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Work & Multiple Sclerosis

Experts describe strategies that help multiple sclerosis patients cope with symptoms of the disease.

How to Tell Your Boss

Often, disclosure accompanies a request for special workplace accommodations. The approach can sway the outcome, Nissen notes. "It's more than saying 'This is what I need from you.' It's 'Here's how I can be more productive, effective, and reliable,'" Nissen tells WebMD.

In the best-case scenario, such discussions with an employer begin as open, two-way dialogues. "It really needs to be an interactive process. You can't just go in there, make your demands, and walk out," Nissen says.

"When it comes to accommodations, there are so many different possibilities based on symptoms and job duties," Nissen tells WebMD. An accommodation may mean an altered work schedule with shortened hours or telecommuting on an as-needed basis when fatigue becomes overwhelming. It may mean adaptive equipment that allows an employee to talk into a computer rather than tap on a keyboard. It might mean keeping one room at a lower temperature than the rest of the office, if heat sensitivity is an issue.

"These types of accommodations seem basic but they can really make a difference," Nissen says. Some cost more than others. To find out what's available, Nissen recommends that employees start researching locally, beginning with an area NMSS chapter and incorporating other resources such as one's state office of vocational rehabilitation.

Alternatives to Work

Choosing not to work full time anymore doesn't have to mean an end to productivity. "There are still ways to contribute as an active member of society," Nissen notes. Levy serves as a prime example. Having cut back to part-time work while battling daily pain and fatigue, she continued to find meaning through volunteer work.

"I stayed positive," says Levy who, almost immediately after being diagnosed, got involved in fundraising for the disease. "That's where I found my support group -- among other fundraisers," Levy tells WebMD.

Attitude Matters

Clearly, how people with MS cope makes a difference in their day-to-day existence.

"Those who have the hardest time are those who see it as a war to win. That's a setup for feelings of failure, guilt, and inadequacy when and if they can't beat it," says clinical psychologist Rosalind Kalb, PhD, director of the NMMS Professional Resource Center.

"Those most successful are those who say 'I can't win the war, but let's look at which aspects I can conquer,'" Kalb tells WebMD. To this end, Kalb urges patients to break the disease down into individual challenges, whether fatigue or spasticity. "This way, they feel like they're managing the disease rather than vice versa," she says.

Lifestyle choices can also make an impact on one's ability to manage MS.

Impact of Exercise

Exercise is one such choice. "Many years ago they used to say 'Don't exercise, it will make you too tired.' Now, we're encouraging patients to stay as active as possible," says Sheila Schaffer, a physical therapist at Kernan Orthopaedics and Rehabilitation Hospital in Baltimore.

New research results promote physical activity. One study found that exercise improved fitness and function in people with mild MS and helped maintain function for those with moderate or severe MS. Investigators found aerobic exercise that incorporated balance training to be the most effective type. In yet another study, an eight-week progressive resistance-training program improved walking and overall functional ability in people with moderate MS.

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