04/22/2002 - Updated 09:18 AM ET
By Mike Falcon, Spotlight Health,
With medical adviser Stephen A. Shoop, M.D.
Montel Williams isn't taking his multiple sclerosis (MS) lying down. The 45 year-old talk show host battles the disease's potentially debilitating effects like he was training for a title fight.
"The only thing that has helped me stay alive is working out every day," says Williams, who has lifted weights, run, biked, and practiced martial arts throughout his adult life.
Add his scrupulous diet, positive mental attitude, deep faith, and well-monitored sleep habits, and Williams has created a model to fight fatigue and create energy for those without MS as well.
His new book BodyChange details the 21-day program combining aerobics, weight-training, and exercises he uses to develop functional strength, flexibility, and endurance.
Williams emphasizes his practices are not a metaphor or merely psychological.
"I am absolutely convinced that my physical shape has helped prevent MS from ravaging my body the way it could have," says Williams, who was diagnosed with MS in 1999 although symptoms had been present earlier.
He also credits a drug used to fight MS called glatiramer acetate (Copaxone) with keeping him ready for the rigors of the gym. "Unequivocally, Copaxone has been what has kept me running, along with some other things that I do. This drug has kept me going to the gym every day."
According to the National Multiple Sclerosis Society (NMSS) about a third of a million in the USA live with the debilitating disease that attacks the myelin sheaths that surround and protect nerve cells, the pathways that conduct nerve impulses.
The deterioration of these pathways can cause a wide range of impairments in sensory, motor, and cognitive function areas. Although the severity and progression of the disease vary widely, fatigue affects over 85% of patients. Many can't walk. Others have balance and coordination problems, pain, and lack or sensation or numbness in their limbs. Still others have vision loss, usually in one eye.
"All of which makes exercise for those who have MS a challenge in many cases," says Andrea White, a widely referenced PhD researcher and exercise physiologist at the University of Utah.
But it's a challenge that often holds enormous rewards.
The benefits of exercise for those with MS echo those without the disease. "People with MS have many of the same health concerns you or I do," says White. "And exercise can help."
The benefits include:
• Cardiovascular conditioning — Regular exercise that raises the heart rate consistently can increase lung capacity and decrease blood pressure.
• Lower body weight — MS patients with limited mobility are at increased risk of becoming overweight and developing associated health risk factors such as hypertension and diabetes.
• Increased mobility — MS can limit mobility through spasticity, weakness, and alterations in gait. Some MS patients rely on wheelchairs. Strengthening muscles involved in standing and walking can help develop compensatory movement — an affected muscle's workload may be taken over by well-trained adjacent muscle groups that compensate for the limitation.
• Less fatigue — White notes that the decreased efficiency "caused by spasticity, ataxia, or weakness raise the cost of walking." It simply takes more work to get the body to move. That translates into more fatigue — unless the person with MS trains to overcome the demands of increased muscular workloads.
• Psychological well-being — "The psychological benefits can be liberating and enormous," says White. For someone who has been confined to a single dwelling, walking to the convenience store can mark a significant victory.
Montel's goals are a little higher than that, however. "I'm a physical, active person and I thrive on that activity," emphasizes Williams.
Watching Williams snowboard — as he did 92 times last year — only confirms that. And brings up a hotly debated topic: Can lifestyle changes like exercise and diet deter, delay, derail, or reverse MS or its symptoms?
The traditional answer is a qualified no. "There's no research that scientifically demonstrates that," says Dr. Nicholas LaRocca, director of health care delivery and policy research for the NMSS. "But we're still learning about the disease and evidence can change. For example, in the distant past people with MS were discouraged from exercising."
"When we talk about lack of evidence, I sometimes think we need to add the word 'yet,'" says White. "It's not that it can't happen — it's that there are a number of mechanisms that haven't been investigated yet."
Williams believes his personal evidence is highly compelling.
"Snowboarding has been a Godsend for me," says Williams. "I think it may help the brain's ability to process where the body is in space. My brain has difficulty processing where my feet are. Before I took up snowboarding the left foot would not come as high as my right foot and that would result in my tripping. But the snowboard absolutely demands that you to be constantly in touch with your feet, and to ride by involving the legs, ankles, calves, hips, and feet."
While the snowboarding information has not yet been subjected to scientific testing, numerous stroke and cerebral palsy patients have improved motor skills through neuromuscular reeducation systems that use similarly unusual movement patterns.
Williams' energy lift while fighting a disease that leaves most patients chronically fatigued has other components as well. His diet is classic low-fat cooking, and he eats many small meals a day, rather than three big ones. "It keeps the energy and fuel expenditures fairly constant without big jolts or letdowns."
Williams has also found that time out for meditation, reflection, and prayers also help. "No matter how active and energetic you are, I think it's always a good idea to spend some time doing some practice most of us would call spiritual," he says.
Not all MS patients can exercise like others. Patients with advanced neurological deterioration need special programs. Often stationary bikes that exercise the arms and trunk are helpful. Since elevated body heat can further harm central nervous system function in MS patients, exercising in a cool environment — or simply swimming in a pool — is recommended.
"I still suffer from odd symptoms," says Williams. "I can get extreme neuralgia pain in my feet and lower extremities. It can be excruciating and go on 24 hours a day, for months."
White points out that the extremely wide range of symptoms and severity in MS usually results in longer rest periods before exercise is resumed. And that exercise is supposed to be modest.
But what is modest for Montel "or any highly trained athlete may be beyond the reach of most people," says White.
Williams has made adjustments in his exercise program. Instead of pushing enormously heavy weights for 6-8 repetitions that promote extreme mass building, he's settled on higher repetitions per set that are a compromise between strength-building and muscular endurance.
Still, his personal weightlifting program is aggressive for even the most experienced lifter. "I have MS," says Williams. "But I'm working to keep as active and healthy as possible through diligent training, diet, and recreation."
And while these components are critical for Williams, he also stresses the importance of accessing appropriate medical treatments for MS.
"Not every single drug works for every person with MS," says Williams. "I take Copaxone. This doesn't mean you need to take the same drug I do. You need to talk to your doctor first. But I was a good candidate for this drug and it works for me, so I have to say thank you to Copaxone.
And Williams' strategy seems to be working — just take a look at him.
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