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a1000shadesofhurt

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Tag Archives: multiple sclerosis

Exercise and disability: ‘Now things hurt for the right reasons’

17 Tuesday Sep 2013

Posted by a1000shadesofhurt in Uncategorized

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confidence, Exercise, multiple sclerosis, Self-esteem, symptoms

Exercise and disability: ‘Now things hurt for the right reasons’

It’s hardly surprising that Shana Pezaro started comfort eating. After 20 years of unexplained and debilitating symptoms, she had just been diagnosed with multiple sclerosis. Having built up her own stage-school business, she was now losing the ability to walk and was forced to sell up. Then her marriage fell apart.

“My husband had found my illness and disability very difficult to deal with, but we always thought I was going to get better,” says Pezaro. “Then, when I was finally diagnosed with MS in 2007 and we realised I wouldn’t, he just couldn’t handle it. I used to be a dancer, but my body had changed and he told me he just couldn’t find me attractive anymore. Within a year of my diagnosis, we’d split up.”

It was a relief, she says, when he finally left, but the experience nevertheless dealt a blow to her self-esteem, not helped by the fact she had started to put on weight.

“I went from 12st to 15st in the space of three years. The fatigue was so bad that I didn’t have the strength to cook. I was living on microwave meals and snacks. The steroids and other medications made me incredibly hungry. And of course as my legs got worse I was getting less and less exercise – I could barely walk. I was miserable.”

Weight gain is a serious issue for the disabled community. In a study of 30,000 people published this summer by the University of Texas School of Public Health, 42% of adults with a disability were reported as obese, compared with 29% of those without a disability. Gaining weight not only affects a person’s emotional wellbeing, but can also make mobility even harder and symptoms feel worse. Yet fatigue and pain can make sport participation seem daunting. And although things are improving following the success of the Paralympics, access remains a major barrier. Just 18% of people with a disability or long-term limiting illness participate in sport each week, around half the level of the general population, according to a survey by Sport England.

“You don’t have to eat a lot to put on weight if you’re not moving and your body isn’t burning calories,” says Vanessa Daobri, a gym instructor who specialises in working with people with disabilities. “Disabled people often suffer because they don’t know how to exercise. If the disability is a result of an injury or it’s been a slow onset, they may find it hard to accept that they can’t do a sport in the way they used to, so they feel there’s no point.”

Organisations such as Aspire and the English Federation of Disability Sport run inclusive gyms across the country. But not everyone is lucky enough to be near one, and regular gyms are still lagging behind, says Daobri. “Often the staff get the approach wrong – sometimes it’s just laziness, sometimes it’s ignorance. Health and safety is used as a crutch, too.” Another issue, she says, is that disabled people can feel frightened to be seen going to the gym in case their benefits are cut.

Daobri has Ehlers-Danlos syndrome, a disorder affecting collagen. In 2007 she grew from a size 12 to a size 24 in less than a year. She felt “stuck”, until she joined a wheelchair racing group and the coach asked her if she used the gym.

“I just laughed,” she says. ‘I thought gyms were not for me – they were for other people.” She was shown how to use gym equipment in new ways and quickly became “addicted” to exercise. Now, she has made a career out of helping disabled people find ways to get fit.

“Once someone opened the door for me I realised there was a whole world out there,” she says. “Whatever your disability, there’s a version of a sport for you – you just have to be a bit creative.”

After six months of post-divorce counselling, Pezaro decided she wanted to lose weight. “I got a brilliant new carer who got me eating healthily,” she says. “Then I found out there was an MS treatment centre near me that runs lots of different exercise classes.”

She signed up to a class she has come to describe affectionately as “sadistic PE”. “The instructor is ex-military but also a counsellor and herself has MS. So she completely understands us, but she doesn’t let us get away with anything. We adapt everything to our own personal needs. It’s not your average fitness class – it’s not unusual for people to collapse and have a leg spasm in the middle of their situps, or to suddenly fall off their exercise ball, but we just laugh about it.”

At first Pezaro was unable to do most of the exercises, but she persevered and since starting the class three years ago has lost nearly 4st.

