MS Impacts US All

It's national MS Awareness Month.

Many people have heard of MS but may not no what MS is. The truth is most people no someone who has MS right now. Maybe it's a co-worker, a neighbor, your child, a spouse, or even yourself. MS affects all of us. Please watch the video to see how MS impacts us all.

http://www.youtube.com/watch?v=fIQTCCaz7lM&sns=em

FAQs about MS

Frequently Asked Questions about Multiple Sclerosis

What is multiple sclerosis?
Who gets MS?
How many people have MS?
What are the typical symptoms of MS?
What causes the symptoms?
Is MS fatal?
Does MS always cause paralysis?
Is MS contagious or inherited?
Can MS be cured?
What medications and treatments are available?
Why is MS so difficult to diagnose?

What is multiple sclerosis?

Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (the brain, optic nerves, and spinal cord). It is thought to be an autoimmune disorder. This means the immune system incorrectly attacks the person's healthy tissue.

MS can cause blurred vision, loss of balance, poor coordination, slurred speech, tremors, numbness, extreme fatigue, problems with memory and concentration, paralysis, and blindness and more. These problems may be permanent or may come and go.

Most people are diagnosed between the ages of 20 and 50, although individuals as young as 2 and as old as 75 have developed it. MS is not considered a fatal disease as the vast majority of people with it live a normal life-span. But they may struggle to live as productively as they desire, often facing increasing limitations.

Who gets MS?

Anyone may develop MS but there are some patterns. More than twice as many women as men have MS. Studies suggest that genetic factors make certain individuals more susceptible than others, but there is no evidence that MS is directly inherited. MS occurs in most ethnic groups, including African-Americans, Asians and Hispanics/Latinos, but is more common in Caucasians of northern European ancestry.

How many people have MS?

Approximately 400,000 Americans have MS, and every week about 200 people are diagnosed. World-wide, MS affects about 2.5 million people. Because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, the numbers can only be estimated.

What are the typical symptoms of MS?

Symptoms of MS are unpredictable, vary from person to person, and from time to time in the same person. For example: One person may experience abnormal fatigue and episodes of numbness and tingling. Another could have loss of balance and muscle coordination making walking difficult. Still another could have slurred speech, tremors, stiffness, and bladder problems.

Sometimes major symptoms disappear completely, and the person regains lost functions. In severe MS, people have symptoms on a permanent basis including partial or complete paralysis, and difficulties with vision, cognition, speech, and elimination.

What causes the symptoms?

MS symptoms result when an immune-system attack affects myelin, the protective insulation surrounding nerve fibers of the central nervous system (the brain and spinal cord). Myelin is destroyed and replaced by scars of hardened "sclerotic" tissue. Some underlying nerve fibers are permanently severed. The damage appears in multiple places within the central nervous system.

Myelin is often compared to insulating material around an electrical wire; loss of myelin interferes with the transmission of nerve signals.

Is MS fatal?

In rare cases MS is so malignantly progressive it is terminal, but most people with MS have a normal or near-normal life expectancy. Severe MS can shorten life.

Does MS always cause paralysis?

No. Moreover, the majority of people with MS do not become severely disabled. Two-thirds of people who have MS remain able to walk, though many will need an aid, such as a cane or crutches, and some will use a scooter or wheelchair because of fatigue, weakness, balance problems, or to assist with conserving energy.

Is MS contagious or inherited?

No. MS is not contagious and is not directly inherited. Studies do indicate that genetic factors may make certain individuals susceptible to the disease.

Can MS be cured?

Not yet. There are now FDA-approved medications that have been shown to "modify" or slow down the underlying course of MS. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging.

What medications and treatments are available?

The National Multiple Sclerosis Society recommends that a person consider treatment with one of the FDA-approved "disease-modifying" drugs as soon as possible following a definite diagnosis of MS with active or relapsing disease. These drugs help to lessen the frequency and severity of MS attacks, reduce the accumulation of lesions (areas of damage) in the brain, and may slow the progression of disability.

In addition to drugs that address the basic disease, there are many therapies for MS symptoms such as spasticity, pain, bladder problems, fatigue, sexual dysfunction, weakness, and cognitive problems. People should consult a knowledgeable physician to develop a comprehensive approach to managing their MS.

