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Women & Wellness: Achieving wellness while living with MS May 28 th, 2011.

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Presentation on theme: "Women & Wellness: Achieving wellness while living with MS May 28 th, 2011."— Presentation transcript:

1 Women & Wellness: Achieving wellness while living with MS May 28 th, 2011

2 The MS Society gratefully acknowledges the educational grant received from Pfizer, which makes possible the Women & Wellness: Achieving wellness while living with MS session. The MS Society does not approve, endorse or recommend any specific product or therapy but provides information to assist individuals in making their own decisions. Identification of needs, determination of objectives, selection of content and speakers, educational methods and materials are the sole responsibility of MS Society staff and advisors.

3 MS Society of Canada mission: To be a leader in finding a cure for multiple sclerosis and enabling people affected by MS to enhance their quality of life.

4 Presenters Josée Vigneault RN, MSCN Multiple Sclerosis Clinic Centre hospitalier régional de Trois-Rivières Zoé Vourantoni Sexologist Centre de réadaptation Lucie-Bruneau Montreal

5 Taking Care of Yourself to Improve Your Quality of Life Presented by Josée Vigneault, BSc, Nursing, MSCN MS Clinic – Centre Hospitalier Régional de Trois- Rivières

6 Introduction MS can be distressing for – Person who has MS – Significant others Need to feel in control – Despite the unpredictable nature of the disease – Over some aspects of the person’s life

7 Objectives How to take control and improve your overall state of health – Empowerment – Lifestyle Food Exercise Stress management Priority-setting

8 Live One Day at a Time Daily management – Redefine distribution of tasks According to needs and circumstances – Enjoy small daily pleasures – Do what you like to do – Take advantage of the present – Listen to your body – Respect your limits – Prioritize activities (postpone what you are unable to do today) – Agree to do things differently

9 Enjoy the Moment When I adjust my camera’s focus on a flower or a bird, I realize to what extent we ignore the simple things in life. Especially at the fast pace we are used to living.

10 Live One Day at a Time Live one day at a time – Focus on what you are able to do and not on what you cannot do.

11 Try to Do Things Differently

12 It is human nature to resist change – especially when we feel we do not master the new circumstances or our life in general. (Translation - Lauren Woodhouse, PhD.)

13 Physical Activity Initiation Principles Must meet your needs Set a goal – Strength, stability, flexibility, ↓ weight, ↑ energy, social activity, improve mood, etc. Consult a health professional Assess your physical ability – Develop a program adapted to Your physical condition Your needs

14 Benefits of Physical Activity Sleep better, reduce fatigue ↓ Stress, ↓ depression and ↓ anxiety Improve posture and balance Improve coordination Improve efficiency of immune system Improve physical condition Improve ability for activities of daily living (ADL) Build up strength

15 Benefits of Physical Activity Produces natural endorphins (chemicals released by the brain) – Helps relieve pain – Helps improve sense of well-being Helps maintain a positive, proactive attitude

16 Types of Physical Activity Aerobic activities (walking or swimming) – Good for cardiovascular system (endurance) – ↓ Fatigue – Help to lose or maintain weight Maintain mental alertness – Memory, concentration, logic Exercises aimed at coordination Exercises aimed at strength training Exercises aimed at relaxation – Stretching

17 Physical Activity How to Guarantee Success Try 15 to 20 minutes, 3 x a week Follow a regular schedule Combine types to make your program more effective Add gradually – Focus on 2 or 3 different exercises per session being careful to use the right technique I listen to my body and take breaks

18 Physical Activity How to Guarantee Success (Cont’d) Wear comfortable clothing Don’t exercise right after a meal Drink a lot of liquid Don’t get overheated Check with your doctor before you begin an exercise program Keep a record of your progress Set reasonable goals

19 Remember to Set Reasonable Goals It is not important to reach the top, it is important to go as far as you can

20 Physical Activity Main Points to Remember Do a little even if you don’t feel like it It is not always easy to stay in shape Doing something – anything – is better than nothing "When you're tired and your limbs feel numb and heavy, fitness is the last thing on your mind, but that's exactly when you need exercise the most.” (Marla Zaichick)

