Having a therapy dog has changed my life. There are 2 kinds of working dogs: Therapy and working dog. The working dog is trained to do a host of services. Help the blind, people in wheelchairs, etc.
The therapy dog is an RX dog prescribed by your doctor. When I flew to Florida all I needed were the letter of prescription and his updated health records. My therapy dog is named Oliver. He is well trained and helps me feel safe if I fall and when I go places alone.
Oliver is a chiuaua. He was given to me as a puppy and I have trained him for this since. I get many comments on him because he is very pretty (fawn) and small. Most people do not know you can use small dogs as service dogs.
Before My diagnosis, I volunteered for the animal rescue league in Denver. I have 2 cats in the house and at the time there were 3. Since my roomie had the 2 cats and I had 1, she wanted no more animals, so I volunteered for the dog behavioral department.
I started out walking dogs. Then I could not handle the big dogs, so I would only walk the little ones. I was exhausted after 2 hours, I did not know why at the time. I then took a break and have not gone back since my diagnosis.
I learned that I never would have been able to handle a large dog as a service dog. Sometimes Oliver wears me out as he is still a dog and still does dog things. Not often, but he can get tired and I have to carry him. Then I can only do it ten minutes at a time.
I have severe anxiety as well, and he helps tremendously with that. He also helps keep me busy. After all, he is 1.5 years old now and very active. My room mate loves and adores him and plays with him often. She feels sometimes I neglect him, but unfortunately, I get fatigued and can't play with him. He is well fed, has dog insurance with the vet and I train him constantly. She does not train, feed or walk him, but I am so grateful she plays with him!
This also keeps he and I in a "master-servant" relationship. When he sees her, he gets excited whereas when he sees me he is on guard. He knows I am the stern trainer and she is the fun, playmate. My concern is that he would want to play at a time when I needed him most, such as if I fall.
Because he is certified he can go anywhere with me. I have to stave people off as he is little and cute, and some never ask if they can pet him. But the fact that he is a chiuaua and a service dog just makes them so curious and respectful of him. Imagine, seeing chiuaua's in this different light? Not the yappy, nippy dogs they are claimed to be? Oliver is not that kind of dog. He growls sometimes and barks, but it is rare, and I nip it in the but right there.
Also, as he is so small, I had to make him a vest. I did costume design when I was in my 20's. Then I ordered the patches from sitstay.com, sewed them on, and when I put the vest on, he knows it is time to work.
There are other ways to get service dogs - you can go through a service dog specialty center which could be thousands or train your own dog with certified professional trainer. For a therapy dog they must have enough training to understand and obey your commands and not use the bathroom while inside buildings. I use public transportation a lot and walk Oliver when we are outside and, of course, bring bags and treats (bully bones keep them busy for a long time).
Whatever dog you choose or wherever you chose to train it be sure it is a dog you can handle. I am fully ambulatory and can walk a dog, but my limbs are week, so I needed a smaller dog. He is perfect for me. He also lives longer than any other breed; up to 30 years! So do your research, leave any outside information and myths you have heard about any breed and do what works for you!
Good luck and happy dog hunting!
Friday, February 26, 2010
Meds and how they interact
As I mentioned earlier, I take adderol for fatigue. I also take Paxil. It works great for anxiety and fatigue, and all the doctors support it. Dr. Corboy caught the fact that I have anxiety when I told him I take Xanax for plane rides. He would not give me Xanax to sleep, he said Xanax is for plane rides only and other times I have severe anxiety, or situations which may cause me severe anxiety; and that I needed to learn self hypnosis and other means. I did not even use it for the breast sonogram which I was beside myself about, or the cardiologist visit below.
Later I complained to my GP I was awakened frequently at night due to spasticity in my arms and legs, then I was unable to sleep afterward. She prescribed Clonazepam which is is for my spasticity in my arms and legs that used to torture me at night. Spasticity is when your
muscles stiffen and feel like you have a "charlie horse". It is very painful. Now I sleep well. Gabapentin also makes you feel relaxed, but it is for nerve pain and seizures, and I take it as well.
So at this time I am taking 100mg Gabapentin, Clonazepam and drinking 5-7 espresso type beverages in the morning; then a shot of Copaxone at night.
