Real Health Spring 2020

YOUR GUIDE TO BLACK WELLNESS

SPRING 2020 $2.99 US REALHEALTHMAG.COM

How Therapy Helped

Michelle Williams Change Her Perception of Depression

Strength Training Can Help Manage Your Diabetes

HIV Discrimination Is Against the Law

More People Are Choosing to Live Life Single

Montel Williams Urges MS Sufferers to Tell Their Stories

Do Fermented Foods Offer Health Benefits?

IMPORTANT FACTS FOR BIKTARVY®

(bik-TAR-vee)

This is only a brief summary of important information about BIKTARVY and does not replace talking to your healthcare provider about your condition and your treatment.

MOST IMPORTANT INFORMATION ABOUT BIKTARVY

POSSIBLE SIDE EFFECTS OF BIKTARVY

BIKTARVY may cause serious side effects, including:

BIKTARVY may cause serious side effects, including: } Those in the “Most Important Information About BIKTARVY” section. } Changes in your immune system. Your immune system may get stronger and begin to fight infections.

Tell your healthcare provider if you have any new symptoms after you start taking BIKTARVY. } Kidney problems, including kidney failure. Your healthcare provider should do blood and urine tests to check your kidneys. If you develop new or worse kidney problems, they may tell you to stop taking BIKTARVY. } Too much lactic acid in your blood (lactic acidosis), which is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms: weakness or being more tired than usual, unusual muscle pain, being short of breath or fast breathing, stomach pain with nausea and vomiting, cold or blue hands and feet, feel dizzy or lightheaded, or a fast or abnormal heartbeat. } Severe liver problems, which in rare cases can lead to death. Tell your healthcare provider right away if you get these symptoms: skin or the white part of your eyes turns yellow, dark “tea-colored” urine, light-colored stools, loss of appetite for several days or longer, nausea, or stomach-area pain. } The most common side effects of BIKTARVY in clinical studies were diarrhea (6%), nausea (6%), and headache (5%).

} Worsening of Hepatitis B (HBV) infection. If you

have both HIV-1 and HBV, your HBV may suddenly get worse if you stop taking BIKTARVY. Do not stop taking BIKTARVY without first talking to your healthcare provider, as they will need to check your health regularly for several months.

ABOUT BIKTARVY BIKTARVY is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in adults. It can either be used in people who have never taken HIV-1 medicines before, or people who are replacing their current HIV-1 medicines and whose healthcare provider determines they meet certain requirements.

BIKTARVY does not cure HIV-1 or AIDS. HIV-1 is the virus that causes AIDS. Do NOT take BIKTARVY if you also take a medicine that contains: } dofetilide } rifampin } any other medicines to treat HIV-1

BEFORE TAKING BIKTARVY Tell your healthcare provider if you: } Have or have had any kidney or liver problems,

These are not all the possible side effects of BIKTARVY. Tell your healthcare provider right away if you have any new symptoms while taking BIKTARVY.

including hepatitis infection. } Have any other health problems. } Are pregnant or plan to become pregnant. It is not known if BIKTARVY can harm your unborn baby.

Tell your healthcare provider if you become pregnant while taking BIKTARVY. } Are breastfeeding (nursing) or plan to breastfeed.

Do not breastfeed. HIV-1 can be passed to the baby in breast milk.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.FDA.gov/medwatch, or call 1-800-FDA-1088.

Your healthcare provider will need to do tests to monitor your health before and during treatment with BIKTARVY.

HOW TO TAKE BIKTARVY

Tell your healthcare provider about all the medicines you take:

Take BIKTARVY 1 time each day with or without food.

} Keep a list that includes all prescription and over-the-

counter medicines, antacids, laxatives, vitamins, and herbal supplements, and show it to your healthcare provider and pharmacist.

} BIKTARVY and other medicines may affect each other.

Ask your healthcare provider and pharmacist about medicines that interact with BIKTARVY, and ask if it is safe to take BIKTARVY with all your other medicines.

Get HIV support by downloading a free app at

MyDailyCharge.com

GET MORE INFORMATION } This is only a brief summary of important information

about BIKTARVY. Talk to your healthcare provider or pharmacist to learn more.

} Go to BIKTARVY.com or call 1-800-GILEAD-5. } If you need help paying for your medicine,

visit BIKTARVY.com for program information.

BIKTARVY, the BIKTARVY Logo, DAILY CHARGE, the DAILY CHARGE Logo, KEEP MOTIVATING, LOVE WHAT’S INSIDE, GILEAD, and the GILEAD Logo are trademarks of Gilead Sciences, Inc., or its related companies. Version date: December 2018 © 2019 Gilead Sciences, Inc. All rights reserved. BVYC0102 01/19

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KEEP MOTIVATING.

Because HIV doesn’t change who you are.

BIKTARVY® is a complete, 1-pill, once-a-day prescription medicine used to treat HIV-1 in certain adults. BIKTARVY does not cure HIV-1 or AIDS.

Ask your healthcare provider if BIKTARVY is right for you.

To learn more, visit BIKTARVY.com.

Please see Important Facts about BIKTARVY, including important warnings, on the previous page and visit BIKTARVY.com.

RHA507370B.pgs 02.06.2019 15:21

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CONTENTS

this month on REALHEALTHMAG.COM

Why dynamic congresswoman Ayanna Pressley went public with her hair loss is a deeply personal story that she chose to share because of little Black girls everywhere who regard her as a role model. Go online for the full story.

Health Basics A—Z Want to lose weight, exercise smart, eat right, find good health care, sleep better or just get healthy? For tips, click on “Health Basics A–Z” on the realhealthmag.com home page.

Now Two Options for PrEP Descovy is a new med for HIV pre-exposure prophylaxis (PrEP). How exactly does this drug differ from Truvada for PrEP? Read more about these two HIV prevention meds.

24

16

10 3 editor’s letter

12 beyond the blues

Should we call aging a disease?

Until she was diagnosed with depression 10 years ago, singer Michelle Williams couldn’t put a name to what she was feeling.

Plus: symptoms of depression.

5 buzz Resolving nonmedical factors can help people achieve better health outcomes; older women can also benefit from PrEP; people living with HIV are protected under the law

16 kitchen science The process of fermentation uses bacteria, yeast and other beneficial microorganisms to produce foods that support a healthy gut— and body. Plus: DIY fermentation.

8 sex Chronic pelvic pain may be caused by a wide variety of conditions; dealing with toxic parents

20 tell your stories 10 fitness

Montel Williams is helping people with multiple sclerosis share their experiences with the progressive disease. Plus: types of MS.

Is there such a thing as too much exercise?; exercise options for those with type 2 diabetes

11 stuff we love

24 thoughts

A roundup of the latest health and beauty products

Who says people must be coupled up to be happy?

Cancer Calculations A new website promises to give people living with cancer and their families a simple way to determine rates of cancer survival.

Digital Real Health Read Real Health magazine online exactly as it appears in print. Go to realhealthmag.com/ digital to view the current issue and the entire Smart + Strong digital library.

REAL HEALTH Question of the Month What motivated you to create a line of feminine hygiene products for very active women and girls?