21 Food No particular food will affect the way MS progresses No particular food will worsen symptoms The number of calories varies from one person to another – Depending on your system – Depending on our level of activity A balanced diet (Canada’s Food Guide) – Fruits and vegetables – Low-fat dairy products – Lean meat, adequate hydration (8-10 cups of water/day) – Avoid eating food with empty calories – Eat foods rich in whole grains and fibre (25 to 30 g/day)

22 Stress and MS Stress does not cause MS It probably plays a role in triggering attacks – Stress effects the immune system – People who are more stressed will be more likely to be sick – Learning to properly manage stress allows us to live better

23 Physical Symptoms of Stress Increased heart rate Higher blood pressure Too much sleep / not enough sleep Headache Faster breathing Digestive problems Fatigue

24 Psychological Signs Crying spells or inability to cry Feel empty or dissatisfied Limited attention/concentration Sadness Ambivalence Feeling depressed Nightmares

25 Behaviour Signs of Stress Irritability Tantrums Critical attitude Forgetfulness, indecision Decreased productivity Increased consumption – Tobacco, alcohol, food, drugs

26 Golden Rules Be aware, analyze, act Talking can help relieve stress Express anger Flexible attitude Surround yourself with positive people Learn how to say “no” Ask for help

27 Rest Lack of sleep can interfere with MS by affecting a number of elements – Mood and cognitive abilities – Immune system – Increased pain – Hormonal balance – Appetite, obesity – Recovery and muscle growth – Strengthening of the cardiovascular system – Lowering of threshold of pain tolerance Conversely, MS can disturb sleep

28 MS Can Disturb Your Sleep Depression Anxiety Spasticity, pain, muscular spasms Leg spasms Sphincter dysfunction Lesion in the basal regulators of sleep (organic insomnia)

29 Insomnia - Treatment First do an investigation – Standard questionnaire, agenda, psychological evaluation, polysomnography Sleep hygiene Psychotherapy and drug treatments for a mental illness Pain treatment Sleeping pill Exercise Relaxation techniques

30 Sleep Hygiene Guidelines Avoid stimulants (caffeine, nicotine) and alcohol for at least 2 hours before bedtime Regular exercise (avoid at least 2 hours before bedtime) Give yourself 1 hour to relax before bedtime Keep the room quiet, dark and comfortable Maintain regular sleep schedule Try to get the maximum amount of sleep and turn off alarm possible (wake up naturally) Short nap if needed in early afternoon

31 Sleep Myths and Reality Myth: Need to sleep at least 8 hours/night Reality: Needs vary according to the individual Myth: A good night of sleep can make up for accumulated fatigue Reality: You need several days to recuperate Myth: It doesn’t matter how long it takes to get to sleep Reality: How long it takes you to go to sleep is closely linked to the quality of your sleep – Bedtime – Cycle of nature (sunlight) – It is better to sleep from 11 pm to 6 am than from midnight to 8 am

32 Take the Time to Sleep Be in Charge of Your Life What are the most important things in your life? Family, freedom, sports, friends, money, love, success, adventure, work, fun, health? Simplify to improve your life Avoid wasting time on activities that do not correspond to your values

33 Conclusion Find your balance

34 Thank You for Listening

35 Sexual problems which may be caused by multiple sclerosis and how to remedy them Zoé Vourantoni, M.A. Clinical Sexologist

36 Objectives Know and understand the various sexual problems caused by multiple sclerosis Be aware of possible impacts on you, your couple relations/your confidence Learn ways to solve the problem: – Maximize the quality of sexual interactions

37 Today Only have 30 minutes, so this is an overview. We will: – Begin understanding how your sexuality is affected by MS – Encourage you to experience and nourish your eroticism – Encourage you to open up discussions with your: Physician Spouse Significant others who can provide you with support – Fuel your creativeness and your inspiration to explore your sensuality – Make you feel more secure about some changes that you have probably noticed in your body

