k n a Th You 093 Spring/Summer 2013 In advance of National Volunteer Week we want to Pregnancy thank all our passionate and dedicated volunteers for their time and talents. Branch officers, committee members, office administrators, board members, prospects fundraisers and anyone who gives so freely to support people with MS, we thank you. Every day the work you do makes a difference in the lives of people with MS. Thanks for doing what you do! # In May 2013, Ireland will host European Month of the Brain as part of our EU presidency, and on the 29th of the month we will mark World MS Day. However, services for over 700,000 people in this country living with Multiple Sclerosis and other neurological conditions are among the worst in Europe. Help us change this INSIDE: Neurological advocacy 9 WOrld MS DaY 4 MS in the media 18 ContenTs Dear reader, This May will be an extra special (and busy) month for MS Ireland as we celebrate European Brain Month and World MS Day. It will be jam packed with activities, and aims to bring some serious attention to those with neurological conditions. We are calling on all our members, friends and supporters to help raise awareness, raise issues or raise funds. Page 4 outlines seven ways you can get involved, including sending the Red Card postcard to your local representatives (see the back page.) In November we were delighted to be chosen as one of five non-profits to win the Vodafone World of Difference award. Over 500 people applied to the scheme, which covers the cost of a person’s salary to work in a non-profit for one year. We are thrilled that our own Emma Rogan was selected as a winner. Many of you will know Emma as an active branch member, board member and passionate advocate for people with MS like herself. Read the article on page 9 to see Emma in action. WANTED NEWS Finally we want to remind everyone to send back their membership form included with this edition of MSnews. It contains important information to ensure we have the correct details for you and that we communicate with you in an appropriate manner. Enjoy reading, 2 Spring/Summer 2013 Taragh Donohoe Communications Manager P.S. We are always looking for contributions, so do drop me a line with any interesting stories or articles you would like to share. New gene linked to interferon levels An Irish team has opened up a potentially valuable new avenue of research into MS, with its discovery of a gene involved in the regulation of interferons 3 Current Affairs Gene discovery 3 World MS Day 4 Carers Week 5 Treatment studies 6 Research news 7 MS pathway 8 NAI strategy 9 Features MS Care Centre 12 Pregnancy 13 MS in the media 18 IRISH SCIENTISTS HAVE found another piece of the MS jigsaw. A 10-person team at National University of Ireland (NUI) Maynooth has discovered a gene linked to the development of MS and other auto-immune diseases. It found that the Pellino 3 gene may have a role to play in the regulation of interferons, making the discovery particularly interesting to those with MS. Interferons are a group of natural proteins released by the body to help fend off viruses. Auto-immune diseases can develop when the body releases too few or too many interferons. Too few interferons can trigger MS, so some people are prescribed Interferon-beta to help suppress the disease. Pellino 3’s ability to regulate the release of interferons means that scientists now have a starting point for the treatment of MS, according to Professor Paul Moynagh, lead investigator and director of the Institute of Immunology at NUI Maynooth. Professor Pau l Moynagh, dire While his team ctor of the Institute of Immunology concentrates on at NUI Maynooth immunology, it has had an interest in MS for some time. “Pellino 3 has to be very tightly controlled, so what we’d like to do now is look at the levels of the protein produced by Pellino 3 and see how it is produced in MS patients,” said Prof Moynagh. “We’d also like to use the models of MS to examine the role of Pellino 3 in the process that leads to the disease.” The Maynooth team’s findings were published in the well-known journal Nature Immunology in October, and have received interest from international quarters. Fundraising Walks and treks 24 Dates for your diary 24 MS READaTHON 25 20 Society appoints new medical advisor Professor Michael Hutchinson looks forward to exciting times ahead in his new role with MS Ireland My husband uses a powered wheelchair and we are looking to buy an automatic Renault Kangoo or similar. We would love to get out more. If you are selling your car, call Norah on 087 977 0128. Disclaimer: вЂ�MSnews’ is the magazine of MS Ireland. It exists to foster informed debate and comment about all issues relating to MS. The view of contributors are not necessarily those of the Society. No treatments or therapies should be 093 9 attempted or products used without qualified medical or professional advice. MultipleSclerosisIreland, 80 Northumberland Rd, Dublin 4. www.ms-society.ie | 01 678 1600 [email protected] | Info Line: 1850 233233 EDITOR Taragh Donohoe, [email protected] EDITORIAL Linda Daly, [email protected] ADVERTISING Taragh Donohoe, Tel: 01 6781610 MS Information Line: 1850 233 233 Prof Michael Hutchinson www.ms-society.ie WELL-KNOWN DUBLIN neurologist and long-time friend of MS Ireland Professor Michael Hutchinson has taken up the role of medical advisor to the Society. Prof Hutchinson will work on research funding and advocacy, research translation, and improving the medical information MS Ireland offers. A consultant neurologist at St Vincent’s University Hospital, and Newman Clinical Research Professor at University College Dublin, Prof Hutchinson has had a career-long interest in MS. Despite semi-retiring last year, he continues to work two and a half days each week as consultant neurologist at St Vincent’s. His interest in MS has not abated. “MS is very exciting at the minute. Lots of new drugs and effective therapies are becoming available.” Alongside Christian Confavreux, Prof Hutchinson instigated and organised the pivotal Pregnancy in Multiple Sclerosis (PRIMS) study in Europe in 1998. “The days when you saw young people suffer greatly are gone. Research into MS is becoming more interesting as time goes on because you can do so much more now for people with MS. I’d like to take part in that,” he said. “I’m delighted to become MS Ireland’s medical advisor. I have long been a supporter of MS Ireland’s work and am pleased to help in any way I can. I hope with my new role I can report on many more new advancements and developments in the care and treatments available.” 3 WORLD MS DAY NEWS Support Your Local MS Community This World MS Day World MS Day takes place on Wednesday 29th of May and is a day for all people with Multiple Sclerosis around the world to unite. This year the focus is on young people with MS and we are asking YOU to help us raise awareness, raise the issues and raise funds! We need your help to spread the word, create your motto, fundraise and advocate for better neurological services. Take action today and support your local MS community! I have MS, MS doesn’t have me 1 ord Spread The W Tell as many people as possible about World MS Day. Send emails, orks, put al media netw use your soci ’s webyour company on ng hi et m so for us. some posters site or put up e and create! Forward, shar 2 Share your m otto with the world . People with M S across the wor ld are being aske d to add their motto to the W orld MS Day website to sh ow what words of strength give them hope. A dd your motto an d encourage others on thei r journey. Organise a tea party in your home , community or workplace in May or June. Money raised locally will be spent locally. Sign up for a Fundraising Pack Today! Text World followed by your first name to 51000 5 4 3 6 Send your TD a Red Card for Neurology Neurology and neurorehabilitation services in Ireland are the worst in Europe (see some of the statistics on page 9) Cut out the postcard at the back of this magazine and send it to one of your local TDs or senators. You can also send it via our website. Organise your own event or activity 7 If you want to run an event yourself we would be delighted to help. We can send out information booklets, services brochures and promotional materials like posters and balloons. We can also send out boxes of pins if you want to put a box in your office or workplace. Attend a local event or fundraiser All over the country our Regional Offices and voluntary Branches are organising local events to inform, support or raise money for local services. Get your hands on The Script Get involved in our Celeb Auction and walk away with The Script, Def Leppard, Imelda May, Brian O’Driscoll, Noel Gallagher, Damien Dempsey or Katie Taylor. Get bidding today! This is an extra special World MS Day as it takes place during the European Month of the Brain. Across Europe many countries will be focusing their attention on neurological conditions and how services and awareness can be improved. In Ireland many events are already planned, including wellness days, a national seminar organised by The Neurological Alliance of Ireland, two key-note conferences and a range of information, advocacy and public relations activities. Check out our website for more details. For more information: W: www.ms-society.ie E: [email protected] T: 01 678 1600 4 MS Information Line: 1850 233 233 Mobility schemes axed The mobility allowance and motorised transport grant have been scrapped, as the Department of Health finds them unlawful THE LOSS OF the mobility allowance and motorised transport grant could diminish the quality of life of recipients, according to Ava Battles, Chief Executive, MS Ireland. In February, the Department of Health announced that the mobility allowance and the motorised transport grant would no longer be available to people with disabilities. It found that, under the Equal Status Act, the payments were unlawful. It has set up a project group, which is reviewing the schemes, and will consider alternative solutions to address the transport needs of those with disabilities. The department says it will look at other ways to deploy the €10.6 million currently ring-fenced for the existing allowance and grant. The group, which is independently chaired and includes representatives of people with disabilities, will report to the Government before the end of May. The Mobility Allowance, which is due to cease in June, is a means-tested payment of €206 a month. It assists a person with disabilities with various transport needs such as taxis to hospital appointments, community activities etc. “The service is particularly important in areas without good public transport,” said Ms Battles. It has proved vital for some people with MS, who have relied on the payments and spent their other income to buy food, fuel and essential medical supplies, said Ms Battles. Another means-tested payment, the Motorised Transport Grant is given to assist people with disabilities to purchase a second-hand car, thus helping them to continue to take part in community life. Ms Battles said both payments enable people with disabilities to take a more active role in their family