S6E25 Top sleep tips for people with MS with sleep therapist Denise Iordache

Denise Iordache  00:00

We don’t have that capacity to basically collect sleep in a bank and use it when we need it. We need to be consistent. And I’ll give you this tip, if you don’t know how many hours you need to sleep properly, ask yourself, how many hours on the weekend do I sleep, or when I go on holiday, you are more likely to be in a more relaxed, you know, state of mind and body. When you’re on holiday, how many hours do you sleep?

 

Overcoming MS  00:30

Welcome to Living well with MS. This show comes to you from Overcoming MS, the world’s leading multiple sclerosis, healthy lifestyle charity which helps people live a full and healthy life through the Overcoming MS program, we interview a range of experts and people with multiple sclerosis. Please remember all opinions expressed are their own. Help others discover Living well with MS. If you enjoy the show, please rate and review us wherever you listen to podcasts, and now let’s meet our guest.

 

Geoff Allix  01:05

Joining me on this edition is sleep therapist Denise Iordache. And Denise will provide her expertise on the importance of addressing both sleep and stress to maintain a healthy and balanced life. And I think it’s particularly important because the overcoming MS program, there’s seven pillars the overcoming MS program all dealing with while we’re awake, but 1/3 of the time we’re not awake, and that is obviously going to have a profound effect on our health. So to start off with, Denise, could you introduce yourself your work and your interest in multiple sclerosis?

 

Denise Iordache  01:42

Sure. Hi everyone, first of all, and second of all, thank you for having me today. So in a nutshell, I am a cognitive behavioral hypnotherapist, and I specialize in sleep and stress related concerns, ie getting people to sleep better and also manage better their stress or worry anxiety as well. They all kind of fall under the big umbrella of stress, from my point of view, and I help people do exactly that, sleep better, worry less, so that they have enough energy to go about their days and prosper in the fields of their personal life as well as in their work life. I am particularly interested in MS because I have had a few of my close friends diagnosed in recent years with MS. And to be honest, I had no idea that it could be affecting you so early on in life. And also recently, one of my relatives was diagnosed with MS. So although I haven’t come into my area of specialty through the lens of MS, I’m realizing more and more how sleep and stress related concerns are affecting MS, but also they become a symptom of it.

 

Geoff Allix  02:55

So what happens in the brain when we sleep? I mean, I think a lot of us don’t really understand what sleep is, as much as I think. So what actually happens in our brains when we sleep, and why is sleep important to our health?

 

Denise Iordache  03:12

For a myriad of reasons, and when I say a myriad, they literally are very many reasons. I would start by saying just as much as we can’t function without food or water, we can’t function without sleep for a long period of time. Yes, there are periods when you can go on with your life with few hours of sleep. However, you cannot do that for extended periods. Right? You need sleep. And why we need to sleep is, let me try to dial it back a little bit and maybe take it one by one in the brain, while we sleep, our brain is not sleeping. What it does, it basically regenerates part of the brain so that it can continue to function normally during the day. And if you think about which parts of the brain, I would say memories, learning and consolidating experiences that you’ve had during the day, so they get cemented, if you would like, while you sleep. Also it improves our learning capabilities. So if you are having a good night’s sleep, you are more likely to learn quickly the next day. Doesn’t matter what you’re learning. It could be sewing or you can be driving. It just helps you do it a little bit quicker, and it helps retain information, and it also helps you manage a day to day life. Because you don’t have what they call the brain fog. You don’t feel like, Oh, I can’t focus on these activities. It basically helps regenerate those particular parts of the brain that we need to function on a day to day basis. Now, the cognitive function’s one side, and that is what you’ve asked me, in terms of the brain, but I wouldn’t be doing my job if I wouldn’t mention that while we sleep, our bodies get regenerated as well. Our cells, not just within the brain, but throughout so for example, if you’re thinking about muscles almost entirely, they get regenerated during sleep time. And if you think about how important the muscle capabilities are with MS, I would say the more sleep you can get in order to be able to have these processes happening at night, I think better it gets for the capabilities of movement and last, but not least, emotionally so having a good night’s sleep helps emotional regulation. It helps decrease the impact of anxiety and depression. These two are very much interlinked with sleep and other mood disorders, of course, but if you think about having a good night’s sleep, you are more likely to entertain good, solid connections the next day with other humans. You wouldn’t be as irritable, as snappy as you know, sometimes saying the wrong things, just because you really don’t have the capability of doing it otherwise.