Why is MS so difficult to diagnose?

In early MS, symptoms that might indicate any number of possible disorders come and go. Some people have symptoms that are very difficult for physicians to interpret, and these people must "wait and see." While no single laboratory test is yet available to prove or rule out MS, magnetic resonance imaging (MRI) is a great help in reaching a definitive diagnosis.


For more information please visit the National MS Society http://www.nationalmssociety.org

How is MS Treated?

Although there is still no cure for MS, effective strategies are available to modify the disease course, treat exacerbations (also called attacks, relapses, or flare-ups), manage symptoms, improve function and safety, and provide emotional support. In combination, these treatments enhance the quality of life for people living with MS.

Modifying the Disease Course

The following agents can reduce disease activity and disease progression for many individuals with relapsing forms of MS, including those with secondary progressive disease who continue to have relapses.

FDA-Approved Disease-Modifying Agents
Avonex (interferon beta-1a)
Betaseron (interferon beta-1b)
Copaxone (glatiramer acetate)
Extavia (interferon beta-1b)
Gilenya (fingolimod)
Novantrone (mitoxantrone)
Rebif (interferon beta-1a)
Tysabri (natalizumab)
Disease Management Consensus Statement (.pdf)
Recommendations and principles from the Society’s National Clinical Advisory Board for health care professionals and people with MS—to guide treatment with the disease-modifying drugs.

The MS Disease-Modifying Medications (.pdf)
A booklet describing the approved use, dosage and route of delivery, side effects, benefits, and available support programs.

Patient Assistance Programs
A listing of the pharmaceutical company financial assistance programs to help manage the costs of the drugs.

Treating Exacerbations

An exacerbation of MS is caused by inflammation in the central nervous system (CNS) that causes damage to the myelin and slows or blocks the transmission of nerve impulses. To be a true exacerbation, the attack must last at least 24 hours and be separated from a previous exacerbation by at least 30 days. However, most exacerbations last from a few days to several weeks or even months. Exacerbations can be mild or severe enough to interfere with a person’s ability to function at home and at work. Severe exacerbations are most commonly treated with high-dose corticosteroids to reduce the inflammation.

Managing Symptoms

Symptoms of MS are highly variable from person to person and from time to time in the same individual. While symptoms can range from mild to severe, most can be successfully managed with strategies that include medication, self-care techniques, rehabilitation (with a physical or occupation therapist, speech/language pathologist, cognitive remediation specialist, among others), and the use of assistive devices.

Promoting Function through Rehabilitation

Rehabilitation programs focus on function—they are designed to help you improve or maintain your ability to perform effectively and safely at home and at work. Rehabilitation professionals focus on overall fitness and energy management, while addressing problems with accessibility and mobility, speech and swallowing, and memory and other cognitive functions.

Rehabilitation is an important component of comprehensive, quality health care for people with MS, at all stages of the disease. Rehabilitation programs include:

Physical Therapy
Occupational Therapy
Therapy for Speech and Swallowing Problems
Cognitive Rehabilitation
Vocational Rehabilitation
The Role of Complementary and Alternative Medicine (CAM)

CAM includes everything from exercise and diet to food supplements, stress management strategies, and lifestyle changes. These therapies come from various disciplines and traditions—yoga, hypnosis, relaxation techniques, traditional herbal healing, Chinese medicine, macrobiotics, naturopathy, and many others. They are referred to as complementary when they are used in conjunction with conventional medical treatments and alternative when they are used instead of conventional treatments.