For years, we’ve only had one or two options: pads or tampons. I designed my products to perform based on the natural bodily functions of females and to solve problems so women and girls can feel more confident and secure at their time of the month. —Crystal Etienne, CEO, Ruby Love

reach out & click!

At realhealthmag.com, you can read more articles; access exclusive, online-only special reports; and subscribe ($9.97 for four quarterly issues; or call 212.242.2163). Plus, sign up for the Real Health email newsletter to get the latest news on issues relating to Black health!

(COVER) OFFICE ON WOMEN’S HEALTH; (PRESSLEY) THE ROOT; CALCULATOR (ISTOCK); (ETIENNE) COURTESY OF RUBY LOVE

An Alopecia Address

EDITOR’S LETTER

Why Call Aging a Disease?

EDITOR-IN-CHIEF

Kate Ferguson

A better chance for good health in our old age

MANAGING EDITOR

Jennifer Morton DEPUTY EDITOR

s science and technology continue to improve our standard of living, the human life span has increased dramatically. But for the most part, medicine has been unable to keep individuals from experiencing an inevitable decline in physical and cognitive health as they age.

In addition to deteriorating health, a longer-lived population faces dwindling financial resources that could eventually make folks a burden to families, communities, states and the country. What’s the use of living longer if it’s going to result in poorer quality of life for everyone?

Although becoming older is a natural process undergone by all living things, a growing number of scientists in the field of longevity research believe in classifying aging as a disease. Doing so, they say, would generate funding for research and incentivize pharmaceutical and biotech companies to develop drugs and other therapies for the prevention and treatment of this biological condition.

In 2018, scientists moved closer to this goal when the World Health Organization (WHO) accepted a proposal to include a code for age-related diseases in the International Classification of Diseases,

A

Trent Straube SCIENCE EDITOR

Liz Highleyman COPY CHIEF

Joe Mejía ASSISTANT EDITOR

Alicia Green ART DIRECTOR

Mark Robinson ART PRODUCTION MANAGER

Michael Halliday ADVISORY BOARD

Goulda Downer, PhD, RD, CNS; Lovell Harris, MD; Dorothy Horton, PsyD; Jeanette L. Pinnace, DPM; Lee SaintMartin, MS, IIPA, CN, ND; Yuan Wan; Terrie M. Williams FEEDBACK

Real Health, 212 West 35th Street, 8th Floor, New York, NY 10001, or email info@realhealthmag.com

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Real Health (ISSN 2688-7258) Issue No. 61. Copyright © 2020 CDM Publishing LLC. All rights reserved.

No part of this publication may be reproduced, stored in any retrieval system or transmitted, in any form by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the publisher. Smart + Strong® and Real HealthTM are trademarks of CDM Publishing, LLC.

the global standard for health information that defines diseases, disorders, injuries and other health conditions. The move signaled the WHO’s acknowledgment of aging as a risk factor for major diseases.

Experts in aging research say scientific evidence seems to suggest that several fundamental processes are primarily responsible. They believe these findings offer hope that scientists may eventually be able to modify how humans age.

One drug, RTB101, is currently in clinical trials to test its potential to check the age-related decline of the immune system.

(Researchers expect results for this antiaging intervention by mid-2020.) Should the findings lead to this medication’s approval, doctors would be able to use the drug to prevent age-related diseases in humans.

Despite the excitement this prospect is generating, however, some scientists have expressed concerns that classifying aging as a disease could further fuel the stereotyping and stigmatization of older people.

This very real problem can affect the health of seniors by weakening their will to live and their efforts to become and stay physically active and recover from illness. In addition, this increased stress can act to shorten their life span.

But it’s undeniable, too, that old age can trigger biological problems that render the body more susceptible to numerous harmful effects. For example, findings show a connection between aging and certain degenerative processes that can lead to osteoarthritis.

I do agree that ageism is an ongoing problem. But this bias will take time to erase. In the meantime, I think we should do what’s necessary to ensure that individuals remain independent and functional throughout all the stages of their lives. If classifying aging as a disease is required to produce positive results, then so be it.

Kate Ferguson, Editor-in-Chief katef@realhealthmag.com

realhealthmag.com I SP RI NG 20 20 RE AL H EA LT H 3

FIND US AT

CancerHealth.com TM

• A daily resource for people living with and affected by cancer • Clear, comprehensive prevention and treatment information • News, personal stories, blogs, community forums and more • Sign up online to receive free treatment and lifestyle email newsletters Follow us on:

A SMART + STRONG PUBLICATION Award-winning consumer health care information

BUZZ

Give Them the Full Treatment

ISTOCK

Nonmedical factors can also affect a person’s ability to get and stay healthy.

INCREASINGLY, HEALTH PROFESSIONALS are recognizing and embracing the idea that socioeconomic circumstances must be addressed in order for individuals not only to have equal access to quality health care but also to experience positive health outcomes. But how should this approach be implemented to ensure the most effective care possible?

Broadly, social determinants of health are the conditions and circumstances under which someone is born, lives, works, grows old and retires. But unless individuals are asked directly about the particulars of their home environment and everyday existence, these complicated areas of their lives can remain hidden from doctors.

“The main way we try to measure [social determinants] is by asking patients if they’re exposed to pollutants or have food insecurity or experience issues with homelessness or domestic violence,” says Karina W. Davidson, PhD, MASc, a clinical health psychologist and senior vice president of research at The Feinstein Institutes for Medical Research at Northwell Health in Long Island, New York. “There’s a long list of conditions and circumstances that can adversely impact someone’s health.”

Findings show that people who suffer economic, mental and physical chal-

lenges often have the most frequent need for high-cost care. Researchers explain that addressing such problems requires a team approach if health care systems hope to reduce disparities and improve the health of individuals in any meaningful way, researchers explain.

In 2014, the Camden Coalition, Primary Care Progress and the Association of American Medical Colleges designed a course to educate students about “hotspotting.” The term refers to the practice of identifying patterns of high use of medical services by people with complex health and socioeconomic needs. These individuals are sometimes referred to as “super-utilizers” of health care systems.

At Thomas Jefferson University in Philadelphia—one of 24 institutions across the country that implemented the course—students received training via the Student Interprofessional Hotspotting Program. Each student was assigned to a team made up of different medical professionals. In turn, each team was charged with assisting a single patient to negotiate Address their social problems and social any other issues that they issues to improve found challenging when health dealing with the health outcomes. care system.

In this pilot program, findings showed that the team approach closed the gap between patients and their providers, resulting in people benefiting physically, mentally and emotionally.

By screening these super-utilizers of the health care system to determine their nonmedical needs, teams found that they were able to help individuals access food and transportation, better understand medical terminology and develop more trusting relationships with medical staff. As a result, these patients’ health outcomes improved markedly.

“Health care systems are just starting to grapple with how best to address these issues for their patients,” Davidson says. “Best practices can include locating community resources and having social workers who can immediately connect a patient upon hearing about an issue so the challenge is correctly dealt with.”

This also helps people find resources they may not be aware are available. But these types of services require funding.

“The money to prevent an illness from happening and to help empower a community to move toward system-wide solutions is scarce,” Davidson says.

