Bulletin Spring 2018

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SPRING <strong>2018</strong><br />

MSWA Member Matt Nichols<br />

and daughter Willow Nichols<br />






NURSING Our MS nurses are usually the first point of contact after the neurologist’s<br />

diagnosis of MS. We’re committed to providing holistic supports; providing a greater<br />

understanding of what to expect.<br />

Lou Hatter, Manager: 9365 4888 or Community Nurse: 9365 4888<br />


29 Parkhill Way (08) 9365 4888<br />

Fax (08) 9451 4453<br />

Freecall 1800 287 367<br />

See Health Team Dept contacts on this page<br />




Sue Shapland: 9365 4840<br />


Manager Community<br />

Care Programs 9365 4851<br />

NDIS TEAM 9365 4824<br />


Wilson Outreach (Mon-Thurs): 9365 4830<br />

Beechboro Lodge (Mon, Fri): 9377 7800<br />

Southside Outreach (Fri): 9592 9202<br />

Albany Outreach (Fri): 9841 6657<br />


1 Mason Street, Davenport 6454 2800<br />


1/21 Cammilleri Street 9754 2320<br />


Manager, Chris Rush: 9385 9574<br />


Manager, Danuta Figurska: 9356 2747<br />


Manager, Jayne O’Sullivan: 9331 5780<br />



50 The Boulevard, Australind<br />

Manager, Linda Kidd: 9725 9209<br />


If you would like to comment<br />

on anything you read in this<br />

<strong>Bulletin</strong> please email<br />

bulletin@mswa.org.au<br />

or write to<br />

MSWA, Locked Bag 2,<br />

Bentley DC WA 6983<br />

The <strong>Bulletin</strong> can also be viewed at<br />

mswa.org.au/bulletin<br />


Greg Brotherson (Editor), Marcus Stafford (CEO),<br />

Paul Cavanagh, Sue Shapland, Ros Harman,<br />

Libby Cassidy, Caitlin Skinner, Sandra Wallace,<br />

Narelle Taylor, Leonie Wellington, Sarah Lorrimar,<br />

Rosemarie Dravnieks, and Dawn Burke.<br />

The Editor welcomes unsolicited submissions.<br />

All articles are subject to a reviewing process.<br />

The views expressed are those of the Authors<br />

and do not necessarily reflect the view of<br />

MSWA’s staff, advisors, Directors or officers.<br />

PHYSIOTHERAPY Our team aims to provide treatment interventions to develop and maintain<br />

mobility and function. Our Physiotherapists are experts in movement and function, and work in<br />

partnership with you to attain the highest possible level of independence.<br />

Dave Hathorn, Manager: 9365 4837 or Physiotherapy Department: 9365 4834<br />

OCCUPATIONAL THERAPY Occupational Therapists enable Members, and Clients,<br />

to continue their work and other interests for as long as possible through advice, aids and equipment.<br />

Rosemarie Dravnieks, Manager: 9365 4804 or OT Department: 9365 4888<br />

SPEECH PATHOLOGY Our Speech Pathologists provide support by assessing, diagnosing<br />

and creating individualised treatment programs for Members who experience swallowing and/or<br />

communication difficulties. We equip Members with information and strategies to promote better<br />

communication and safe swallowing.<br />

Jamaica Grantis, Manager: 6454 3140<br />


Talking with a Counsellor creates a safe, respectful and confidential environment for you<br />

and those close to you to explore options, create change or gain understanding about your<br />

life. Attending counselling with our tertiary qualified practitioners enables opportunity<br />

for personal growth and exploration in a non-judgemental environment. We have a Peer<br />

Support & Health Education Coordinator who organises peer connection & events and<br />

supports health and wellness education services. She can be contacted on 9365 4858.<br />

To make an appointment please call:<br />

Lisa Papas, Manager: 9365 4836 or Main Counselling line: 9365 4811<br />

SOCIAL WELFARE Social Welfare Officers assist people living with MS and their<br />

families to access services and supports to remain living independently at home.<br />

They specialise in case management, advocacy and sourcing funding options.<br />

They provide information on benefits and entitlements through Centrelink and other<br />

government departments. Monitor NDIS/WANDIS Services.<br />

Kath Knights, Manager, Social Work: 9365 4835<br />

INDIVIDUAL OPTIONS We provide long-term and time limited in-home supports<br />

including assistance with personal care for people with MS, to help them remain in their<br />

homes. Care and supports are provided through a combination of funding from the<br />

Disability Services, Department of Communities and our own fundraising efforts.<br />

We manage both DSC and NDIS individually funded care packages.<br />

Aileen Ward, Manager on 9365 4851 for more information.<br />

THE NDIS TEAM We can help answer all NDIS questions.<br />

Our experienced team can help determine whether you may be eligible for NDIS support<br />

and assist you with your application. This includes developing an individual plan that<br />

best suits your needs. We support people with all neurological conditions including<br />

MS, Stroke, Parkinson’s Disease, Huntington’s Disease, Acquired Brain Injury and<br />

Motor Neurone Disease, to name a few.<br />

Geoff Hutchinson, Manager NDIS Business Development: 9365 4879<br />

CAMPS & RECREATION MSWA provides separate recreation camps for Members,<br />

carers, and families, primarily funded by Lotterywest, and for a nominal cost to participants.<br />

These camps provide a break from daily routines, and strengthen friendships and<br />

support networks.<br />

Coordinator for Camps & Recreation: 9365 4843<br />

DIETITIANS are university-qualified nutrition experts who promote general health and<br />

disease prevention/management through dietary changes. They provide evidence-based<br />

dietary counselling and education, empowering individuals, with practical strategies,<br />

to meet their goals and improve health, wellbeing and independence.<br />

Jamaica Grantis, Manager: 6454 3140<br />

2 | MSWA BULLETIN SPRING <strong>2018</strong>



“Change is everywhere. Today it is fine; tomorrow it could be snowing.”<br />

Anonymous.<br />

Welcome everyone to the <strong>Spring</strong> Edition of your <strong>Bulletin</strong>, once<br />