Treatment Updates


FDA Updates Tysabri Label to Include Lab Test that Helps Identify Person’s Risk of Developing PML
Jan 23, 2012
The U.S. FDA has approved a change to the prescription label for Tysabri to show that a lab test that detects antibodies to the JC virus can help determine a person’s risk of developing PML, a severe brain infection. PML has emerged in some people who have taken Tysabri. The lab test should enhance the ability to weigh risks and benefits of this therapy.
European Medicines Agency Commences Safety Review of Gilenya
Jan 20, 2012
The European Medicines Agency has started a review of the oral medication Gilenya (fingolimod, Novartis) after reports issued on January 20 that there have been 11 deaths among patients who received treatment. Our sympathies go out to the families of all of these individuals. As more information becomes available, we will release it as soon as possible to the MS community.
Study Shows Potential of Lab Test to Detect Virus Which Causes PML in People with MS – ongoing study may help identify risk for PML in people treated with natalizumab
Dec 22, 2011
Biogen Idec researchers have published results on a blood test that detects antibodies to the JC virus, the virus responsible for PML. This paper reports that in an ongoing study of over 1,000 people being treated or considering treatment with Tysabri, 56% had evidence of JC virus antibodies. The presence of antibodies indicates that a person has at some point been infected by or exposed to the virus. Ultimately the study may show whether detection of antibodies to JC virus can help guide treatment decisions.
Possible Safety Issue Being Investigated with Novartis Pill Gilenya
Dec 12, 2011
Our sympathies go out to the family of an individual who recently died within 24 hours of receiving a first dose of the oral medication Gilenya. Novartis has confirmed this event and has reported it to the FDA. Until more information is available about the circumstances of this individual’s death, it is impossible to know what role Gilenya may have played in it.
Multiple Sclerosis Emerging Therapies Collaborative - UPDATE
Nov 14, 2011
We are proud to announce the launch of the Multiple Sclerosis Emerging Therapies Collaborative. The Collaborative – which includes the members of the MS Coalition, the American Academy of Neurology, and the VA Multiple Sclerosis Centers of Excellence East and West – has as its mission:

For more information please visit the National MS Society http://www.nationalmssociety.org

How is MS Diagnosed?

At this time, there are no symptoms, physical findings or laboratory tests that can, by themselves, determine if a person has MS. The doctor uses several strategies to determine if a person meets the long-established criteria for a diagnosis of MS and to rule out other possible causes of whatever symptoms the person is experiencing. These strategies include a careful medical history, a neurologic exam and various tests, including magnetic resonance imaging (MRI), evoked potentials (EP) and spinal fluid analysis.

The Criteria for a Diagnosis of MS

In order to make a diagnosis of MS, the physician must:

Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
Find evidence that the damage occurred at least one month apart AND
Rule out all other possible diagnoses
In 2001, the International Panel on the Diagnosis of Multiple Sclerosis updated the criteria to include specific guidelines for using magnetic resonance imaging (MRI), visual evoked potentials (VEP) and cerebrospinal fluid analysis to speed the diagnostic process. These tests can be used to look for a second area of damage in a person who has experienced only one attack (also called a relapse or an exacerbation) of MS-like symptoms — referred to as a clinically-isolated syndrome (CIS). A person with CIS may or may not go on to develop MS.

The criteria (now referred to as The Revised McDonald Criteria) were further revised in 2005 and again in 2010 to make the process even easier and more efficient.

The Tools for Making a Diagnosis

Medical History and Neurologic Exam

The physician takes a careful history to identify any past or present symptoms that might be caused by MS and to gather information about birthplace, family history and places traveled that might provide further clues. The physician also performs a variety of tests to evaluate mental, emotional and language functions, movement and coordination, balance, vision, and the other four senses.

In many instances, the person’s medical history and neurologic exam provide enough evidence to meet the diagnostic criteria. Other tests are used to confirm the diagnosis or provide additional evidence if it’s necessary.

MRI

MRI is the best imaging technology for detecting the presence of MS plaques or scarring (also called lesions) in different parts of the CNS. It can also differentiate old lesions from those that are new or active.

The diagnosis of MS cannot be made solely on the basis of MRI because there are other diseases that cause lesions in the CNS that look like those caused by MS. And even people without any disease — particularly the elderly — can have spots on the brain that are similar to those seen in MS.

Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5% of people who are confirmed to have MS do not initially have brain lesions on MRI. However, the longer a person goes without brain or spinal cord lesions on MRI, the more important it becomes to look for other possible diagnoses.

Evoked potential (EP) tests are recordings of the nervous system's electrical response to the stimulation of specific sensory pathways (e.g., visual, auditory, general sensory). Because damage to myelin (demyelination) results in a slowing of response time, EPs can sometimes provide evidence of scarring along nerve pathways that does not show up during the neurologic exam. Visual evoked potentials are considered the most useful for confirming the MS diagnosis.

