Friday, December 01, 2006

Outdoor medicine: MS becomes an excuse ... to get outdoors


There is no clinical cure for multiple sclerosis, but for some, there is an environmental cure - the outdoors.

Larimer County and Colorado have some of the highest rates of the neurological disease in the country. But while many people diagnosed with multiple sclerosis, or MS, fear they'll end up in wheelchairs, some area residents battling the debilitating disease think more of snowboards, bikes and hiking boots. They say it's a way to help them live with MS and hope their experiences will encourage others with the disease to see the outdoors as the next best thing to a cure.

Susannah Wright, of Livermore, Jim Dunlap, of Fort Collins, and Dave Rud, of Loveland, all were active outdoor types when stricken with the disease in the prime of life, which is the case for most. They were initially as confused as the next person about the disease.

"The misconception is that you are in a wheelchair right away and that you are on a pretty fast slippery slope to disability," said Wright, 38, who was training for a marathon when she first noticed symptoms that included fatigue and imbalance. She was diagnosed with MS in 2003. "I don't think that's necessarily true."

Dunlap, 46, was an avid bike racer when he was diagnosed in 2004.

"Everybody knows about MS and they know it's a bad thing and they think that people will struggle until they end up in a wheelchair," said Dunlap, who was struggling through a relapse when interviewed for this story. "That's what I thought at first. But now I know differently. It's not what happens, it's how you come out on the other side."

And that other side of this frustrating and unpredictable disease can be enhanced by staying active, said Christy Dittmar, occupational therapist with the Center for Neurorehabilitation in Fort Collins.

"They don't know when they get up if they will be able to do what they planned to do that day, and things can change in a matter of hours,'' she said. "They live with the disease hanging over them. However, those who are active and keep moving forward with goals and plans and are able to adjust psychologically and cope with relapses will be farther ahead than if they wouldn't do those things.''

Mysterious MS

There is plenty of reason for the confusion, which ironically, is a common symptom of the disease, along with bouts of blurred vision, extreme fatigue, balance loss, partial paralysis, numbness and tingling sensations.

Despite 70 years and $500 million in research led by the National Multiple Sclerosis Society, the disease remains pretty much a mystery. It's thought to be an autoimmune disease in which the immune system attacks a person's central nervous system.

Myelin, the tissue protecting nerve fibers that help send electrical impulses to the brain, spinal cord and optic nerve, are attacked and damaged. The result is scar tissue, or sclerosis, forming on the nerve fibers, which disrupts signals to the brain.

Although not directly inherited, genetic factors are suspected of making some people more susceptible than others. Others suggest environmental conditions might be the cause. Most often, an MRI is needed to definitively diagnose the complex disease.

For about 85 percent of the 400,000 Americans with the disease, symptoms flare up for varying lengths of time before subsiding and going into remission for varying lengths of time. For others, the disease continually progresses at various rates.

Occurrences and the magnitude of the effects of the disease are unpredictable, although some people do fall into patterns.

Food and Drug Administration-approved medications as well as therapeutic and technological advances have lessened the frequency and severity, and in general, the progress of the disease.

Studies also have shown another promising treatment to manage MS is exercise, when matched to the capability of the individual. Wright, Dunlap and Rud can attest to the physical, but more importantly, the mental healing effects of exercising outdoors.

Though slowed by the disease, Wright continues to snowboard with her husband and two children when she's not working on hiking the entire 3,100-mile Continental Divide Trail in segments.

"When I'm in the outdoors, it makes my heart sing," Wright said. "There is a lot of mental stress with MS. I remember after I was diagnosed going on my first backpacking trip and not feeling well. The farther I got, the better I felt. My eyesight got better and my feet weren't tingling.

"There is a peace being out in the environment that helps reduce the stress. It helps me not to see myself as a sick person."

Helping others with MS

Wright wanted others with MS to imagine themselves in that same frame of mind. She attended an adaptive ski and snowboard camp in 2004 and this year was awarded the National MS Society Pioneering Spirit Award.

She parlayed that into funding through the local Mildred Arnold Foundation to launch a new program in Larimer County called "Active with MS." The program helps people with MS experience outdoor adventures, including skiing, biking, climbing and rowing.

The program has an adaptive ski and snowboard trip to Breckenridge scheduled Dec. 16.

"What's been found with newly diagnosed people is that experiences like these can change their outlook on living with the disease so you start looking at things you can do instead of things you think you can't do," Wright said. "The mental aspect of how you picture yourself with the disease is so important and carries on through the rest of your life."

This year, Dunlap raised more than $15,000 for the Tyler Hamilton Foundation, which benefits those with MS.

The disease forced him to resign his position on the board of The Group real estate company and has forced him periodically to walk with a cane. Initially, he gave into the disease, quitting competitive cycling, falling out of shape and eating poorly. But then his competitive juices kicked in.

These days, he leads spinning classes for the Colorado Eagles hockey team, rides recreationally, still runs a few races, including the Horsetooth Half Marathon with his girlfriend Laura Heath, and lifts weights.

"The long camping trips and climbing Longs Peak are pretty much off the table, but getting back in better shape and eating right has made a huge difference," Dunlap said. "I chuckled when I read there was a study on Parkinson's patients that found that Pilates improved strength and helped in everyday life. Well, duh."

Unlike Wright and Dunlap, Rud no longer takes medication, saying the outdoors is his drug of choice.

Diagnosed with MS in 2000, he celebrated his 50th birthday in August 2005 by climbing 14,255-foot Longs Peak in Rocky Mountain National Park. Going off medication might not be the right thing for everyone, he said, but that experience was so freeing to his mind and body that he believed it was the right decision for him.

The trip moved him to start the Climbing for Those Who Can't campaign, which raises funds for the MS Society through his pursuit of all 54 of Colorado's peaks 14,000 feet or higher in elevation.

"Hope has to come from within, and I want this to fuel the fire," Rud said. "I realized through all of this that the most powerful thing on the planet is the mind. Either you control it or it controls you. I'm climbing all 54 of them, but if just one person will use this as motivation to just go for a longer walk, I'll be happy."