Intentional Motivation

It’s hard to stay motivated to do everything that I think I should do to be healthy and live well with Multiple Sclerosis. It seems like the hope of living with fewer MS symptoms and potentially less disease progression should be enough motivation, but temptation, fatigue and a bit of resentment that I even have to deal with MS demotivate me. 

Demotivation can also come from unlikely sources. A few years ago, I saw a physical therapist for hip pain. I described my fitness routines that I’d done for years. It included a daily minimum stretching and activity quota, and I was proud of myself for always doing it. I was very flexible and fairly strong. My habits supported my fitness level. 

Accurately, the physical therapist told me I had plateaued with my exercises. I needed to do more strength training to address the hip pain and improve my fitness level.  I did the prescribed exercises until the pain subsided, but it was tough doing everything they suggested. I was discouraged that I wasn’t doing it all. Not only did I stop doing the prescribed exercises, I stopped doing my minimum daily fitness regimen.  

I took good information, and I mentally warped it into nonsense.  Because my previous minimum daily routines weren’t enough, I concluded they weren't worth doing. I justified that I was still active and exercising, I just wasn’t doing it every day.  

Put in writing, it’s obviously flawed and unhelpful logic. In my mind, it made sense.  In reality, I squandered good habits that were helping me.  After a few years without daily stretching, my flexibility and strength diminished. Things that used to be easy are painful. I recently reintroduced my daily minimum regimen as mandatory, and I’m seeing improvement. My flexibility and strength are increasing, and movements are less painful.  

Reflecting on this experience inspires me to be more intentional about what motivates me and what discourages me.  

Motivation that comes from excitement works better than fear.  I have more success working toward goals than trying to avoid potential consequences. I want to feel like I’m being rewarded, not punished. 

My resentful and fearful thought process is that I have to exercise so that I maintain my mobility as best as possible, because I have a sucky disease that mostly targets my spine and affects my legs and arms. If I don’t keep moving, I won’t be able to keep moving. 

My enthusiastic thought process is that I get to exercise and live in a body that can do things I enjoy. The better I treat my body, the better I’ll feel, the more I’ll be able to do, and the better odds I’ll have aging with MS. If I keep moving, I’m more likely to be able to keep moving. 

Both approaches are true, and both work. When my resentful mindset kicks in, I hope to notice it and not give up.  I want to remember how much my body has done for me and continues to do for me, and set a goal that excites me.  It doesn’t have to be a big goal, it just needs to be meaningful and encouraging. When motivation comes from an enthusiastic mindset, I’m eager to do what’s good for me, and I'm happier overall. It’s a win-win!

Multiple Sclerosis Generations: From Diagnose & Adios to DMT to Crowdsource

Generations offer connection with those before us, with us and after us.

When age groups are categorized by generations, it’s interesting to see how birth year and world events influence life circumstances and outlooks. In the United States of America, the generally accepted generations include the Lost Generation, the Greatest Generation, the Silent Generation, the Baby Boomer Generation, Generation X, Millennials, Generation Z and Gen Alpha.  It occurred to me that people with Multiple Sclerosis could also be considered as living in other various generations depending on how old we were at first symptoms and diagnosis, the year we were diagnosed, and the understanding of MS and available treatments during early adulthood.  

I look at these differences and similarities not to segregate us, but to assess my own health, see where it can help me with my own journey, and consider how I can pay it forward for others. I see people older and diagnosed before me as farther along the MS path. I might not follow the same path, and I likely have more health care options than they had.  That said, I can see where their path seemingly led and learn from them.

I created the chart below that aligns the standard generations with three pivotal advancements in MS diagnosis, treatment and patient connection. Please don’t tune out yet, I promise to explain what it meant for me. By looking at the orange No or green Yes, it shows whether people in that generation had certain advancements available to them at age 20.  I chose age 20 to reflect when symptoms may have been present. While everyone is unique and experiences MS differently, it was a reasonable age for this purpose. 

There are many interesting MS facts in the Timeline – The History of Multiple Sclerosis. The three years and corresponding advancements I chose to include are:

• 1981, the year MRI scans became a tool to view images of MS lesions, 
• 1993 when the first MS disease-modifying therapy (DMT) was approved for use, and 
• 2010 when Facebook established the option to create groups and online support communities became more commonly accessible.   