Analysis of the cerebrospinal fluid, which is sampled by a spinal tap, detects the levels of certain immune system proteins and the presence of oligoclonal bands. These bands, which indicate an immune response within the CNS, are found in the spinal fluid of about 90-95% of people with MS. But because they are present in other diseases as well, oligoclonal bands cannot be relied on as positive proof of MS.

Blood Tests

While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including Lyme disease, a group of diseases known as collagen-vascular diseases, certain rare hereditary disorders, and AIDS.

Other Conditions Cause Demyelination (Damage to Myelin)

Demyelination in the Central Nervous System
Although MS is the most common, other conditions can damage myelin in the CNS, including viral infections, side effects from high exposure to certain toxic materials, severe vitamin B12 deficiency, autoimmune conditions that lead to inflammation of blood vessels (the "collagen-vascular diseases"), and some rare hereditary disorders.
Demyelination in the Peripheral Nervous System
Demyelination of the peripheral nervous system (the nerves outside the brain and spinal cord) occurs in Guillain-Barré Syndrome. After some injuries, the myelin sheath in the peripheral nervous system regenerates, bringing recovery of function.
Some demyelinating conditions are self-limiting, while others may be progressive. Careful (and sometimes repetitive) examinations may be needed to establish an exact diagnosis among the possible causes of neurologic symptoms.

For more information please visit the National MS Society http://www.nationalmssociety.org

Symptoms of MS

In multiple sclerosis , damage to the myelin in the central nervous system (CNS), and to the nerve fibers themselves, interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption of nerve signals produces the primary symptoms of MS, which vary depending on where the damage has occurred.

Over the course of the disease, some symptoms will come and go, while others may be more lasting.

Symptoms

Most Common Symptoms
Some symptoms of MS are much more common than others.

Fatigue
Numbness
Walking (Gait), Balance, & Coordination Problems
Bladder Dysfunction
Bowel Dysfunction
Vision Problems
Dizziness and Vertigo
Sexual Dysfunction
Pain
Cognitive Dysfunction
Emotional Changes
Depression
Spasticity
Less Common Symptoms
These symptoms also occur in MS, but much less frequently.

Speech Disorders
Swallowing Problems
Headache
Hearing Loss
Seizures
Tremor
Respiration / Breathing Problems
Itching

For more information please visit the National MS Society http://www.nationalmssociety.org

Who gets MS?

In the United States today, there are approximately 400,000 people with multiple sclerosis (MS)—with 200 more people diagnosed every week. Worldwide, MS is thought to affect more than 2.1 million people. While the disease is not contagious or directly inherited, epidemiologists—the scientists who study patterns of disease—have identified factors in the distribution of MS around the world that may eventually help determine what causes the disease. These factors include gender, genetics, age, geography, and ethnic background.

Patterns in the Distribution of MS

As in other autoimmune diseases, MS is significantly more common (at least 2-3 times) in women than men. This gender difference has stimulated important research initiatives looking at the role of hormones in MS. Read more on autoimmune diseases.
MS is not directly inherited, but genetics play an important role in who gets the disease. While the risk of developing MS in the general population is 1/750, the risk rises to 1/40 in anyone who has a close relative (parent, sibling, child) with the disease. In families in which several people have been diagnosed with MS, the risk may be even higher. Even though identical twins share the same genetic makeup, the risk for an identical twin is only 1/4—which means that some factor(s) other than genetics are involved.
While most people are diagnosed between the ages of 20 and 50, MS can appear in young children and teens as well as much older adults. Studying the disease in different age groups may help scientists determine the cause of MS and explain why the disease course differs from one person to another. Important questions include why the disease appears so early in some children and why people who are diagnosed after age 50 tend to have a more steadily progressive course that primarily affects their ability to walk.
In all parts of the world, MS is more common at northern latitudes that are farther from the equator and less common in areas closer to the equator. Researchers are now investigating whether increased exposure to sunlight and the vitamin D it provides may have a protective effect on those living nearer the equator.
MS occurs in most ethnic groups, including African-Americans, Asians and Hispanics/Latinos, but is more common in Caucasians of northern European ancestry. However some ethnic groups, such as the Inuit, Aborigines and Maoris, have few if any documented cases of MS regardless of where they live. These variations that occur even within geographic areas with the same climate suggest that geography, ethnicity, and other factors interact in some complex way.