again written amidst the renovations by our willing contributors<br />

here at the treadmill. MSWA is on the move in so many places<br />

at the same time, it can be difficult to keep track of everything.<br />

Beside the roll-out of the Nation Disability Insurance Scheme<br />

(NDIS), it is the new MSWA facility at Butler that will capture<br />

the eye once completed, and I can assure you, it will be<br />

magnificent. You will learn about all of these other projects in<br />

this information-packed edition of your magazine.<br />

Change is also everywhere and impacting on our lives. When<br />

the fees for using another bank’s ATMs were waivered, my<br />

branch office at the Garden City Shopping Centre removed<br />

all of their ATMs from inside the Centre. They also failed to<br />

advise their customers, who were left to play ‘hide and seek’<br />

party games in the Centre looking for an ATM.<br />

What remains of a once thriving banking facility is reduced<br />

to the bank foyer, now home to a singular, brand-new model<br />

ATM with screens and keyboards which can carry out all of<br />

the functions of a real-life teller. If you want to find the sole<br />

remaining teller then join the queue behind the partition where<br />

there used to be four pleasant, courteous tellers situated.<br />

To be fair, after fifty-six years of marriage my wife and I<br />

have adapted well to change over the years, but the sudden<br />

confrontation with this inexorable march of technology threw<br />

us slightly off balance. Never mind, the bank’s concierge,<br />

an impeccable woman, was at hand to talk us though the<br />

intricacies of this new world of banking.<br />

Reassuringly our guide talked my wife through the procedure.<br />

It turned out to be easy enough, but hardly a pleasant<br />

experience. The concierge, however, could just as easily<br />

been thinking aloud when I heard her murmur, “change is<br />

everywhere … today it is fine; tomorrow it could be snowing.”<br />

This got me thinking about all the changes MSWA has to make<br />

to accommodate the game-changing NDIS. MSWA has never<br />

been stronger than it is at present. To continue to achieve its<br />

goals, it is now a provider of support services under programs<br />

administered pursuant to the NDIS Act 2013 (Commonwealth)<br />

and has rebadged itself as MSWA.<br />

Continued over<br />

INSIDE SPRING <strong>2018</strong><br />














WELLNESS 18-19<br />




FATIGUE 22-23<br />

COGNITION 23<br />










SPEECH PATHOLOGY WEEK <strong>2018</strong> 29<br />

VOLUNTEERING 30-31<br />








MSWA BULLETIN SPRING <strong>2018</strong> | 3

This brave new world of the NDIS, however, has been a long<br />

time in the making. In April 1995 the then Federal Minister for<br />

Health in the Keating Government, Dr Carmen Lawrence (also<br />

the first woman to become the Premier of Western Australia,<br />

1990 to 1993), visits the Society to meet the Board and<br />

discuss concerns it has about future Commonwealth funding.<br />

In particular, the Board wants to discuss the imbalance in<br />

the funding agreement with the Commonwealth, where the<br />

Society is contributing seventy seven percent for the provision<br />

of services to Members, by fundraising.<br />

For years the Society had been largely excluded from applying<br />

for Commonwealth funding because those organisations on<br />

the inside argued that the Society was a so-called ‘single<br />

disability’ organisation, the mud stuck, and the Society<br />

cannot shake this concocted historical tag.<br />

The Society counters such humbug by flying its multiple<br />

sclerosis (MS) credentials like a battle flag, to become a very<br />

successful independently-minded fundraiser. However, at<br />

that particular time in 1995, because the next battle to have<br />

Beterferon (treatment) made freely available is yet to be won,<br />

funding to enable people with MS to live at home has become a<br />

heart-rending, calamitous problem. There are cases of people<br />

mortgaging their homes to raise the $100,000 necessary to<br />

purchase this first disease modifying treatment ever offered.<br />

Dr Lawrence informs the Society that the Home and<br />

Community Care guidelines are under review, explaining that<br />

the Commonwealth is planning to introduce legislation to<br />

provide funding to the individual in need of home care and<br />

allow that individual to choose their service provider. This will<br />

include people with MS.<br />

It is now history that the following year, the Keating-led Labor<br />

government was defeated by the Howard Liberal National<br />

Coalition Government. It would be another seventeen years<br />

before the NDIS Bill was introduced into Parliament in<br />

November 2012 and enacted the following year.<br />

Today people with disabilities, MS and similar neurological<br />

conditions at long last have the ability to access funding in<br />

a more timely and equitable fashion. They also have the<br />

amount adjusted to meet changed need and they can choose<br />

their own provider, as the NDIS is rolled out throughout<br />

Western Australia.<br />

The big losers however, are people aged 65 years and over.<br />

It is these people who have been shuffled off into a grossly<br />

inadequate Aged Care System where thirty percent of the<br />

package is immediately recouped by the provider, and the<br />

hourly rate of service is exorbitant. If that person happens to<br />

be high-care, then the care cost doubles. It is little short of a<br />

disgrace that the disabled elderly should be even thought of<br />

in such a manner.<br />

MSWA is not currently an approved Aged Care Provider, but<br />

once again it is left to us to pick up the broken pieces of an<br />

ill-thought-out policy so as to keep people with MS who do<br />

not qualify for the NDIS, living at home.<br />

On behalf of the Editorial Committee I would like to thank<br />

you for your forbearance as MSWA follows its five-year<br />

plan and reassembles itself in readiness for the future.<br />

“Change is everywhere … today it is fine; tomorrow we<br />

know Summer is coming.”<br />

Do you want to receive<br />

the <strong>Bulletin</strong> online?<br />

Want monthly information updates?<br />

Register your email address today to start receiving our<br />

monthly Vitality e-newsletter or the <strong>Bulletin</strong> magazine online.<br />

Just email damien.hill@mswa.org.au or call 9365 4814<br />

and let us know your current email address.<br />

4 | MSWA BULLETIN SPRING <strong>2018</strong>

From the desk of the CEO<br />


A clear vision backed by definite plans, delivers success.<br />

It is always pleasing to note the delivery of a record-breaking<br />

year for MSWA, but perhaps most satisfying is the posting of<br />

those records within the context of challenging times.<br />

The 2017-<strong>2018</strong> year saw MSWA’s gross revenue reach<br />

the highest in our history, and our balance sheet further<br />

strengthened. We stand alone in Western Australia as the<br />

dominant generator of our own funds, with the majority of our<br />

revenue coming from our own rich and diversified activities<br />

within both the retail and commercial market.<br />

MSWA led the nation in its research contribution, lifting to<br />

a record-breaking $3 million for the year, with a thoughtful<br />

balance of funding allocated within Western Australia,<br />

Australia and internationally.<br />

Apart from the regular and ongoing support of a multitude of<br />

multiple sclerosis (MS) research projects, this includes strong<br />

contributions to MS Research Australia, the International<br />

Alliance for research into progressive MS, and the ongoing<br />

support of symbiotic research into other neurological conditions.<br />

Our investment into research increases the overall knowledge,<br />

and ultimately benefits all of our Members and Clients living<br />

with a neurological condition. MSWA’s continued leadership<br />

in Australia is seeing advances in neurological research that<br />

is making a real difference to people’s lives. And in keeping<br />

with this focus, we are pleased to announce that we have<br />

made a significant contribution to Motor Neurone Disease<br />

research this year.<br />

The number and range of services offered to people with<br />

MS and other neurological conditions was extended further<br />

during the year, along with the number of locations within<br />

both the Perth metropolitan and rural areas.<br />

Our cohort of people receiving services in 2017-<strong>2018</strong><br />

showed 65% having MS and 35% having other neurological<br />

conditions. That balance is expected to become 60%-40% by<br />

the end of <strong>2018</strong>-19.<br />

The annual Member survey had a total of 753 responses this<br />

year, and once again, the respondents resoundingly expressed<br />

appreciation and satisfaction for MSWA. I am pleased to say<br />

that we consistently get outstanding positive results from our<br />

survey every year, and we will continue to work to place ‘our<br />

Customer’ at the centre of our activities.<br />

Our strategy to extend scale to counteract the cashflow<br />

uncertainties of the National Disability Insurance Scheme<br />

(NDIS) environment, and to provide sustained support for<br />

people who are not eligible to join the scheme, has been<br />

successful. That success has given peace of mind and surety<br />

to all people we serve, including people aged over 65 with<br />

MS, and those who are newly diagnosed or only requiring<br />

low support.<br />

Meanwhile, within the organisation’s footprint developments,<br />

our new Supported Accommodation and Services Facility in<br />

Butler is coming along nicely, and the site is currently at lockup<br />

stage. Our Mega Home Lottery launched in early August<br />

and tickets are selling fast which is very pleasing, but perhaps<br />

unsurprising, with a $2.7 million grand prize package.<br />

Our dedicated events team delivered another fantastic Annual<br />

Dinner and Auction and it was great to see both familiar<br />

and new faces. Always thinking ahead, the team are now<br />

preparing for Ocean Ride in November.<br />

So, we bask in the glory of an outstanding year for<br />

just a moment, but now focus on the year ahead with<br />

the intention of delivering successful results for our<br />

Members and Clients. Onwards and upwards!<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 5

A message from the General Manager –<br />

Member and Client Services<br />

SUE SHAPLAND RN, BN, Cert MS Nursing, MSCN<br />

“What lies behind you and what lies in front of you, pales in comparison to what lies inside of you.”<br />