The Lost, Greatest and Silent Generations had none of the three advancements available to them when they were 20 years old.  Likely they lived in the “diagnose and adios” days when doctors might have known they had MS and told them, but they didn’t have any treatments to help them manage their MS.   Whether adios referred to goodbye or “to God” (as in you’re in God’s hands and there’s nothing they can do) is semantics. Either way, you’re on your own, and the doctor has done what they can.  Even worse were those not told they had MS, because some doctors believed a patient knowing they had an incurable disease was worse than not knowing. 

The Lost and Greatest Generations could be thought of as the “Diagnose & Adios Generation” or just the “Adios Generation” if not told they had MS. The youngest of these two generations would have been nearing 60 by the time MRIs were available to identify their lesion locations, and perhaps some of them benefited from that technology.  

I have and have had friends in the Silent Generation age group who lived with MS for many years and experienced disability by the time they were in their 50s and DMTs became available. They told me of participating in the lottery for early DMTs.  It wasn’t until I did research that I more fully understood what that meant.  

I’d known about the ABC drugs, and here’s an overview for those who might not. The three ABC drugs (Avonex®, Betaseron®, and Copaxone®) were approved between 1993-1996.  They were the first medications to help reduce the frequency and number of exacerbations a person with MS has, thereby delaying disease progression for those able to access the medication and for whom they helped.  

The first disease modifying medication was approved in 1993, and there wasn’t enough supply for all who wanted it. An article from the New York Times described the situation.  

“A computer lottery will be used to distribute a limited supply of a newly approved drug for multiple sclerosis, angering and saddening patients who might be helped by the therapy.  

“The arrangement may leave four out of five of the eligible sufferers unable to obtain treatment when the drug goes on the market in October. Doctors and ethicists called that a reasonable compromise.”

My friend was one of the lucky ones to be selected in the lottery. She began Betaseron® treatment and had positive results.  Currently 81 years old, she is of the Silent Generation. Timing for the medication’s availability benefited her and many others, and the subsequent approval of Copaxone® in 1995 and Avonex® in 1996 changed the disease course and prognosis for generations of people with MS to come. She and her peers could be thought of as the first of the “DMT Generation.” 

From MSAA’s page “Who Gets Multiple Sclerosis,” “Most people with MS experience their first symptoms and are diagnosed between the ages of 15 and 50, although individuals of any age may be diagnosed with MS.” It’s possible people in the Baby Boomer Generation may have had DMDs available at diagnosis. Those in Generation X are more likely to have had ABC medications available at time of diagnosis than any generation prior.   Please note that by saying these medications were available, I’m not saying people with MS had insurance, could afford medications, their doctor prescribed them or they chose to take them. Issues surrounding access, affordability and effectiveness are a huge conversation beyond what I’ll mention in this post. 

Millennials are more likely to only know a time when DMDs were available, and Generation Z were born into a world with DMD existence.   

I was diagnosed with MS in 2008, and at that time the prevalence of online patient communities was scarce. Patients Like Me originally started for patients with ALS in 2004, and they added a group for people with Multiple Sclerosis in 2007. I found them in 2010, and it was a terrific venue for learning, interacting and not feeling alone. Facebook groups started in 2010, and since then many groups with a myriad of MS interests have been created. I’ve found them helpful as they increase opportunities for connection, information and mutual support.  

I used to look to my elders for insight.  Then I added peers similar in age to those I sought advice and support. Now I look to the youth as well. It seems to me it can be thought of as a “Crowdsource Generation,” where we share information, learn from each other, support and apply what make sense for us.  

I look forward to ongoing medical advancements to see what the next MS Generation might be. Hopefully someday there will be a “Cured of MS Generation” and ultimately a “Post MS Eradication Generation.” I have hope.