“But there are health care systems that know it’s the right thing to do, and they’re willing to do it.” —Kate Ferguson realhealthmag.com I SP RI NG 20 20 RE AL H EA LT H 5

BUZZ

Discrimination Just Ain’t Right People living with HIV are protected under the law.

Individuals with HIV who take antiretroviral medications to treat the virus can lead healthy, long lives, but they may still face social stigma and discrimination.

While stigma refers to negative attitudes about people with HIV based on ignorance, discrimination entails treating people with HIV differently than people without the virus. Individuals who discriminate might deny someone a job or an essential service because of his or her status, which is illegal.

The Americans with Disabilities Act of 1990 (ADA) protects people with HIV against such discrimination by all public employers, Older women can also benefit from PrEP. private employers with 15 or more employNO MATTER HER AGE, AS LONG AS A While two in three respondents to the ees, state and local government entities and woman is sexually active she risks ac- survey said they would talk with their all public accommodations. quiring HIV. This simple fact of life is one care provider if they experienced a sexStill, some may believe they’re not covthat community women’s organization ual health problem, 83% had not spo- ered by the ADA because the virus does not Older Women Embracing Life (OWEL), in ken with a doctor about their sexual affect their ability to work or function. But an Baltimore, has been stressing since the health in the past two years. amendment to the law in 2008 clarified that Additionally, findings show that older people with HIV are fully protected whether group launched in support of HIV-positive women—especially those over 50— people are less likely to initiate a talk or not they have symptoms. as well as women who may be at risk about safe sex practices or be asked by Furthermore, the ADA states that reasona health care provider about their sexual able modifications in policies, practices or for the virus.

“We want to prevent others from hear- health, take PrEP for prevention, use a procedures must be implemented in order to ing the diagnosis that tells them you’re condom, get tested for HIV or discuss accommodate individuals with disabilities.

HIV positive, so we do a lot of prevention condom use with their sexual partners.

Finally, the law also protects people who Women’s HIV prevention experts don’t have the virus if they have been diswork, which includes treatment as prevention and support with adherence as suggest that an effective way to criminated against by someone who prevention,” explains Melanie Reese, implement PrEP among older believes that they do.

OWEL’s executive director. “Over the female adults is through acIndividuals who believe years, new tools and skills evolved that tivities and interventions they have been discrimwe’ve incorporated into our skill set to that increase their knowlinated against because help women, especially seniors, who edge about HIV. of their HIV status should DISCRIMINATION file a complaint with the “It is also important to don’t feel they’re at risk and who medical use language that conveys providers don’t see as being at risk.”

Department of Justice or, In 2017, the University of Michigan a positive tone and to disif the complaint is about a used a national sample to conduct a cuss the risk of acquiring an job, the Equal Employment Opportunity Commission. countrywide poll on healthy aging. Re- HIV infection across a womAdditionally, people may also file sults showed that 40% of adults, ages an’s life span,” say researchers 65 to 80, said they were sexually active. who follow this issue. —Kate Ferguson private lawsuits with the help of an attorney or a nonprofit, such as Lambda Legal.

In 1983, Lambda Legal won the nation’s first HIV/AIDS discrimination case, People v.

West 12 Tenants Corp. The case concerned tenants of a building who tried to evict a neighbor, noted HIV/AIDS doctor Joseph Sonnabend, because he was treating people with HIV. The landmark victory helped pave the way for the ADA’s legal protection of peoSource: Centers for Disease Control and Prevention ple living with HIV. —Joe Mejía

Age Doesn’t Protect Against HIV

AS OF 2018, THE NUMBER OF STATES THAT HAVE LAWS CRIMINALIZING EXPOSING SOMEONE TO HIV

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BOTH IMAGES: ISTOCK (MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY)

HIV

NEW

WHEN IT’S

HARD BELLY

IT MAY BE TIME FOR

EGRIFTA SV

™

ASK YOUR HEALTHCARE PROVIDER ABOUT NEW EGRIFTA SV , A TREATMENT FOR HARD BELLY (EXCESS HARD ABDOMINAL FAT).

TM

LEARN MORE AT EGRIFTASV.COM

Actual patient living with HIV.

IMPORTANT INFORMATION FOR PATIENTS ABOUT EGRIFTA SV (tesamorelin for injection) TM

What is EGRIFTA SV (tesamorelin for injection)?

• EGRIFTA SV is an injectable prescription medicine used to reduce excess hard abdominal fat (hard belly) in adult patients living with HIV and lipodystrophy. EGRIFTA SV is a growth hormone-releasing factor (GHRF) analog.

• EGRIFTA SV is not for weight loss management.

• The long-term safety of EGRIFTA SV on the heart and blood vessels (cardiovascular) is not known.

• It is not known whether taking EGRIFTA SV helps improve how well you take your antiretroviral medications.

• It is not known if EGRIFTA SV is safe and effective in children, do not use in children.

TM

TM

TM

TM

TM

TM

TM

Before using EGRIFTA SV , tell your healthcare provider if you: • Have or have had cancer.

• Have problems with blood sugar or diabetes.

• Have scheduled heart or stomach surgery.

• Have breathing problems.

• Are breastfeeding or plan to breastfeed.

• Are taking any other prescription and non-prescription medicines, vitamins, and herbal supplements.

TM

EGRIFTA SV may cause serious side effects including: • Increased risk of new cancer in HIV positive patients or your cancer coming back (reactivation). Stop using EGRIFTA SV if any cancer symptoms come back.

• Increased levels of your insulin-like growth factor-1 (IGF-1). Your healthcare provider will do blood tests to check your IGF-1 levels while you are taking EGRIFTA SV .

• Serious allergic reaction such as rash or hives anywhere over the body or on the skin, swelling of the face or throat, shortness of breath or trouble breathing, fast heartbeat feeling of faintness or fainting, itching and reddening or flushing of the skin. If you have any of these symptoms, stop using EGRIFTA SV and get emergency medical help right away.

TM

TM

You should not take EGRIFTA SV if you: • Have a pituitary gland tumor, surgery, or other problems related to your pituitary gland, or have had radiation treatment to your head or head injury.

• Have active cancer.

• Are allergic to tesamorelin or any of the ingredients in EGRIFTA SV .

• Are pregnant or become pregnant. If you become pregnant, stop using EGRIFTA SV and talk with your healthcare provider.

• Are less than 18 years of age.

TM

TM

TM

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• Swelling or fluid retention. Call your healthcare provider if you have swelling, an increase in joint pain, or pain or numbness in your hands or wrist, • Increase in blood sugar (glucose) or diabetes • Injection site reactions. Injection site reactions are a common side effect of EGRIFTA SV , but may sometimes be serious.

• Increased risk of death in people who have critical illness because of heart or stomach surgery, trauma of serious breathing (respiratory) problems has happened when taking certain growth hormones TM

The most common side effects of EGRIFTA SV include: • Pain in legs and arms • Muscle pain These are not all of the possible side effects of EGRIFTA SV .

For more information, ask your healthcare provider or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or to THERA patient support® toll-free at 1-833-23THERA (1-833-238-4372).