 

Geoff Allix  06:06

How much sleep does, I think you hear different things about how much sleep a person needs, and some people deal on incredibly low amounts of sleep, but how what’s typical, and is that different if someone has MS?

 

Denise Iordache  06:21

So I have researched this thoroughly because I was thinking maybe there is a difference and there isn’t. I would say, before I give you an answer to that, I would like to emphasize the fact that we are all individuals there. We are all unique in our ways. Some people would function very well on five, six hours of sleep. Others will need nine to 10, whichever end you are, or maybe down in the middle, at eight. It doesn’t matter. It doesn’t say so much. It basically means that your body to process everything it needs to process. It needs X amount of hours. Now there is a guideline from the NHS, the guideline is for adults between seven and nine hours of sleep. That is, again, a guideline. I have met people who function incredibly well on six hours, and I have met people who say, without my nine hours, I am not really coping very well. So I would ask the question to the listeners to actually understand how many hours do they need to wake up feeling rested. That is the key here.

 

Geoff Allix  07:28

Should that be consistent throughout the week, or could you sort of think, Oh, well, it’s the weekend, I’ll sleep two hours, but in the week, I’ll only sleep six.

 

Denise Iordache  07:36

Great, great question, no, in the sense of we do not have a magical bank where sleep goes and we put it there so we take it when we need it. If we haven’t slept, we haven’t slept. Yes, fatigue can be accumulated. Then you will feel like I’m more likely to sleep 10 hours the weekend, but that is because you’ve worked your body so hard that it needs more time. It doesn’t mean that I can do it 10 at the weekend, but only five or six during the week. We don’t have that capacity to basically collect sleep in a bank and use it when we need it. We need to be consistent. And I’ll give you this tip if you don’t know how many hours you need to sleep properly, ask yourself, how many hours on the weekend do I sleep? Or when I go on holiday, you are more likely to be in a more relaxed, you know, state of mind and body. When you are on holiday, how many hours do you sleep then? And if you say, Oh, I sleep nine, well why do you think it’s good to do it five during the week when you’re at work?

 

Geoff Allix  08:46

That’s good point, actually, as well holiday, because you’re actually doing something interesting. It’s something you want to do. You’re on holiday, so you’re not whereas, actually, sometimes you will lay in bed in the weekend thinking, Well, I have nothing to do. I’m and you it’s almost like because you haven’t got anything to do, but because I’m not setting an alarm if I’m on holiday, but I do want to get up and go to the beach or go do whatever I’m going to do. So actually, you kind of have a natural, you just wake up, but when you wake up and you’re fully awake, then you get up.

 

Denise Iordache  09:17

Yeah, we have to remember that sleep is not some elusive luxury thing that only happens to some and not to others. We are born by knowing to sleep. Look at the babies. It’s something that we inside our bodies, we know how long is enough, how much good quality sleep is enough for me or for you in order to function. So instead of thinking about what the guru, or, you know, somebody tells you, have a look at what is in good enough for you. And the holiday tip is where I would start.

 

Geoff Allix  09:51

Circadian rhythms. So there’s sort of that natural rhythm of 24 hours, and how that affects with with natural daylight. Right? Do we need natural light to keep? What is circadian rhythm to start with?

 

Denise Iordache  10:05

Yes. So the circadian rhythm is basically a 24 hour cycle that happens to us humans. That’s how we function. We function on the 24 hour cycle, and this include our physical, metabolical, mental, behavioral experiences and changes that need to happen within 24 hours. In simple terms, the circadian rhythm as we know it would be the internal body clock. So what we’d say by that is the internal body clock knows that when it’s light outside, the body will decrease the amount of melatonin, sleep hormone that we create, and we will increase cortisol, because we want the human to be alive. So that is happening in the morning, in the evening, when the sun sets. We our 24 hours are around the clock, the sun clock, if you’d like, when it comes to evening time, the body will create more melatonin, right, and less cortisol, because cortisol is also like the, you know, awake hormone, if you would like, you need energy and adrenaline and so on to be operating during the day. So that happens every 24 hours. Now, light for us, for millennia, has been the trigger like, okay, the sun is out. The light has come to our faces, okay, this is the moment we will start getting awake and have activity. The sun sets. Light is being diminished, okay, more melatonin floating through our bodies, more sleep. And why the light plays a central role is a because of the evolution how we’ve been evolving as humans, but also it has a signal of alertness. This is why, maybe we will come to it a little bit later. This is why, when you go to bed, you don’t want to have bright light, because that might give the wrong signals to to your mind. So that’s why light in the morning, even if it’s not outside, even if it’s cloudy, it will still have the same effect. Some people you will hear would say, stay for about 10 to 20, minutes by window in the morning when you wake up, because that helps regulate this 24 hour cycle. And if you don’t have real light, if we don’t have real light, there are different lamps to help, especially in the winter time. So those could be something to look into.