Are the Numbers of People with MS Increasing?

While more people are being diagnosed with MS today than in the past, epidemiologists have found no evidence to suggest that the disease is on the increase. More likely explanations include a greater awareness of the disease, improved medical care, and more effective tools for making the diagnosis. In addition, the availability of effective treatments makes physicians more likely to communicate the diagnosis to their patients.

What are MS Clusters?

A "cluster" of MS can be defined as the perception that a very high number of cases of MS have occurred over a specific time period and/or in a certain area. Such clusters of MS—or of other diseases where clusters are occasionally reported—are of interest because they may provide clues to environmental or genetic risk factors which might cause or trigger the disease. So far, cluster studies (in the Faroe Islands, Galion, OH, DePue, IL, and El Paso, TX, among others) have not produced clear evidence for the existence of any causative or triggering factor or factors in MS.

For more information please visit the National MS Society http://www.nationalmssociety.org

What causes MS?

While the cause (etiology) of MS is still not known, scientists believe that a combination of several factors may be involved. Studies are ongoing in the areas of immunology (the science of the body’s immune system), epidemiology (that looks at patterns of disease in the population), and genetics in an effort to answer this important question. Understanding what causes MS will be an important step toward finding more effective ways to treat it and—ultimately—cure it, or even prevent it from occurring in the first place.

The major scientific theories about the causes of MS include the following:

Immunologic

It is now generally accepted that MS involves an autoimmune process—an abnormal response of the body’s immune system that is directed against the myelin (the fatty sheath that surrounds and insulates the nerve fibers) in the central nervous system (CNS—the brain, spinal cord and optic nerves). The exact antigen, or target that the immune cells are sensitized to attack, remains unknown. In recent years, however, researchers have been able to identify which immune cells are mounting the attack, some of the factors that cause them to attack, and some of the sites, or receptors, on the attacking cells that appear to be attracted to the myelin to begin the destructive process. Ongoing efforts to learn more about the autoimmune process in MS—what sets it in motion, how it works, and how to slow or stop it—are bringing us closer to understanding the cause of MS.


Environmental

MS is known to occur more frequently in areas that are farther from the equator. Epidemiologists—scientists who study disease patterns—are looking at many factors, including variations in geography, demographics (age, gender, and ethnic background), genetics, infectious causes, and migration patterns, in an effort to understand why. Studies of migration patterns have shown that people born in an area of the world with a high risk of MS who then move to an area with a lower risk before the age of 15, acquire the risk of their new area. Such data suggest that exposure to some environmental agent that occurs before puberty may predispose a person to develop MS later on.

Some scientists think the reason may have something to do with vitamin D (.pdf), which the human body produces naturally when the skin is exposed to sunlight. People who live closer to the equator are exposed to greater amounts of sunlight year-round. As a result, they tend to have higher levels of naturally-produced vitamin D, which is thought to have a beneficial impact on immune function and may help protect against autoimmune diseases like MS. The possible relationship between MS and sunlight exposure is currently being looked at in a Society-funded epidemiological study in Australia.

Other scientists study MS clusters—which are defined as higher-than-expected numbers of cases of MS that have occurred over a specific time period and/or in a certain area. These clusters are of interest because they may provide clues to environmental (such as environmental and industrial toxins, diet, or trace metal exposures) factors that might cause or trigger the disease. So far, cluster studies have not produced clear evidence for the existence of any triggering factor or factors in MS.

Infectious

Since initial exposure to numerous viruses, bacteria and other microbes occurs during childhood, and since viruses are well recognized as causes of demyelination and inflammation, it is possible that a virus or other infectious agent is the triggering factor in MS. More than a dozen viruses and bacteria, including measles, canine distemper, human herpes virus-6, Epstein-Barr, and Chlamydia pneumonia have been or are being investigated to determine if they are involved in the development of MS, but none have been definitively proven to trigger MS. Read more on viruses as the cause of MS

Genetic

While MS is not hereditary in a strict sense, having a first-degree relative such as a parent or sibling with MS increases an individual's risk of developing the disease several-fold above the risk for the general population. Studies have shown that there is a higher prevalence of certain genes in populations with higher rates of MS. Common genetic factors have also been found in some families where there is more than one person with MS. Some researchers theorize that MS develops because a person is born with a genetic predisposition to react to some environmental agent that, upon exposure, triggers an autoimmune response. Sophisticated new techniques for identifying genes may help answer questions about the role of genes in the development of MS.