life, work life and local community. “Taking away people’s right to social participation diminishes their quality of life and ability to contribute to society. For the few hundred people with MS we estimate are in receipt of these payments, we know many will suffer if an alternative, appropriate scheme is not introduced soon,” she added. MS Ireland has been working with the Disability Federation of Ireland to ensure that the payment is redeployed as quickly as possible. GET READY FOR CARERS WEEK With National Carers Week fast approaching, MS Ireland is urging everyone to support local events and help celebrate the work of family carers NATIONAL CARERS WEEK takes place from 10 to 16 June this year, and MS Ireland is calling on all members to get involved. Aimed at celebrating and promoting family carers, the week will see events and activities take place around the country. Family carers make a huge contribution to our society, but many are not recognised for the great work they do. National Carers Week sets out to remedy this. Olga Estridge, Services Manager with MS Ireland, says the Society is delighted to be involved. “There’s a large number of people with MS who rely on the support and care of their family members. We believe that highlighting the challenges and experience www.ms-society.ie of carers is very important.” Weather presenter Nuala Carey To mark National launches Carers Week Carers Week, MS with the aid of some helpers. This year it takes place from 10 Ireland will launch to 16 June an online toolkit for carers on its website. It provides information on practical aspects of caring, covering topics such as skin care, cognition, bowel spasticity and nutrition, as well as emotional aspects such as coming to terms with being a carer. Check out www.ms-society.ie for details of the events taking place during National Carers Week. 5 NEWS Studying up on MS Teams at University of Limerick (UL) have been investigating new ways of alleviating some of the symptoms of MS BLADDER DYSFUNCTION BLADDER DYSFUNCTION AFFECTS approximately three out of every four people with MS. Yet, research has found that people with the disease appear reluctant to seek treatment for incontinence. The problem can affect people’s confidence, as it impacts on social participation, activity levels and sexual activity. But there are ways to manage it, and self-management in particular will boost social participation and quality of life. Led by Catherine Browne and supervised by Dr Maria Garrett, the research being conducted at UL aims to identify the specific factors of bladder dysfunction that contribute to the reduced quality of life in people with MS. It is also looking to identify best practice in assessing and managing the symptoms. The first phase of the project, which involved interviews with people with MS, has been completed. The team found a knowledge gap in terms of the type of self-management strategies employed by participants, as well as their understanding of bladder dysfunction and reporting symptoms to health professionals. According to the researchers, these results suggest there may be a role for health professionals in providing education specific to bladder dysfunction to people with MS. The next phase of the project, which will get under way shortly, will include a focus group made up of health professionals in order to get their views on the topic. This will be used to inform a national survey, which will help identify best practice in managing bladder dysfunction. Sensory Problems A second project at UL is looking at the importance of sensation in rehabilitation strategies for people with MS. Marcin Uszynski, a PhD student under the supervision of Dr Susan Coote, says studies show that sensory abnormalities are common in those with the disease. “There are different reasons people with MS suffer loss of sensation. Abnormal feelings usually take the form of numbness or tingling, often in the arms and legs,” he says. 6 NEWS Some people also experience a loss of sensation or an inability to feel temperature. It is important to have good tests to detect and treat these problems, but there is currently no gold standard tool to assess sensation in the MS population. “One of our research projects investigated four tests which may help to detect changes in sensation. Preliminary results suggest that a Neurothesiometer, which detects vibration threshold, and a Verbal Analogue Scale, which determines a patient’s feeling of sensation, seem to be the most reliable,” says Mr Uszynski. A new treatment, which uses a Whole Body Vibration (WBV) platform, has been put forward as having the potential to strengthen muscles and treat sensation problems in people with MS. Anecdotally, patients give positive feedback, reporting a higher level of energy afterwards, and noting that their feet feel warmer and more sensitive. “Results from our pilot study confirmed it is a safe treatment with no adverse effects. It has the potential to be performed independently of a therapist once a person is instructed, but we need more research into its effect.” Are you interested in taking part in research studies? If so, the MS research team at UL is putting together a database of people with MS who would like to be informed of what studies are being conducted through the university. The studies will look at rehabilitation, exercise and other aspects of living with MS, rather than clinical trials of drug therapies. If you would like more information or for your details to be added to the database, please contact Dr Susan Coote ([email protected]; 061 234278) or Dr Maria Garrett (maria. [email protected]) and they will send you a letter with further details and a contact form. By signing up to the database you are not committing to taking part in future studies, rather you will be kept informed and can choose whether to take part later on. Researchers often approach MS Ireland to help recruit people with MS for various studies. At the moment we are looking for people interested in studies on mindfulness and decisions on medications. For more information log onto our website. MS Information Line: 1850 233 233 Green light for Tecfidera Decision means oral first-line therapy could be available here by late 2014 TECFIDERA, A NEW oral therapy for MS previously known as BG-12, has received approval in Europe and the US. This could see the drug available in Ireland within 18 months. The European Medicines Agency (EMA) and the Food and Drug Administration (FDA) in the US gave the therapy positive opinions in March. On 21 March, the EMA’s Committee for Medicinal Products for Human Use (CHMP) recommended the granting of a marketing authorisation for Tecfidera 120mg and 240mg capsules for adults with relapsing-remitting MS. The recommendation has been referred to the European Commission, with a decision expected this month. On 27 March, the FDA approved Tecfidera as a first-line therapy for those with relapsing-remitting MS. The drug, which is manufactured by Biogen Idec, is believed to reduce inflammation and protect the nerves. It is taken in tablet form two or three times a day. Studies have shown relapse rates drop by 48% for the twice daily dose and by 53% for the three times daily dose. Disability progression also fell by 38% for those who took Tecfidera twice a day and by 34% for those who took it three times a day. Common side effects include gastrointestinal upset such as diarrhoea, nausea and abdominal pain, and flushing. This is an exciting development in MS, as Tecfidera could be the first oral therapy available as a first-line treatment. Currently, all first-line treatments are injected. PPMS impedes cognition more than RRMS Research into the cognitive abilities of people with MS finds that those with PPMS fare particularly poorly A NEW STUDY from France has compared the cognitive abilities of people with primary progressive MS (PPMS) and relapsing-remitting MS (RRMS) with those of healthy controls. The study took 41 people with PPMS, 60 with RRMS and 415 controls. Participants then took part in neuropsychological tests including the Stroop test, a numerical span test, and computerised tests as part of the Test of Attentional Performance (used since the late 1990s to analyse different aspects of attention in adults with medical and neurological conditions). The study found that people with PPMS performed worse than controls on nearly all neuropsychological tests, while those with RRMS performed worse than the controls on just some of the tests. It concluded that people with PPMS had poorer cognitive ability than those with RRMS. www.ms-society.ie No evidence for CCSVI link A new study has found no basis for claims of a role for CCSVI in MS A STUDY PUBLISHED in the journal Annals of Neurology in March found no association between chronic cerebrospinal venous insufficiency (CCSVI) and MS. This was one of seven studies funded by the US and Canadian MS societies, and was initiated after CCSVI received much media coverage over the past few years. It found no increase in the prevalence of CCSVI among people with MS. Researchers from the University of Texas Health Science Centre in Houston measured blood outflow from the brain. Some 276 people were assessed for CCSVI, 206 of whom had MS. CCSVI was present in 3.88% of people with MS and 7.14% of those without MS. 7 NEWS NEWS SHOUTING Finding a pathway A new initiative hopes to put a plan in place for how the care of MS should proceed from diagnosis onwards, thereby demystifying the process for patients PEOPLE WITH MS could soon have a care pathway in place to help co-ordinate their care from diagnosis through to treatment and services. In 2012 MS Ireland ran a campaign to highlight and rectify the issue of certain treatments not being available to people with MS. Working with other organisations, we were successful in getting Gilenya reimbursed by the HSE. Access to Tysabri is still an issue. One of the consequences of the work we did on the access campaign was an invitation to a meeting with the then director of the Quality and Clinical Care Directorate for the HSE, Dr Barry White, and key members of his staff, as well as the Neurology Clinical Programme group. In 2010, the HSE set up a Quality and Clinical Care Directorate to help improve patient care throughout the health system. At the time, 20 clinical programmes were established, with a clinician appointed to lead each one. Among the 20 areas covered in the directorate were primary care, heart failure, diabetes, epilepsy, stroke and neurology outpatients. The neurology clinical programme is led by Professor Tim Lynch, Consultant Neurologist in the Mater Hospital. The aim of this group is to confirm baseline versus nationally agreed outpatient targets, to establish ways to measure performance and to put in place clinical process and practice changes. A working group of the neurology programme has now been set up to focus on MS. We are delighted that MS is the first neurological condition to be looked at under the programme. The working group is being headed by Drs Niall Tubridy and Chris McGuigan, Neurologists with St Vincent’s Hospital. The group also has a wide range of disciplines represented