By Julie Stachowiak, Ph.D., About.com Guide
Ever since I was older than 12 and no longer merely a passive recipient of holiday joy, gifts and food, I have found the holidays to be fairly stressful. You have to not only participate in producing festivities, but also you're expected to behave in a consistently festive manner with people you encounter.
Unconditional joviality has never really been my trademark, to be honest. I did an OK job of hiding this fact until I was diagnosed with multiple sclerosis (MS) and started really being able to identify some of the symptoms that were interfering with all-out holiday revelry. Since my diagnosis, I have tried different approaches to the holidays with MS – avoidance, bitterness, and disdain for everything happening between mid-November and January 2nd.
Not only did none of these approaches really work in reducing holiday-related stress, they also left me feeling a little guilty and in definite need of an attitude adjustment (and the necessity to apologize to people that I had inadvertently or purposely offended).
This year, I am going to try something new. I have made a list of potential holiday pitfalls to strategize in advance. I am determined to maintain my inner peace and try to find my own joy this year. I realize, however, that to do that, I should not be striving to keep up with everyone. Instead I need to pick and choose what I will do, contribute, participate in, so that I am at my best. I have written up my list to share with my fellow MSers. I am sure that some of you simply love the holidays and cannot understand what I am talking about when I refer to holiday stress. Others of you might find a point or two that resonates, but have completely different things that you need to watch out for. Still others may see lots of things on this list that have tormented them in the past and be able to use this list to strategize along with me.
All of that said, here are the “holiday hazards” that I am going to try to avoid this year:
Too Many People: One of my worst MS symptoms is cognitive dysfunction. This impacts my life in many ways, but one of the most frustrating is with communication. I truly cannot keep up with a conversation when more than a couple of people are participating, especially if it is a party-type setting with unfamiliar people and widely varying topics. I was never one for small talk anyway. I am going to try to solve this potential problem by avoiding parties where I don’t know many people, or at least finding quiet corners where I can have more intimate conversations.
Too Much Noise: Related to my cognitive dysfunction is my inability to maintain any train of thought if there is too much ambient noise. This includes loud (or annoying) music, a television playing in the background (especially football games) or people cheering during football games, among other things. I will try to avoid these situations by running out of the door when I hear the opening notes of “Grandma Got Run Over By a Reindeer.”
Infection Risk: Clearly, we cannot stay locked up in our houses or wear protective masks when we come into contact with people during holiday season, the time of year which happens to coincide with cold and flu season. However, as people with MS, we are at risk for relapses if we happen to get a febrile illness (like the flu) and are at risk for complications from the flu (especially H1N1), such as pneumonia, due to respiratory dysfunction and decreased lung function. I have strategized this pitfall by getting vaccinated against both seasonal flu and H1N1. I also ask people in a roundabout way if they are all infection-free before I visit, by saying things like, “Boy, it sure is a miracle that we are all healthy with so much crud going around this time of year, isn’t it?”
Losing Sleep: Everyone gets tired during the holidays. However, for those of us with MS who pretty much live in a constant state of fatigue, the frantic pace of fitting in all the revelry can really affect us in very negative ways. Part of this has to do with sleep loss – we all know the pattern – go to bed a little later here, wake up to hit the sales or put the turkey in the oven the next day, can’t go to bed before Uncle Ted leaves, and so on… We end up with a sleep deficit that exacerbates our fatigue. Be as strict with bedtimes as possible and budget naps into your schedule.
Stress: I try to stay calm and peaceful as much as possible. Most of the time, it works. However, I have learned the hard way that unless I really strategize holiday time, there is no feeling of calm or peace to be found in my world. Stress seems to radiate off of frenzied shoppers and harried hosts. This year, I am going to have all of my shopping done before Thanksgiving, all menus planned far in advance and a very specific schedule of what is going to be happening when, so that I know what to expect. I can’t guarantee that my “plan to plan” will work to eliminate 100% of the potential stress around the holidays, but at least I will feel like I am somewhat in control of the situation.
Getting Too Cold/Hot: Many of us with MS are sensitive to temperatures. I know that when I get too hot, I start losing function. Usually, this is a summertime problem, but I have also experienced strange symptoms while standing over a hot stove or sitting too close to a hot fire (experts say that a rise of as little as one-half of a degree in one’s core temperature can bring on a pseudoexacerbation). Although I am not one of them, many people complain that their symptoms get worse in cold temperatures. Plan accordingly, and don’t hesitate to use your disabled parking placard when you need to.
Eating Too Fast or While Talking: Swallowing problems, also known as dysphagia, are a pretty common problem for people with MS. I have never been formally evaluated, but have experienced enough uncomfortable moments of coughing when food went “down the wrong way” to guess that I can add this to my MS symptom list. I try to remember this when I am at holiday gatherings, and really put effort into eating slowly and only talking when my mouth is completely empty. I also try to avoid eating or drinking when I am talking to people whom I know to be humorous, as laughing and trying to swallow are a very bad combination for me.
Trying to Do Too Much: Most people with MS battle with fatigue and often have to limit what we do. Holidays can be fun and exciting and make us push past feelings of fatigue in order to get one more present wrapped or attend one more party. Schedules that would make other people feel a little tired the next day can bring us to our knees with fatigue. I’m not recommending that social events get skipped or preparations go undone out of fear of worsening our fatigue. However, I will say that often something has to give. Let up a little on the housework in lieu of a holiday concert. Delegate others to bring something to the meal, rather than doing it all yourself. Do some of your shopping online and avoid busy stores and long lines. Bring the frenzy down a notch and enjoy what the holidays have to offer instead of just adding a bunch of stuff into your existing schedule.
Skipping Meds, Exercise or Other Things that Keep Us Well: When the holidays get in full swing, things get overlooked, especially those things that might not be the most pleasant things we do each day. I know that there have been times that I wake up, bleary-eyed, the day after a holiday and notice that my nighttime syringe is still sitting by the sink. Exercise also tends to get ignored or crossed off of to-do lists when everything else seems so pressing. It goes without saying that we need to keep up with personal “maintenance” during the holidays – otherwise, you get the double (or triple) whammy of neglecting important health or medication tasks, compounded by all of the holiday-related health hazards, which often comes with a big ol’ dollop of guilt on the top.
Constipation: Hmmm, let’s see… do we choose bran cereal with blueberries or Aunt Helen’s famous homemade cinnamon rolls for breakfast? Don’t get me wrong, I’m a big fan of indulging in the treats that are associated with the holidays. However, realize that many of us with MS are prone to constipation, and last time I checked, chocolate peppermint truffles and egg nog were not known for their fiber content. Do yourself a favor and supplement with fiber, use a stool softener or stick with the eating plan that works for you and just take small samples of the goodies.
Depression: Depression is a very real symptom of MS. Depression also peaks around the holidays, probably as a result of stress, seasonal effects of reduced sunlight and all sorts of other factors. Keep one simple rule in mind: If you have MS and feel very sad or have no interest in things around you, you need to seek help.