This information is not intended to replace discussions with your doctor. For additional information about EGRIFTA SV , go to: www.egriftasv.com for the full Prescribing Information, Patient Information and Patient Instructions for Use, and talk to your doctor.

For more information about EGRIFTA SV contact THERA patient support® toll-free at 1-833-23THERA (1-833-238-4372).

TM

TM

TM

TM

EGRIFTA SV is a trademark of Theratechnologies Inc. THERA patient support is a registered trademark of Theratechnologies Inc. © 2019 Theratechnologies Inc. All rights reserved.

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SEX

Ask Doctor Dee Dorothy Horton, PsyD, answers your questions.

A Difficult Diagnosis What to make of aching below the belly button and above the hip that lasts at least six months?

CHRONIC PELVIC PAIN MAY BE SHARP and can range from mild to severe enough to interfere with normal activities. This problem haunted one woman for almost 17 years.

“I’d tried everything, including physical therapies and different recommendations that doctors had made, and I’d exhausted what I felt were any options,” she says. “I’d quit my job. I didn’t want to work anymore. I was constantly nauseated from the pain.”

Finally, she found a team of doctors who properly diagnosed the problem and helped her get relief.

According to the American College of Obstetricians and Gynecologists, chronic pelvic pain may be caused by a wide variety of conditions. The pain may not be linked to a woman’s reproductive organs and may result from urinary tract or bowel issues.

Men also suffer from the condition, which may result from swelling and inflammation of the prostate gland, among other potential causes.

Pain in some individuals could be caused by more than one factor, or doctors may find no reason whatsoever for the aching.

The first step to identifying the source of the pain, however, is to get a physical, including a pelvic exam. In addition, doctors may order tests such as X-rays, MRI scans, ultrasound, colonoscopy, laparoscopy, cystoscopy or sigmoidoscopy.

Experts suggest that patients work with specialists, such as a gastroenterologist and urogynecologist, to address the condition. Additionally, doctors may recommend medications, physical therapy, nutritional therapy or surgery to help relieve the pain. —Kate Ferguson

THE MOST RECENT ESTIMATE OF DIRECT MEDICAL COSTS IN THE UNITED STATES AS A RESULT OF OUTPATIENT VISITS BY WOMEN AGES 18 TO 50 SUFFERING FROM CHRONIC PELVIC PAIN Source: Obstetrics and Gynecology

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Realistically, if kids are minors, they’re limited in how they can deal with a toxic parent. However, young children can talk to a trustworthy adult, such as a school counselor, teacher, religious leader or other family members and friends, about problems they’re having at home.

For older children, this may mean ignoring a parent’s negative comments or not trying to please them in the face of unreasonable demands for time or money.

For young adults who live at home, handling a dysfunctional parent may require they move out.

Such individuals should set boundaries and not allow a parent to manipulate them with guilt or blame for their shortcomings.

Gradually, kids can learn to detach emotionally from toxic parents and not take their behavior personally or try to change them. Remember that parents are adults who have made certain decisions—for better or for worse—in their lives.

In addition, it’s important to understand that some toxic relationships can’t be repaired. But parents should be treated with respect and courtesy at all times.

If this means totally cutting off communication with mom or dad or spending less time in their company, this may definitely be better for a child’s personal growth and mental health.

In all relationships, one’s first obligation is to care for oneself.

(GIRL) ISTOCK (MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY); (HORTON) COURTESY OF DOROTHY HORTON, PSYD

What can kids do if mom or dad is a toxic person?

Chemotherapy may destroy your cancer, but it doesn’t have to destroy your hair. “ Not having that reminder every time you look in the mirror that you are sick, and you look normal to your friends and family, made the chemo much more bearable. Instead of illness, I saw myself. Many people had no idea I had cancer.”

- Carolyn Dempsey, NY

PRO-20190816-01-EN

DigniCap is FDA cleared to minimize hair loss in patients with solid tumors undergoing chemotherapy.

Learn more at dignicap.com

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FITNESS

Treatment Tools Exercise options for those with type 2 diabetes

Lifting weights can help people with type 2 diabetes manage their blood sugar levels, advise experts. In the beginning, try doing two sets of eight repetitions of the following basic strength-training exercises:

Yes, there is such a thing as too much exercise.

NOT TAKING A BREAK FROM WORKING OUT CAN LEAD TO OVERTRAINING syndrome (OTS), warns the American Council on Exercise. In turn, OTS can decrease your fitness level and result in possible injury. Here are some signs that you may be overworking your body.

Decreased performance. If you increase your training intensity and frequency but don’t see any results, this is a telltale sign that you’re overtraining.

Excessive fatigue. Of course, working out can drain you. But not giving your body the chance to rest and recover before resuming fitness THE NUMBER OF MINUTES activities can deplete your energy MOST ADULTS WITH supply and leave you exhausted.

No appetite. Are you not eating DIABETES SHOULD like you used to? Although more ENGAGE IN MODERATE training should stimulate your appetite, exhaustion related to OTS can TO VIGOROUS INTENSITY kill your desire to eat.

ACTIVITY DIVIDED INTO Chronic or nagging injuries.

AT LEAST THREE DAYS Overuse of your muscles and joints can stress the joints and result in A WEEK WITH NO MORE constant aches and pains. If you’re THAN TWO CONSECUTIVE hurting for more than two weeks, you may be badly injured.

DAYS WITHOUT ACTIVITY The solution? Get to your doctor Source: American Diabetes Association ASAP for a checkup. —Alicia Green 1 0 RE A L H EALT H S P R ING 2020 I realhealthmag.com

Bicep curls. Hold a weight in each hand with your arms at your sides and palms facing your thighs. Bend one arm to bring the weight to your shoulder, palm side up. Return your arm to its original position. Repeat the movement using the other arm.

Chair raises. Sit at the edge of a chair positioned securely on the floor.

Cross your arms over your chest and lean back. Move your upper body forward to sit up straight, straighten your arms in front of you and stand. Sit back down and repeat.

—AG

BOTH IMAGES: ISTOCK (MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY)

Enough Already!

Wall push-ups. Stand facing a wall with your arms straight in front of you and palms flat against the wall. Bend your elbows to lower your chest to the wall while keeping your body straight in a strong plank or push-up position.

Slowly push away from the wall to straighten your arms and return to the starting position.

STUFF WE LOVE

Koios Nootropic Drink (12-pack of 12 fl. oz. cans, assorted flavors, $26.39) This tasty beverage was formulated using a proprietary blend of vitamins, minerals and such ingredients as MCT oil, green tea and lion’s mane mushroom, among others, and is intended to boost energy, enhance cognition, mood and brain power. koiosbeveragecorp.com

Crushed Tonic (sampler kit, $15; 30-pack, $105) Organic superfoods in these packets include matcha, turmeric and lucuma powders with marine collagen, probiotics, biotin and antioxidants.

Pour into warm milk, coffee, smoothies or juices and sip for skin, hair, muscle, joint and bone health. crushedtonic.com

A ROUNDUP OF THE LATEST MUST-HAVE FINDS FOR HAIR, SKIN, HEALTH, BEAUTY AND MORE. THESE PRODUCTS ARE WORTH EVERY CENT.