Ralph Waldo Emerson.<br />

This quote supports that belief, and we often see living<br />

examples, that everyone has an inner strength that may not<br />

become evident until life’s challenges come along. I have met<br />

so many inspirational Members in my time here at MSWA<br />

and their stories are varied, but they have all risen to the<br />

challenge of being diagnosed with multiple sclerosis (MS) and<br />

the ongoing changes that can bring.<br />

What a difference a decade or two can make; the introduction<br />

of new therapies over the years has and will continue to make<br />

a real difference in people’s MS journey. We now have 12<br />

therapies and thankfully some in trial for progressive MS, and<br />

perhaps the promise of some treatments to repair damaged<br />

myelin. The ongoing research really shows just how complex<br />

MS is; over 200 genes are now implicated, and we know<br />

more about other factors that contribute to the cause but<br />

there’s still more we don’t know.<br />

MSWA is very proud to contribute funds to support MS<br />

research efforts here in WA, nationally and internationally.<br />

Our annual contribution continues to grow – it’s $3 million<br />

this year! We also now support research into other<br />

neurological conditions.<br />

Of course, the financial year has just ticked over and we are<br />

busy finalising the reports.<br />

The year ahead will be busier and even more exciting on many<br />

fronts. Our new Butler Supported Accommodation and High<br />

Support Facility looks amazing. The building is on track to<br />

open in January next year, and it certainly won’t disappoint.<br />

We are also currently fitting out premises in Kelmscott bringing<br />

services closer to home for those in the eastern corridor. Work<br />

is continuing, negotiating the Busselton premises with delays<br />

beyond our control and we are also doing preparatory work<br />

on the Albany premises.<br />

The National Disability Insurance Scheme (NDIS) is expanding<br />

across WA, with the roll out of Fremantle, Melville and South<br />

Perth local Government areas from July 1. Our NDIS team are<br />

busy working with our Members to prepare them for planning<br />

meetings and we are holding seminars as well as one to one<br />

appointments. If you need any information about the NDIS<br />

please contact our team, see the update in this edition.<br />

The next big roll out will include the remaining southwest<br />

areas around Bunbury, the City of Joondalup and the City of<br />

Wanneroo from October 1, <strong>2018</strong>. If you know anyone under<br />

65 living with a neurological condition who wants information<br />

about the NDIS, please refer them to our team.<br />

As you may have heard, Wilson has had a massive and well<br />

overdue facelift! This has been a major undertaking and we<br />

have had many months of upheaval and relocation of teams<br />

and functions; but we had our eyes on the prize and now<br />

we can enjoy our great building and new décor. I would like<br />

to sincerely thank the wonderful staff who have been very<br />

tolerant of the ongoing movements and noise AND of course<br />

the Members who have been dislocated from Wilson to Como<br />

where we held the Outreach Group for many months. The<br />

larger gym and new massage rooms have been well received.<br />

I hope not too many Members were affected by the winter<br />

flu season, there have been some quite virulent infections<br />

around and the weather hasn’t helped.<br />

Please remember your Member Services Team are<br />

here to assist you with accessing quality advice on<br />

many aspects of MS and up to date information on<br />

treatments and research. Please don’t hesitate to<br />

make contact through reception on 9365 4888 or<br />

Get-in-touch@mswa.org.au.<br />

We hope you enjoy this <strong>Bulletin</strong> and find the articles of use.<br />

Want to access research articles?<br />

Here are the places you can access up to date research<br />

articles relating to multiple sclerosis:<br />

• Vitality – Our monthly research focussed e-newsletter<br />

• Our website – https://mswa.org.au/news/latest-news<br />

• Right here as part of your Member magazine <strong>Bulletin</strong>.<br />

It includes great research articles and information every quarter.<br />

Just email communications@mswa.org.au if you would like any further information.<br />

6 | MSWA BULLETIN SPRING <strong>2018</strong>




SUE SHAPLAND RN, BN, Cert MS Nursing, MSCN<br />

From the UK MS TRUST<br />

Relapses and brain fog<br />

Giedraitiene N, et al. Cognition during and after multiple<br />

sclerosis relapse as assessed with the brief international<br />

cognitive assessment for multiple sclerosis. Sci Rep. <strong>2018</strong><br />

May 25;8(1):8169.<br />

Many people with MS talk about ‘brain fog’ or ‘cog fog’ when<br />

describing the feeling that their thinking processes are not as<br />

organised or reliable as before. This study assessed memory<br />

and thinking (cognition) to see how it changed during and<br />

after a relapse.<br />

For this study, 60 people experiencing an MS relapse, 30 with<br />

stable MS and 30 without MS took part in this study. Cognition<br />

was assessed using BICAMS, a quick and easy set of tests<br />

measuring different aspects of thinking and memory. For<br />

those experiencing a relapse, the tests were applied during<br />

the relapse, and then one and three months after. The group<br />

with stable MS and the group without were tested just once.<br />

All test scores were lower in people with MS, both relapsing and<br />

stable, vs those without MS. The test measuring information<br />

processing speed was worse in relapsing MS than in stable<br />

MS. Tests assessing visual and verbal memory were not<br />

significantly different for relapsing MS and stable MS. Within<br />

the relapsing group, scores improved one month after relapse.<br />

The study confirms relapses can impact on cognition, with<br />

information processing speed most affected; thus, it’s wise to<br />

avoid making big decisions during a relapse. The good news<br />

is that processing speed improves quite quickly and is back to<br />

levels typical for people with MS after just one month.<br />

The researchers commented that cognition is not often<br />

monitored during clinic appointments and recommend<br />

BICAMS as a quick and effective way to do this, particularly<br />

for those having a relapse.<br />

Intensive physiotherapy technique improves hand and<br />

arm use.<br />

Mark VW et al. Phase II randomized controlled trial of<br />

constraint-induced movement therapy in multiple sclerosis.<br />

Part 1: effects on real-world function. Neurorehabil Neural<br />

Repair. <strong>2018</strong> Mar;32(3):223-232.<br />

Constraint-induced movement therapy (CIMT) is a form of<br />

intensive physiotherapy originally developed to help people<br />

with one arm weaker after a stroke. It involves restricting the<br />

use of the stronger arm and intensively training the weaker<br />

arm and providing coaching for use in everyday life.<br />

In this small study, researchers tested this technique with<br />

people with MS and looked for MRI evidence of changes to brain<br />

structures. 20 people with MS with significant weakness in one<br />

arm received either CIMT or a package of complementary and<br />

alternative therapies (CAM). Both groups received 3.5 hours<br />

of direct contact therapy daily for 10 consecutive weekdays.<br />

Eight people in each group completed treatment and returned<br />

for follow-up assessment one year later.<br />

Advanced MRI techniques were used to compare brain<br />

structures in the two groups before and after treatment.<br />

The CIMT group showed greater improvement in the everyday<br />

use of their weaker arm than the CAM group and the<br />

improvement was retained at the one-year follow-up.<br />

Both groups showed improvements in speed and dexterity<br />

of their weaker arm immediately after treatment courses. At<br />

one-year follow-up, speed and dexterity of the weaker arm<br />

had continued to improve in the CIMT group but was returning<br />

to pre-treatment levels in the CAM group.<br />

MRI results suggested that in the CIMT group there were<br />

measurable changes in brain structures at the end of the ten<br />

days of treatment; this was not seen in the CAM group.<br />

The researchers conclude that the results warrant further<br />

studies with greater numbers and longer follow-up times.<br />

They intend to evaluate CIMT on people with MS with mobility.<br />

Continued over<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 7

Read more at:<br />

mswa.org.au/researchupdate<br />

From the Barts Blog.<br />

EBV in the brain<br />

Epstein Barr Virus (EBV) is a herpes virus spread by saliva and<br />

infects around 95% of us during our lifetimes. In many people<br />

EBV infection does not cause prominent symptoms – it may<br />

cause a ‘flu-like’ illness which gets better on its own, or it<br />

may go completely unnoticed.<br />

Some people infected with EBV experience the more severe<br />

illness – glandular fever or infectious mononucleosis – with<br />

fatigue, sore throat, enlarged lymph nodes, fevers, and a mild<br />

hepatitis (liver inflammation).<br />

There is lots of evidence to suggest a link between EBV<br />

infection and the risk of developing MS:<br />

• PwMS have high levels of antibodies, suggesting a specific<br />

immune response against EBV<br />

• Slightly higher rates of EBV infection in pwMS; 100% of<br />

pwMS are infected vs 95% of the general population<br />

• Increased risk of developing MS after glandular fever; 2.5x<br />

more likely<br />

• The detection of EBV infection in the brains of pwMS<br />

The hypothesis that EBV infection is an important step<br />

in developing MS makes sense. We know EBV evades the<br />

immune system by infecting B cells, driving them towards<br />

dormancy, and then promoting their long-term survival.<br />

EBV has an ingenious arsenal of tricks to promote its own<br />

survival by fashioning a long-term niche for itself inside B<br />

cells. This dormant period is termed ‘latent EBV infection.’<br />

A minority of EBV-infected cells will enter the ‘lytic phase’ of<br />

infection, in which the virus rapidly replicates, kills the host<br />

cells, and is shed to infect other cells. Recent data suggests<br />

that B cells are key drivers of the disease, any factor which<br />

promotes survival of B cells and hijacks the normal pathways<br />

of B cell maturation could conceivably predispose people to<br />

developing the disease.<br />

Whether EBV is present in the brains of people with MS has<br />

been slightly controversial – some people have said yes, and<br />

others have been unable to replicate those results.<br />

A study used a combination of biopsy and post-mortem brain<br />

tissue samples to see whether EBV-infected B cells could be<br />

detected in the brain; samples came from 17 pwMS and nine<br />

controls without neurological diseases.<br />

Latent EBV infection was detected using a marker called<br />

Latent Membrane Protein 1 (LMP1), and lytic infection was<br />

detected using a marker called BZLF1. LMP1 was detected<br />

in chronic lesions both with and without active inflammation.<br />

Importantly, LMP1 was also present in the brains of healthy<br />

individuals. BZLF1 was present in both control brains and<br />

brains from pwMS. Interestingly, BZLF1 was not present in<br />

chronic active lesions – this is surprising and implies that<br />

lytic infection is present in healthy brains, in chronic inactive<br />

lesions, but not in lesions with acute inflammation.<br />

The blog comments that this paper does not answer the<br />

question it set out to answer and they are unsure how to<br />

interpret these results. EBV-infected B cells appear to be<br />

present in both control and ‘MS’ brains, and may be slightly<br />

more common in MS.<br />

The best evidence to date does suggest that EBV is present<br />

in both MS and control brains, but is more common in pwMS<br />

(90% vs 24%).<br />

Clearly, the presence of EBV-infected B cells in the brain is<br />

not sufficient to drive disease activity. Further work needs to<br />

be done to understand why some people are perfectly healthy<br />

despite having EBV in their brain, whereas others go on to<br />

develop MS. Deeper understanding of how EBV is linked to MS<br />

is an essential first step towards developing safe treatments<br />

(and vaccines) which target EBV. EBV-targeted treatments are<br />

in early stages of development.<br />

Spinal cord volume loss: A marker of disease progression<br />

in multiple sclerosis.<br />

Tsagkas C, Magon S, Gaetano L, Pezold S, Naegelin Y,<br />

Amann M, Stippich C, Cattin P, Wuerfel J, Bieri O, Sprenger<br />

T, Kappos L, Parmar K.Neurology. <strong>2018</strong> Jun 27. pii: 10.1212/<br />