including MS specialist nursing, physiotherapy, ophthalmology, occupational therapy and others. Aidan Larkin, National Services Development Manager with MS Ireland, is also a member. The first piece of work for the group is establishing an MS care pathway. “We’re trying to set up some sort of standard practice, so that a person presenting with the symptoms of MS might know a typical time frame for expecting such things as an MRI scan or being called back for diagnosis. We’re also looking at the most appropriate pathway of care throughout the life of the condition so that clinicians have some framework out of which to operate,” says Aidan. At present, a person with MS may not know what to expect of any healthcare professional from the time they notice symptoms and contact a GP right up to being diagnosed with MS and beyond. “It’s a work in progress but the idea is that we will come up with an agreed pathway, which will feed into the neurology group.” The Clinical Care Directorates are key agents of change in the HSE. The stroke and epilepsy directorates have had huge successes in changing practice and care for the benefit of those with stroke and epilepsy. MS Ireland believes that similar improvements can be made in MS and neurology in general so we are focusing much of our advocacy work in this area. One of our key concerns is that discussions and changes in care and services do not focus solely on hospital-based services. “One of the key challenges is linking up the services and care in the hospital with those in the community. As it is a lifelong condition, most people are tapping into services in their local areas. It is vital that both community and acute services link up and improve in tandem,” says Aidan. MS Ireland would like to hear your views on changes to the delivery of hospital and community-based services. Over the coming months we will be involving people with MS in a series of consultations and questionnaires. Check out our website for more details. 8 MS Information Line: 1850 233 233 LOUDER NEUROREHABILITATION ON 25 FEBRUARY, MS Ireland helped launch the Neurological Alliance of Ireland’s (NAI) neurorehabilitation manifesto. The manifesto calls for the Government to implement the 2011 neurorehabilitation strategy and protect funding to non-profits. An NAI survey painted a grim picture of current neurorehabilitation services. It revealed that 71% of people with a neurological condition couldn’t access any neuropsychology services at all, whilst 68% said physiotherapy and speech and language therapy were either inadequate or not available. Person with MS Alexis Donnelly spoke at the event. Alexis contributed to the original strategy and is dismayed that action has not been taken. “I feel my continued existence is threatened if we do not invest now. If I deteriorate I will be in hospital more, and both I and my wife would have to quit our jobs as she would have to care for me. Neurorehabilitation has long been the Cinderella of the healthcare system. It’s about time Cinderella went to the ball.” Other findings from the survey include: • 80% couldn’t access adequate residential or day services • 78% could not get proper counselling services • 76% couldn’t access adequate occupational therapy services NEUROLOGY SERVICES On 27 February MS Ireland joined NAI for its Lobby Day in Leinster House. The aims were to educate our elected representatives on the dire state of neurological services, show the positive impact non-profits are making and ask them to prioritise people with neurological conditions. Person with MS Emma Rogan spoke of her experience of living with a neurological condition. She was joined by Professor Orla Hardiman, Consultant Neurologist, and Chris Macey, Chair of NAI. “The bottom fell out of my world when the doctor and nurses gathered around my bed and told me I had MS,” said Ms Rogan. “Dazed and confused, I was on autopilot for a while. I then made contact with an MS volunteer at home in Mullingar and they put me in touch with Mary www.ms-society.ie Improvements in neurological care and neurorehabilitation services are top of MS Ireland’s advocacy agenda this year Below: Emma Rogan highlights the fact that over 5,000 people with neurological conditions wait more than a year to see a neurologist n with MS Above:  Perso e lly launches th Alexis Donne to es if an ationM Neurorehabilit Chris Macey ir ha with NAI C who works with MS Ireland. She has listened, advised, encouraged, cautioned and been a tower of strength for me over the years. More government cuts take the Marys of this world away from those in most need.” In advance of the briefing we asked members to email their TDs with information and invites to the event. Thanks to everyone in MS Ireland who did this. To find out which TDs attended, log on to www.nai.ie. Shocking facts about our neurological services include: • 38% of patients, more than 5,580 people, are waiting more than a year to see a neurologist • Over 1,000 patients are waiting more than four years for a hospital outpatient appointment • Ireland has seven rehabilitation consultants; if we had 50 we’d still have the second lowest per capita rate in Europe. If we had 150, we’d have fewer per capita than Serbia, the Czech Republic, Estonia, Latvia or Croatia. Check the back page for a postcard you can send to local representatives to ask them to support the calls for improvements. You can also email your TDs from our website: www.ms-society.ie 9 services services FORGING LINKS MS Ireland and the MS Northwest Therapy Centre in Sligo are strengthening their relationship OVER THE PAST year, representatives from MS Ireland and the MS Northwest Therapy Centre in Sligo have met with a view to reinforcing links between the organisations. For example, they have discussed activities and fundraising events they could run together. “We have had a number of meetings with the MS Northwest Therapy Centre and have agreed to work more closely together,” said Olga Estridge, Services Manager, MS Ireland. The MS Northwest Therapy Centre has become a valuable resource for people with MS in the west of Ireland over the past 20 years. It provides a number of services, including physiotherapy, counselling, holistic therapies, hyperbaric oxygen therapy and foot care. “It is a wonderful facility, which offers a very practical response to people on the western seaboard. There’s no doubt that MS Ireland members use the centre, so there’s a link there. We hope to work closer with the centre going forward,” said Ms Estridge. Calling all service users National database’s usefulness will depend on people coming forward with details MS IRELAND IS calling on people with MS to sign up to the National Physical and Sensory Disability Database (NPSDD). Set up in 2002, the NPSDD is a planning tool for the Health Research Board (HRB), which measures the needs of people with physical or sensory disabilities, including those with MS. The tool profiles people who are receiving or waiting for specialised health and personal social services, the type of service they are waiting for, and when in the next five years they may need those services. 10 Katie Hourigan, Regional Co-ordinator for MS Ireland’s South East region, says: “the better we understand the needs of those with MS the better we are able to address their needs”. In a press release issued by the Department of Health in May 2011 the Minister for Health, Dr James Reilly, stated that “Every health policy developed during the time that I am in office is going to be based on knowledge derived from research”. It is research, therefore, that determines how much is spent and where. In much the same way in which the census helps us plan for schools and local amenities, the NPSDD database helps us plan health-related services. Once the Health Service Executive (HSE) can quantify needs and identify gaps, it can then plan services appropriately. In some areas the HSE is already using information from the database to allocate funding and resources; for example if physiotherapy is identified as a key need in a certain area, resources can be allocated appropriately. We encourage everyone with MS to get their details added. This involves a 15-minute phone interview based on a standard set of questions. To be included on the database contact your MS Ireland regional community worker or your HSE Public Health Nurse. MS Information Line: 1850 233 233 Rehabilitation conference to see international experts discuss exercise participation and mobility UL to host conference on mobility in MS INTERNATIONAL EXPERTS ON physical activity in MS are set to descend on Ireland next month as Rehabilitation in MS (RIMS), the European network for best practice and research in MS rehabilitation, hosts a conference here. The two-day event, which takes place on Friday and Saturday, 7 and 8 June, will cover a range of topics as it looks at changes in mobility and exercise participation. Areas to be discussed include exercise, education and the psychology viewpoint on exercise and physical activity for people with MS. Rehabilitation physicians, physiotherapists, sports scientists, MS clinicians and researchers will attend. The event aims to share the latest knowledge and information around physical activity in MS so that the participants can build on the research to date. RIMS is hosting the event, at University of Limerick (UL), alongside SIG Mobility and Education. This is the first time a RIMS meeting has taken place in Ireland. Dr Susan Coote, Board Member of MS Ireland and lecturer in physiotherapy at UL, is the local organiser. “We hope to have a range of speakers from across Europe presenting the latest research,” she said. “We hope everyone in attendance will use this information to develop interventions based on the latest evidence.” She added that the event was very timely for the research team at UL as it works on the next stage of Getting the Balance Right, MS Ireland’s national physiotherapy and exercise programme. The event is open to all health professionals working in MS rehabilitation. We will be interviewing many of the speakers and making available as much reader-friendly information as possible. Check out our website or the next edition of Msnews for more. Kindly sponsored by Biogen Idec MS Ireland National Awards It’s that time again when MS Ireland prepares to honour those who make a real difference EVERY YEAR, MS Ireland honours people associated with MS through its National Awards. From those who care for loved ones or neighbours, to those who selflessly volunteer their time, to people with MS who inspire us each and every day, the awards have gone to an eclectic bunch of worthy recipients over the years. They are the Society’s way of recognising the contribution many of its members make within their families, local communities and MS Ireland itself. The nominations for this year’s awards are now open. Branches, individual members and staff can nominate those they feel deserve recognition. There are awards in the following three categories: www.ms-society.ie • MS Person of the Year • MS Carer/Helper of the Year • MS Volunteer of the Year Full details and nomination forms are available on the website or by contacting Alice McKeon on 01 678 1600. We recommend that you return your nomination forms to the National Office now. The closing date for receipt of forms is Friday, 28 June 2013. The 2013 awards will be presented at the national conference and AGM in September. 