Crossrope (sets and bundles, $98 to $138) Get lean, strong and fit with these durable, tangle-free jump ropes. Engineered with pro-grade ball bearings encased in ergonomic handles so you can enjoy a smooth jumping experience. Features a fast-clip connection for quick switches between light and heavy ropes. crossrope.com

Cocofloss Fresh Coconut Floss (32 yards, $9) A soft, textured, chemical-free dental floss treats your gums while delighting your taste buds. Made with microcrystalline wax, coconut oil and fruit oils. cocofloss.com

Ballsy Goodhead Shampoo and Conditioner (16 oz., $15 each) These high-end botanical formulations are chemicalfree. Designed to smooth, nourish, hydrate and strengthen men’s hair with quinoa protein, green tea and hibiscus as well as tea tree and olive oils. ballsybrand.com

Mad Hippie Vitamin C Serum (1.02 fl. oz., $33.99) This blend of vitamins C and E and hyaluronic acid promises to plump the skin and help reduce the appearance of wrinkles and discolorations.

Clary sage hydrates, and chamomile extract soothes, protects and calms. madhippie.com realhealthmag.com I SP RI NG 20 20 RE AL H EA LT H 11

Michelle Williams took the first step toward managing her depression when she disclosed her condition and sought professional help.

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BEYOND THE

BLUES UNTIL SHE WAS DIAGNOSED WITH DEPRESSION JUST 10 YEARS AGO, MICHELLE WILLIAMS COULDN’T PUT A NAME TO WHAT SHE WAS FEELING.

By Kate Ferguson

GETTY IMAGES/OXYGEN MEDIA

Entertainer Michelle Williams, a former

member of Destiny’s Child, lives with recurrent depression, which she has learned to manage through therapy. In 2017, Williams shared her struggles with the mental health condition on the national TV show The Talk, admitting that at the pinnacle of her successful career with the group, she was beset by suicidal thoughts.

In 2017, according to the National Institute of Mental Health, an estimated 17.3 million adults in the United States experienced at least one major depressive episode. This common disorder is more prevalent among women compared with men.

More than just feeling blue or down for a few days, depression is a real illness

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that can be chronic and affect a person’s day-to-day life.

“I want to normalize this mental health discussion,” says the singer. To that end, Williams has continued to tirelessly advocate for education and awareness about depression and getting treatment for the condition. She first went public about having the mental health disorder in 2013.

Will you tell us a little bit about your experiences with depression? My

experience with depression started in my early teens, but it wasn’t until my 30s that I knew what to call it. I thought it was growing pains. I thought that was simply how it felt to be a girl growing into a woman. I also experienced depression for a period of time in college and then again while

everything. When I was depressed, I had no interest in the things that usually brought me joy and energy. It felt like I was simply going through the motions of my life without really being there. And during those times, if I had to cancel performances or fall behind deadlines, I didn’t feel bad about it.

Now, when I recognize that I’m starting to feel this way, I try to do exercises or other activities to stop me from melting completely. If I melt completely, I find it much harder to get back to my normal self.

When did you realize you needed treatment? For many years, I didn’t

think treatment was for someone like me. I thought it was for people who had lived through very difficult experiences, like abuse, or who had more

extreme symptoms than me. It wasn’t until I was in my 20s and a friend talked about her own therapy that I realized therapy could be right for people in many different situations.

I turned to therapy in my 30s, when I realized my depression had led me to isolate myself and to feel hurt and angry around those closest to me.

I didn’t want to be unhappy or make unhealthy decisions that would change everything I’d worked for. I didn’t want to get to the point where I would isolate myself from everyone who had ever helped me or could ever help me.

When I finally sought help, I was so happy with my therapist that I recommended her to everyone around me! It helped me figure stuff out about myself and my actions. And it helped me un-

in Destiny’s Child.

What I’ve found especially hard is trying to share my feelings with people who haven’t dealt with depression.

I’ve had people tell me, “You have all these great things in your life—you can’t possibly be depressed.” They think that being depressed means I’m not grateful or thankful. But that’s not what’s going on. I can be thankful for the sun that’s shining but still feel sad.

What did depression feel like to you?

For me, depression felt like a slow crumble, a slow melt. I felt sad and deeply tired, and I could sleep through an entire week. I also felt a sense of hopelessness, of wanting to give up

SHE BEGAN TO ISOLATE HERSELF AND COULD NOT SHAKE HER FEELINGS OF HURT AND ANGER.

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learn the less healthy behaviors I had been doing for 20 years.

How do you manage your symptoms now? One of the biggest things that

works for me is setting boundaries.

I’m aware when people around me start talking about something that I can’t help with because I am worried about taking on someone else’s problems. I try to set boundaries with those conversations.

I’ve also found that it’s important to tell yourself once or twice a week that you love yourself. You need to figure out what tells you that you love yourself—things you neglect when you’re feeling depressed. It could be going outside, going on the bike path, look-

(THE MASKED SINGER) GETTY IMAGES/FOX; (DESTINY’S CHILD) GETTY IMAGES/JEFF KRAVITZ

Left: Michelle Williams with Nick Cannon on The Masked Singer.

Far right: Williams with Beyoncé and Kelly Rowland at the Grammy Awards in 2000.

ing at flowers or even enjoying a milkshake. I’ve found that working out regularly does wonders too.

Do you still have low days, and what do you do on those days to care for yourself? Depression can make me

want to sleep through the entire day or even the week. So if I recognize that it could be a low day, I do my best to get up, make my bed and tell myself, “No, that’s not what we’re doing today.” I don’t have any magical solutions. I just remind myself that I’ve been doing well and that I’ve come too far to let a low day get everything off track.

What role do you think our mental health plays in our overall health?

Our minds and emotions control everything. Our brains are telling our bodies how to function. It’s all coming from our heads and our minds.

Do you have advice for women who may be too embarrassed to get help?

Try to put everything you were taught that’s making you hesitate aside. Getting help and opening up can help you to see so much great stuff about your life. I have friends who didn’t always have the most emotionally healthy lives, but you can tell they’ve been able to create a positive environment where their kids can grow up healthy.

It’s important for women to be aware that some people enjoy dysfunction or don’t even realize they’re living in dysfunction. People might have unresolved issues that are affecting their relationships with you, even if those issues have nothing to do with you.

You have to take care of yourself, and you have to do it for you.

What do you want women who are living with depression or other mental health conditions to know? Don’t be

like me and think the worst about having depression. We shouldn’t think about mental health conditions as though they are worse to have than other ailments. We need to normalize the topic so women are comfortable getting help for depression just as they would get help if they had the flu or diabetes. You’ve got to get help.

There are also things you can do to

care for yourself in your daily life.

Speak positively to yourself before the end of each day. God doesn’t speak negatively about anyone, so why do we say those things about ourselves or others?

I’ve also found keeping a vision board to be therapeutic. It helps me consider what I have, what I want, the goals I know I can attain and the goals I think I can’t attain. Traveling was something I wanted but never allowed myself to do in the past; by putting it on the board, I’m reminded of the achievement now that I have traveled.