WNL.0000000000005853.<br />

Cross-sectional studies show that spinal cord volume (SCV)<br />

loss is related to disease severity in MS. However, long-term<br />

data is lacking. This study aimed to evaluate SCV loss as a<br />

biomarker of disease progression in comparison to other MRI<br />

measurements in a large cohort of patients with relapseonset<br />

MS with a six -year follow-up.<br />

The upper cervical SCV, total brain volume, and the brain T2<br />

lesion volume were measured annually in 231 patients with<br />

MS (180 RRMS and 51 SPMS) over six years using three<br />

-dimensional, T1-weighted, MRI images. Expanded Disability<br />

Status Scale (EDSS) score and relapses were recorded at<br />

every follow-up.<br />

8 | MSWA BULLETIN SPRING <strong>2018</strong>

Patients with SPMS had lower baseline SCV (p < 0.01) but<br />

no accelerated SCV loss compared to those with RRMS.<br />

Clinical relapses were found to predict SCV loss over time<br />

in RRMS. Furthermore, SCV loss, but not total brain volume<br />

and T2 lesion volume, was a strong predictor of EDSS score<br />

worsening over time.<br />

The blog commented that loss of nerves in the spinal cord is<br />

a prediction of whether you will lose leg function. This is not<br />

surprising as the spinal cord is the nervous highway from your<br />

brain to your legs.<br />

Every one percent increase of the annual SCV loss rate<br />

was associated with an extra 28% risk increase of disease<br />

progression in the following year in both groups.<br />

The researchers commented that SCV loss over time relates to<br />

the number of clinical relapses in RRMS, but overall does not<br />

differ between RRMS and SPMS. SCV proved to be a strong<br />

predictor of physical disability and disease progression,<br />

indicating that SCV may be a suitable marker for monitoring<br />

disease activity and severity.<br />

From MS Research Australia<br />

Australians Develop Promising Technique for Myelin Repair<br />

Repairing damaged myelin is essential to prevent the disability<br />

progression in MS and techniques to promote repair are a<br />

huge unmet need in MS.<br />

Melbourne-based researchers, funded by MS Research<br />

Australia, have developed a synthetic molecule called TDP6<br />

that mimics a natural brain protein. Giving TDP6 as a treatment<br />

after myelin damage increased the number of myelinated<br />

nerve fibres and myelin thickness, indicating myelin repair.<br />

It is hoped that this could lead to new therapies to repair<br />

damaged myelin in MS.<br />

The ability to repair damage in MS is one of the most pressing<br />

goals of MS research. The myelin coating around nerve fibres<br />

is damaged by the immune system, exposing the nerve and<br />

interrupting the nerve signals travelling between the brain<br />

and the body. Current treatments for RRMS aim to reduce the<br />

damage caused by relapses and inflammation, but treatments<br />

to repair damage are not currently available.<br />

Myelin can be naturally repaired, however this repair is<br />

often incomplete and eventually fails completely, leading to<br />

progression disability. Stimulating and enhancing the natural<br />

repair processes is a goal for many MS researchers.<br />

Research conducted by Dr Jessica Fletcher, working with Dr<br />

Simon Murray, Dr Junhua Xiao, and Assoc Prof Richard Hughes,<br />

led to the development of a synthetic protein, which mimics a<br />

naturally occurring brain protein to promote myelin repair.<br />

Given as a treatment after myelin is damaged, TDP6 increased<br />

the number of mature myelin-producing cells in the brain and<br />

repaired myelin; in that the number of myelinated nerve fibres<br />

increased and myelin thickness improved after the synthetic<br />

protein was given.<br />

This work has shown that this synthetic molecule can repair<br />

myelin in a biological model of MS. While more laboratory<br />

work is needed to further develop the treatment it’s hoped this<br />

molecule could form the basis of a new therapy for repairing<br />

existing damage and provide treatment options for people in<br />

the progressive phase of their MS.<br />

Read more at: https://msra.org.au/news/develop-promisingmyelin-repair<br />

Modern MS Therapies Improve Employment Outcomes<br />

New research, involving 874 people on disease-modifying<br />

therapies in the previous five years, showed that more<br />

effective disease-modifying therapies are associated with<br />

increases in the amount of work, work attendance and work<br />

productivity.<br />

Being employed has benefits beyond purely financial – it can<br />

improve quality of life, provide social interaction and give us<br />

a sense of purpose.<br />

MS studies in previous decades showed that pwMS were<br />

much more likely to fall out of employment than people with<br />

other chronic conditions and the general population. The<br />

financial impact of reduced employment for people with MS<br />

places a substantial burden on individuals, families and the<br />

wider community.<br />

Research published in 2016 by Dr Pieter Van Dijk at Monash<br />

University, and Assoc Prof Ingrid van der Mei, using data from<br />

MSRA’s Australian MS Longitudinal Study (AMSLS), showed<br />

the gap in employment rates between pwMS and the general<br />

population is closing.<br />

The team at the Menzies Institute for Medical Research delved<br />

deeper into the data from the AMSLS to explore whether the<br />

use of disease-modifying therapies has played a role in this<br />

improvement in employment retention for pwMS.<br />

This latest study showed that pwMS on high-efficacy diseasemodifying<br />

therapies were two to three times more likely to<br />

report improved employment outcomes than those on the<br />

lower-efficacy first generation MS treatments.<br />

This study indicates the newer generation MS therapies are<br />

having a positive effect on people’s quality of life, and allowing<br />

people to maintain their health, keeping them well enough to<br />

stay fully active and productively employed.<br />

Many personal factors are taken into consideration when<br />

choosing a medication, so it’s important to discuss your<br />

therapy options with your neurologist.<br />

Read more at: https://msra.org.au/news/therapies-keepingpeople-employed<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 9




