Like many people with MS, Ann Serafin of Ferndale, Mich., takes a daily fistful of pills to stave off some of her symptoms and reduce exacerbations. In fact, as she spoke with New Mobility, she was receiving one of her monthly IVs — this one Gammunex — a treatment that she says when coupled with a physical workout with a personal trainer has helped increase her strength and energy.

For those of us with MS, SCI, and other disabilities, fatigue, pain, muscle spasms and depression are at the top of the list of accompanying problems. To combat these secondary conditions — sometimes caused by our necessary prescriptions — many of us pile on the pills, following a nationwide trend of using prescription and over-the-counter medications to fix whatever ails us. But for some — those who lack insurance, are unwilling to take injected medications, or are more afraid of the side effects than the original disability — taking prescription medications is not an option.

The thoughtful use of medication can help us find the right balance, and a slight change in our medication diet can reduce the number of drugs we rely on, while increasing our energy, lowering pain levels, and generally making us feel better. Though we don’t suggest stopping your medication regime, you may consider adding one of these complementary therapies to your arsenal. And who knows? Maybe in time you’ll be able to ditch a pill or two.

Stretch, Reach, and Repeat
After reading NM’s “Pumping Iron” (May 2005) about using a personal trainer to help strengthen muscles after the effects of MS, Ann Serafin put in a call to author Patricia Lay-Dorsey. Lay-Dorsey, it turns out, lives only 30 minutes from Serafin, as did the personal trainer. After calling him for help, Serafin set up a program with the trainer to help her exercise and stretch.

“He comes right to my house and has been doing so since June,” Serafin says. “He’s been working a lot on strengthening my legs.” Serafin takes Baclofen and Zanaflex for spasticity; Amantadine for energy; Copaxone to reduce exacerbations; Sarafem for depression; Oxytrol to control bladder spasms; Vivelle and Prometrium for estrogen replacement; Zyrtec and Flonase for allergies; Dipridamole to improve circulation; Gammunex to suppress immune system response; Fosamax for osteoporosis; a multivitamin; and cranberry capsules to control UTIs. Though she hasn’t dropped any of her medications because of the training, Serafin says the training has increased her energy level, decreased spasms, and strengthened muscles in her legs and arms.

Serafin’s trainer helps her with exercises, including leg squats to stretch her calf and thigh muscles, and while Serafin — who normally uses a power wheelchair — holds onto her walker, her trainer helps her to bend both knees and tilt back on her heels. They also do leg swings, and her trainer has been working on her left knee, which stiffened up a few years ago.

Serafin says she occasionally stops taking the Baclofen for spasms without negative effects. It’s her workout that helps most to relax muscles and alleviate spasms. She also has a friend who comes to her home three times a week to help her stretch and do her knee bends. “My girlfriend also does Thai massage,” Serafin says. “With traditional massage, where they’re rubbing muscles, I’ll spasm more. With Thai massage, I lie face down on a bed and my friend literally walks on my legs — with one foot — which puts a lot of weight on my muscles.”

Her friend walks up and down her legs for about 10 to 15 minutes, then does some stretching. One stretch they perform is again with Serafin on her stomach — her friend pulls both of her arms back while Serafin lifts her upper body slightly. It opens up her torso area, stretching out her chest and arm muscles.

Biofeedback for Pain Management
We profiled Dick Elhardt of Roseville, Minn., in our August 2005 issue in the article “Disability, Substance Abuse and Addiction.” Both his legs were amputated after being burned in a 1964 car accident, and he recently began using a wheelchair to help reduce pain in his shoulders after years of cane use. He also experiences excruciating phantom pain where his legs once were.

He has been sober for almost a year, yet because of his past drug and alcohol addiction, Elhardt is unable to take any pain medication. Instead, he uses biofeedback and meditation twice or more a day for 15 to 20 minutes to alleviate and eliminate pain. In fact, it’s the first thing he does to start his day.

Biofeedback uses signals from your body to “feed back” information about your body’s condition. You’ve used biofeedback if you’ve ever had your temperature taken or been weighed: Both devices, the thermometer and scale, feed back information to you about your body. According to advocates, biofeedback can be useful in reeducating damaged nerves or treating irritable bowel syndrome, chronic headaches, high blood pressure, stress, anxiety, insomnia and, in Elhardt’s case, managing pain.

“The relaxation process is a way of regulating your body temperature,” Elhardt says. “You use it to shut everything out and to just relax. You can do it anywhere.”

When he first learned biofeedback, Elhardt used an indoor-outdoor thermometer to know when his skin temperature reached 97 degrees; now he doesn’t need one and knows when it hits the mark. He says he usually puts on mellow music, “the kind you hear when you’re getting a massage,” and then clears his head.

“It relaxes your muscles and is a time to clear your mind, just shut out the pain and everything that’s going on around you so you get a chance to rejuvenate,” he adds. “It takes a lot of practice, but eventually you’re able to stop those thoughts of pain and anxiety that keep popping into your head.”