References:

“Multiple Sclerosis Drug to Be Dispensed by Lottery” The New York Times, September 2, 1993, Section A, Page 15, https://www.nytimes.com/1993/09/02/us/multiple-sclerosis-drug-to-be-dispensed-by-lottery.html 

“Who Gets Multiple Sclerosis.” mymsaa.org, May 31, 2022, https://mymsaa.org/ms-information/overview/who-gets-ms/ 

“PatientsLikeMe Update: May 2007.” Blog.patientslikeme.com, May 2007, https://blog.patientslikeme.com/health-conditions/als/patientslikeme-update-may-2007/ 

“Timeline – The History of Multiple Sclerosis.” mymsaa.org, Feb 18, 2016, https://mymsaa.org/publications/motivator/summer-fall12/cover-story/timeline

“A Brief History of Facebook, Its Major Milestones” by Christopher McFadden, Interesting Engineering, July 7, 2020, https://interestingengineering.com/culture/history-of-facebook 

Cultivating Kinship On Social Media

An estimated 2.8 million people worldwide are living with Multiple Sclerosis, and some choose to use social media.  They share their experiences, and they allow us to see their vulnerability for the betterment of all. Social media can be cold and hurtful, yet it can bring us community and kinship. It’s an individual decision to participate or avoid it.  It’s scary and risky to put ourselves out there, and we need to support those who are willing to share.  

 

I’m grateful for individuals living and speaking their truth.  Some have been sharing for decades, and some are just starting. I’m heartened by commenters who support with compassion and scroll past when things don’t speak to them.  I’m inspired by so many who cheerlead and model respectful interactions with exceedingly tough topics. I hope we can hang on to the benefits of social media and lose the hurt it can cause.  We need to protect our vulnerable peers, and I hope we can do this with compassion.  We are better for the myriad of voices and experiences. Suffering alone is misery. Knowing we aren’t alone helps us get through the tough stuff. 

 

It’s tough with any community where individuals are going through a lot personally.  Some people deal with it by lashing out or blaming.  It can be hurtful even when unintentional. I can give lots of examples I’ve experienced and seen, but I’ll share one of my earlier experiences that I think shows how people who understand MS can feel anger toward people who are doing their best.  

 

Years ago, I agreed to be interviewed for the local newspaper.  The article focused on how I have MS, am open with my health and was doing well professionally. The headline said I wasn’t going to let MS stop me. A comment on the article said I was doing a disservice to all people in the MS Community. She explained her husband had MS and continued working long after he should have left the workforce. It caused her a lot of stress and frustration, because he wasn’t accepting his limitations.  That comment stung.  I hadn’t written the story. I was interviewed, the reporter interpreted what I said, and they presented it in a way that was intended to be complimentary.  I don’t fault them for that.  That said, I didn’t say MS wouldn’t stop me, and it took much more time and brain space than I’d like to admit to accept her comment wasn’t about me. I felt compassion for her situation, but it hurt having her anger directed at me.

 

At some point the newspaper removed the comment.  I’m not sure if it was a broad-brush removal of comments on old stories or specific to this comment, but I appreciate that it isn’t there anymore. 

 

This experience helped me to shift how I look at social media interactions. When receiving comments, I consider the following:

• Are they disruptors pushing an agenda or are they genuinely trying to learn?
• Can I show compassion for them while maintaining my own wellbeing?
• What can I learn from them?
• Is the comment about me or them?
• Does the comment warrant a response? 
• Sometimes a lack of a response is more effective than engaging. 
• Remember comments can be deleted on some platforms.

When commenting on other people’s posts, I consider these questions and perspectives:

• Does it apply to me?  Do I have anything useful to provide? 
• Why do I feel compelled to react or comment? Am I being supportive?
• Is my response about me or about their experience?
• Am I staying on point for what they posted, and is it helpful? 
• Remember each person has a different experience, and what’s true for one is not true for all.  

We all learn different lessons at different times. Things I needed to learn when I was newly diagnosed differ from what I need to learn today and what I’ll need to learn in the coming years.  I see newly diagnosed people expressing where they are in their health journey, and I try to meet them where they are.  Usually it’s just listening and validating their experience. 

 

Some comments can be aggressive, cruel and scary. Others can validate and lift us up. The more we engage respectfully and compassionately, the less scary the internet may become. Cultivating kinship and community helps us individually and collectively. The MS Community is 2.8 million people, and the number of people who care for or about us is exponentially larger. We can make a difference.