MSWA is the largest funder of research into multiple sclerosis<br />

(MS) in Australia, and the total contribution to neurological<br />

research is nearly $14 million over the last 11 years. This may<br />

come as a surprise to some, but not the loyal people who<br />

continually support MSWA’s fundraising initiatives.<br />

For the thousands of Western Australians living with a<br />

neurological condition the latest commitment of a record<br />

$3 million to research in the last financial year, offers hope<br />

and relief.<br />

The funding will be allocated across a number of institutions<br />

this year, including $1 million to MS Research Australia and<br />

$500,000 to the International Progressive MS Alliance.<br />

MSWA CEO Marcus Stafford AM said, “this year’s<br />

unprecedented investment was only made possible by the<br />

people of Western Australia’s ongoing support.”<br />

“We’re committed to improving the quality of life for people<br />

with MS and other neurological conditions, and pleasingly,<br />

we have been able to increase year-on-year the amount of<br />

money we’ve invested into research and spent on providing<br />

support, services and accommodation across the State.<br />

And, it’s something we want to continue to do for many years<br />

to come.”<br />

For a fourth year in a row, MSWA has set aside substantial<br />

amounts of money for local research and one project to receive<br />

funding from MSWA, is Professor Allan Kermode, Head of<br />

Demyelinating Diseases Research at the Perron Institute.<br />

His research will focus on the potential of neurofilament light<br />

(NfL) to be used as a biomarker of MS activity, using a simple<br />

blood test.<br />

Currently, clinicians use methods such as MRIs or the<br />

monitoring of clinical symptoms to assess whether a treatment<br />

for MS is effective, or if the condition is progressing. However,<br />

these methods are expensive or time-consuming.<br />

“NfL is a nerve protein that is a component of nerve cells,”<br />

said Professor Kermode. “When nerve cells die, the presence<br />

of NfL can be detected in the blood stream. What we’re doing<br />

is analysing NfL levels in patients’ blood to work out whether<br />

it’s a useful biomarker as a predictor of MS activity and<br />

progression.”<br />

Professor Kermode said the progression of MS varies widely<br />

from one person to another and so does their response to<br />

various treatments.<br />

“Specific blood tests will not only permit more timely and<br />

precise assessment of the response of MS to treatment,<br />

as well as help guide personalised pharmacotherapy, but<br />

they will also accelerate the development of new therapies,<br />

especially those that may arrest clinical progression,”<br />

Professor Kermode said.<br />

“In a world-first, biomarker testing for NfL will be carried<br />

out in people with Clinically Isolated Syndrome (CIS) who<br />

have undergone narrowband UVB therapy,” Professor<br />

Kermode added.<br />

“People with CIS have experienced a first episode of<br />

neurological symptoms that could progress to MS. As part of<br />

this research, one group has been treated with narrowband<br />

UVB phototherapy and the other hasn’t. The NfL levels of each<br />

group will be compared to determine the effect of the UVB<br />

phototherapy on conversion to full MS.<br />

“The funding from MSWA will enable the Demyelinating<br />

Diseases Research program to advance a range of initiatives<br />

that would otherwise be beyond our reach.”<br />

The money will also be invested in a research project that<br />

evaluates the molecular and immunological aspects of MS,<br />

employing a senior research fellow and MS nurse, and<br />

migrating data onto an Australia-wide MSBase platform.<br />

Mr Stafford said, “I would like to thank everyone who made<br />

a donation, took part in one of our events, or bought a ticket<br />

in the Mega Home Lottery. Because of you, we’ve been able<br />

to support the Perron Institute and other brilliant medical<br />

research organisations that offer hope to people living with<br />

MS and other neurological conditions.”<br />

As well as Professor Kermode’s research, MSWA’s recordbreaking<br />

funding will be allocated across a number of institutions<br />

this year, including $1 million to MS Research Australia and<br />

$500,000 to the International Progressive MS Alliance.<br />

Over the next couple of months, there will be more exciting<br />

research announcements to come.<br />

10 | MSWA BULLETIN SPRING <strong>2018</strong>




On July 1, the National Disability Insurance Scheme (NDIS)<br />

expanded to include the new geographical areas of Fremantle,<br />

the City of Melville and the City of South Perth.<br />

In anticipation, the NDIS team hosted a series of information<br />

sessions to explain how our Members can get started with<br />

the NDIS and what supports and services are available.<br />

Attendance has been strong, and we are now actively<br />

engaging with over 70 Members from these areas, as they<br />

start their NDIS journey.<br />

In fact, NDIS eligibility for some of these Members has<br />

already been approved and they are now waiting for their first<br />

planning sessions with the NDIS.<br />

The NDIS team is still very keen to meet and support you<br />

if you live in Fremantle, the City of Melville and the City of<br />

South Perth and we haven’t yet spoken with you. We would<br />

be happy to have an individual discussion with you in your<br />

home, have coffee with you in a neighbourhood café, or one<br />

of our facilities. The coffee and cake are on us!<br />

The next NDIS areas to be launched will be the City of<br />

Joondalup, City of Wanneroo and City of Bunbury and<br />

surrounding shires. These will commence from October 1.<br />

It should be noted that the City of Joondalup and City of<br />

Wanneroo cover an extremely wide geographical area, so you<br />

may well be included if you live in the northern suburbs!<br />

We have over 500 Members on our database for these areas<br />

and once again we will be actively contacting you to assist<br />

in understanding the process and your possible transition to<br />

the NDIS.<br />

On another topic, we have been contacted by many Members<br />

who are transferring from WA NDIS plans to Commonwealth<br />

NDIS plans.<br />

The transfer process is proving to be quite challenging, so<br />

we do encourage you to contact us when you are asked to<br />

transfer your plan. We can assist by checking your existing<br />

plan and planning for a new one, as the processes are slightly<br />

different between the two.<br />

The future schedule for transfers is as follows:<br />

August – October <strong>2018</strong>: Members who live in the Cockburn /<br />

Kwinana areas will be asked to transfer to the NDIS.<br />

September – December <strong>2018</strong>: Members who live in the<br />

Lower South West, Busselton and surrounds, will be asked to<br />

transfer to the NDIS<br />

We are pleased to announce a Lucky Draw to celebrate<br />

the expansion of the NDIS!<br />

Here’s your chance to win a $100 shopping voucher!<br />

Just answer the following three questions about the NDIS:<br />

• What do the initials NDIS stand for?<br />

• Name the three new NDIS areas that commenced on July 1<br />

• Name one Member of the MSWA NDIS team<br />

Email your responses to Mark Douglas at<br />

mark.douglas@mswa.org.au<br />

However, be quick!<br />

Only the first three correct replies can win a voucher!<br />

Finally, do have a chat with our friendly NDIS team if you<br />

require any further information about the NDIS.<br />

The NDIS team members at MSWA are:<br />

Christine Richards: Client Relationship Coordinator<br />

Email: christine.richards@mswa.org.au<br />

Phone: 9365 4867<br />

Pranjal Pawar: Client Relationship Coordinator<br />

Email: pranjal.pawar@mswa.org.au<br />

Phone: 9365 4810<br />

Annabel Vasquez: Client Relationship Coordinator<br />

Email: annabel.vasquez@mswa.org.au<br />

Phone: 9365 4806<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 11

WITHIN A<br />



“In every conceivable manner, the family is link to our past, bridge to our future.”<br />