 

Geoff Allix  12:46

And so are we causing a problem by having artificial light far into the evening?

 

Denise Iordache  12:52

Look, the research is still out there in this particular field. There are still many studies going on at the minute trying to understand how much it affects, whether it is affecting melatonin because it’s artificial light, the jury is still out. However, if you think about shift workers, one of the reasons why they feel alert at night, let’s say somebody working in a hospital or in a very bright environment that artificial light keeps them awake, they are less likely to fall asleep versus if they are a shift worker and they need to work in a mine. So I cannot say for a fact that it does affect the sleep hormone, because, as I said, this research is still out, but I would say having the lights fully on at 10 o’clock at night with the hope that you’ll fall asleep in 10 minutes. Maybe we need to reconsider.

 

Geoff Allix  13:51

You can, from what you’re saying, you can sort of cheat the system a little bit, so you could get so we have lights, which we use in breakfast time in the in the winter, apparently, they sort of give out the same length as sunlight exactly

 

Denise Iordache  14:08

They emulate, yes, they emulate that.

 

Geoff Allix  14:11

In the summer, we’ve got blackout blinds that we use so that we don’t get woken up really early, so that’s okay, is it? We’re not doing anything wrong by that.

 

Denise Iordache  14:24

We’re not doing anything wrong by that. Because I will tell you, we’ve evolved in many different ways, but from what we know today, our brains haven’t really evolved compared to when we were in the cave. And if you think about it, back then, the situation was much simpler. You would be out when the sun is out, even if there was no actual sun but daylight, and you would go to sleep when it was night. And if you can use blackout blinds in order to emulate that, I would say, go for it, rather than trying to wait for the sun to set.

 

Geoff Allix  15:02

And we talk a lot about sleep well, you hear a lot about sleep hygiene. So what’s the what’s the best bedroom setup? It particularly maybe with someone with MS, but if you have struggle, struggles getting to sleep?

 

Denise Iordache  15:18

Well, let’s split them into routine and set up, because then it might become quite a big of a answer. But before I talk about the bedroom setup, I would like everyone to take inventory of their thoughts around sleep, because you might have the most amazing setup in the world, and you might think that sleep is treacherous and diabolical, and then even though you are in a queen’s bed, literally, you might still have trouble falling asleep. So let’s remember that in the back of our heads, in terms of bedroom environment, I would start by looking at the bed itself. So the mattress is that the right firmness, the right posture, as in supporting the posture of the person sleeping. Are the pillows, the right ones, also the bed linens and the sheets. Do they make noise? Because if you’re very sensitive to noise, for example, it might be that the movement itself wakes you up, and then also remind reminding ourselves that the bed itself should be the place for sleep or personal relations. It’s not the place where we eat and watch TV and work and grade papers. That’s not the place taking the bed to one side and everything that is around it, including the bedside tables. A fun fact, I had somebody who was always waking up themselves because they had a glass of water and their bedside table was made out of glass. So imagine glass on glass in a very quiet environment. They were waking themselves up they didn’t realize so things like that also take, take into account and then ease of movement around the bed. Is it? Is it easy for you to move away to go to the bathroom? Maybe it’s best to have dim lights on the landing and things so that you don’t have to turn on all of the lights in the house if you have to go to the bathroom, what is the temperature? Is it too cold? Too hot? Is it the right temperature? We talked about the darkness and blackout blinds. Some people love to sleep in total darkness. Others would like light again, adjust the I think sometimes we just need to give ourselves permission to take inventory and say, Hey, this place where I’m taking almost a quarter of my, no, a third of my life I’m spending, is it the right place for me? Do I actually like it? Or maybe I need to get earphones because I’m next to an airport and I always, you know, wakes me up, those kinds of things sometimes feel like aha moments. So yeah, please take inventory of what you can change.

 

Geoff Allix  18:00

Should you have a routine going up to the time you go to sleep?