 

 

Holding On & Letting Go

A dear friend of mine is nearing the end of her earthly life. I’m grieving her pending departure, and I’m immensely grateful to have known and loved her. 

As this year began, I intended to center myself with “Letting Go” as my theme for 2023. I envisioned letting go of belongings and beliefs that no longer serve me.  Things like clothes, knick-knacks, and the hurts some people have caused me.  I didn’t foresee letting go of people I love. 

 

I will cling tightly to her friendship, lessons she taught me, and memories of time together. I will fiercely hang on to her with complete support and love. I aim to experience this time fully in all its bittersweet glory.

 

I know this also includes letting her go and fully supporting her in letting go. I aim to respect, accept and advocate as she wishes. I don’t want to make it harder for her, and I’ll try to not make our interactions about losing her. I’ll attempt to couch my sadness with appreciation. She lived gorgeously and supportively, and she will continue to live on long after her passing in me and many, many others.

 

As I cherish and celebrate her, I’ll share she was among the first people I met with Multiple Sclerosis almost 15 years ago when I was newly diagnosed with MS. She was one of the people I needed to navigate my own health challenges.  She was a mentor, confidante and cheerleader.  In her I saw resiliency, humor, love and acknowledgment for how hard MS can be.  She gave me hope and a model to follow.

 

She was diagnosed prior to MS disease modifying medications. She volunteered and was selected for a lottery to use one of the first medications available in studies.  Today many people with MS live with fewer relapses and less disease progression due to people like my friend who took the chance. Each generation has a better prognosis due to the collective efforts of the generations before them.  

 

My friend spearheaded creation of the local MS Self-Help group where I met her.  I watched her lead meetings with compassion, share insight, suggest options, and facilitate conversations with grace to ensure all attendees had their needs met. Her patience is unyielding and truly inspirational.

 

Today, I live better for the wisdom she imparted and leadership she quietly and compassionately provided. I’m better for knowing her, and I hold tightly to all she means to me. She is securely and forever held in my heart and spirit.

I’m Still a Rock Star…And Yet

I wrote a blog post in 2014 I Feel Like A Rock Star! where I described learning my Multiple Sclerosis lesions were all two or more years old. This led to me proclaiming I felt like a Rock Star. 

For many years I related to the song by Pink, “So What,” because I connected with the lyrics. I felt my body had let me down, yet I would prevail even though it felt like MS and my body were fighting me. The song felt like an anthem rebelling against my MS. 

“And you're a tool

So, so what?

I am a rock star

I got my rock moves

And I don't want you tonight”

Friday was a very long day with MRI scans in the morning and a neurologist appointment late afternoon. I awoke at 5:30 am and left home in the dark at 6:35 am. A ferry ride and congested freeway drive are part of the routine getting to the imaging facility and my neurologist’s office. An hour in the tube for the MRI scans was so much better than years past. I saw Alonzo again - a terrific technician and delightful person. He always adds good cheer and compassion.  The facility also updated the scan rooms to allow seeing a digitized underwater seascape. Watching yellow and blue fish and skate swim under water was more relaxing than looking at the inside of the imaging tube.  

Morning scans and a late afternoon neurologist appointment allow me to do it all in one day.  It’s a long day, but it’s worth it to do it all in one trip. 

Today’s scans show no evidence of disease activity (NEDO) for at least ten years now. This is beyond great news.

I’ll give this context. When I was diagnosed in summer of 2008, I read a statistic that the majority of people with MS will likely need assistance walking (with a cane, walker, crutches or wheelchair) within ten years of diagnosis.

A few years ago, there was a false alarm that I’d had more lesions.  One set of MRI scans had shadows that I was told could be an old relapse.  Later it was clear that they were scan shadows and not evidence of any lesions. It felt like riding a roller coaster of emotions and belief in how I’m doing based on imperfect medical test results. The relief was immense learning that the scans were off and I didn’t have new lesions. Old damage continues to frustrate me and cause increased MS symptoms. Yet NEDA is the best I can hope for, and I’m immensely grateful for this win. 

