This presentation was part of the Chicago Wellness for MS Forum held Saturday April 22, 2023
“Each of us has a cup that we hold and can handle. Our cups fill with all sorts of exposures and stuff as we get older: illness, traumas, toxins, crappy food, bad air, toxic stress. These things are chronically inflammatory to our bodies – and inflammation is bad for our health. There will come a point when your cup will overflow or even tip over if all you do is put stuff in it. Overflow looks like a breakdown, a major medical illness, a smoldering problem that finally gets your attention, or any number other life-altering events.” -—From Monday Mantras with Megan by Megan Weigel
Watch the full presentation: Integrative Medicine and MS: Why “Wholistic” Care is Important with MS nurse Megan Weigel
Facts about MS
Multiple sclerosis affects over 1 million people in the US. It affects 3 to 4 women for every 1 man. According to new research on newly diagnosed patients in the modern era, the MS incidence may be higher in Blacks than non-Hispanic whites.
Risk factors for MS include:
- smoking
- low vitamin D levels
- obesity in adolescence
- hundreds of susceptibility genes which turn on depending on the environment
- one vascular comorbidity occurring at anytime in the disease course causes the progression to an Expanded Disability Status Scale (EDSS) of 6 up to six years sooner than people with MS who don’t have vascular issues
- There are 25 disease modifying therapies (DMTs) approved to treat active relapsing forms of MS and 1 to treat primary progressive MS
- Lifestyle changes (diet, exercise, stress reduction, smoking cessation, etc.) improve symptoms and may help modify the disease
Typical MS Treatments
Disease Modifying Therapy (DMTs)
25 choices with some generic
Symptom management
- Medication
- rehabilitation strategies
- adaptive aids
- social changes
Relapse Management
Relapses are now very uncommon due to advancements in DMTs compared to when Megan became a nurse 20 years ago.
- Steroids
- Adrenocorticotropic hormone (ACTH) gel
- Plasma exchange
Mind/Body/Spirit and General Health Care
- keep the root strong
- promote adaptability
- cultivate resilience
Definitions of (w)holistic types of care
You are a tree and if your roots are very strong, they will help you when the sun is too hot or the wind is too strong.
Integrative Medicine
“Integrative meditation is a healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence and makes use of all appropriate therapies.” – Arizona Center for Integrative Medicine
“Integrative medicine focuses on the lease invasive, least toxic, and least costly methods to help facilitate health by integrating both allopathic and complementary therapies. These therapies are recommended based on an understanding of the physical, emotional, psychological, and spiritual aspects of the individual. [It] maintains that healing is always possible, even when curing is not.” – Philosophy of Integrative Medicine
Conventional medicine
- Disease focused
- treats symptoms using drugs, radiation or surgery
- serves as knowledge base for Western medicine.
Alternative Medicine
- used in place of conventional medicine
- treats symptoms using medications that are “closer to nature”
- not all treatments are scientifically validated
Complimentary medicine
- modern approach that uses both conventional and alternative medicine to diagnose and treat symptoms; a hybrid
Integrative Medicine
- combines conventional and alternative medicines in a coordinated way
- emphasis on data driven solutions that are safe, and patient focused
Functional medicine
- Questions the foundations of conventional medicine
- treats the patient, not the disease
- scientifically based in systems biology which focuses on prevention rather than treatment
Comorbidities
Comorbidities can worsen the course of MS. They are additional diseased and conditions that a patient has in addition to MS (or anther disease.) Telomeres are a part of the chromosome and shorter telomeres are associates with higher disability and lower brain volume. When the body is not in homeostasis we are in fight of flight mode, our immune system is disregulated which causes inflammation.
Telomeres shorten due to:
- smoking
- dehydration
- nutrient-poor diets
- lack of exercise
- stress physical and emotional)
- poor sleep
- infections
MS Management
- Keep regular MS check-ups
- Get an MRI annually and note changes
- Tell your healthcare provider about new or worsening symptoms
- Evaluate if your DMT is working for you or if you need to switch
- heck on medication interactions
- Ask about alternative therapies that could help you
The body as a whole system
You cannot silo your symptoms, they all affect each other. Healthy choices improve the health of the system. Learn to choose wisely for the mind, the body and the soul/spirit. When we feel attached out pupils dilate, our blood moves to our organs, our heart rate increases, our hormones go back to a resting state. Today our modern life is in high stress all the time and we cause a state of disease due to high stress. A good book on the topic is Complementary and Alternative Medicine and Multiple Sclerosis by Allen C. Bowling
Mind
- make a manageable to do list
- have support team contacts available in case of need
- limit new watching and reading and social media time (not more than 20 minutes per day), if you are compelled to watch/read don’t do before bed
- prioritize your health and take care of it
- schedule time for body and spirit
Stress Management
- Depression and anxiety are common in MS
- If you aren’t asked as a provider’s office, share your concerns
- Ways to manage stress
- talk to a health care provider to get a referral for talk therapy or medication
- meditation, mindfulness, breathing exercises (check out Megan’s Mindful Moments podcast)
- exercise
- go outside
- decrease caffeine, alcohol use, sugar and processed food s in the diet
- increase omega 3s, plant food in diet
- learn to say no
Body
- Eat food, not too much, mostly plant. Read Food Rules by Michael Pollan
- The right diet for you is the one you will follow (all of the MS diets have a lot of overlap)
- Drink plenty of water daily
- Ask what can you take out? Alcohol, soda, sweet tea, processed snacks, desserts…
- What can you put in? Greens, chia or flax seeds, swap out for a healthier alternative
The standard American diet (SAD) is full of refined grains, sugar, sodium, chemicals, fake foods and fillers. This is a diet that’s high in convenience and is missing nutrition, real food and variety. The SAD causes obesity, diabetes, high blood pressure, high cholesterol, non-alcoholic fatty liver disease, an increased risk of cancer, inflammation and pain.
