TRANSCRIPT: Ask Me Anything with Dr. Mar... - My MSAA Community

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TRANSCRIPT: Ask Me Anything with Dr. Mary Rensel

Good evening and welcome, My MSAA Community, to our Ask Me Anything with Dr. Mary Rensel! We are grateful to have Dr. Rensel joining us to answer YOUR questions.

Mary R. Rensel, MD, FAAN, ABIHM is the Assistant Professor of Medicine at the Cleveland Clinic Lerner College of Medicine. She is also the Staff Neurologist and Director of Wellness and Pediatric MS at the Mellen Center for MS.

For the next hour, please feel free to ask Dr. Rensel your questions about wellness and living a healthy lifestyle with MS as a reply to this post. Don’t forget to keep refreshing the page to see the latest questions and responses.

Bring on your questions below!

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45 Replies
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Hi all- thanks for coming tonight, who has questions out there on wellness issues related to MS?? Someone start!

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Hello, this is CalfeeChick. I was wondering , even though I know exercise is very important, "Why do I have to force myself to go to the gym, or go for a walk." Am I depressed and not know it? I was very active before MS. Long distance bicycle rider 200-300 miles a week, swimming laps and walking a mile or more after dinner.

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Yes, I hear you, MS can be exhausting. Some gentle movement, a mild short walk , any movement matters. Fatigue can be a challenge, it is hard to work around it. I do hear from MS folks a little movement at a time can help at times.

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What role does Vitamin D play in MS?

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Vitamin D seems to support a health immune system, it is important to have a normal blood level of Vitamin D, this can be super hard in the northern climates with little sun!

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We're grateful to have the opportunity to ask questions of Dr. Rensel.

What, in your opinion, is the most important factor in a healthy lifestyle for MS patients? Is diet even more important than exercise?

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What exercises do you find to be more beneficial with MS?

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It appears to be a mix of moderate cardio and weight lifting, so the current recommendation is 2x a week of mild weight lifting and at least 150 min of moderate exercise (as able) / week for heart and brain health.

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If your at home and you don't have exercise equipment what can u use for weights?

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Some folks go into the pantry and find things that weigh 1-2 pounds..

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thanks

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What are some of the best ways to say, work both sides of the brain cognitively?

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The brain seems to like a few things to stay healthy- movement, interaction with other humans and learning new things. It is best to try a few of these things each week if one is able, the great news is having fun and getting out with others keeps us healthier.

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HI all, thanks for coming tonight. We do not know the most important factor in brain health related to MS, it seems to be a few things that are important. Exercise is one, Nutrition is another.

Healthy Lifestyle like- no smoking, moderate alcohol are important as well!

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Thank you! And thank you for being here!

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Thank you. Please elaborate on nutrition.

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Nutrition is a hard one, so many details. Some studies say avoid sugary drinks and processed meats like hot dogs to start. Then add colorful fruits and veggies a few times a day and lean proteins.

Carbohydrates, try to go with whole grains, so this is typically no the white fluffy bread.

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Thanks, but what about gluten-free diet? It is a part of the anti-inflammatory diet.

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Gluten free is not needed in MS, some MS folks find avoiding gluten feel better off high carb diet.

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I quit smoking over 20+ years ago. And quit drinking at the same time because I associated the two together. Now, two of my medications prefer no alcohol. It works for me. That's when I started Bicycling long distances, swimming and walking frequently. Do you think my super healthy lifestyle could of delayed MS's onset at age 68?

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Interesting.. it is hard to know but we sure know that "super healthy" lifestyle has been known to delay memory problems with dementia so I think you did your brain proud!

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When you have gone through menopause, what effect does the lack of estrogen have on ms?

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Hi, yes this is a special time for the brain, lots of changes. At this time an intentional brain health program- healthy nutrition, being social, seeing primary doc to address any risk factors like blood pressure and no smoking really help the brain. Estrogen does seem to be involved in memory, most menopausal women feel a difference, the studies at this time seems to support adding the overall brain health regiment.

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Having had a full hysterectomy 5 years ago, my physical abilities have declined. In your opinion would taking estrogen on a regular basis help me in any way?

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Estrogen replacement is an issue that needs some time to decide as there are risks, sit with your Gyn about his and talk about family history and your history, this will help. It is likely fine as far as MS is concerned, we do not have a lot of studies to help us one way or another with MS.

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Thank you

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Do people who have MS who also smoke experience a worsened disease course?

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Smoking , including vaping and chewing tobacco, is negative for the brain, the brain needs alot of healthy blood bringing it oxygen.

Smokers with MS tend to have more troubles walking earlier, plus it will save you money to quit!

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What would you say to someone whos just starting out?

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Starting with MS, take some time to read from credible sources and then set health goals, great news lately is 4-5 things are important for brain health- Nutrition, being social , movement, no smoking, moderate alcohol and medical management.

See your primary doc at least once a year.

Make sure to treat the MS as the MS care provider suggests, early treatment has shown long term benefits.

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Wait, did I miss the 4-5 bran health?

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NM read that wrong. Sry

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Great question Jesmcd2 !!

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Can you discuss the importance of being mindful of comorbidities for people with MS?

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Comorbidities means MS plus another disease like High blood pressure. MS mixed with another disease like high blood pressure is extra hard on the brain, please see the primary doc to try to prevent this is if you have it please take care of it.

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Can you offer any basic stress management tips?

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Stress management can be different for different folks, at times something simple like deep slow breathing will do the trick and other times it takes working with a professional like a Psychologist to learn some new ways to manage stress.

Other stress management ideas: exercise, meditation, walking, looking at nature, being with others.. so many to choose from.

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Can you recommend any exercises for people who have limited mobility?

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Physical and occupational therapist are invaluable to help folks increase their abilities. I would recommend seeing them at least once a year.

There are some PT and others who post videos of exercise on You tube, so if you have a computer and internet, find some 10 minute stretches and you can work a bit while at home.

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Can you recommend any?

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There are millions, search under specific topics like 10 minute gentle yoga and then you can find ones that you like.

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What health and wellness resources do you recommend that are free?

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Yes, it is nice when things are free ... the websites have lots of info: MSAA and NMSS, definitely check them out and attend some of their wellness events.

You Tube has free exercise videos, you can search for gentle abs or stretch classes.

NIH website has lots of info on it for general health.

Talk to your local provider about local resources as well.

If you have Silver Sneakers (typically retired age), use that , it is free and an amazing resource.

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On behalf of everyone here at MSAA, we thank Dr. Mary Rensel for her time and expertise, as well as our My MSAA Community members who have participated and asked questions! We would also like to thank Celgene and Novartis for supporting this AMA through an educational grant. For more information about wellness and MS, we encourage you to check out the Overall Wellness section of our website at the following link:

mymsaa.org/msaa-help/overal...

Also, please check out our most recent MSAA Podcast episode on a related topic, The Impact of Nutrition in MS, as well as other episodes wherever you listen to podcasts or on our website here:

mymsaa.org/podcasts

Thank you!

- John, MSAA

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Good night all, thanks for caring for your brains. As a Neurologist, we love those brains. Keep up the good work.

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