Alex Haley.<br />

In my years of working with families, I have learnt the<br />

importance of keeping the entire family in mind when<br />

counselling individuals, couples or the family as a whole.<br />

When one member is suffering, it will most likely impact the<br />

entire unit. When a family member receives a diagnosis of<br />

MS or other chronic or terminal illness, it has the potential to<br />

affect all members and can often change the course of the<br />

family story.<br />

The best way to think of the family affected by illness, is of<br />

a tapestry altered by a change in its pattern. Sarah Burton<br />

MacLeod MD from Canada describes the family as an<br />

interactive system:<br />

• families contain and interact with many subsystems based<br />

on relationships<br />

• a change with one of the members of the family will<br />

influence the entire system<br />

• emotional interdependence has evolved to promote<br />

cooperation to protect their members (Mehta et.al., 2009)<br />

The predictability of the family surviving or managing an<br />

illness can be found in how resilient or healthy the family is to<br />

start with. Questions to ask may include:<br />

• how has the family adapted to change in the past?<br />

• how supportive are members of each other?<br />

• what complications are getting in the way?<br />

Complex family systems with multiple challenges such as<br />

economic, mental health, family conflict or multiple health<br />

issues may complicate navigation through a new family<br />

health challenge. Stresses within the system may need to be<br />

addressed before anything else will change. Often the core<br />

strengths of the family based on love, caring and shared<br />

family values will motivate members to go the extra mile to<br />

do what is needed to promote positive change. Sometimes<br />

this shared challenge will bring the family together.<br />

Strategies to help families cope can include:<br />

• improving communication within the family<br />

• educating family members on health issues and what to expect<br />

• creating awareness of how each member is affected<br />

• learning practical skills to decrease stress and promote a<br />

healthy lifestyle<br />

• accessing professional help for members of family that are<br />

most affected<br />

Counselling individuals who are dealing with a chronic illness<br />

can have a positive impact on the entire family. When a<br />

Member is feeling supported and heard, stress levels can<br />

decrease. Most of our counselling at MSWA is on an individual<br />

level but can incorporate a family systems approach or<br />

family inclusiveness. This can lead to cooperation within<br />

the system, increased resilience and shared understanding.<br />

What if someone is isolated or has an unsupportive family?<br />

Counselling can often bridge the gap or to help the client<br />

build a larger support network. MSWA Groups for Members<br />

or carers can expand this even further, as meeting others<br />

affected by similar challenges can help someone feel more<br />

connected or bring about change on a community level.<br />

What I have learned learnt from my experience working with<br />

families is that there is an emotional bond between Members<br />

based on the history of the family and the need for the family<br />

unit to survive. Most families I meet love talking about their<br />

family, even the dark side of the story over generations. The<br />

past traumas, conflicts and challenges are noted as what<br />

made the family stronger or in some cases fall apart. Talking<br />

about the past can often uncover what may have contributed<br />

to family stress to begin with.<br />

Whether promoting positive change, companioning<br />

along a journey or supporting family during loss and<br />

grief, MSWA counsellors are here to help.<br />

References:<br />

The Family as the Unit of Care: Challenges & Rewards; Sarah<br />

Burton MacLeod, MDCCFP & Kim Crowe, BSW RSW<br />

Mehta, A., Cohen, S.R., & Chan, L.S. (2009). Palliative care:<br />

A need for a family systems approach. Palliative & Supportive<br />

Care, 7(2), 235-243<br />

12 | MSWA BULLETIN SPRING <strong>2018</strong>




We are told that change is inevitable and that may be so,<br />

but sometimes we have change forced upon us in a most<br />

unexpected manner that leaves no room for choice. I<br />

remember my then seven-year-old son having an “I’m not<br />

going to school today” moment, as he very unhappily got out<br />

of the car, he said to me with a big scowl “you always say<br />

we’ve got choices!”<br />

“Yes” I reply, “you can do this willingly or unwillingly.” When I<br />

relay this story, it is usually greeted with sympathetic laughter,<br />

because I think we can all relate to his frustration.<br />

Some research suggests that there are phases we go<br />

through on our way to a different life. In the beginning we<br />

may not recognise a need to change or be unaware that<br />

change is about to be put upon us. This is regarded as<br />

the Precontemplation Phase. The Contemplation Phase is<br />

when we begin to recognise a possible change, then comes<br />

Preparation, Action and Maintenance. That is, if the change<br />

was a personal choice.<br />

When change is thrust upon us, there is often little or no<br />

time for the luxury of contemplation before action is required.<br />

However, there are still some things, such as those listed<br />

below, which people may find helpful. These are responses<br />

where we potentially have a choice, at any given time, of<br />

taking an action or not, according to whether we perceive<br />

that action as making matters better or worse.<br />

Staying focused in the present and working with what is<br />

right in front of us at any given moment, is helpful in not<br />

becoming overwhelmed. However, a broader awareness is<br />

also helpful in planning ‘where to from here.’ The following<br />

suggestions may be of some help when facing a situation<br />

beyond our control.<br />

1) Knowledge. Do your homework; what do I need to know<br />

right now? Do I need to have a witness or a guide to help<br />

me understand the situation?<br />

2) Emotions. Honour our feelings, how do I feel right now?<br />

Remember feelings are not right or wrong – they just are.<br />

3) Situation. Is there something going on around me that I<br />

am a part of? Can I make a difference?<br />

4) Self-awareness. Am I focused on reality or am I<br />

distracting myself with fantasy and illusion? What do I<br />

need right now to be able to stay in reality without being<br />

overwhelmed?<br />

5) Community-awareness. What outside supports are<br />

available to me? Who best can help me with access<br />

to support?<br />

6) Fear. Sometimes the only way to deal with things is<br />

keep moving through them (maybe at an angle – like<br />

swimming through a rip – just don’t stop swimming).<br />

Doing ‘the next indicated thing’ or ‘forward movement’<br />

can be aided by skills such as meditation and mindfulness.<br />

There may be times that we fall flat on our face but that is<br />

still forward motion.<br />

7) Alternatives. What small thing can I do differently to<br />

simplify my life at this time? Am I getting enough sleep?<br />

8) Humility. People will want to help, and we need to let<br />

them. It’s good for all of us, sometimes being the giver<br />

and sometimes the recipient.<br />

9) Gratitude. Acknowledge the good in our life. The good<br />

fortune to have food and shelter.<br />

10) Set the scene. Create the space of our desire. Make our<br />

environment work for us. Is it a time of quiet or a time of<br />

stimulus? Do we have a place that meets those needs<br />

and helps keep the balance?<br />

None of these tasks are set in concrete, they have their own<br />

pattern and their own time frames. Some things we can<br />

manage easily and simply, others maybe not, or not at this<br />

time. Sometimes we need to ask for help, whether we want<br />

to or not and sometimes it is more beneficial to get help from<br />

outside of family and friends.<br />

If you would like to talk freely and in confidence to<br />

someone who has skills in helping, please contact the<br />

Counselling Department at MSWA on 9365 4888.<br />

Reference:<br />

www.prochange.com/transtheoretical-model-of-behavior-change<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 13