As I mentioned, I went home to Florida for Christmas and was having pretty frequent heart palpitations. I was there for almost a month and when I got back, I immediately went to my GP who did an echo and said my rhythm had changed and she ordered a halter and I set an appointment with the cardiologist for a week after I turned the halter in.
I went to the cardiologist and had the entire workup done - echo, sonogram (by a strapping young man of 32 who was feeling my breasts (for the sonogram) but it felt great!!! Silver lining - when I saw that handsome young man who was to do it, all anxiety went away : ). Plus they let me have Oliver, which is really what he is for - doggy Xanax. He now has his vest and certifications, so he can go with me anywhere. He was so great; when they put the IV in (which I have tons of anxiety about), he knew to come up and lay his head on my shoulder, look me in the eyes while I petted him.
Then I saw the cardiologist, who was knowledgeable in everything from how all the drugs I was taking interact (even how they effect sexual function!!) Here is what I learned (this was before I was prescribed adderol):
1) Copaxone causes heart palpitations. What!!! It is the best on the market. She asked if I wanted to change, I flatly said"not a chance!"
2) Coffee causes palpitations and can worsen if combined with any other drug that causes it. Right on - I knew this as I smoked for many years and thought it was the smoking. It was both. Now, I had a 15 year career in restaurant management, part of which I spent working for Seattle's Best Coffee and Starbucks. I also lived in Seattle for 5 years, and coffee was more prized than alcohol. Believe it baby! I was drinking it 24-7 and my tolerance is the highest possible. I now carry the Via with me and am never without. She asked me to give up coffee. Uh, another no. Can you do half and half? Yes. So I get half regular and half decaf ground into a pound and I bought decaf Via and do half and half with those.
3) Adderol, which was prescribed that day and she spoke with my GP about, she told me would give me the most palpitations. She told me Provigil was non-narcotic and worked well. I agreed, until I found out the price. So, here is what I did.
I went to my GP and asked her if I could take the 100mg of Gabapentin, 1 mg of Clonazepam, drink the half and half coffee and asked how it would interact. She said it was fine, and that lots of people get agitated by adderol and the Clonazepam will offset that.
So now I have energy and stamina and no agitation, along with no pain thanks to the Gabapentin. As soon as I get a job or SSDI I will switch to Provigil as the long term effects of adderol may be bad. After all, it is an amphetamine salt!
One more suggestion on drugs prescribed. When you go to your pharmacy, ask for a consult. Especially when getting a new drug. Ask them to look over your list on the computer and tell you how they may all interact. That is what they are there for. Pharmacists know better than anyone how these drugs interact as they make them.
Good luck and have a wonderfilled weekend!
Cristen
Fatigue *sigh*
Good afternoon, fellow MS er's and family members of the same:
Before I was diagnosed I used to be known to sigh quite frequently, and most people thought I was bored or being rude. Now I know why.
Before I was diagnosed I used to be known to sigh quite frequently, and most people thought I was bored or being rude. Now I know why.
I am sure after your diagnosis you got all those "aha" moments when you remembered all the symptoms in a vacuum that got diagnosed as other issues. I got diagnosed with migraines for blindness in my right eye in 2003, stress for right side numbness in 1996, severe emotional problems for emotional lability, anxiety for bladder urgency, and the list goes on.
I have the worst fatigue known to MS called "lassitude fatigue". Basically, you are sleepy (you feel drugged) and can fall asleep anywhere. Until recently, I had no idea I had this. I thought fatigue was muscle related. There is the type that makes you feel drained, which I also get, and you want to fall over like a tree, but I always thought it was my menses that caused it. I also have a "short circuiting " fatigue that causes limb weakness. This is why I got a small dog as a service dog; I am unable to handle dogs over 10 lbs - and working out does not make the limb stronger, but helps with balance and falling.
Here are a few examples: I went to Florida for Christmas. I stayed at my father's and we got up and ready around noon on Christmas day to go to Palm Beach to meet with mother and one of my brothers. The trip took an hour and my father and I were talking and he looked over and I was asleep. Concerned, he said he allowed me to sleep till noon. I told him I was exhausted.