What can women do to help fight the stigma associated with mental health conditions? Talk about it. Normalize

it as we’ve normalized talking about

body-shaping underwear and PMS. I have a friend who asks, “How is your head, and how is your heart?” Th is gives people a chance to really think about how they’re doing. People may open up, and it’s important to let them. We need to create the space for people to talk about how they’re really feeling. ■ Editor’s note: This interview was made possible by the Office on Women’s Health. If you or someone you know are experiencing suicidal thoughts, call 911 or the National Suicide Prevention Hotline at 800-273-8255, or visit SuicidePreventionLifeline.org. If depression is getting in the way of your daily life or the life of someone close to you, you can find help at FindTreat ment.samhsa.gov.

KNOW WHAT AILS YOU

Depression is not just a bad case of the blues.

Beyond feeling blah and out of sorts, many different emotions can characterize depression. In addition, Black women may express this common mental health disorder differently than women from other population groups, according to the Black Women’s Health Imperative (BWHI).

For example, findings from a survey conducted by the Department of Health and Human Services Office of Minority Health showed that while nearly 10% of Black women reported feeling that everything was an effort, less than 6% of their white counterparts expressed the same outlook. In addition, double the percentage of Black women compared with white women said they felt sad and hopeless.

Depression varies from person to person, and symptoms differ between men and women and between youngsters and older adults.

But the more symptoms someone experiences, the stronger these signs are and the longer they last, the likelier it is that the depression is

severe enough to interfere with that person’s ability to think, feel and function effectively.

Some of the most common symptoms of depression include the following: ■

Feelings of helplessness and hopelessness

■

A loss of interest in favorite activities and pastimes

■

Losing or gaining significant amounts of weight

■

A marked change in sleep habits, temperament, energy levels, behavior, self-esteem and ability to concentrate

■

An increase in unexplained aches and pains.

The key takeaway, however, is that depression is treatable.

“Seeking treatment is not a sign of weakness,” advises BWHI. “Saying ‘I need help’—and then actually getting that help—shows just how strong you really are.”

—KF

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KITCHEN SCIENCE

THE PROCESS OF FERMENTATION USES BACTERIA, YEAST AND OTHER BENEFICIAL MICROORGANISMS TO PRODUCE FOODS THAT SUPPORT A HEALTHY GUT—AND BODY.

By Gerrie E. Summers

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preserved using an ageold process that not only boosts the food’s shelf life and nutritional value but also gives your body a dose of probiotics that may be good for your health. These live microorganisms can aid digestion by promoting a healthy balance between good and bad bacteria in the gut.

“Food fermentation has been practiced all over the world, and knowledge about fermenting specific foods has been passed down through generations with no knowledge of the microorganisms involved in the process or the health benefits of these foods,” says Los Angeles–based registered dietitian Sofia Norton. “Nowadays, we know exactly what is involved in the fermentation of foods and what, if any, benefits there are to this.”

Almost all food groups can be fermented, but grains, dairy, vegetables, meat and fish are the most common.

EXPERTS SUGGEST THAT FERMENTED FOODS MAY ALSO POSITIVELY AFFECT MENTAL HEALTH. Popular fermented foods include yogurt, kefir, kimchi, kombucha, sourdough bread and vinegary sauerkraut.

Some studies have shown that probiotics may have an advantageous effect not only in the gut but also in other organs, such as the brain. In addition, they defend against bad bacteria and possibly aid in the prevention of certain diseases.

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which probiotics break down carbohydrates, such as sugar and starch, and convert them into lactic acid. This acidic environment acts as a natural preservative, inhibiting the growth of harmful bacteria while also increasing a food’s shelf life.

“Fermented dairy and vegetables frequently contain probiotics—live bacteria and yeast that improve gut health,”

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Norton says. “These microorganisms produce short-chain fatty acids and butyrate—a type of fatty acid—which protect the lining of your intestines.”

They also improve glycemic control, reduce inflammation and contribute to better brain functioning via the gutbrain axis, the two-directional interaction between the gastrointestinal tract and the central nervous system.

“Some fermented foods are easier to digest than their unfermented counterparts, which helps reduce GI discomfort and boosts the capacity to absorb nutrients,” Norton adds.

Fermented grains are easier to digest than unfermented grains and may have a higher nutritional value because they contain a lesser amount of phytic acid. This substance can interfere with the absorption of minerals such as iron and magnesium. “Sourdough reduces the concentration of fermentable carbs in a food, which can be helpful for people with irritable bowel syndrome,” Norton says. “Yogurt and kefir contain less lactose and a high concentration of bacteria that hydrolyzes lactose, making them easier to digest for people with lactose intolerance.”

Jennifer Singh, a registered dietitian based in Raleigh, North Carolina, suggests that fermented foods may also lower insulin resistance, improve cholesterol levels, reduce blood pressure, boost immunity and reduce cancer risk. “Also, because of the benefit to gut health, fermented foods may help with mental health,” she says. “The research is young but promising that anything beneficial for the gut may in turn reduce mental disorders such as anxiety and depression.”

“There are several ways fermented

foods are likely to have a positive impact on mental health, such as improving the gut mucosal barrier, which protects us from environmental toxins, food antigens and bacterial secretions, such as lipopolysaccharide (LPS) endotoxins,” Singh adds. “LPS can increase symptoms of depression and inflammatory response and increase the risk of alcoholic hepatitis [a type of liver disease] and insulin resistance. Another way a healthy gut supports mental health is via beneficial bacteria that

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ermented foods are

Many fermented foods “contain probiotic bacteria, such as lactobacilli and bifidobacteria, which are said to improve the health and balance of gut flora and can treat and manage irritable bowel syndrome, gastric reflux, constipation and other GI [gastrointestinal] disorders,” Norton explains.

“Studies show that probiotics in food can reach the intestines, where their effect is transient but beneficial,” she continues. “For example, they can complement the action of the gut microbiome, inhibit pathogenic bacteria [bacteria that can cause disease, such as salmonella and E. coli] and stimulate the production of short-chain fatty acids, which cells in the gut lining use to make energy.”

The fermentation process employs the help of microbes, such as bacteria, yeasts and mycelial fungi, as well as their enzymes. “These microorganisms are either naturally present in a food or the environment or are added to food as a starter culture,” Norton explains.

“Sometimes environmental conditions like pH, temperature and moisture content are tightly controlled to help with fermentation.”

Most foods are fermented via the process of lacto-fermentation, in

produce most of the body’s neurotransmitters, such as serotonin and dopamine, which both aid in boosting mood.”

But are foods created by a process that utilizes bacteria, yeasts and molds, safe to eat—not just once but every day? Singh believes the answer is yes.

“Eating fermented foods daily should not necessarily cause any issues in healthy individuals,” she says. “I would be concerned if someone was drinking a large amount of kombucha every day because they are following a detox diet.

Yet eating a six-ounce cup of yogurt daily is considered perfectly normal and healthy in addition to being associated with reduced cancer rates.”

Due to the reputed health benefits of these foods, Singh recommends eating a variety of them but advises doing so in moderation.

“I would note that some people who

recommend avoiding fermented foods might be trying to sell you on their ‘proprietary’ probiotics, so be mindful of motive,” Singh advises. “Often, their product lacks the support of scientific research so be mindful of their sources of information.