11 MS CARE CENTRE Cover Story For a person with MS, the prospect of having a child – from conception right through to the early months as a parent – can seem daunting. But the evidence points to it being a very positive experience for most Home away from home Each year hundreds of families benefit from the wonderful services at the MS Care Centre. But how does the application process to the MS Care Centre work, and how can you avail of the invaluable services it provides. EACH WEEK THE MS Care Centre caters for 12 residents. Ireland’s only dedicated respite and therapy centre for people with MS provides a number of social and therapeutic activities. From yoga and massage to physiotherapy, nursing assessments and evening entertainment, visitors to the care centre can mix pleasure with support services. In the leafy suburbs of Rathgar in Dublin, the MS Care Centre is open to people from all over Ireland. Niamh Sweeney, Support Services Manager at the centre, says you don’t have to be a member of MS Ireland to stay there. “There is a waiting list, the length of which can vary at different times of the year. People can come in for five, seven or 12-day breaks,” she says. People can be referred to the centre through their Regional Community Worker, GP, public health nurse or any health professional. “They can also self-refer or be referred by a relative,” adds Niamh. All potential residents need to complete an application form, which includes their contact details, information about their MS and their preferred dates to stay. All applications are assessed by Niamh and one of the Clinical Nursing Managers. Niamh looks at administrative issues such as dates and the persons insurance status - private healthcare, medical card holders or other. The Clinical Nursing Manager looks at the clients potential care needs. “It is vital that we know the level of care needed by a client. We can cater for up to seven high care needs residents a week so we ensure that the needs of the person can be met appropriately by staff,” she says. Some potential residents may not be accepted if their dates don’t suit, too many high care needs clients are booked in already, or the person is just too unwell at the time. “To the best of our ability we try to provide equal opportunity of access to our services. However, residents 12 In the family way will be prioritised based on their social and family circumstances and on their needs,” says Niamh. If possible, requested dates will be catered for, but if they’re not available alternative dates will be put forward, or applicants will be placed on a waiting list. If dates are suitable and the person’s needs can be met, a confirmation letter is sent to potential residents to confirm their stay. A week before the person is due to come to the centre one of the nurses will make contact by telephone. They will talk through the person’s needs in relation to medications, nutrition, equipment or any other requirements. This information helps the team to create a care plan for all residents. On the day of arrival, the nursing and care staff meet with each resident to run through any requirements again and arrange appointments with the centre’s various therapists. They will also talk to the resident about any events they can take part in during the week or additional therapies they may want to book. A voluntary donation of €20 per day is asked of each resident to help cover costs caused by reductions in fundraising and cuts in state funding. MAKING THE DECISION to have a baby is a huge one for any woman or couple, but for people with MS there are more considerations involved than for the average person. Years ago, women with MS were advised not to become pregnant, as it was believed that pregnancy would worsen the disease. However, in 1998 an international study, the PRIMS study (Rate of Pregnancy-Related Relapse in Multiple Sclerosis), offered a new view. Professor Michael Hutchinson, Consultant Neurologist and Medical Advisor for MS Ireland, worked with a number of European neurologists and researchers to carry out the study, funding for which came from MS Ireland. “I felt this was an area that wasn’t properly understood,” he says. PRIMS studied 254 women with MS in 12 European countries throughout their pregnancies and for up to 12 months after delivery. The aim was to determine the rate of relapse per trimester. That rate of relapse was compared with the relapse rate during the year before the pregnancy. It also analysed the effects of epidural and breastfeeding on the relapse rate. Prof Hutchinson says that if you take pregnancy and the three-month postpartum period, the overall experience is disease neutral. The study found that, during the pregnancy, disease activity reduces, particularly in the last trimester. In the few months after birth, relapse rate increased and one in four women experienced a relapse of varying degrees of severity. Relapse rate returned to normal soon after. The PRIMS study is still the most comprehensive research in this area and smaller studies have backed up the findings. Getting pregnant Contact the MS Care Centre today: The MS Care Centre, 65 Bushy Park Road, Rathgar, Dublin 6, Ireland [email protected] 01 490 6234 MS Information Line: 1850 233 233 Prof Hutchinson says people with MS should be very energetic and “feel well” in order to embark on a pregnancy. Very often those who get pregnant have mild symptoms of the disease. The advice for women with MS who are on any diseasemodifying drug therapy is to come off the drug at least www.ms-society.ie a month, but preferably two or three months, before conception, according to Prof Hutchinson. “If they’re planning a pregnancy, they should start taking folic acid as with all potential pregnancies,” he adds. Women on Tysabri are advised to stop taking the medication three months before conceiving. Relapses during pregnancy are rare, as the hormonal effect on MS tends to reduce activity, but they do happen. If someone has a relapse during pregnancy they can be put on steroids. Prof Hutchinson says that the majority of women who do relapse during term go on to Tysabri straight after delivery. Any woman looking to get pregnant should talk to their neurologist, who will follow up with them throughout their pregnancy. Midwife Doreen Buckley suggests that all women, including those with MS, attend a course during pregnancy to prepare them for going home with the baby. “While the recommendation is always to get lots of sleep when the baby is born, pregnant women also need to be rested when coming in to have the baby,” she says. “When people have MS in pregnancy they are often known to get remission from the symptoms but they’ll still be fatigued just by the fact that they’re 30-plus weeks pregnant. “I suggest old-fashioned things such as having a bath and using lavender oil, and slowing down at night by listening to their favourite, relaxing CDs.” Recommendations from Ms Buckley include avoiding the use of mobiles in the bedroom, and no television within 30 minutes of bedtime. “By watching television right up until we sleep or 13 COVER STORY checking our phones after the lights are out, we’re not allowing our body to slow down. We’re not getting into restorative sleep so we will wake up fatigued.” She suggests going to bed at the same time every night and getting up at the same time every morning. Labour Labour is often long and exhausting, especially for first-time mothers. For women with MS, the fear that it can cause fatigue is not unjustified. In some circumstances fatigue can affect the second stage of labour and prevent pushing. However, there’s no association between the length of labour and relapse, according to Prof Hutchinson. Just because you have MS doesn’t mean you have to have a Caesarean section. Caesarean sections will be suggested for those women who experience lower limb weakness or spasticity and so may find it difficult to push or squat during labour. Any birth plan should be discussed with the midwife and obstetric physiotherapist during the pregnancy. Likewise, there is no evidence that women with MS can’t take pain relief medication during labour, including entonox (gas), pethidine and epidural. In some cases, the TENS machine can exacerbate lower limb spasms. Men with MS The issue of having a child is not one confined to women with MS. Sometimes men with MS worry about conceiving and being able to look after their children when they arrive. Male fertility doesn’t appear to be affected by MS but some men do experience issues around ejaculatory dysfunction and impotence. These problems can be remedied, however, by medication for erectile dysfunction, electronic ejaculatory stimulation or artificial insemination. No studies have been published to show the effect of disease-modifying therapies on fertility or foetal development when it is the father taking the medication. Men should talk to their GP and neurologist before trying to conceive. One option could be to freeze your sperm before starting treatment. If you experience fatigue, and will find it difficult to be there throughout the entire labour, you should arrange for a family member to take over while you rest. For men with physical disabilities, the inability to play with their child or teach them practical things like cycling a bike may deter them from having children, but remember there are many other things you can teach your child, and you can show them all the love in the world. Discuss any fears you may have with your partner. 