Elhardt suggests first getting into a comfortable position — whether sitting or reclining. If using a thermometer, tape the outdoor wire to your finger, then clear your thoughts. Connect your hands and take deep, relaxing breaths while consciously being aware of how your body feels. When you become good at meditating, your temperature gets to the desired level on its own — for him, scientific proof that the meditation is working.

Now, he says that when he does experience pain it isn’t nearly as bad as when he was taking prescription pain medication, adding that pain medication can increase pain levels as a side effect. As with Elhardt, it’s up to you to decide if the benefits of a drug outweigh its side effects.

Complementary vs. Alternative Therapy
At the Shapiro Center for Multiple Sclerosis in Minneapolis, Dr. Randall Shapiro works specifically with people who have MS, but he says complementary therapies can benefit anyone when used in addition to scientifically proven agents such as prescription drugs.

“Complementary medicine includes massage therapy, acupuncture, yoga, some would say physical or occupational therapy, rehabilitation in general, exercise, and diet,” he says. “They make a lot of sense if you’re using them in an appropriate manner.”

But he warns against trying alternative treatments or therapies, which have included bee stings, cobra venom, pregnant-cow’s milk, removing mercury amalgams from your mouth, hyperbaric oxygen, and huge amounts of vitamins. He says alternative therapies or “medicines” are pie-in-the-sky treatments that someone has dreamed up, which will likely be gone within a couple years. But what bothers Shapiro most is that these treatments are alternative, not complementary. When people try alternative treatments, they usually stop taking their medicine.

“Prescription drugs are based on evidence as well as experience. As medical scientists, we go to great extents to come up with medicines to treat specific things,” he says. “We study them, we test them, we run them through as rigorous a process as we can to come up with the best possible, scientifically oriented treatments that are available.

“How medicines are used by doctors is another issue — whether they’re used appropriately or whether they’re actually working in individuals — but these are scientifically proven agents.”

Experts suggest altering your diet as one of the most important and least expensive complementary treatments you can do. Eating nutritional food per the USDA food pyramid guidelines and taking a multivitamin will set you on course for healthier living. Roger Long is a C5-6-7 quad — who is also legally blind — and eats small amounts of raw, fresh ginger to reduce gas, nausea, heartburn and carsickness.

“Riding in the back of a van is very bouncy, and being blind, I easily get carsick,” the Hazel Park, Mich., native explains. “When I go for a ride, I put about 3 grams of fresh ginger in my cheek and chew off small bits as I need.”

Long also takes Baclofen, wears an Oxytrol patch for bladder spasms, takes stool softeners, garlic, fish oil and vitamins. He says he used to take 20 grams of ginger for carsickness and stomach ailments, but the high dosage became ineffective and he now only takes it sparingly. He suggests starting with half-gram pieces and to bite tiny bits at a time and suck on it like chewing tobacco; you have to build up a tolerance for the potency. Fresh ginger should not be stringy or pulpy or taste bitter. Long has had good luck with Trader Joe’s brand.

Help for Depression
Though there are many good prescription drugs available to combat depression, many of the complementary treatments we’ve mentioned can help, too. For people with MS who take an interferon to decrease the frequency of exacerbations, common side effects are fatigue, flu-like symptoms and — though it’s a hot debate — depression. Whether your depression is from prescription side effects or natural causes, help may come from something other than a pill.

Psychiatrist and holistic healer Henry Emmons outlines in his new book, The Chemistry of Joy, his three-step program for overcoming depression combining Eastern wisdom with Western-style medicine. At his clinic in Northfield, Minn., though he cautiously prescribes antidepressants, instead of writing a prescription for only the medicine, Emmons recommends a combination of dietary changes, exercise, meditation, conscious breathing and vitamins.

He explains that diet has a direct bearing on brain chemistry. The brain produces what it needs based on what it gets from food. Those with depression should watch their calories, limit sugar intake and how much they eat in one sitting, and should eat complex carbohydrates that are high in fiber. He suggests getting omega-3 fatty acids, which serve as an anti-inflammatory, and exercising according to your body type.

Emmons says using his holistic approach to treat depression makes sense because depression is a holistic illness: It affects the body, mind, heart and soul.

No matter what course you take with your medical treatment, never treat yourself blindly. If you have more than one doctor, make sure they all know what drugs and treatments — prescription, over-the-counter and otherwise — you are taking. Read labels and be aware of side effects; if you have access to the Internet, check out pharmaceutical watchdog sites. For a wealth of information on complementary and alternative treatments, visit Rocky Mountain MS Center’s site at www.mscenter.org. But most importantly, as with any change in your health life, consult your doctor first.

“Doctors don’t have ESP,” notes Shapiro. “We have to work together — this isn’t a competition.”