deliver clinically meaningful benefits to patients by using their extensive experience and proprietary delivery technologies in partnership with pharmaceutical companies. Products enabled by their technologies are used by millions of patients each day. More information is available at www.elandrugtechnologies.com.

Forward-Looking Statements

This press release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements, other than statements of historical facts, regarding management’s expectations, beliefs, goals, plans or prospects should be considered forward-looking. These statements are subject to risks and uncertainties that could cause actual results to differ materially, including Acorda Therapeutics’ ability to successfully market and sell Ampyra in the United States and to successfully market Zanaflex Capsules, the risk of unfavorable results from future studies of Amypra, the occurrence of adverse safety events with our products, delays in obtaining or failure to obtain regulatory approval of Ampyra outside of the United States and our dependence on our collaboration partner Biogen IDEC in connection therewith, competition, failure to protect Acorda Therapeutics’ intellectual property or to defend against the intellectual property claims of others, the ability to obtain additional financing to support Acorda Therapeutics’ operations, and unfavorable results from our preclinical programs. These and other risks are described in greater detail in Acorda Therapeutics’ filings with the Securities and Exchange Commission. Acorda Therapeutics may not actually achieve the goals or plans described in its forward-looking statements, and investors should not place undue reliance on these statements. Acorda Therapeutics disclaims any intent or obligation to update any forward-looking statements as a result of developments occurring after the date of this press release.


MS: Remaining Active for Mental Sanity

Okay– I realize this title and photo are a little convoluted. Yet it’s so true: in order to stay positive, fulfilled, and mentally agile, one needs to maintain an ACTIVE life (despite having multiple sclerosis.) This doesn’t mean running marathons or even working full-time. It merely means that patients must find ways to thrive and remain true to themselves even in the midst of health changes and setbacks. And I’m the first to admit that it’s HARD.

I’ve found myself in a couple of slumps over the past five years (post-diagnosis.) Downgrading to part-time work– or no work— can make one feel like less of a person. It definitely knocked me for a loop: did I ever imagine that I’d have to drastically slow my pace in my thirties? My perception of myself went from being an active health professional to that of a sick, barely-contributing patient. And no matter what loved ones told me, the blows to my ego— not financially providing for our household, not having a meaningful career, accepting others’ condolences and assistance— became a heavy burden at times.  It STILL smarts on occasion, but things have picked up in the past year.  I would never have believed that mental “convalescence and rehabilitation” could take so long. Except I’ve now experienced both and have just emerged, dignity and self-respect intact, on the other side. Here is what I’ve gleaned from the experience:

It is OKAY to work on your mental health

Sanity is not always a given. Uncontrollable circumstances can– and will– rip apart the fabrics of our peaceful, predictable worlds. Seek out the emotional help (whether through support groups, individual counseling, or online support) to stay active and in the game.

Find things that challenge and activate your brain

Keeping mentally active is key to having an active, fulfilling life with MS. It’s so easy to become stuck and set in comfortable habits. But it’s better for overall health to seek new and challenging mental pursuits: new word games, classes, new hobbies, new friendships. Find that which makes you excited and joyful and creates a daily mental expansion.

Seek the support of experts: life coaches

These individuals can assess your needs and what you can incorporate into you life to be more involved with your community, your family, work, volunteering, and so on.

Set ONE manageable goal and work on achieving it

I had so many ideas rattling around in my brain, but I found that when I focused on ONE plan, some of the other ideas naturally fell in place with it. And then setting the next goal became that much easier.

Seek out others who cultivate your desire to be active

This one can be tricky. It’s mentally healthier to align yourself with others who want to thrive (whether they have MS or not.) But thankfully some of the most challenged people also have the greatest drives to succeed.

Accept imperfection and persevere

Things will go wrong. Illness will likely return. Failures crop up. But the definition of courage says it all: “the ability to move ahead even though one is afraid.”

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