“While there may be some lessthan-beneficial bacteria and yeasts present in these foods, any properly fermented food will have killed off and crowded out large numbers of these microbes,” she adds. “I say ‘properly fermented’ because precautionary measures do need to be followed to avoid the risk of contaminating foods with harmful microbes, as well as taking the right steps during the fermentation process to allow the right microbes to thrive. Also, keep in mind that we are constantly exposed to all sorts of microbes in our food and environment. They can be hard to avoid!

So not eating fermented foods is not necessarily going to limit exposure.”

Certain people, however, should avoid or limit consumption of fermented foods. For example, Singh cautions those with an active bowel infection, especially SIBO (small intestinal bacterial overgrowth) to avoid fermented foods until their problem resolves. In addition, those with esophageal tears, ulcers or varicose veins and

histamine intolerance (fermented foods are high in histamines) and those living with irritable bowel syndrome should also avoid these foods.

The same goes for people with compromised immune systems—such as people with AIDS, individuals undergoing chemotherapy or radiation therapy, recent recipients of an organ transplant or those with severe burns—who should avoid such foods due to the risk of contamination, Singh explains.

In the case of certain fermented

foods and drinks, such as beer and wine and store-bought items like sauerkraut and sourdough bread, pasteurization, baking or filtration may render live bacteria inactive. Not all foods claiming to have live and active cul-

tures contain the strains of bacteria known to have probiotic health benefits. However, fermentation also adds nutrients, such as omega-3 fatty acids and B vitamins, to foods.

When buying fermented foods from the refrigerated section in a store, look for labels that say “naturally fermented” and “probiotic.” The active cultures they contain should also be listed. Additionally, if you are buying kombucha, the water, yeast, tea and sugar (ideally less than 10 grams) that the beverage contains should be organic, naturally fermented—never force carbonated—and raw.

But why not try conducting your own marvelous experiment with fermentation? Check out our convenient do-it-yourself guide below. ■

HOME ECONOMICS Fermenting food is super cheap and relatively easy. Here’s how to do it: First, use only tested recipes for your fermentation challenge. Check out the book Fermented Vegetables, by Kristin K. Shockley and Christopher Shockley, and visit their website, Ferment.

Works. In addition, be sure to read Sandor Ellix Katz’s comprehensive work The Art of Fermentation. You can also find recipes at his website, WildFermentation.com.

Before fermenting foods, sanitize all surfaces, containers and utensils you will be using by washing them with hot, sudsy water. Then rinse them with hot water, and wipe everything down with a clean cloth. Don’t let fermented foods come into contact with contaminated materials. (For example, don’t use cutting boards on which raw meat is prepared.)

Choose containers made of the right materials. Avoid using most metals, which can react with acid that can leach into food and create an off flavor. (Stainless steel is fine.) If using plastic, make sure it’s food grade, with no scratches or cracks

that can harbor harmful bacteria and other germs.

Start with fresh vegetables— preferably organic ones—or at least those grown under good food safety guidelines.

For recipes, use a starter brine that contains a culture (called a starter culture) or a mixture of salt, water and whey. Completely cover the vegetables with the brine.

Begin the fermentation process within 24 hours of buying or harvesting veggies.

Follow the recipe to the letter. For example, it’s essential to use the correct amount of salt.

Store fermenting vegetables in a sealable container (such as a mason jar) at 70 to 75 degrees. To reduce the amount of oxygen reaching the vegetables, don’t disturb the jar or mold could develop.

Once fermenting is done—typically when bubbles form and the food smells vinegary or like a pickle— refrigerate the container.

—GES

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TELL YOUR STORIES MONTEL WILLIAMS IS WORKING WITH AN ONLINE PLATFORM TO HELP PEOPLE WITH MULTIPLE SCLEROSIS SHARE THEIR EXPERIENCES AND CONNECT WITH OTHERS.

By Jeanette L. Pinnace

MONTEL WILLIAMS AND MULTIPLE

sclerosis (MS) are well acquainted. The Emmy Award–winning former talk show host and television personality was finally correctly diagnosed with the autoimmune disease in 1999, at age 43, almost two decades after he first exhibited symptoms. That’s how long it took physicians to identify the elusive culprit that punished his body with sporadic

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attacks that left him with a slew of alarming, unexplained health issues, including temporary vision loss and excruciating leg and foot pain.

“I had difficulty explaining the disease to anyone, including the doctors,” Williams says. “The doctors and caregivers didn’t understand what I was going through.

“Here it is another 20 years later,

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Montel Williams has shared his story about living with MS for years and is helping others do the same.

and my disease has been a roller coaster,” he continues. “Some of my symptoms have abated, and some of them have gotten worse.”

In 2018, Williams suffered a hemorrhagic stroke from which he’s since recovered. “But my MS has been manageable, so that’s been helpful for me,” he says. “MS doesn’t necessarily get worse for everyone as they get older; some of us stay in a specific category.”

ACCORDING TO THE MOST CURRENT

statistics from the Multiple Sclerosis Association of America, the illness

window of time.

Symptoms of MS can be mild—and easily overlooked—or severe. They may include abnormal fatigue, intermittent numbness, tingling and tremors that may come and go. In severe cases, people experience permanent symptoms that might include partial or complete paralysis.

Additionally, MS can lead to cognitive impairment that may affect memory and concentration.

Treatment to help manage the disease should start as soon as possible to delay its progression and prevent dam-

age to the central nervous system. Early medical interventions that target the inflammation present can help protect nerve fibers and brain tissue from being injured.

Since there is no cure for MS, doctors emphasize proper management of the disease via drug regimens and lifestyle changes.

“I’ve changed my diet from the day I was diagnosed, and I try my best to incorporate as many plant-based foods as I can and focus on eating in a way that reduces inflammation,” Williams says.

My MS Second Act enlisted Montel Williams as a spokesperson to help educate the MS community about the disease’s progression.

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“MY MS SECOND ACT IS A WAY FOR PEOPLE TO ANTICIPATE CHANGES THEY MAY HAVE TO DEAL WITH ONE DAY BECAUSE OF MULTIPLE SCLEROSIS.”

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IN ADDITION, THE FORMER MARINE

follows a consistent regimen of physical activity and stays current on the illness via news he finds online. “Information is king,” he says. “You can google MS and find hundreds, if not thousands, of documents [about the disease]. The most important thing that people with MS can do is arm themselves with knowledge.”

This is why Williams partnered with the Multiple Sclerosis Association of America and the pharmaceutical company Novartis to become a spokesperson for the My MS Second Act initiative. The educational program— hosted on the online storytelling platform The Moth—enables those with multiple sclerosis to share their stories with the MS community.

As an MS advocate for 20 years, Williams believes that even though many people living with MS may share core symptoms, those with less common signs of the illness may find it

ALL IMAGES: COURTESY OF MULTIPLE SCLEROSIS ASSOCIATION OF AMERICA

affects nearly 1 million people in the United States and 2.3 to 2.5 million people worldwide. The disease can strike people in all ethnic groups but is more common among Caucasians. MS also affects more women than men.