14 COVER STORY Relapse after birth Studies have shown that one in four women relapse during the first three months after having a baby, with the risk of relapse during the postpartum period estimated to be between 20 and 40%. There is no way to predict who will experience a relapse or how severe it will be. The first few months of having a baby are naturally exhausting but for women who experience a relapse the difficulties are compounded. Be extra vigilant about spotting MS symptoms and contact your neurologist immediately. Fast and immediate treatment can help minimise the impact. Speak to family before the birth and prepare them to offer extra help if you do relapse. Emotionally, a relapse can be difficult as mothers often feel guilty about not being able to tend to their child’s every need. They may be reluctant to accept help or admit that they are having difficulties. However, by caring for yourself you will be better able to care for your child in the long run. If family can help with the more practical duties, you can focus on bonding with your child. Ms Buckley says it’s common for women to become overwhelmed when breastfeeding on the first night home from hospital. If you suffer sore or cracked nipples, see a lactation consultant as soon as the early warning signs appear, she says. While getting sleep can be a difficult task for new mothers, sleep is important in order to produce good-quality milk. “Keep visitors away and ask family and partners to look after the baby while you get some sleep in a different room,” she says. For first-time mothers, having a baby can be daunting, and the added stress of dealing with the threat of an MS relapse overwhelming. It’s important to remember that relapses aren’t a given and studies have shown that pregnancy shouldn’t affect the course of your disease. Having a baby can be a positive, life-changing experience. Be prepared and informed, and enjoy the ride. POSITIVE OUTCOME I WAS DIAGNOSED with MS in 2010 after having what I now know to be fairly frequent relapses. I would have never considered myself very maternal but when I found out about the MS, it was one of the first things I thought about. I started treatment and stayed on it for about six months before coming off to try and conceive. I stopped my treatment in November 2010 and I found I was pregnant in February 2011. Until the fourth month I had pretty bad morning sickness and was exhausted, as most women are. Overall I had a really good pregnancy; not having to inject every day and being able to blame the fatigue on pregnancy was great. My energy levels felt higher than they had in a long time. I’m lucky to have fantastic support from my family. I opted not to breastfeed. For me it meant I could let other people help out with feeds when I was too tired, and I started back on my treatment after four weeks. My last MRI scan showed some positive results... a combination of pregnancy and my treatment! Breastfeeding A number of publications have reported that exclusive breastfeeding reduces the relapse rate in this period. “If you do decide to breastfeed you should be fairly well and have a milder form of MS. “It is an exhausting time for the mother but it can produce lots of prolactin, a hormone in the blood stream which can have a positive effect on the central nervous system,” said Prof Hutchinson. Ms Buckley says it’s important that women are trained properly in breastfeeding “Breastfeeding presents a number of benefits including losing body fat and immunity against illness but breastfeeding exclusively can be very difficult for any of us,” she says. She suggests visiting your local breastfeeding support group before having the baby. “It’s a great idea to get yourself down there and meet other women doing the same thing.” New mothers must be able to distinguish whether the baby is looking for food or comfort, says Ms Buckley. They must also eat healthily to keep up their energy and ensure the right nutrients are being produced, she adds. “Eat plenty of fruit and veg, and protein at two meals a day. Eat at three to four-hour intervals and no dieting or fasting,” she adds. MS Information Line: 1850 233 233 THREE’S COMPANY A man’s perspective WHEN I WAS diagnosed with MS I was very concerned, as I thought for some reason that having MS meant I wouldn’t be able to have a child. There was a real lack of information around this and it wasn’t until I educated myself that I found out MS didn’t have a negative effect on the male in this regard. I was diagnosed seven years ago. Four years later, we had our first child, Lilyanna, and she is a very fit and healthy young girl. In July we are having our second and we are all very excited. I would like to have more children, although I have to run it past my wife first. Conor Devine www.ms-society.ie I GOT MARRIED in 1998 and decided to leave it at least five years before having children just to make sure my symptoms were under control. I had my first child in 2003 and had a great pregnancy with no issues. I loved being pregnant. I had a birthing plan in which I stated that there was to be no intervention unless the baby was at risk. The labour was quite long and I refused all offers of epidural, mainly because I was afraid of the potential side effects. I was offered a C section and refused. In the end the midwife called my husband and advised him to get me to have the epidural as I was probably putting my body under unnecessary stress. I did take it and all went well. Both my baby and I were great. Twenty one months later I had another child, and three years later my third and final child. On the last two I didn’t have the epidural, and both went fine. Since being diagnosed with MS I have made efforts to watch what I eat and to try to keep as physically strong as possible. I did my best to keep a healthy diet and exercise regime while pregnant. Thankfully it worked. I have been symptom free for 16.5 years. 15 COVER STORY A TOUGH TIME mobility I ALWAYS WANTED children, and hoped to have two or more, so when I was diagnosed with MS in November 2005 I decided not to wait too long to have my first. I got married in April 2006, and fell pregnant in May. My pregnancy didn’t run smoothly. At six months I relapsed, which is very rare. I had a Caesarean section because I wouldn’t have the energy to push the baby out. Despite all the difficulty, my daughter was born in perfect health, which made up for all the hardship. Unfortunately I did suffer a relapse after the birth. Spasticity and extreme fatigue took hold of me. I breastfed by expressing for two weeks to help my daughter thrive, but was then put on medication which meant I had to move to formula. Having a good support network is essential, and I had great family support, along with my husband. They were able to take up the slack while I rested and got over my relapse. My symptoms may have progressed with the pregnancy but that could have happened anyway. My pregnancy was an isolated, severe case but this shouldn’t put you off. MS or not, pregnancy differs from person to person. The main thing is I got my bundle of joy from it. And today, that’s what I remember most. Some questions answered Will I give my child MS? No. MS is not considered an inherited condition. The risk is estimated at between 1 and 4% for children of those with MS. In the general population, the risk is 0.1%. Will pregnancy affect my MS in the long term? No. A number of studies have shown that pregnancy does not change the long-term course of MS. Does MS affect my fertility? No. MS does not affect fertility, conception or gestation. There is no evidence to show it increases the chances of ectopic pregnancies, miscarriages or premature birth. Does pregnancy bring on relapses? Studies have shown that relapse rates during early pregnancy tend not to be affected, but reduce during the later months of pregnancy. However, relapse rates in the 16 first few months after birth are high. After the baby is six months, relapse rates return to the pre-pregnancy rate. Will my current symptoms get worse? Most women with MS feel well during pregnancy and encounter no problems. Some, however, see an increase in symptoms such as fatigue and bladder problems. What should I do about medication? Discuss it with your GP or neurologist, but you may have to come off medication before getting pregnant. Can I receive steroids if I have a relapse when pregnant? Only under вЂ�certain exceptional circumstances’ such as a severe relapse will your neurologist recommend steroids. Source: HSE’s MS Guide to Best Practice MS Information Line: 1850 233 233 Keep MOVING With the right set of wheels to match their needs, people with MS can stay independent and active BUYING A MOTORISED wheelchair or scooter is a big decision for people with MS, and one that must be accompanied by professional assessment. That’s according to Tess Kennedy, Regional Community Worker, MS Ireland North East. She says people who buy powered wheelchairs without any proper assessment could end up with one that is entirely mismatched to their needs. She asks people to remember that, often, suppliers want to make a quick sale or don’t understand the subtle needs of people with MS. “This means people with MS are often paying large amounts of money for something they then find is unsuitable. As such, an assessment by a qualified person is needed, either an occupational therapist or someone registered with the Assistive Technology Practitioner (ATP) Society,” adds Tess. Occupational therapists assess aids for daily living, which include manual and motorised wheelchairs, but not scooters. Some suppliers of motorised wheelchairs and scooters are qualified to assess the needs of users, however. Myrddin James, ATP with 3r mobility and a founder member of the ATP Society, says assessments are extremely important because there are many aspects of wheelchairs and powered scooters that users may not consider. The professional, he says, will consider various wheelchair features such as the frame, wheels and tyres, foot, arm and back rests. For indoor wheelchairs, they’ll look at the width of doors and the manoeuvrable space within rooms. For outdoor use, they’ll examine the distance the user wants to travel and the types of paths and roads they’ll encounter. Are there ramps in the right places and can the chair handle bigger kerbs? By having a stable seating base and correct positioning, the wheelchair will make everyday tasks much easier. Something that is often overlooked is whether the seat is wide enough to accommodate outdoor clothing. www.ms-society.ie The ATP will assess things such as the wheelchair’s controls and the aids for transferring in and out. Manufacturers of wheelchairs tend to claim that their chairs can be dismantled and folded for transporting in cars. But is this easily done? Will you be able to lift the components into the car, then out, then back in and out again when you get home? “We look at things such as transportation. Who’s going to lift the chair if it needs to be lifted? Are other family members going to be involved? And will they be able to lift the wheelchair?” says Myrddin. The ATP Society promotes the professionalism of specialists and assistive technology salespeople. You can find out if an ATP is registered with the society by inserting their practitioner number at www.atpsociety.org. “There is a very clear code of practice, which all ATP practitioners will be following. This will ensure that people are not buying products incorrectly and that their money is being spent wisely,” says Myrddin. The good news is that assessments for motorised wheelchairs and scooters are free. Contact your occupational therapist or see www.atpsociety.org. 17 MS in the MEDIA MS IN the MEDIA What the papers say Recent media coverage of court cases involving people with MS has portrayed a disproportionately negative image of the condition THE IRISH WRITER and poet Oscar Wilde once said “the only thing worse than being talked about is not being talked about”. Thus followed a number of other quotes from a variety of sources, but in the 20th century the proverb “there’s no such thing as bad publicity” emerged. Recent cases involving MS in Ireland seem to question this theory. In the past six months, MS has featured heavily in the media, in particular through two heart-wrenching stories. THE MARIE FLEMING CASE In January, the High Court ruled against assisted suicide after person with MS Marie Fleming brought a landmark case. Ms Fleming contested the validity of the Criminal Law Suicide Act of 1993. Under the act, a person who assists another to die faces prosecution. Ms Fleming wanted the law changed so that her partner, Tom Curran, could assist her to die at home when the time came. Ms Fleming has had MS for the past 27 years. She is a full-time wheelchair user, as she has lost power in her limbs. Her swallowing and speech have been affected, and she lives in pain. During the case, Ms Fleming stated that the 1993 act contravened “her rights to autonomy and dignity under the Constitution and the European Constitution of Human Rights”. She called for a change to the section on assisted suicide, or for the Director of Public Prosecutions to set out what would be considered when prosecuting people who help others to die. After a four-day hearing, the three-judge divisional High Court rejected her call for the change. It agreed that her right to autonomy was affected but could not agree the legislation was disproportionate. 