“It’s not been easy,” she says. “It took me 30 months to lose 45 pounds. But I didn’t get demoralised. I knew that over the years it would add up. And the more I’ve exercised the better my fatigue is. I still can’t walk, but I now have less weight to lift when I’m using my frame, or getting on and off the toilet, so everything is easier.”

Pezaro’s confidence has been transformed and now she is enjoying dating again. But perhaps most the important gain has been to her sense of control.

“I really worked myself at last night’s class, and today every muscle in my body hurts,” she says. “But I’m so used to living with pain, it’s kind of nice to know that for once, things are hurting for a good reason.”

• For information and support on multiple sclerosis visit mssociety.org.uk. Aspire’s Instructability programme offers free fitness industry training to disabled people. Visit aspire.org.uk

NHS is failing patients with neurological conditions, claims report

01 Wednesday Aug 2012

Posted by a1000shadesofhurt in Brain Injury, Neuroscience/Neuropsychology/Neurology

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brain damage, dementia, dystonia, emergency hospital admission, epilepsy, mental health issues, motor neurone disease, multiple sclerosis, neglect, neurological condition, Parkinson's disease

NHS is failing patients with neurological conditions, claims report

People with neurological conditions such as epilepsy, multiple sclerosis and Parkinson’s disease suffer “neglect” by the NHS, claims a report by an alliance of charities representing patients.

Poor care means that too many of the 8 million patients in England with a neurological problem are admitted to hospital as emergencies, experience delays in having their condition diagnosed, and receive too little information about what is wrong with them, according to the Neurological Alliance.

The alliance is a group of more than 70 charities that work with people who have suffered damage to their brain, spinal column or nerves either as a result of illness or injury. Its members also include charities representing those with motor neurone disease and rarer conditions such as dystonia.

An alliance report accuses the NHS of not taking patients with neurological conditions seriously enough, and warns that the coalition’s health reforms will do nothing to help them. “Policy levers for improving care in the new NHS landscape are not being mobilised to support improvements to neurological services.

“Five of the six key policy levers, including national outcome strategies and the commissioning outcome framework, are not currently being used to improve services for people with neurological conditions,” it claims.

This is despite neurological services taking up more than 5% of overall NHS spending, which makes them the service’s eighth largest category of spending, and the fact that one in six people are affected, it adds.

The report urged the plethora of new NHS bodies being created next April by the Health and Social Care Act to tackle “the legacy of neglect which has resulted in unacceptable variations in outcomes and higher than necessary costs”.

Inadequate and poorly co-ordinated care of such patients by GPs and other community health and social care services result in undue numbers of emergency hospital admissions, it says.

Research by the alliance uncovered what it called “a spending lottery” on neurological services by NHS primary care trusts (PCTs). While Central Lancashire PCT spends £11.37m per 100,000 of population on them, Haringey Teaching PCT in London spends just £4.31m for the same number of people.

Similarly, there is a sevenfold variation in the proportion of PCT spending on these conditions that goes on emergency care. In places such as Liverpool, Sunderland and Wandsworth in London, it is more than half. “Not only are emergency admissions distressing for patients and extremely costly for the NHS, but they are often an indication that conditions are not being well managed within primary care, community and social care services,” the alliance claims.

Arlene Wilkie, the organisation’s chief executive, said action was urgent because half a million people a year are diagnosed with a neurological condition and the number of patients with one is set to skyrocket in the next decade.

“If the NHS reforms do not address poor standards of care for people with neurological conditions, then they will fail. The government has said that managaing health reforms should be all about outcomes, but it has failed to identify the outcomes which matter to people with neurological conditions,” she said.

The charities want the Department of Health and new NHS Commissioning Board to devise indicators for quality of care and patients’ outcomes that will prompt the service to overhaul such services.

The Department of Health said that the commissioning board is already planning to drive improvements to services for those with mental health problems, dementia and neurological conditions by ensuring that some of the first strategic clinical networks set up next year cover them.

“We want NHS services to focus on what matters to people most. This will make sure that people with neurological conditions get integrated care and the support they need at the right time and in the right place,” said a spokeswoman.

“We are working closely with patient groups and health professionals to develop a new Long-Term Conditions Strategy. The NHS commissioning board is already planning to drive improvements to improve mental health services, dementia and neurological conditions,” she added.

More:

NHS warned of ‘neurology timebomb’

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