In people with MS, the immune system attacks and destroys the myelin sheath—a fatty material that covers and protects nerve fibers and helps transmit electrical signals throughout the brain and spinal cord. Without myelin, communication between the brain and other parts of the body breaks down, causing a lack of sensation and motor control.

The inflammatory condition can be difficult to diagnose. Someone could have MS and be unaware of it, as no currently available lab tests can confirm the disease. What’s more, symptoms of the illness can vary widely. In order to diagnose MS, doctors use MRI scanning and apply specific guidelines to symptoms that occur within a certain

challenging to explain their condition to family, friends and even care providers.

Because no two patients suffer exactly the same symptoms, sharing personal experiences is essential, Williams explains. “My MS Second Act teaches people how to develop their stories and own and share them with others, which may help people see something in another person’s experience that may be similar in themselves.” (Find the storytelling tool kit at mymsaa.org.)

THROUGH THE YEARS, WILLIAMS’S

advocacy work has helped sustain him, and he encourages others to advocate for themselves. “A lot of us sit back and wait for someone else to tell us what’s going to happen to us or what they think is going to happen to us,” he says.

“But we know there aren’t any crystal balls, so it’s important to be your own advocate and get as much knowledge as you can from different resources.”

My MS Second Act also encourages people living with MS to be more proactive in taking notice of signs of disease progression and to speak confidently with their doctors and loved ones about their symptoms as they advance. In this way, people with MS can take charge of the disease and find a path to healthy aging with MS. As time passes and those living with the illness grow older, the appearance of any new issue should be evaluated in order to differentiate whether it’s related to normal aging or is a new symptom of MS. “I’ve been dealing with this [his age-related MS symptoms] for close to four years as I’ve been getting older,” Williams says. “I happen to be fortunate that I’ve been on lots of programs and done research and looked at different things and I’ve been able to stay resilient.”

After being diagnosed with MS, everyone is affected differently. “People need to know these things and understand that only you alone can impact your illness; you must apply yourself and try your best to do the things that you find work for you,” Williams says.

“But you’ve got to stay on it.”

He reiterates how valuable it is for those with MS to keep searching for information that may lighten the burden of the disease. “There are programs

out there that can help those who can’t afford their medication,” he says.

Williams chooses to be an optimistic advocate. “I think everyone in this country knows what’s going on with our medical establishment, and it’s of no value to castigate and cast aspersions [at our health systems],” he observes.

“It’s of value to focus on the things that do work,” he says. “I think that as we move forward as a nation, we will try our best to be more inclusive and make sure that there’s access for everyone.”

In the meantime, Williams constantly strives to adapt to, as well as overcome, any adversity his illness triggers. “As long as I can do that, I see hope in every day,” he says.

A trace of defiance is always tangible

in Williams’s voice when he speaks about MS. Early in his journey juggling the ups and downs of this progressive illness, a doctor told him he’d probably be in a wheelchair within five years.

Since then, Williams has employed a variety of strategies that have helped him outpace that prediction.

“LONG BEFORE I BECAME AN ADVOCATE,

I learned that I alone own the definition of who I am,” he says. The statement is a mantra that’s helped him defy the diagnosis he received decades ago.

Now, 63, Williams is still standing and walking tall—except on those days when he takes a seat to talk to others with MS about effective ways to tell their own stories. ■

More About Multiple Sclerosis Generally, people most commonly experience one of three types of MS. MS is difficult to diagnose. What’s more, it’s impossible to predict who will experience the most severe stage of the disease. And because the illness does not present the same way in everyone, treatment varies. However, most experts advise those affected to get their symptoms checked out by a doctor as soon as possible in order to help protect the health of the nervous system and the brain. The three most common types of MS are: Relapsing-Remitting MS (RMMS) is the most common form of multiple sclerosis; 85% of patients are at this stage when first diagnosed. This type of MS is characterized by periods of recovery or remission and phases that involve new symptoms of the illness or a worsening of existing symptoms.

Secondary-Progressive MS (SPMS) is a stage of slow, steady progression of MS that follows the previous course of the illness. This is when symptoms may worsen as time passes. SPMS can be active or nonactive, with or without progression. If there is no recurrence of symptoms or new symptoms don’t arise during this stage, the illness doesn’t progress. But when symptoms do recur or new ones present themselves, the disease can get progressively worse.

Primary-Progressive MS (PPMS) is a pattern of illness marked by symptoms that steadily worsen from the illness’s onset, with no periods of relapse, remission or relief of symptoms. This type of MS affects about 15% of people living with the disease.

Experts advise that treatment, along with lifestyle changes, can shift the course of the disease for many people. The key, they stress, is to be proactive in getting the best care for yourself at any stage of MS. —JLP

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THOUGHTS

A Solo Act Who says people must be coupled up to be happy?

For many people, living singly offers a chance to soar to new heights.

AT THE AMERICAN PSYCHOLOGICAL ASSOCIATION’S 124TH ANNUAL Convention, Bella DePaulo, PhD, a scientist at the University of California, Santa Barbara, who has spent decades studying single life, challenged the science behind the cherished notion that marriage makes people happier, healthier and less isolated.

“The preoccupation with the perils of loneliness can obscure the profound benefits of solitude,” says DePaulo. “It is time for a more accurate portrayal of single people and single life—one that recognizes the real strengths and resilience of people who are single and what makes their lives so meaningful.”

According to the U.S. Census, there were 110.6 million unmarried people older than 18 in America in 2016, representing 45.2% of this population. In contrast, in 2014, the Bureau of Labor Statistics reported that 50.2% of the U.S. population identified as single. Findings suggest that a number of socioeconomic factors may be driving down these numbers. However, one reason is rarely acknowledged, DePaulo proposes.

“Increasing numbers of people are single because they want to be,” she says. “Living single allows them to live their best, most authentic and most meaningful life.”

—Kate Ferguson

The Expert Says In the course of her research, social psychologist Bella DePaulo, PhD, has debunked a number of myths about single people. Here are a few: 2 4 RE A L H EALT H S P R ING 2020

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Single folks are sad and lonely.

This is just not so in many cases. Individuals who choose to remain single happily look forward to their solitude and rarely worry about feeling lonely when they’re alone, DePaulo says.

Singles really want to be coupled.

Many men and women consciously choose to be single and relish a lifestyle that allows them the free-

dom to experience more personal growth through self-improvement, DePaulo says.

Single people are selfish.

Research shows that marriage tends to make individuals more focused on their partners, while singles are more connected to family members, friends, neighbors and colleagues.

In addition, many volunteer to do work in their communities.

—KF

ISTOCK

Party of One

Recently, I chanced upon the book Happy Singlehood: The Rising Acceptance and Celebration of Solo Living, by sociologist Elyakim Kislev, PhD, and it helped me to rethink my life.

I grew up being told that finding a mate, getting married and having children was absolutely necessary for a woman to be satisfied with life.

When relationships would come to an end, fear would prompt me to once again immediately begin another search for “the one.”

But as years passed, I grew tired of this quest. There had to be more to life than the constant pursuit of a relationship.

Kislev’s book inspired me to think about singlehood in clearer, more positive ways.

What I’ve learned is that life being single suits me just fine.

—As told to Kate Ferguson

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