 

Denise Iordache  18:04

Sleep loves routine. The more routine you can provide sleep, the easier it will get to fall asleep. And a second ago, you were asking me about whether you should change the amount of hours based on whether you’re at home or weekend or working again, stick to a schedule if you say you want to wake up at seven, go to bed at 10, do that throughout, and make only exceptions when you’re not falling asleep and waking up at the same Time, because that specific routine, a sleep wake cycle helps our body and our mind to be very conscious of, oh, this is now the time to relax. So I’m just going to get into my relaxation mode. If you would like routine means many, many, many things I would just give the top lines, watch your diet and drink before bedtime. That sometimes really disrupts our sleep, and when I say drinks, I’m referring to particularly caffeine, alcohol, food would be either salty, spicy, chocolate, sometimes it has caffeine. So have a look way before bedtime, what are you eating and drinking? And then aim for about 45 minutes to one hour of doing something pleasant, relaxing, soothing for yourself. So basically, you’re saying to yourself, Okay, I’ve done with a day, and in the next half an hour, I’m going to do take a bath. I’m going to take a shower. I’m going to apply my moisturizer, listen to a podcast that is soothing and relaxing for me, or a hypnosis state or a meditation that literally, the list is endless. The goal here is to do something that you find relaxing and soothing for those minutes, even reading a book is working wonders for some people. But avoid the screens with a bright light, with a blue light, avoid them, limit them to before bedtime with about one hour, two hours before you want to go to bed, and if you can’t sleep at any point during the night, do the same thing you did that helped you fall asleep. So if you’re saying, I listened to a meditation for 10 minutes and that helped me a lot, oh, I woke up at three. What should I do? Please go back to the meditation. If it helped you once, it might help you right back. It’s the same routine, routine, routine, routine.

 

Geoff Allix  20:46

Specifically, people with MS often wake up multiple times in the night. They might need to pee more frequently. They might have spasticity, restless legs, nerve pain. There’s numerous reasons. But is there anything that people with MS can do to prevent waking in their nights, and would the same advice apply to falling back to sleep when they do wake up?

 

Denise Iordache  21:14

I think, from what I understand today, I think first of all, they would need to speak and have an evaluation by MS, knowledgeable urologist, if they are having trouble with urination at night, they have very different reasons why bladder problems can be present. And I think before I say, oh, drink less water, speak, speak to a specialist in that field, just to make sure that they help you as best they are the specialists there right. Once you do that, I would likely say, limit the liquids before bedtime. That doesn’t mean don’t drink during the day. God forbid. Please have water. You have to be hydrated. But if you know you are more likely to wake up in the middle of the night and you fall asleep at 10, maybe your last glass of water is around 830 so that it then allows you to go once more to the bathroom before you fall asleep. But again, this is with a huge caveat of, there are different bladder problems, and they should be assessed by a medical specialist in to make sure. Also, I would say, watch out for salty or spicy foods before bedtime. We know even people without the struggles with the bladder or MS, they are more likely to wake up or have disrupted sleep because of the food they’ve consumed. So ensure that you’re not having a bag of crisps right before bedtime. That might make you more thirsty, hence wake you up, and then in a couple of hours, you might need to go to the bathroom. So have a little bit of self awareness in terms of those kinds of things and exercise. I know this may be difficult for some people any form of exercise, even if it’s about stretching. Obviously, swimming and walking are really good for us, but try to incorporate exercise during the day, so that you’re more likely to get to that point in the evening where you can easily fall asleep. And they’ve made a lot of headwind in the sense of research with exercise and sleep and how it helps, and people who tend to exercise regularly, they have more good quality sleep for longer periods of time at night. Hence, any form of exercise is better than no exercise. And lastly, what I said earlier, if meditation helped you fall asleep and you woke up in the night, try meditation again. Try something soothing, relaxing that can help you. However, if you’ve been in that bedroom for more than 20-30, minutes and you are still wide awake, please get out if you can move away, either to another place in the house to try to fall asleep, or take a soothing, relaxing, for example, some chamomile tea or stretching or relaxation. We have something that we use a lot in CBT, which is progressive muscle relaxation. It’s about relaxing the muscles in turn, one by one, and that could be very helpful to do, but I think most of the people are waking up, they cannot fall asleep and just sit there and wait, or they’re trying to convince themselves to fall asleep. Unfortunately, we have no button for pushing and sleep immediately. So if you’ve tried it with all your efforts for 20-30 minutes, it’s time to again, get away from it, if you can, if you have the possibility, and see whether you can get better sleep in a different room.