18 Ms Fleming appealed the decision to the Supreme Court but in April they ruled that the legislation should not be changed. THE STORY OF EVELYN JOEL In March, the tragic case of person with MS Evelyn Joel hit the headlines again when the courts handed a two-year suspended sentence and 240 hours of community service to her carers for manslaughter by neglect. Mrs Joel’s daughter Eleanor and Eleanor’s boyfriend Jonathan Costen had been caring for Evelyn at the couple’s home in Enniscorthy, County Wexford. Family members and social workers had been refused entry to the couple’s home in the lead up to Evelyn’s death. When she was finally taken out of the home, in January 2006, Evelyn was found to be malnourished and unwashed. She died a short time later. The details of the case were appalling, and extremely difficult to hear. Media coverage At the time of the judgement, Ava Battles, Chief Executive of MS Ireland, said she was concerned about the way MS was being perceived. “It is disheartening to read again details of the neglect Evelyn Joel needlessly suffered. It is an unfortunate coincidence that the sentencing has occurred only a few days after the ruling in the Marie Fleming assisted suicide case. Both cases portray a life with MS that is both very uncommon and negative,” she said. “Yes, for a small number of people life can be extremely difficult but for the vast majority a long and relatively comfortable life can be led. “Living with MS is very possible with the right support from family and friends, the services of organisations like MS Ireland and appropriate state services such as neurology and rehabilitation and social welfare payments. MS Information Line: 1850 233 233 “We applaud people like Marie Fleming for standing up for her rights and believe that neglect of any kind of someone with MS is unacceptable. However, a more balanced image of MS must be presented so people with MS live with hope not fear.” While the details of the two cases were in themselves upsetting to hear for people affected by MS, the media coverage was also at times misleading and hurtful. In many stories both women were called вЂ�MS sufferers’. Regular readers of MSnews may have noted that MS Ireland uses the term вЂ�people with MS’. This is similar to how other organisations such as the Rehab Group avoid the term вЂ�disabled people’ in favour of вЂ�people with disabilities’ and вЂ�wheelchair users’ in some cases. We don’t think people should be defined by their condition. Other language such as вЂ�bed-bound’ and вЂ�no quality of life’ was used repeatedly. Most upsetting for many readers was the fact that Ms Fleming was constantly referred to as вЂ�terminally ill’ or in the вЂ�end stages’ of MS. As a result, MS Ireland received many calls and emails from people with MS and their families, who were afraid that a bleak and painful future lay ahead of them. MS Ireland asked its website visitors for their opinions on the matter. One user, Willeke, said: “I contacted some newspapers asking why they kept referring to MS as вЂ�a terminal illness’ because I knew people in my environment thought I had been вЂ�hiding’ things from them by never referring to my MS as terminal. “The newspaper editors said that they use the language the solicitors use and that they therefore use their lingo in papers and/on TV. While the editors agreed with me, they just follow what is being used in court despite knowing the negativity it brings.” Another user, Sharon, added: “Yes I do believe that these stories portrayed in the media have caused fear and concern for younger MS sufferers. My sister is in her late 20s and was diagnosed with MS three years ago. I feel she is still coming to terms and trying to move on with her life as positively and courageously as she can. The media doesn’t help when it adds more fear and trepidation to whatever fear and hurt people are feeling already. “Everyone’s diagnosis is different and future prospects are different, and I feel that people with MS need to know that there can be a future and positive outcomes for them.” Even those who had the disease for some time found the coverage difficult to take. Stephanie commented: “I was 35 when diagnosed and with a young family. Such a scary time! I’m happy to say 12 years later I’m doing great. However, I too was very upset and found the media talk frightening. It has had such a negative impact on my thinking that I have to try to ignore any further reports.” www.ms-society.ie RAISING AWARENESS OR SCAREMONGERING? If the two high-profile cases did anything,they heightened the media’s interest in MS. But the media coverage sometimes painted a very different picture of MS than what it is for most people. MS is a progressive neurological condition. The vast majority of people with MS live relatively comfortable lives with available services and supports. However, a small proportion face significant challenges. Assisted suicide debates are not confined to MS. Familial neglect is something that happens vulnerable people of all ages and in all societies. That said, we acknowledge that the Marie Fleming case would have been watched carefully by people who have considered this route. Nor can we ignore the fact that cases of neglect do occur. When it comes to media reporting, Taragh Donohoe, Communications Manager with MS Ireland, calls on the media to provide more balanced coverage. “Throughout the coverage of both cases we were often asked to comment. Our aim was to never betray the experience of the two women involved as their experience of MS is as true and valid as anyone else’s. “However, we always asked reporters to balance the coverage to reflect that most people with MS focus on life-enhancing ways of life and have support from their family, friends or health professionals, no matter how limited. We offered people with MS for interview, and many of our members contacted the papers themselves.” However, as the media coverage focused intently on the two women, disappointingly the experience of other people with MS was rarely represented. It was refreshing to see a young person with MS on The Late Late Show in January talking about his experience of MS. Conor Devine spoke about his life with MS and his newly released book. (Read about Conor on page 20.) During World MS Day, MS Ireland hopes to challenge the public’s perception of MS by telling the stories of young people with MS and their desire to achieve their dreams despite MS. See page 4 to see how you can get involved. Many may believe that Oscar Wilde’s quote still stands, but we would point to another expression used in the early 20th century and first published in a US newspaper around 1915: “All publicity is good if it is intelligent.” If you have MS and are concerned about the topics discussed please contact the MS Information Line on 1850 233 233 or your local regional office. 19 readers’ stories readers’ stories Devine inspiration OPERATION  TRANSFORMATION Tyrone businessman Conor Devine has hit the headlines recently after his appearance on the Late Late Show to publicise his new book about life with MS MS CAN STRIKE at any time. For Conor Devine his first encounter with the disease came while he was honeymooning in Mauritius in 2006. It wasn’t an idyllic start to the relationship with MS. In fact it was hellish. On the first day of his honeymoon, Conor began to experience pins and needles in his arm. Over the next 24 hours, his central nervous system came under attack. Much of his honeymoon was spent in hospital. Doctors dismissed an initial diagnosis of stroke in favour of a virus, and predicted that he would get back to normal when he returned to Ireland. He didn’t. For the next 12 months, Conor experienced severe pain; his throat felt like it was closing over, and there was intense pressure in his head. He took six months off work, and attended a neurologist. Every possible eventuality went through his mind. He imagined stomach cancer or motor neurone disease. But almost a year to the day after his first symptoms, he was diagnosed with relapsing-remitting MS. “Initially it was a relief because some questions were answered, but then I had more questions. How would I pay my mortgage? How would I have children? I was convinced I’d be in a wheelchair in three years. Over the next 18 months I slipped into a dark hole,” he says. Conor hails from a footballing background, played soccer competitively from a young age, and has taken part in a number of international tournaments. He was devastated that his sporting life was at an end. “It was a massive blow because I felt I was in my prime. I was completely in denial, and I shut down.” Despite his despair, Conor began to research the disease. Eventually he came across the American chat show host and person with MS, Montel Williams. “I bought his book and was blown away by his story. It gave me some hope.” Three and a half years after diagnosis, Conor felt himself emerge from the hole to a world that wasn’t as dark as he’d imagined. “I put a plan in place, which involved three things: 20 medication, diet and exercise, and a positive approach.” He changed his medication from Rebif to Copaxone. He cleaned up his diet and returned to the gym, slowly building up from 20-minute sessions to one-hour sessions, as well as running and cycling each week. He also started taking a positive approach to his circumstances. Within six months, he began to see his MS symptoms lessen, and since 2010 has become stronger. Today he uses his MS to reach out to others, and has written a book called вЂ�Attitude is Everything’. “MS is an extremely difficult disease to talk about because its course differs in so many ways, but I wrote the book because I’d like to inspire people and give them hope. I’d like newly diagnosed people with MS to read my book and get some strength from it,” he says. He has run two marathons, and is set to do GaelForce North in June, a racing event comprising a 19.5km run, 42.5km bike ride and 2km kayaking race. His business, a real estate and corporate restructuring firm, is also doing well. He was asked to talk about his MS at a pharmaceutical conference in Berlin in April, with plans to speak further afield over the next year. He balances all of this with being a father. He and his wife Kate have a two-year-old daughter, Lilyanna, and are expecting a new baby in