Loneliness is becoming an increasing problem in the 21st<br />

Century. Recent studies have shown that the effect of poor<br />

social connections and interactions can be harmful to our<br />

health. People who feel lonely, or have few social connections,<br />

have been linked with higher rates of early death comparable<br />

to well established disease states that are usually linked to<br />

poor diets, alcohol and cigarette use, not our social lives.<br />

(Valtorta NK, Kanaan M, Gilbody S, et al, 2016).<br />

We, as human beings are social creatures and do better in life<br />

when we feel connected to others. But in its absence, we feel<br />

a sense of isolation and separation from others, contributing<br />

to feelings of low mood, sadness and even depression.<br />

Ironically, we can feel lonely in a crowd. It is not necessarily<br />

being in the company of others that promotes connection. Our<br />

psychological happiness is enhanced when we feel heard,<br />

understood and bonded with others.<br />

So why is it that when the world is populated by the greatest<br />

number of inhabitants ever that we are experiencing this<br />

loneliness epidemic? It seems a strange thing.<br />

People cite various reasons for their lack of social connections<br />

– being time poor, too busy for friends as their lives are<br />

dominated by work and family commitments. Throw a chronic<br />

illness such as multiple sclerosis (MS) into the mix, where<br />

fatigue often compromises one’s ability to spend time in the<br />

company of others, and the issues of loneliness and a sense<br />

of isolation becomes compounded.<br />

Working as a counsellor with people living with MS, I encounter<br />

the subject of loneliness and social isolation frequently.<br />

Many of my clients disclose they miss the interaction and<br />

connection with others. They go on to say that prior to their<br />

illness they enjoyed a variety of social activities, and had a<br />

wide circle of friendships and acquaintances, but over time<br />

these activities were hindered by their fading physical ability.<br />

Friendships dwindled to infrequent contact or none. A hidden,<br />

and often unspoken and unrecognised cost, of chronic illness<br />

along with the feelings of grief and longing, accompany the<br />

loss of this important aspect of a person’s life. And hence<br />

some find themselves in a chair opposite me speaking and<br />

sharing their experience.<br />

So, what do I say? How do I respond?<br />

I share that what they are feeling is very typical – that many<br />

others living with a chronic illness have experienced something<br />

similar, that they are not alone in their experience of having<br />

to reduce their social participation and have people fade<br />

and disappear from their lives. I reassure them that it is not<br />

their fault but a consequence of unfortunate circumstances.<br />

And I will state that it is within their power to improve and<br />

rejuvenate their social connections by following a few tips.<br />

1. Change up how you see ‘social’ interaction – create<br />

ways of seeing people which conserve and protect your<br />

precious energy levels; instead of going out have your<br />

friends come to you.<br />

• Plan a movie night on your couch complete with popcorn,<br />

fizzy drink and choc tops.<br />

• Enjoy a carpet picnic under the stars in your back yard<br />

complete with your favourite take away meal.<br />

• Host a pyjama party where your friends visit in their<br />

pyjamas and play some old-fashioned games like<br />

Scrabble or Monopoly.<br />

2. Communicate with your friends – educate them about MS<br />

and fatigue. Many people are not aware that fatigue is such<br />

an issue for those living with MS. Having an understanding<br />

that it’s your low energy levels that make socialising<br />

a struggle, dispels the myth that you just don’t want to<br />

see them.<br />

14 | MSWA BULLETIN SPRING <strong>2018</strong>

3. Communicate using different mediums – send texts<br />

or Facebook messages, Skype or Facetime; or whichever<br />

app you prefer to use. Even go old school and send a card<br />

or letter in the snail mail! Small acts go a long way to<br />

maintaining connection.<br />

4. Talk to strangers – use everyday interactions to increase<br />

your social connectedness to the wider world. Strike up that<br />

conversation with the taxi driver, the checkout attendant,<br />

the person next to you at the doctor’s receptionist, it may<br />

not be a long-term relationship, but small interactions can<br />

build your confidence and promote wellbeing.<br />

5. Partake in one of the MSWA groups on offer. A variety<br />

of different groups, run by the various departments, are<br />

available to you to join and participate in. This will offer you<br />

the opportunity to meet with others in similar circumstances<br />

– so you already have something in common with them!<br />

Loneliness and social isolation is a problem, but it does<br />

not have to be yours. If you would like further support in<br />

this area of your life I encourage you to contact the MSWA<br />

counselling department and make an appointment to see<br />

one of the counsellors. Go on do it …. Life is for living<br />

and sharing it in the company of others!<br />

Reference: Valtorta NK, Kanaan M, Gilbody S, et al. Loneliness<br />

and social isolation as risk factors for coronary heart disease<br />

and stroke: systematic review and meta-analysis of longitudinal<br />

observational studies. Heart 2016; 102:1009-1016.<br />



As we go through life our spiritual self is accumulating a<br />

layer of little hurtful slights, heartaches, disappointments and<br />

betrayals which can cloud our good judgement in a cloak of<br />

mistrust, and in some cases, hopelessness. Let us call this<br />

the cosmic dust of life.<br />

Like all good housekeepers however, a regular dusting is<br />

necessary to make room for happiness and the better things<br />

that life has to offer. Of course, when you stir things up you are<br />

sure to get a little dust in your eyes which may hurt a little, you<br />

may feel sorry for yourself and even bring a tear to your eye.<br />

All of this is natural, for venting your emotions is an excellent<br />

way of ridding yourself of all this unwanted accumulated<br />

baggage. The trick is to let these tears wash away the dust<br />

and restore your vision so that you can get on with living. You<br />

need to know what you are doing, like what you are doing,<br />

and then believe in what you are doing.<br />

Begin your dusting by mastering some simple principles of<br />

human relations. Try never to criticise, condemn or complain.<br />

Learn instead to praise, encourage and look at the positive<br />

side of things before pointing out any problems or faults. Try<br />

to be sympathetic and tolerant. Be kind and understanding<br />

but above all, learn to forgive others and especially yourself.<br />

Give sincere and honest appreciation. Be enthusiastic. Don’t<br />

talk down to people. Instead find out their needs and become<br />

genuinely interested in them. Just be aware that the person<br />

you think is drowning might only be waving to a friend.<br />

Try not to win an argument, because it is rare to win over<br />

the other person’s ‘goodwill.’ Instead use tact, empathy,<br />

diplomacy and try to see the other person’s point of view.<br />

Then thank people for their interest, step back and allow<br />

some thinking time.<br />

These little things are at the core of human understanding.<br />

When you are right, be gracious. If you are wrong admit it<br />

immediately, and then you are in the position to maintain<br />

your self-control by making amends. You can remain calm,<br />

because you can only help people find the answer. You cannot<br />

teach a person anything other than to find themselves. In the<br />

end the best way to win an argument is to avoid it.<br />

Therefore learn to persuade people with gentleness. If<br />

you want to win friends let the other person do most of<br />

the talking. If you want cooperation you must first show<br />

the other person that their ideas are as important as your<br />

own. Finally, and you would think this is the easiest as<br />

every person has one; make a special effort to remember<br />

a person’s name.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 15




Assertiveness can help us in many areas of our lives. To<br />

be assertive means that we feel confident in personal<br />

interactions, whether responding to demands, asking for what<br />

we want, dealing with criticism, or setting our boundaries.<br />

Lots of people find that they can be assertive in one context,<br />

eg. at work, but find it much harder with family members or<br />

friends or doctors, or vice versa. They need ways to transfer<br />

these skills!<br />

Sometimes people believe that to be assertive means being<br />

aggressive, but this is a misunderstanding. Aggression is a<br />

sure-fire way to alienate people and create a bad reputation<br />

for yourself, even if you ultimately get the outcome you<br />

were seeking. Bullies are aggressive; whereas courteous,<br />

empathic, clear and firm people are assertive.<br />

Why might we be nervous about dealing with others<br />

assertively? Some of our fears can be:<br />

- Fear of being seen as uncaring<br />

- Fear of being called a bully<br />

- Fear of anger or retaliation by the other person<br />

- Fear of being labelled and opportunities blocked eg<br />

promotion at work<br />

- Fear of coming across as selfish, all about you<br />

Interestingly, due to these fears, many of us adopt a passive<br />

or manipulative approach to getting what we want, or to<br />

avoiding what we don’t want. You know the kind of friend who<br />

says vaguely that she’ll get back to you about an arrangement,<br />

then doesn’t? Or perhaps a family member who persuades<br />

you to do something for him by mentioning a favour he did<br />

for you? Being on the other side of these behaviours is just as<br />

unpleasant as being bullied, and most of us would rather be<br />

given a straight answer, or to give a straight answer, such as<br />

‘No, I can’t help you with that.’<br />

Assertiveness can help us in situations with friends, family,<br />

carers, colleagues, health professionals, sports and fitness<br />

buddies, fellow volunteers, retail workers, and members of<br />

our faith community. For example, if you feel you are being<br />

taken advantage of, or treated badly by someone, an easy<br />

formula to remember is:<br />

‘When you do …..X….. I feel …..Y…… so instead I’d prefer…<br />

…Z…..’<br />

Nobody can argue with how you feel even if they didn’t intend<br />

to make you feel that way! You’re the expert on how you feel.<br />

Here’s an example:<br />

“When you ask me to help with chores at 6 pm, I feel guilty<br />

that my fatigue stops me from helping. So instead, please<br />

would you ask me to help in the morning when I have more<br />

energy?”<br />

Another one might be:<br />

“When you say you’re broke and ask if I can lend you $100, I<br />

feel pressured to help you out even though I don’t have enough<br />

money either. So please don’t ask me again.”<br />

Of course, when we firm up our boundaries and state clearly<br />

what we want, the other person might resist hearing us, and<br />

here’s where the broken record technique comes in (for those<br />

of you who remember needles getting stuck on turntables)!<br />

Here, we empathise with the other person’s feelings and<br />

wishes, without getting sucked into fulfilling their request. We<br />

maintain our polite but firm position and repeat if necessary.<br />

It goes something like this:<br />

“Yes, I know you’re down to your last $10, but I’m still not able<br />

to lend you anything.”<br />

“I realise that you are struggling, but I’m sorry (only if you are<br />

sorry – this bit is not compulsory) I can’t help you out.”<br />

“I can hear how stressed out you are, and I know it’s hard, and<br />

I still can’t spare any cash for you.”<br />

Play your broken record until the message gets through!<br />

16 | MSWA BULLETIN SPRING <strong>2018</strong>

Why is this so hard for lots of us to do? In general, because we<br />

want to be known as kind, helpful people and not be accused<br />

of being ‘selfish.’ Let’s acknowledge that in our broken<br />

record technique:<br />

“I realise that to you I seem selfish right now, and I’m still your<br />

friend, but I don’t want to lend you money for the reasons I’ve<br />

already said, and that’s why I’m saying no.”<br />

Remember that if someone accuses you of being selfish or<br />

uncaring, it’s usually because they haven’t managed to get<br />

you to do what they want, and you can choose to let those<br />

words bounce right off you.<br />

Think about a difficult scenario which tends to come up<br />

in your life – with your boss, your in-laws, your child, your<br />

partner, friend or helper, and consider whether you could deal<br />

with this person more assertively. Practising how you speak<br />

to them in a role play or even talking to yourself in a mirror,<br />

will help you to find a form of words you are comfortable with,<br />

and say them calmly without blushing or stammering.<br />

Counsellors can also guide you in learning to become<br />

more assertive, and the MSWA counselling team can<br />

be contacted on 9365 4888. There are also lots of good<br />

websites on the internet describing assertiveness<br />

techniques to learn. Go for it!<br />



MSWA Peer Support Volunteers are people living with multiple<br />

sclerosis (MS) who give their time to provide support to others<br />

living with MS. Peers provide a unique and invaluable support<br />

which comes from a lived experience. They understand what<br />

it is like to live with MS – receiving the diagnosis, the physical<br />

symptoms, the emotions and all the other things which MS<br />

can bring about.<br />

Peer volunteers are there to answer questions, share their<br />

experiences and help people link in with resources and<br />

services. The role of the peer volunteer is not to say what<br />

they think people should do, or to judge, instead it is to listen<br />

respectfully and privately. For a peer support relationship to<br />

be effective, there needs to be trust and an understanding<br />

that all conversations and the information shared in these<br />

remains confidential.<br />

The support provided by our peer volunteers can be seen in<br />

various forms, some attend groups and workshops to share<br />

their story whilst others provide support over the phone and<br />

via email. People can choose the way in which they provide<br />

and receive support, and it can be done anonymously.<br />

Our peer volunteers are provided with ongoing support from<br />

MSWA and before engaging with other Members, the peer<br />

volunteers meet with the Coordinator of Health Education<br />

and Peer Support to discuss the role, its responsibilities,<br />

and receive and sign a manual agreeing to adhere to the<br />

peer volunteer guidelines. The guidelines which surround<br />

confidentiality, boundaries and communication are developed<br />

to ensure everyone involved feels safe and supported, and to<br />

provide clarity about the purpose of the peer relationship. It is<br />

also a good way to provide support and skills to complement<br />

the experiences and understanding that our peer volunteers<br />

already have.<br />

Engaging in peer support, whether through a peer volunteer<br />

relationship or attending support groups can be hugely<br />

beneficial. With an opportunity to connect with others, people<br />

feel less isolated, they can gain a better understanding of their<br />

diagnosis, feel more at ease and make proactive changes to<br />

improve their health and wellbeing.<br />

If you would like more information about the peer<br />

volunteer role, please contact Sarah Lorrimar on<br />

9365 4858 or Sarah.Lorrimar@mswa.org.au.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 17