Disease modifying medications have greatly changed the prognosis for people with MS. I’ve been fortunate to have them available at diagnosis, and they’ve been effective for my disease course.  My first year of diagnosis, I had three relapses. They were so impactful, I began to forget what feeling well was like. 

This blog post is about me, but it’s also not about me. In the early 1990s, no medications that tempered the immune system attacks on myelin (the nerve coating eroded by MS) existed. In the early to mid-90’s, three existed. In 2008 when I was diagnosed, there were four.  As of this writing, there are at least 24 options. The number of medications is notable for the magnitude, and it would seem excessive.  The sad part is not every medication works for every person, and it’s trial and error finding what works for each person. It’s also important to note that the effectiveness varies for each medication, and risks associated with modulating an immune system carries other health risks. It’s a necessary evil.  

All of the medications are expensive beyond belief, but they are saving grace for those of us who need them.  I’ll refrain from repeating my thoughts on this issue here, but I have written about insurance denials and prescription coverage previously if you want to check them out. Short story, I’m doing well and have coverage.  Not all do, and it’s a mess. 

These are four posts I wrote about medical insurance, if you feel like heading down that rabbit hole: 

• Dealing with Insurance Denials: A Necessary Skill When Living With a Chronic Illness, October 3, 2017
• Necessary Medication and Politics: The Devastation Falls on Patients. January 30, 2018
• Necessary Medications and Politics: Part 2, February 28, 2018
• Prescription Coverage Drama and Trauma: It Breaks Me at Times, August 29, 2019

I’m hard pressed to leave this on a negative note, so if you want to read a post that’s a bit more empowering for tracking and navigating insurance billing to help with financial impact, check out 

• Creating Some Order in the Medical Billing Chaos, September 11, 2016

I want to acknowledge and celebrate this personal milestone of ten years without new disease activity. This summer I’ll reach 15 years post MS diagnosis. When I was diagnosed, the prognosis for people with MS was 20% of people would be bedridden, 20% require a wheelchair or mobility aid, and 60% would be ambulatory.  Ambulatory is such a sanitized word to convey the threshold that people are able to walk 150 feet, walk one block, and climb one flight of stairs. The bar is low, and the ability to do these things is everything when on the cusp of not being able to meet them. The prognosis for 1/3 of all patients was that they would go through life without any persistent disability, and suffer only intermittent, transient episodes of symptoms.” These statistics are from the National Institute of Health.

“Intermittent, transient episodes of symptoms” minimizes the impact MS has on a person. Even with the best possible disease course and NEDA, my life still revolves around managing my health and symptoms. All of my friends and family are impacted at one point or another by my health. I look like a healthy person, I work full time, and I am very active. And I’m extremely lucky.  

This past year, I walk-jogged a marathon. At mile 18, I was physically unable to run anymore. I could still walk though.  I didn’t care about how fast my pace was, and I knew I could walk the rest of the course and still make the time limit required to get credit and earn the title of “Finisher.”

I am doing well. So far, I continue “to go through life without any persistent disability, and suffer only intermittent, transient episodes of symptoms.”

It might sound great, and it is. That said, MS symptoms are a hassle. While grateful I’m doing as well as I am, it’s not a cake walk. My sympathy for all who experience health issues that inhibit them from activities and a lifestyle they desire. 

This weekend as I process the results of my health scans and consider milestones and the health journey I’ve endured, I celebrate my good fortune and I acknowledge it’s not guaranteed for things to come.  I sympathize with those who are experiencing a more difficult health journey of any flavor, and I extend my well-wishes and effort to help.  

Bittersweet is an apt description for how I feel. I embrace feeling like a rock star with rebellion, pride and full knowledge that it’s not all within my control. I extend my heartfelt compassion for those vulnerable, not faring well, or living with challenging times.

I hope you find your inspiration to weather all you experience.  For me it’s still Pink’s song, “So What.”

"So, so what?

I'm still a rock star

I got my rock moves

And I don't need you

And guess what?

I'm having more fun

And now that we're done

I'm gonna show you tonight"

Much love and sincere well wishes for all.    