 

Geoff Allix  25:15

And I think you’ve mentioned mindfulness. So there’s a couple of things you’ve mentioned, actually, which are core pillars of overcoming MS. So for example, that exercise is something that we are encouraged to do, and it’s going to be different for different people. Of course, physical abilities, but it’s still exercise and but another one is mindfulness. So you just mentioned that is that, is that something that you would put in before bedtime. I mean, I have to say this, people who talk about mindfulness with Overcoming MS, they do say it’s actually important for your mental state to do it when you’re not going to sleep as well. So there’s they say actually mindfulness to get to sleep is a good thing, but you should also do it other times, because that’s a different thing, if you like. But is it a useful technique, though, to get to sleep and if you’ve got a racing mind.

 

Denise Iordache  26:09

I will, tell you why that advice is like that is because Mindfulness means being present in the here and now, right this instant, right this second, and confirm to yourself that you are safe and secure. So if you think about it during the day, when your mind worries about something right, or you get anxious about doesn’t have to be sleep related, if you practice mindfulness during those times, what you are saying to yourself is, there might be a problem in the future. May or may not, we don’t know, but in this moment, right here, right now, this second, I’m safe and secure. So the more you can bring yourself to practice this, the easier it is with anxiety and worry and so on, because the without trying to derail the conversation, the definition of anxiety is something bad is going to happen, and I won’t be able to cope with it. But the emphasis is something bad is in the future. It hasn’t happened. I have no certainty of it happening, but I’m gonna stay here and worry now for something in three weeks. So if you bring your attention to the actual physical moment here and now to the present that already goes out the window because we don’t know what the future is going to hold. And mindfulness can be done very, very simply. It’s about breathing, for example, it’s the entry level, if you’d like, for somebody who wants to start to pick it up, deep breathing exercises. What do I mean by that? Taking the air in through your nose, and you’re imagining your breathing into your belly, into your abdomen. It gets a little bit inflated, and then you release it gently through your mouth. One of the best that I know of is something called the box breathing, meaning you inhale for four seconds, exhale for four, inhale for four seconds, exhale for four. And for those of you watching me, I’ve drew a box in the air with my finger, and that is how you train your mind to say, Okay, in this moment, I want to be present, so I’m going to take these deep breaths, and I’m going to focus on right here, right now. There are many practices with mindfulness. And yes, you are absolutely right. It’s helpful to do it during the day. The more present in the present you can be, the least likely you’re going to be worrying about something that may or may not happen. We are as humans, artists of this, we can worry about everything, and we don’t always have a logical reason. Sometimes the worry is purely in our imagination. But guess what? The reaction it has in our body is exactly the same as if we were being chased by a saber tooth tiger. So if you can take a few deep breaths to recenter yourself, and again, I want to say there are many, many techniques, maybe we should put them in the like a little list, in the show notes, because there’s quite a few people can use.

 

Geoff Allix  29:17

Absolutely so, yeah, I always say this, do check out in the show notes, because we’ll have links to your resources. So as a final question, we hear a lot about journaling, particularly with people with MS, but more to do with stress relief than anything else, not specifically sleep, but is journaling useful to help with sleep? And what would you what would you journal What would you list? Or would it? Would it help?

 

Denise Iordache  29:43

100% that is a quote, unquote, homework that I give everyone that I work with in my practice. So first of all, we as humans, we tend to be very subjective, and gathering data in our journal would actually help us become more objective and this is especially true when it comes to, for example, a thought diary or a sleep diary. A thought diary would be exactly what it says on the tin. Keeping track of your thoughts doesn’t matter if they’re negative or positive, and how they make you feel or how they make you act, right? And it’s just keeping the inventory. Sleep diary is doing exactly the same thing. Now here you can say you can capture 1,000,001 things, it’s however long a piece of string is what I find useful, and what I give to my all my clients, is four different columns, if you would like, on a piece of paper or in your phone, you have four columns. First one is, how many hours did you sleep? So this is basically filled up in the morning and you say, Okay, six hours. Let’s say, How do you feel this morning? Maybe you’re great, maybe you’re rubbish. Who knows? Doesn’t matter. One word, what did you do to go to sleep? Oh, I listened to that podcast. I really liked it. It helped me fall asleep. And last column is any sensations of thoughts or thoughts that you have right now. So it’s basically gathering data, and you do it for at least two weeks. Some people would say to do it for longer. I normally want it to be done at least for two weeks, because that will give a lot of patterns. And you would see every time I sleep for five hours, I feel rubbish. Every time I sleep for seven hours, I feel on top of the world. So we are looking for data gathering now, what I also say is you cannot change or improve something you’re not fully 100% aware of I’m not saying that people who struggle with insomnia don’t know they have insomnia. What I’m saying is, if you do not understand the whole picture of what is actually happening, how many hours, how do you feel, and so on, it’s very easy to assume. Now, roughly x amount of hours, I roughly did this, but when you see it captured in black and white, you will be like, Oh, okay, really, this is what I do every time, and you become your own detective. Nobody will know you better than yourself, and that’s why I always encourage people to keep a diary, to ensure that they are as objective as they can be, and maybe even uncover things they have never thought about. Hopefully, that answers.