Saturated fats are pro-inflammatory. Long chain fatty acids (LCFAs) from processed foods like seed oils, and foods high in omega 6 stimulate naive T cells to become Th1 and Th17 (pro-inflammatory).
Choose the MS diet that works for you
- Swank diet – dairy free, low/no fat, minimal red meat, limit processed foods,
- Wahl’s – gluten free, dairy free, meat as a condiment, limited processed food
- MIND diet – limited processed foods, no red meat
- McDougal diet – dairy free, low fat, no meat, limited processed foods, vegetarian
- Ketogenic diet – low gluten, restriction on fruits/veggies
- Intermittent fasting for 12 hours is doable and ideal for people with MS (can be combined with any other MS diet) – shown to reduce fatigue
- Autoimmune Diet – gluten free, dairy free, grain free, limited processed foods
- Longevity diet – diary free, minimal red mea, limited processed foods
Megan’s Opinion on Supplements
- People take too many supplements without guidance
- Supplements can results in drug-supplement and financial harm
- supplements are dumped into unhealthy guts that can’t absorb them
- it’s better to eat what you need; a plant-based diet that is hight in fiber helps the body make anti-inflammatory chemicals that support the central nervous system
- a safe supplement that alleviates a symptom can create an environment for healing
Beneficial supplements for MS
- Vitamin D3
- Alpha Lipoic Acid or R-Lipoic Acid
- Magnesium
- B vitamins (measure your levels)
- A good quality multivitamin if your diet is not well-balanced
- Should be individualized – probiotics, CBD and adaptogens
Exercise tips for people with MS
- Do what you enjoy
- exercise 150 minutes per week or 21.4 minutes per day
- move at your best time of day
- use cooling equipment and drink cool fluids
- split up exercise if you need to, the cardiovascular benefits are the same in two short sessions as one long session
- involve your family and friends
Rest your body
- Avoid using electronic for at least an hour before bed
- If you read on a hand-held device, use a blue light filter or blue light blocking glasses
- Avoid caffeine, excessive alcohol and sugar before bed
- Create a calming bedtime ritual – gratitude journal, gentle stretching, essential oil diffuser, caffeine free herbal teas
Spirit
Start your day with a positive affirmation. Make time for mindfulness or meditation with apps like Insight Timer, Calm, Oak, Headspace or Hallow. Exercise your creativity by doing things like coloring or painting, arranging flowers, planting a garden, play with kids. Remember to breath, connect with loved ones and consider energy healing (acupressure, acupuncture, Reike, etc.)
“A cure is a medical procedure that reliably helps you recover from illness. Healing is an inner process through which the human organism seeks its own recovery physically, mentally, emotionally, and spiritually.” Michael Lerner
STOP technique to be in the moment
- Stop what you are doing
- Take a few deep breaths
- Observe what you are feeling and name your emotions
- Proceed with what you need
“Wholeness is what we ought to be striving for and part of that is sadness, disappointment, frustration, failure; all of those things which make us who we are. Happiness and victory and fulfillment are nice little things that also happen to us, but they don’t each us much. Everyone says we grow through pain and then as soon as they experience pain they say, ‘Quick! Move on! Cheer up!’ I’d lkie just for a year to have a moratorium on the word ‘happiness’ and to replace it with the word ‘wholeness.’ Ask yourself, “Is this contributing to my wholeness?’ and if you’re having a bd day, it is.” – Hugh Mackay
Megan Weigel, DNP, ARNP-c, 200RYT is an Author and Advanced Practice Holistic Nurse, Multiple Sclerosis Certified Nurse. She is a nurse practitioner specializing in neurological care in Jacksonville Beach, FL. She has been a Multiple Sclerosis (MS) certified nurse since 2005, and an NP for over 20 years. She is also a board-certified Advanced Practice Holistic Nurse. She earned her doctorate of nursing practice from the University of Florida, where her research emphasis was on preventive healthcare. She completed a fellowship in Integrative Medicine at the University of Arizona in the Fall of 2018 which complements her practice focus on wellness and holistic care. She is the past-president of the International Organization of MS Nurses and the co-founder of oMS Yoga, a non-profit organization that brings free yoga classes to people living with MS (www.omsyoga.org). Her bestselling book, Monday Mantras with Megan, offers an approachable mindfulness journey and is available on Amazon.
Her areas of expertise include:
Multiple Sclerosis
Migraine Management
Integrative Medicine/Lifestyle Medicine
Neurological Complications of Post-Acute COVID
Advanced Practice Holistic Nurse
HeartMath Biofeedback Certified