Tracking Symptoms & Treatments with Compassion & Encouragement

With each new year, I think about what’s ahead, what I can control, and what will make the next 12 months fulfilling for me.  Instead of pushing myself to do more or be better, my approach this year for health management is to track what helps me manage my health with methods that are easy to use and visually informative. 

Knowing what my body needs is an ever-changing puzzle, and tracking provides clues for what could be the cause or remedy for things contributing to health challenges. Add aging and menopause to living with Multiple Sclerosis, and knowing how to best manage my changing body is not easy. 

Tracking helps reveal immediate issues and needs, and over time it divulges patterns and trajectories. It can show similarities and differences in my health condition over time, and it can indicate overall improvement or decline. 

Monitoring can be as detailed or general as each person likes, and it can ebb and flow over time. Periodically entering full details for how I’m doing in a moment is terrific for long term health status review.  Simple checklists and charts can provide reminders to do things. Over time, they can give clues to explain changes throughout a week or month. 

I like systems that easily fit into my habits and schedule instead of forcing me to make drastic changes. I will do things that help my health when I remember, and often a note, comment or routine is enough encouragement to make good choices. When my routine changes, it can completely derail good habits that keep me well.

 

I’ve often noticed when spasticity and leg pain increase, I’ll realize I’ve forgotten or neglected to do some or many of the treatments proven to help me manage spasticity. I may have run out of supplements or medication, missed my daily banana or stretching, or have just been dehydrated.  No one thing on a single day causes my MS symptoms, but missing one or more a few days in a row can really throw me off track.  

Without tracking, I don’t notice the correlation as readily. With tracking, I clearly see how frequently my biggest MS symptoms occur AND which good health measures I’ve done or haven’t done.  

I use both digital apps and a hard-bound journal to track my symptoms and treatments, and I like them both for different reasons. I’ll share examples for each method in this blog post.

MSAA has an app My MS Manager that is a terrific comprehensive tracking tool for monitoring MS symptoms, treatments, and well-being. I particularly like that the app is flexible and can be customized with items to track or receive reminders to do them. In the daily journal section under “Treatment Taken?” section, I added prescriptions and treatments that I know help me with the frequency desired and an option to set up reminders.  Items can be added from a standard list and custom items can be created. To track each item on a given day, I can easily click yes, no or not required for the question, “Did you take this treatment today?”

Seeing my individual symptoms and mood charted over long periods of time and being able to compare current and past data is invaluable.  Knowing I’ve experienced similar peaks and valleys helps me weather today’s challenges. Seeing what helped previously offers suggestions for what might help this time.  

I use the app My MS Manager to provide comprehensive tracking, and I use other apps for fitness and activity tracking as well. Syncing my watch and scale to other apps makes it easy to access data without added effort or time on my part. 

  

Technology is incredible these days, and apps are convenient. I always have my phone handy, so it’s a good option for a lot of my tracking.  

Yet I learned long ago there’s never one solution that will meet all my needs. I like pen and paper for its flexibility and visual reminders.  I use it to track and remind myself to do daily or weekly things that help me maintain my health. I use a nicely bound journal with blank dot grid pages.  This approach works great for me for symptoms that are helped by a long list of treatments.

By entering treatments and activities next to the symptoms I’m managing each day, I have a built-in visual to connect how I’m feeling, why I might be experiencing symptoms, and what I can try to feel better. I’m including an image below to show the format I’m using and is working well for me.  

Page from my journal showing tracking example

In this example for spasticity and leg pain in my extremities, I have a number of things that help reduce pain including stretching, movement, supplements, daily banana, a vinegar muscle tonic, staying hydrated and medication.  Tracking on the same page the symptom or challenge along with actions I can take helps me see easily what else might help or if I am already doing everything I know helps and it’s getting worse. It was clear to me that when my leg pain became excessive that I could get back on track with stretching, supplements and the vinegar muscle tonic. It’s getting better every day, and I can see that with my chart. 

 

Please know that MS symptoms can often be unpredictable and uncontrollable. Tracking doesn’t prevent relapses.  This may be obvious but it is important, so I’ll say it again:  

Tracking does not prevent relapses.