 

Geoff Allix  32:27

Yes, and I just want to say, is there anything else that we haven’t covered that could help?

 

Denise Iordache  32:34

I realized that your previous question was asking me also about what to do when your mind is racing, and I mentioned a lot about mindfulness, and of course, it helps. But another trick that I wanted to share with people is not a trick, it’s a tip. Is about taking time during the day and you assign it to worry. Let’s call it the worry time for 10 minutes you go to that particular part of your house, maybe it’s a chair, maybe it’s a sofa, and you just worry. You worry the hell out of it, about anything and everything. Maybe you worry about your diagnosis, maybe you worry about the state of the world, maybe you worry about a job. It doesn’t matter what you’re worrying about, but write it down and that is your dedicated worry time, when later in the night, or when you’re trying to fall asleep, those worry come back again. You will say to yourself, Okay, I’ve already assigned these. Yesterday at three. We’ve talked about this. Me, myself and I. It’s okay. It’s taken care of. It’s not I’m not forgetting about it. Or equally, you can write it down and say, Okay, tomorrow, when I do my worry time, I will assign time for this. And you basically take it out of your mind so it doesn’t spin into a washing machine of things. And you say, Tomorrow, I have time dedicated for it, and I’m going to think about it. I’m not trying to trick my mind into not thinking about it. I’m telling it has a specific, dedicated time. It’s a brain dump, if you would like. I call it the worry time, and it helps relieve this washing machine of thoughts that I call and the other thing that I would really like to remind everyone listening, and I think it’s a very important subject for many of the people struggling with MS, and also population at large, is that during the time of sleep, our weight also gets regulated, if you like. There is a deep connection between sleep and weight. So if you have a weight concern, ensuring that you get enough quality sleep would actually balance the hormones and will lead to a better, stable appetite. Or if you’re trying to lose weight, it would actually help you get to where you’re going and. A lot of people try to manage their weight healthily, but because of sleep deprivation, that doesn’t seem to happen when we don’t sleep enough, we crave high calorie foods. We crave the very hyper palatable foods that the food industry made for us. So it’s basically like stabbing ourselves in the foot. And I wanted to mention that so that we know that if that is a concern, or you want to maintain a good, healthy weight, sleep also plays a role there.

 

Geoff Allix  35:34

I think you would that’s almost counterintuitive. You think sleeping more would mean I’m doing less, and therefore put more weight on but no.

 

Denise Iordache  35:44

It actually that the sleep helps regulate the hormones that tell us whether we are hungry or not. So the ghrelin and leptin, they get regulated during during sleep, and there is a big link between them, and that’s why people who would be sleeping less or feeling sleep deprived, they are more likely to reach for the crisps, for the cookies, for the donuts because we need something to get you a little bit hyper, versus if you had a good enough rest, you wouldn’t be as likely to have those spikes in your in your appetite.

 

Geoff Allix  36:20

Okay, so thank you very much for joining us. And I think there’s, I think everyone will get some fantastic tips from that. In fact, whether you have MS or not, I think people will get fantastic tips from that. And just to reiterate, do check out the show notes, because, you know, obviously you have huge amounts more resources than what you shared for us in this time. Yes, yeah, thanks again for joining us.

 

Denise Iordache  36:43

Thank you so much for having me.

 

Overcoming MS  36:48

Thank you for listening to this episode of Living Well with MS. Please check out this episode’s show notes at overcoming ms.org/podcast you’ll find useful links and bonus information there. Don’t forget to subscribe to the podcast so you never miss an episode, and please rate and review the show to help others find us. This show is made possible by the Overcoming MS community. Our theme music is by Claire and Nev Dean. Our host is Geoff Allix. Our videos are edited by Lorna Greenwood and I’m the producer Regina Beach. Have questions or ideas to share? Email us at podcast at overcoming ms.org, we’d love to hear from you. The Living Well with MS Podcast is for private, non commercial use and exists to educate and inspire our community of listeners. We do not offer medical advice. For medical advice, please contact your doctor or other licensed healthcare professional.