July. Life is busy. “It is very structured, I get up every morning at 5.30 and when I come home from work at 6.30pm I spend time with the family. If you don’t work at your MS, your marriage or your business, then you won’t get the rewards,” he says. When it comes to MS, Conor has one goal: “to change the perception of MS across the world”. Given his determination, he could very well achieve it. вЂ�Attitude is Everything’ is available to buy at www. createspace.com, an Amazon company. Conor is a guest speaker at our вЂ�Young People with MS Gathering’ event on 11 May. See page 4 for details. MS Information Line: 1850 233 233 Person with MS Maura Tummon underwent a hip replacement operation last June despite advice against doing so, and concerns about recovery. Here she tells of her experience I WAS DIAGNOSED with MS 11 years ago, and for the past two years found myself limping a lot and falling on occasion. At the age of 66, I had been using a crutch and rollator for mobility around the house and for short walks. I wasn’t on continuous medication but needed oral and/or IV steroids every two to three months to reduce bouts of severe tiredness. I was increasingly unhappy with my condition, and despite the fact that I had no pain in my hip, I went to my GP and requested an X-ray. The results showed severe degeneration of my left hip but the GP advised that because of my MS I would not be able to have a hip operation. I requested a referral to an orthopaedic consultant for specialist advice. The consultant told me that a вЂ�new hip’ operation was required. The MS was not a factor for him, though he had never performed a hip operation on a person with MS. I was given a check-up in the hospital, and met with a neurologist who voiced concerns about how my MS would react to the operation. After much discussion with family and nursing friends, I decided to go ahead. I had the operation last June. It went very well, and the recovery was вЂ�normal’ and without incident. There has definitely been an improvement in my overall mobility since then, and although I still use the rollator I can travel bigger distances than before. Another big benefit is that I have not had to take any steroids since last April, and overall my health is better. I am very pleased with the outcome. I hope this little story about by вЂ�gamble’ will give some comfort and help to people with MS who are considering undergoing operations. Every condition or circumstance is unique. I would be delighted to answer any questions or share more details with anyone who would like to contact me. My email and address details are with the editor. An innovative pill box could make forgetting important medication a thing of the past Box of tricks WHEN BENNY HENRY was diagnosed with Parkinson’s disease seven years ago, he never thought he’d get to a stage where he forgot the disease long enough to forget his tablets. However, after a couple of years Benny decided that enough was enough and he was going to stay positive. The Cork native started running every day, leaving his Parkinson’s behind, he says. This did pose a slight problem, though, as Benny started to forget his medication. A businessman, he began to look around for a solution and came across an inventor of a pill box that comes complete with eight compartments to hold tablets, a digital clock and a www.ms-society.ie unique alarm system with eight settings. The apparatus, called Tab Time, is the size of a mobile phone. Benny tracked down the inventor and has come to an arrangement whereby he will be distributing the boxes in Ireland through his business Meds Management. Phil Sexton Curry, member of the Clare voluntary Branch of MS Ireland and involved with MS for many years, has found the pill box extremely helpful. She is assisting Benny in promoting the product. The Tab Time is being sold through pharmacies and will be available nationwide shortly. It retails at €28.99. Contact your local pharmacist or Benny on 086 807 1880 or [email protected]. 21 Readers’ stories BRANCH NEWS Fundraising wonder FIGHTING FOOT DROP Foot drop is a debilitating MS symptom that can severely curtail movement, but Grace Kavanagh found relief in technology WHEN GRACE KAVANAGH had an MS attack in 2011, she was affected by foot drop. A gait irregularity, it occurs when the forefoot drops due to damage to a nerve in the fibula or a paralysis of muscles in the lower leg. The person is unable to move their ankle or lift their toes on the affected foot as a result. At that stage, Grace had MS for five years, and the disease affected her mobility, balance and energy levels. “I had a more severe attack in 2011 which left me with a lot of weakness in my right leg, and foot drop, which makes walking difficult, exhausting and at times hazardous,” she says. Grace became reliant on her walking stick. Even a short trip to the shop would turn into a 20-minute journey that she couldn’t do alone. “I lost my independence and was reliant on family and friends to help me get around as I never left the house alone due to fear of falling. This was a very frightening time and required a lot of adjustment for me as I had been quite independent.” She started doing physiotherapy in an effort to rehabilitate her foot, but soon it became evident that she needed something to stop the falls. Grace tried various Working better for you MS Ireland’s Regional Offices and voluntary Branches are working more closely to plan and deliver services IN THE PAST 18 months MS Ireland has been working hard to establish better ways of working to improve the services we deliver to people with MS, their families and others with whom we work. These changes were based on feedback we got from research done in 2011 among our service users. One of the most significant changes is the integration of services at a local level. Our staff in the Regional Offices and volunteers in the voluntary Branches have been working closely to plan and deliver services together. 22 h Grace Kavanag things with her physiotherapist, including massage and a Dictus band (an ankle strap). “My foot drop continued to get worse, so we decided we needed something more significant to help me walk. My physiotherapist suggested I try the Bioness L300 device. This system made walking a far less frightening and exhausting prospect. It ensures that my foot lifts correctly when walking so I am not dragging my leg or having to put in so much effort to move short distances.” Grace wears the electronic device, which consists of three pieces, under clothes, so it is quite discreet. It cost in the region of €5,500, and there is no government funding available for it. “With my Bioness my walking is faster, steadier and more balanced. I feel much more confident when wearing the device, so much so that I don’t rely so much on walls and furniture for support at home and am far less reluctant to get up and move as I know each step won’t be as tiring. “I do still have MS and the ups and downs that come with it. Bioness can’t change that or take away the other symptoms, but it does give me back a level of freedom I thought I had lost,” she says. Key developments have included: •Staff and voluntary Branches are now meeting every quarter to plan services and address issues •Branch training has commenced; this will give all committee members better information about roles and responsibilities. It is also an important tool to learn about issues we can help Branches with •Members of the Senior Management team and Board members have attended every AGM to explain more about the integrated model, the role of national office and the importance of teamwork •Voluntary Branches continue to financially support services in their regions by responding to our request of 15% of cash in the bank. We wish to thank all our staff and volunteers for their patience, commitment and hard-work through these changes. We realise change is hard but we know we are on the best path to ensure people with MS get the best supports available. MS Information Line: 1850 233 233 THE MS EAST Wicklow Branch recognised the work of Persis Quin earlier this year when it presented her with a gift. Here she is pictured with Ava Battles, Chief Executive of MS Ireland, at the Branch’s New Year lunch. Persis has worked tirelessly on behalf of people with MS for 48 years, fundraising for MS Ireland long before voluntary Branches were established. She set up the Bray voluntary Branch, where she served as committee member, and was also latterly committee member of the East Wicklow Branch. Persis won the MS National Carer of the Year award in 2010 in recognition of her work in caring for her husband Aidan, who has MS. 21 years young FRIENDS AND MEMBERS of the Dublin West Brendan Kenna Branch had a very special, fun night at the Branch’s recent 21st birthday celebrations. At the event, Chairman Francis Timmons said a big thank you to everyone involved. Without the dedication, hard work and support of the various committees and volunteers, the Branch would not be able to help people the way it does. Lorraine O’Neill and Sabrina Reid share a laugh From left: Sabrina Re id, Angela Connolly, Fran cis Timmons, Katie Cumm ins, Imelda Connolly, Mich ael Fox, Noleen Walker and Caroline Mc Kiernan MSNEWS WOULD LIKE to celebrate and promote the work of the voluntary Branches across Ireland and as such we are looking for submissions for the magazine. Do you have news about your Branch you’d like to share? If you send us images and text – either by email or in hard copy – we will include them in the magazine and on the website. Please send your contributions to Denise Carey at [email protected] or call her on 01 678 1623. www.ms-society.ie Offaly celebrations THE OFFALY BRANCH recently celebrated its 26th year in existence, during which time it has done wonderful work for people with MS. Pictured at the Branch’s 25th birthday celebrations in 2012 were (from left) committee members ГЃine Smyth, Marie Duffy, Andy Duffy, June Martin and Damien Fox. ARTY WEST FOURTH-YEAR ART and design students from the Galway-Mayo Institute of Technology in Castlebar held an art exhibition in February, with all proceeds going to the South Mayo Branch. The Missing Spark, co-ordinated by Seamus Burke, took place in the Linenhall Arts Centre. Internationally renowned artist Breda Burns officially opened the exhibition. The South Mayo Branch would like to say a huge thank you to the students for their support. Charitable campaign MS IRELAND IS set to benefit from a fundraising campaign at Bunbrosna GAA on the Westmeath/Longford border. The club is hosting a Lord Mayor campaign, with four candidates in the running. Each candidate is raising money by holding events in the locality, and half of all money raised is going to charity. Candidate Andrew Whitney has chosen MS Ireland to receive his support. So far, he has had some very successful events, including a celebrity training session for children, an All-Ireland ticket raffle, and an American tea party, which was attended by over 200 people. Andrew’s next event is a barbeque in Feerick’s Hotel, Rathowen, County Westmeath, on 25 May. Andrew and the Mullingar Branch are calling on everyone to come along and show their support. 