If you have a relapse, don’t blame yourself. If you know someone who has a relapse, don’t blame them. It’s easy to judge others and try to assign blame, but it doesn’t do anyone any good. We’re all doing the best we can with what we have and where we are at each point in our lives.  Take any Judgy McJudgy-Pants conclusions elsewhere. Okay, this side rant is over and we’ll get back to tracking health items. 

 

It helps me to look at tracking as a monitoring tool rather than a long list of things to do that can put more pressure on myself. I don’t need more pressure, stress or judgment, even if it’s from me. I need to know I’m trying, and I need to remember I’m doing the best I can. A tracking tool can remind me without requiring me to take action. I still get to choose what I will or won’t do in each moment. I aim to tend to myself with compassion and encouragement rather than judgment and harshness. I wish all this for you too. 

A Season of Convergence

The holiday season for me is one of convergence. A convergence of work demands, holiday tasks, gatherings, gifts and merriment.  It feels like everything needs to get done, and there’s not enough time in the day or energy in my body to do everything. It affects my routines, eating habits, cash flow and health. Yet I love it and look forward to it every year.  

Decorations brighten the landscape, workplaces and homes. Stress abounds, but so does good cheer. Frenzy and serenity coexist. 

I rush and rest, plan and adjust.  Priorities get met, yet they can change.  Checking in with myself helps ensure I’m clear on what’s reasonable for me to do or needs to be let go. My aspirations exceed my ability, and ruthlessness for what stays on the priority list is essential. 

There’s no possible way to do it all.  Picking and choosing matters. 

Convergence of deadlines and expectations organically occurs each year. Intentionally merging needs with wants can help lessen the amount of precious energy and time needed for them.  It can help make things less stressful and more fulfilling. My goals for the season are:

• Know what I need and want, what’s good for me, and what aligns with my goals.
• Batch things I need to do with things I want to do.
• Look for ways to merge my needs and wants with things that are good for me, align with my goals and bring me happiness.
• Be clear in each moment what’s important and let everything else fade away.
• Have fun!

I often schedule walks with friends and colleagues to connect and be active. These outings are filled with updates, planning, problem solving, advice, encouragement, reminiscing, merriment and belly laughs. With these walks, my goals for movement, connection and fresh air for the day are met: check, check, and check. They do more than that though. They motivate, encourage and recharge me mentally and physically. Afterward, I feel both productive and indulgent – a perfect convergence of seemingly opposing mindsets.

With creativity, competing wants and needs can be fulfilled as complementary aspects of a single activity. For example, I enjoy writing, photography and art, and I want to spend time and energy pursuing them. They add to my quality of life, yet they don’t pay my bills or qualify as absolute needs. Managing my health and addressing my Multiple Sclerosis symptoms are definite needs for me.  In order to live as well as I can with MS, I need to listen to my body and learn what it needs.  I need to rest and manage stress, fatigue and other MS symptoms as best as possible. Monitoring and reflecting on how my body works and researching MS related topics takes time, energy and focus. If I think of my health and writing as separate and competing, I wouldn’t feel like I would have enough time or energy to spend on both. Instead, I unite my need to tend to my health and my want to explore creative endeavors by writing about MS challenges and what helps me live well with MS.   Writing helps me work through what I myself need, be clear about what helps me and create reference materials that are useful to me later. Writing ultimately helps me manage my health AND express myself creatively. 

This year, our office party changed from our usual dinner out to a wreath making event at a cidery and farm. We each learned something new, and we admired each other’s creativity. We shared stories and laughter while enjoying the ambiance of the venue and sipping delicious cider. Each of us left with a beautiful wreath as we marveled at the star-filled night sky and pointed out constellations. The pragmatist in me can say we checked the boxes for holiday gathering, connecting, learning, and creativity. The idealist in me knows it was a magical way to celebrate the season and my colleagues.  

In the midst of the holiday season with extra tasks, deadlines and desires, I seek ways to meet my needs and wants that are fulfilling and feasible.  I make time to reflect, write and tend to my health. I prioritize walks and friendship, and I aim to add merriment wherever possible. 

My wish for each and every one of us this holiday season is that our needs and wants converge for maximum fulfillment and joy. Cheers to you and yours!