38 Sexual Reality Sexuality - need – Integral part of being human (Couldrick 1998) – Important component of the total well-being of the individual (Davis 2006, Sengupta 2008) Nothing is normal. The best thing to do is to make some adjustments Taboos Complicated by illness We often eliminate things that don’t work The Challenge: to allow yourself to experience your eroticism differently

39 How MS Affects Sexuality Acts – Directly – Indirectly Acts on three levels – Physical – Personal/psychological – Relational/confidence in ability to develop relationship

40 How MS Affects Sexuality These 3 facets (physical, psychological and relational) have a combined impact on sexual response and may cause difficulties in all phases – Loss of sexual desire – Decrease in/insufficient vaginal lubrication – Decrease in/change in feelings/pain (genitals, erogenous zones) – Difficulty/impossibility of having an orgasm – Decrease in intensity of orgasm

41 Physical Impact on Sexuality Direct impact – Physical symptoms Loss of vaginal lubrication/engorged clitoris Change in genital feelings (numbness, pain, hypersensitivity) Loss of muscle tone (near vaginal entrance) Change in sexual response Indirect impact – Side effects of medication – Fatigue/loss of endurance, reduced strength makes sexual repertory impossible or uncomfortable – Spasticity (pain, positioning difficult during intercourse) – Bladder and intestinal problems (fears)

42 Psychological Impact on Sexuality Loss of personal points of reference Deception about the change in feelings Self-esteem is often affected Altered body image Cognitive problems Fears – Rejection – Failure – No longer able to please – Fecal/urinary incontinence  avoidance

43 MS Impacts Personal Relations Imbalance/the dynamics are upset Less communication/many things not said, assumptions, inferences Role of caregiver/patient Frictions due to irritability Distance between spouses (physical and/or emotional) Amplifies problems which were present previously

44 Summary Faced with this combination of factors, a number of women feel discouraged and eliminate sexuality or isolate themselves Vicious cycle which continues to fuel and accentuate difficulties – Self-esteem – Confidence – Sexual desire – Communication difficulties

45 To Stop the Vicious Cycle Ask questions about the reasons for your sexuality

46 Purpose of Sexuality What does your sexuality give you? Risk – Drop in performance, work Focused on – Orgasm – Penetration – Strict sexual script Aimed at – Emotional/physical pleasures – Quality time for yourself / the couple – Intimacy/bring you closer together – Meeting your need for affection and connection

47 Possible Solutions Material solutions For you For the couple In the environment In the execution

48 Possible Material Solutions Change in medication – Talk to your doctor! Lubricant Vibrator/ dildo/eros clitoral therapy device Use pillows, rolled-up towels, your partner’s body to support you

49 Possible Solutions Redefine your objectives Take charge of your sexuality Get to know your body again Use relaxation techniques Errors and imperfection are allowed Flexibility/creativity Become aware of your own helpful factors (logbook) Humour

50 Possible Solutions for the Couple Redefine your objectives TOGETHER Communicate (before, during, after) saying “I” Seduce, reintroduce sensuality Explore/do it differently Use a wide sexual repertory Use humour Prepare Plan B

51 Possible Solutions for the Environment Think about the best location and try it (bed, couch, chair, armchair, etc.) Start with a hot bath (spasms) Or an ice massage Begin well before the actual interaction

52 Possible Solutions for Making Changes Close to an orgasm – Contract your muscles to trigger the orgasm – Imitate the movements and sounds of the orgasm Spend more time on the “preliminaries” All of the “preliminaries” are part of your sexuality If necessary, adopt more passive positions Vary positions Choose the best time of day

53 In Closing Sexuality is for pleasure Quietly relearn to be erotic with the other person Changes are obvious, but feelings, reactions and impacts on the other person perhaps less so It is worse to assume and be wrong than to check. It’s even worse to ignore It is often a relief to FINALLY broach the subject Be brave Try, try again

54 Question & Answer Period

55 Thank you for your participation in today’s session. Please visit for the transcript of today’s event in the coming

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