For more information please visit the National MS Society http://www.nationalmssociety.org

What is Multiple Sclerosis?

Multiple sclerosis (or MS) is a chronic, often disabling disease that attacks the central nervous system (CNS), which is made up of the brain, spinal cord, and optic nerves. Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The progress, severity, and specific symptoms of MS are unpredictable and vary from one person to another.

MS is Thought to be an Autoimmune Disease

The body’s own defense system attacks myelin, the fatty substance that surrounds and protects the nerve fibers in the central nervous system. The nerve fibers themselves can also be damaged. The damaged myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms that can occur.

Most people with MS learn to cope with the disease and continue to lead satisfying, productive lives.

The Four Courses of MS

People with MS can typically experience one of four disease courses, each of which might be mild, moderate, or severe.

Relapsing-Remitting MS
People with this type of MS experience clearly defined attacks of worsening neurologic function. These attacks—which are called relapses, flare-ups, or exacerbations —are followed by partial or complete recovery periods (remissions), during which no disease progression occurs. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.
Primary-Progressive MS
This disease course is characterized by slowly worsening neurologic function from the beginning—with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.
Secondary-Progressive MS
Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups, minor recoveries (remissions), or plateaus. Before the disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within 10 years. Long-term data are not yet available to determine if treatment significantly delays this transition.
Progressive-Relapsing MS
In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsening neurologic function along the way. They may or may not experience some recovery following these relapses, but the disease continues to progress without remissions.
Since no two people have exactly the same experience of MS, the disease course may look very different from one person to another. And, it may not always be clear to the physician—at least right away—which course a person is experiencing.


Some Important Facts

MS is a chronic, unpredictable neurological disease that affects the central nervous system.
Different people are likely to experience very different symptoms.
MS is different from muscular dystrophy (MD), which is a group of disorders that cause progressive and irreversible wasting away of muscle tissue. Although MD has some symptoms in common with MS—such as weakness and problems with walking—MD affects the muscles directly while MS affects the central nervous system.
MS is not contagious and is not directly inherited
Most people with MS have a normal or near-normal life expectancy.
The majority of people with MS do not become severely disabled.
There are now FDA-approved medications that have been shown to reduce the number of relapses and "modify" or slow down the underlying course of MS.
People who are diagnosed with a clinically isolated syndrome (CIS) have had one episode of neurologic damage that is similar to the damage that occurs in MS, but they have not yet met the criteria for a definite diagnosis of MS.

For more information please visit the National MS Society http://www.nationalmssociety.org

100 years of Girl Scouting

Today marks 100 years of Girl Scouting, a landmark celebration happening throughout the nation. It's moments like this that I pause amidst the festivities and personalize what this means to me. Here are a couple of reflections I have today:
I imagine a passionate Juliette Low travelling for days to get from England to Georgia; invigorated enough to start Girl Scouting the night she arrives home.
I think about 50 million people around the world united by the values of the Promise and Law; committed to making the world a better place.
I consider my own part in this international web of leadership; rededicating to my goals as a member of the Girl Scout Movement.
I encourage you to pause today for your own leadership reflection. When you're done, engage in a purposeful conversation that will begin the next century of service to Girl Scouting.

Happy Birthday, my Girl Scout sisters!
Girl Scouts of Minnesota & Wisconsin Lakes & Pines

he said / she said with serge and monica bielanko

The Little Things: Part 1

Posted By Monica Bielanko On March 6th, 2012 at 12:58 pm

Love is hard.

She Said:

I lay awake in bed. Waiting. For the next inevitable snore to rumble through my non-slumber. Again.

There it is.