23 FUNDRAISING IRELAND CONTINUES ITS new-found love affair with exercise, as an increasing number of people take on various challenges while raising money for charity. You can help MS Ireland by participating in a number of treks and marathons over the next few months. FLORA WOMEN’S MINI MARATHON The 2013 Flora Women’s Mini Marathon takes place on 3 June, and it’s not too late to get involved. We have some spare race entries for anyone who wants to sign up now and fundraise for MS Ireland. Just contact Caitriona on 01 678 1600 or [email protected]. Ailis Egan, the Irish Women’s Rugby team prop, pictured above, is supporting the campaign by taking part in the marathon with some of her team mates. CAMINO TREK MS Ireland’s Camino Trek continues to be a hugely popular fundraising event. From 1 to 11 June 2013, walkers will once again get to experience some of the lesser known and unspoilt parts of northern Spain as they pass through fundraising Thanks for readin’ and raisin’ poppy fields, the lanes of enchantment of Galicia and the mystical city of Santiago de Compostela. This year sees walkers take a different route, passing through some additional sun-swept villages. MALIN TO MIZEN HEAD The Malin to Mizen Head walk has become an established feature on the Irish walking calendar. This year, MS Ireland supporters Steve Broekhuizen and Claire Coughlan are taking on the challenge from 12 August to 5 September. They are hoping people will join them even for one day on the route. For a full itinerary or to join in the walk, which is sponsored by Motorparts.ie, call Steve on 087 603 1824. MAY MADNESS As the summer fast approaches, Ireland’s walkers have already been out enjoying the brighter skies. The Connemara trek, which took place over the May Bank Holiday weekend, allowed walkers to discover the rugged beauty of the west. Meanwhile, the second annual Royal Canal Walk drew a huge crowd, as walkers made their way from Mullingar Railway Station to Longwood Harbour to Maynooth Harbour and to Ashtown over the three-day event. Thanks to all; we look forward to getting some images from the adventures! DATES FOR YOUR DIARY Adventure seekers should look out for the following upcoming events being held in aid of MS Ireland 7-15 September: October: Follow in Dracula’s foot steps and trek with us in Transylvania, Romania. Discover the mountains, landscapes and mountains of prince Vlad the Impaler of Wallachia, the inspiration for the fictional character of Dracula. An information evening takes place on 10 May in Dublin. If murder mysteries are your thing, a Murder Mystery Weekend will take place at the Thomas Prior Hall in Dublin 4 in October. See if you can work out the murderer and his or her motive! 5-6 October: MS Ireland is calling on the daring among you to take part in our Skydive at the Iris Skydiving Club. 2 November: TombRaider is a 10km walk through the Dublin Mountains with a twist; it takes place at night! A group of walkers will start in the foothills and pass four ancient tombs on their travels. This spooky event is very timely, coming just after Hallowe’en. We’ll have more details about these events in our next issue. YOUNG READERS AROUND the country immersed themselves in all things literary last October as the 2012 MS READaTHON took place. Some 17,000 readers in 515 schools, 320 libraries and 160 bookshops around Ireland helped raise more than €580,000. A huge big thank you to everyone who took part in the MS READaTHON this year - students, teachers, librarians, parents, families and anyone who supported or sponsored. Of course, the great thing about the MS READaTHON is that we get to give back, and some very avid readers were awarded great prizes: MS Information Line: 1850 233 233 Independent 1st - Children’s House, Stillorgan, County Dublin 2nd - Montessori Education Centre, Dublin 1 3rd - CBC Monkstown Park Junior School, Dun Laoghaire, County Dublin Library winner ColГЎiste Pobail Acla, Westport, County Mayo A THANKFUL BUSINESS 1st Winner of a SONY NEX compact SLR camera: from Saint Patrick’s BNS, Lombard Street, County Galway MS Ireland would like to extend a huge thanks to companies that have lent their support to the Society in recent months. 2nd Winner of a trip to see Manchester United play at Old Trafford: CPL Thomas Mann Gillian O’Connor from Lios Maighir NS, Newmarket, County Cork 3rd Winner of a digital camera: Emma Gardiner from Saint Nicholas NS, Adare, County Limerick 4th place - Winner of a one-day family pass to Dublin Zoo: Charlie O’Shea from Ballinteer Community School in Ballinteer, Dublin 16 Winning Teacher - Winner of a weekend break away: Alizia Gisler from CBC Monkstown Park Junior School in Dun Laoghaire, County Dublin And the 2012 school and library winners were: Primary 1st - Inishboffin NS, Cleggan, County Galway 2nd - Scoil Caitlin Naofa, Tralee, County Kerry 3rd - Esker NS, Athenry, County Galway Secondary 1st - ColГЎiste Naomh FeichГn, Corr na MГіna, County Galway 24 2nd - Meanscoil Nua An Leith Triuigh, Castlegregory, County Kerry 3rd - ColГЎiste Oiriall, Monaghan Town, County Monaghan www.ms-society.ie We are delighted to be chosen as one of the charities of the year for CPL, a recruitment, outsourcing and HR solutions company with offices throughout Ireland. Each year CPL plans a number of fundraising and volunteer events to raise money for its chosen charities. eBay Inc/Paypal Online trader eBay donated €4,000 to MS Ireland recently through its PayPal Giving Fund. It will go towards counselling services in North Dublin. There are lots of ways your company can help support the work of MS ireland Sell pins: MS Ireland is asking supporters to take a box of emblem pins to their workplace. Our pins are being sold for €2 each. If you think your workplace would be interested, contact Grainne on 01 678 1600. Nominate us as charity of the year: If your company nominates a charity to raises funds or volunteer for, please consider MS Ireland. We can provide you with a corporate fundraising pack and would be happy to visit your company to give out information about MS. 25 AGM campaign 14th Annual General Meeting (53rd AGM since MS Ireland’s foundation) Dear Member, IN AN EFFORT to reduce costs, the call for motions and board nominations are advertised in this issue of MSnews (below). The AGM legal notice and voting papers will be sent to each member along with the next issue. Notice is hereby given that the 14th Annual General Meeting of the Multiple Sclerosis Society of Ireland will take place in Galway on Saturday, 28 September 2013 at 3pm in the Clayton Hotel, Galway. The results of the postal vote for the board vacancies and motions, if any, plus the council’s nomination to the Board will be announced at the AGM. The procedures for motions and board nominations are listed hereunder. Every registered member is entitled to a postal vote. Voting papers will be posted to all registered members three weeks prior to the AGM and must be returned to National Office, MS Ireland, 80 Northumberland Rd, Dublin 4 by Friday, 20 September 2013. Ava Battles Company Secretary ctive blog a new intera ch n u la l il w d S Ireland eriences an IN JUNE, M re their exp a sh to S li M with e an on ne for people d Me’ will b n a S вЂ�M . S h about M d and watc learn more h MS to rea it w le p o e lt p for ns, hea h community ers, clinicia h rc a se re ns from ther people contributio portantly, o im st o m , d n ls a professiona y MS. r affected b o h it w y we are g n vi li e communit n li n o r u o d about their To help buil d in writing e st re te in people looking for f MS. nowledge o k r o s ce is desirable n e experi r the public fo g n ti ri w ple ence g from peo Some experi ed in hearin st re te in a st mo ation nd but we are aring inform sh t u o b a ssionate who are pa ers. helping oth Motions Any member or branch may forward a motion to the Standing Orders Committee so that it can be clarified legally and its suitability for an AGM confirmed. (Operational motions should only be sent to the Chief Executive or Chairman for decision by the Board). Closing date for receipt of motions is Friday, 23 August 2013. Call for Board Members We are currently seeking candidates to go on to our panel of potential board members. Members, branches, council, the Board and staff may propose candidates. All nominations must be proposed and seconded by members. The nominating committee reviews the applications annually and recommends candidates to go forward for election by the members. The nominating committee will take into account the range of skills necessary for board membership and, where possible, the geographical spread, gender balance, experience and qualifications of the candidates. The committee will evaluate candidates (both new and those seeking re-election) as to their suitability prior to putting its recommendations to the overall membership for decision in a postal vote. Further details and nomination forms are available on the website. Closing date for receipt of nomination forms for the incoming Board is Friday, 23 August 2013. HOW TO USE OUR TD POSTCARD MS IRELAND AND NAI’S Red Card campaign is aimed at highlighting the fact that neurology and neurorehabilitation services in Ireland are the worst in Europe. If you’d like to get involved you can send the postcard opposite to your local TD. Let them know that you’re unhappy with neurological services in Ireland. Here’s how you do it: Bloggers wanted • Cut out the postcard along the dotted line. • Go to www.ms-society.ie to find out the address of one of your local representatives. • Put your name and address on the bottom of the postcard. This way you let the TD know you’re one of their constituents and give them the chance to reply. • Put a stamp on the postcard and send to the TD’s address – or if you’d rather some privacy, put it in an envelope and send it on. • Let MS Ireland know what response you get. Visit our website to email all your local TDs. With a few clicks of the mouse you can send a prepared email to all the representatives in your area. # Dear I am a member of your constituency and I want to ask for your help in solving a very serious problem in our health care system. Did you know: MS Information Line: 1850 233 233 The only national organisations providing information, support and advocacy services to the MS community. AFFIX  STAMP  HERE • Many people have to wait over a year for a neurology appointment in Ireland. In the UK, the maximum waiting time is 19 weeks. • Ireland has the fewest rehabilitation consultants per capita in Europe. • Continuous cutbacks mean that vital neurological services are being curtailed or cut down completely. I am asking you to help by calling for an implementation plan for the Neurorehabilitation Strategy published 18 months ago and by supporting initiatives that can improve services for people with MS and other neurological conditions. I look forward to your response. Signed: Address: 26 For an information sheet or to sign up, contact Emma Rogan at [email protected] or 01 678 1600. Contact details: www.ms-society.ie | [email protected] 01 678 1600 | MS Info Line 1850 233 233
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