Throughout the day and night, I was fighting my eyelids, even with caffeine (which I drank 5-7 cups of espresso type coffee per day). We went home, I slept, and the next day felt well rested.
I took the LSAT on February 5th. With coffee I fell asleep. I would wake up when my pencil fell. I even went to bubble in answers and would fall asleep as my pencil hit the paper. Lucky for me the test was administered incorrectly, so I get another shot.
I went to the nurse practitioner, who I have already gleamed about her awesomeness, and she said I had a few choices, but we started on adderol. 20 mg did not do the trick, but I have been doing better with 30-40. The irony is that she told me not to take it after 1 pm and I do, and still fall asleep by 10 pm!
There are other treatments as well. Pilots take Provigil, but when you have only generic drugs on your insurance plan, it is a very expensive drug. From what I hear, it is great, though.
The scoop
Non-stimulant meds:
Symmetrel - has anti-viral effects and may turn skin blue;
Antidepressants for those who may or may not be depressed: Prozac, Paxil (which I take for fatigue and anxiety) and Zoloft (highly recommended by my docs);
Moldafini (Provigil): Used by pilots on long flights, non narcotic but VERY expensive. It is a neurochemical which has a unique mode of action shown to decrease fatigue and is the most popularly used.
Stimulant meds:
Can be habit forming, which you would need to speak with your doc about:
Adderol or generically Amphetamine salts combo:
Used mainly for focus in ADD in teens and adults;
Cylert: aka Pemoline;
Ritalin: Used for ADD in younger children;
Dexadrine: aka Dextroamphetamine.
Again, these should be used with caution as they can be habit forming. My doctors advise rest (well timed naps), antidepressant meds and stimulants as needed.
I have learned ways to conserve energy by taking breaks and doing NOTHING, meditation, yoga and low impact exercise.
Also, anytime you see your nurse practitioner, remeber to ask her for books and other materials on MS. They usually get these to give to patients as support materials. Copaxone offers a doctor visit checklist (as well as a travel one) to bring to the doc. They will often take it from me and read down the list and answer line by line. You can use it to document falls, fatigue or any other symptoms that are bothersome.
Good luck and remember to visit the sites above; they have an avalanche of info just for you!
Cristen
My docs and resources for you
Good morning fellow MS'ers;
I was fortunate enough to get into the University of Colorado Neurosciences team of doctors after my initial diagnosis. These folks really know their stuff, and head up all research, travel around the country and are professors (it is a teaching hospital). If you get with any Neurosciences team, find a teaching hospital in your area. You will not regret it.
This is a handy site for you to read up and coming everything related to MS. Both my doctor (John R. Corboy) and Vollmer established this center. It has resources such as attorneys to help patients with paperwork and tests to get SSDI for clients, social worker Pat Daly for counseling or referrals, newsletters, and long term and life insurance professionals who work with MS patients only. All at no charge.
Click on the article by Pat Daly, LCSW, Summer 2009 (PDF) "It's Just the Tip of the Iceberg: A New Paradigm for MS" where she interviews one of my doctors. It gives you the latest up to date studies on MS by my team of doctors. Dr. Vollmer explains that remission is not really remission; your disease just becomes invisible again.
As for my symptoms, which are quite invisible if you look at my pictures, I have the following: Lassiter fatigue (I fall asleep anywhere as if I have not slept in days, worst type); Bowel dysfunction (I cannot have a movement without a laxative but I take fiber daily as well as acidophilus); Bladder dysfunction (urgency and unable to empty bladder); severe anxiety; severe nerve pain headaches and backaches; left leg weakness (sometimes I trip); upper arm fatigue in both arms; and before I knew I had MS I had a symptom called emotional lability, which you can read about here:
Which by the way is another great tool for MSer's. You fill out all the information and print a doctor visit sheet with all medications, symptoms, questions and it shows your progression so you can follow it. I love it.
I feel blessed to have these doctors as my own. I now see all my doctors there; from cardiologists to mammography to my general practitioner. My GP did an internship with MS patients and know exactly what I need and can understand where I am coming from. They truly are amazing.
I will stop here as I know we have difficulties sitting and reading long diatribes. I will do my next posting on fatigue, management and drugs that can help.
Cristen
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