Now a minute goes by and there is nothing. Just when my body relaxes into the mattress, when lovely gorgeous luxurious sleep is imminent, another fog horn blast rockets through the bedroom. In this moment I hate him, I really hate him, and I can really understand how married couples turn to murder. Because, yes, I could murder him for this. This snoring that is destroying my sleep night after night after night after night.

Do people divorce over one, big, catastrophic event within a marriage? Cheating? Money? Sex, or lack thereof? Or is it all the little things? Do all those annoying quirks and habits that make up someone’s personality add up over time until you just can’t. Take. Another. Second? Say Serge cheated on me with another woman. What would have caused me more pain over the seven years of our marriage? The single incident of cheating or seven long years of not being able to sleep, of tossing and turning, of secretly wishing him dead? If you told me he’d stop snoring forever if he had sex with another woman I would be all for it. Yeah, sure, screw some hussy the one time and I’ll probably get over it. But snore like a chainsaw for another seven years and, buddy, we’re done. So yeah – maybe it is the little things.

Click here to watch Serge and Monica share the little things that drive them nuts about each other.
He Said:

I have no idea how love grows.

Sometimes I see little boxes in the local newspaper saying some couple has just celebrated 60 years together by gathering their 17 kids and their 623 grand-kids at The Olive Garden and they all had such a wonderful time and love is still alive and  blah-blah-blah. It’s great, don’t get me wrong, but I don’t understand it, really.

If it were me and my wife, my Monica, that probably wouldn’t be some fun evening of Spaghetti Carbonara and Riunite and flashbulb pops and whatever. I mean, after all that time so many little things can change us, and do.  After all those years of nit-picking and annoying each other with our stupid quirks, quirks that long ago made us chuckle and sigh: it’s easy to imagine how time has sharpened the tips of the thousand sticking points we have with each other.

Truth be told, for me it’s almost easier to imagine the grand-kids shoveling lasagne and meatballs down their hatches as Pop-Pop Serge takes a final bite of the poisoned tiramisu that Grandma Monica has put in front of him, not really to murder him so much as to just get him to stop with his constant throat-clearing once and for all.

In love, it’s the little things that make us or break us.

Always has been/always will be.

More He Said/She Said:

Click here to see Serge and Monica discuss their different parenting styles and how it affects their relationship.

Click here to see Serge and Monica talk about sex after marriage and parenthood.

You can also find Monica on her personal blog, The Girl Who while Serge can be found onThunder Pie.

Image: TommyMakinen.com

What a Difference a Day Makes

After years of worry, sleepless nights and crying myself to sleep. After moments in time I thought would never end. After pleading, conniving, begging, anger and frustration. After denial, co-dependency and heartbreak. After prayers that seemed to go unanswered. After phone calls in the middle of the night. After trips to the hospital and trips that should have been. After waking to police and trying to do the right thing. 


One night, one day, it all came to an end. My daughter took her last drink. She choose to take her life back.  

MARCH 6th, we celebrate her FIRST YEAR of SOBRIETY!

After 365 days living one day at a time, many things have happened that would've once had her hiding behind the bottle. One day at a time, I have watched my daughter regain control. This girl, once was timid and shy, anxious and afraid, who was more of a follower; has become a bright young confident woman. Ready to face the world and meet the challenges that lie ahead with confidence and poise.  Sobriety, has opened up a whole new world for her. Those days of running to her bottle and so called friends are gone. She has found the strength within herself and the ability to reach out for help before she falls. She has learned the one thing she once believed in was the single most thing that destroyed everything she loved about life. 

As we celebrate her 1st year of sobriety not even the miles between us could change how important this day is to us. This anniversary marks the next chapter in her journey as she eagerly chases her dreams. To be a parent and watch your child who is full of life again and living every day with such admiration is remarkable. I can't begin to tell you how proud we are. 

My Child, 

They say Respect and Trust are the two easiest things in life for someone to lose and the hardest things to get back. I told you many times how disappointed we were and that you had to earn these back. I want you to know I respect you for everything you are and have become and I trust you. Always remember no one is perfect and everyone should be allowed to make mistakes. I trust you will always do what you believe is right for you and follow your heart. Reach for the stars!! We love you and are so proud of you!!! HAPPY BIRTHDAY!!!!