Wellness involves making positive choices about the way you<br />

live your life, to ensure you are feeling your best. This includes<br />

your behaviours, your lifestyle choices and taking action to<br />

keep informed about your health. It is a process which is<br />

unique to everyone and is something which will continue<br />

to change and evolve over your lifetime. There has been an<br />

increasing interest in the subject of wellness amongst people<br />

living with multiple sclerosis (MS) and although it may require<br />

some added consideration, incorporating healthy lifestyle<br />

choices into your daily life will help you achieve improved<br />

health and wellbeing.<br />

What’s Been Happening<br />

Information Sessions<br />

An important aspect of wellness is keeping informed, by<br />

accessing reliable and relevant information and resources.<br />

Being aware of MS and other aspects of your health, will<br />

help you feel more prepared and confident to make informed<br />

choices about your health and wellbeing.<br />

In June and July, two MSWA information sessions were held<br />

for people living with MS and their support persons. The first<br />

session was tailored for those newly diagnosed with MS and<br />

the second session was open to all. Each session began with<br />

a presentation from Community Access Nurse, Rosie Hunt<br />

which included a general overview of MS, symptom and<br />

relapse management, new treatments and the influence of<br />

a healthy lifestyle. Following Rosie’s presentation, our peer<br />

volunteers Tom and Sonya both shared their experiences of<br />

living with MS, which proved an invaluable inclusion to the<br />

evenings. To close the sessions, a Q&A panel made up of<br />

various allied health team members including Physiotherapy,<br />

Counselling, Nursing, Occupational Therapy, Dietetics,<br />

Speech Pathology and Social Welfare discussed the services<br />

they provide and answered questions from attendees. The<br />

sessions were a great way to share information amongst<br />

health professionals and peers and both received positive<br />

feedback including:<br />

“Great start to a long journey, very positive information.”<br />

“That was excellent, and the speakers were wonderful.”<br />

“Thank you for a great session!”<br />

Move…Breathe…Mindfulness for MS<br />

As I write this, we are halfway through the four -week mindful<br />

movement program run by Cathy Goldie, one of our counsellors<br />

who is also a qualified yoga instructor. Classes are being held<br />

at a small yoga studio in Wangara from 5-6pm. Focused on<br />

movement, breathing and yoga, the postures are adjusted to<br />

suit everyone taking part. With guided breathing, the class is<br />

led through standing and seated yoga postures for one hour<br />

before the session is closed with a meditation in Shivasana<br />

pose. Following the meditation, group Members are welcome<br />

to enjoy a cup of herbal tea and relax in the yoga studio’s<br />

designated ‘chill out area’. Unfortunately, due to the strong<br />

winds and heavy rains in our second week, the class was<br />

cancelled but we look forward to seeing everyone again soon!<br />

Keeping Your Brain Active<br />

Just like exercise for your body, mentally stimulating your<br />

brain helps it to stay active which is particularly important for<br />

people living with MS. Challenging your brain can improve its<br />

ability to adapt to cognitive changes brought about by MS. To<br />

challenge your brain, you could take part in activities at work<br />

as well as leisurely activities such as reading, painting, doing<br />

puzzles and playing board games.<br />

A 3-letter word has been taken out of each of the<br />

following words. Can you figure it out?<br />

B_ _ _TE<br />

_ _ _SE<br />

F_ _ _L<br />

OP_ _ _TE<br />

18 | MSWA BULLETIN SPRING <strong>2018</strong>

Managing Stress<br />

Everyday life can bring about a variety of stressful situations,<br />

particularly when living with MS. It is important to find<br />

effective strategies to help manage your stress and help you<br />

deal with the challenges of daily life. This will be different for<br />

everybody and can include catching up with friends, listening<br />

to music, exercising, being creative, yoga and meditation.<br />

Meditation is used to calm the mind and consequently relax<br />

the body. When we are tense, we breathe from the chest<br />

rather than the belly. One way to relax and reverse this style<br />

of breathing is to sigh. Three sighs is a short meditation which<br />

can be done anywhere and anytime and was adapted by<br />

Eric Harrison from the Perth Meditation Centre. This simple<br />

exercise allows you to purposely relax for a few moments.<br />

Eating Well<br />

Protein is one of the major building blocks in our foods, along<br />

with fats and carbohydrates. Proteins are made up of chains<br />

of smaller units called amino acids. When we eat foods<br />

containing protein, enzymes in our digestive tract break up<br />

these chains so that they can be absorbed into our blood and<br />

used in our body.<br />

Protein plays several very important roles in our bodies,<br />

including; forming and maintaining cells, maintaining<br />

muscles, being an important part of enzymes, which assist<br />

many essential chemical processes in our bodies, and<br />

forming blood cells. Adequate protein maintains lean muscle<br />

mass which contributes to strength and stamina, reducing<br />

the risk of falls and injury and improving independence and<br />

quality of life.<br />

Good sources of protein in our diet include:<br />

• Lean meat, chicken and fish (unprocessed is best)<br />

• Nuts and seeds<br />

• Tofu and tempeh<br />

• Beans<br />

• Eggs<br />

• Milk, yoghurt, cheese and dairy alternatives<br />

People of different sex and ages need a different amount of<br />

protein each day.<br />

If you are a male, you should aim for:<br />

3 serves if you are 19-50 years of age<br />

2.5 serves if you are 51 or over.<br />

If you are a female, you should be eating roughly:<br />

2.5 serves if you are 19-50;<br />

2 serves if you are 51 or over.<br />

Here’s how to do it:<br />

Breathe in deeply, opening the rib cage<br />

Sigh: let the breath go without forcing it<br />

Rest in the pause, feeling the belly soften<br />

Wait until you really need to breathe in again<br />

Take a second big in-breath. Feel the chest open further<br />

Drop into the soft, loose out-breath<br />

Pause again and wait<br />

And a third time, feeling everything loosen<br />

Let your breathing resume its natural rhythm. It will now feel<br />

slow, deep and soft<br />

Breathe naturally or sigh gently as you wish<br />

If you are interested in further practice of meditation,<br />

our counsellors are facilitating a mindfulness meditation<br />

session on Thursday, 20 September in Nedlands.<br />

For more information, please contact Sarah Lorrimar on<br />

9365 4858 or sarah.lorrimar@mswa.org.au<br />

Try this tasty protein-rich recipe<br />

from LiveLighter<br />

Lamb Tagine<br />

Ingredients<br />

• spray olive or canola oil spray<br />

• 200g lean lamb, diced<br />

• 1 onion chopped • 1 clove garlic finely chopped<br />

• 1 tsp ground cumin • 1 tsp ground coriander<br />

• 1 tsp ground cinnamon • 1 tsp smoked paprika<br />

• 1 tsp reduced-salt vegetable stock<br />

• 1 400 g can no-added-salt diced tomatoes<br />

• 1 carrot • 1/3 400 g can no-added-salt chickpeas, drained<br />

• 8 dried apricots • 3/4 cup couscous (GF option:<br />

• 3/4 cup boiling water • 1/2 lemon, zest and juice<br />

• 1/4 cup coriander stalks and leaves, optional<br />

Method<br />

1 Spray a large non-stick pot with oil and place over<br />

medium heat.<br />

2 Add the lamb to pan and brown on all sides for 2 minutes,<br />

stirring frequently. Remove from the pan and set aside.<br />

3 Cook onion and garlic over medium-high heat for 3 minutes,<br />

stirring often. Add spices and cook for 1 minute until fragrant.<br />

4 Return meat to pan along with stock powder, tomatoes,<br />

chickpeas, carrots, apricots and coriander stems (if using).<br />

Season with pepper and stir to combine. Cover and allow to<br />

simmer for 20 minutes until vegetables are tender and lamb<br />

is cooked through. Check halfway through and add a little<br />

more water if required.<br />

5 In a medium heatproof bowl combine couscous, lemon juice<br />

and zest and boiling water. Cover and set aside for 3 minutes<br />

or until ready to serve. Fluff couscous with a fork to separate<br />

grains and stir through half the chopped coriander leaves.<br />

6 Divide couscous between serving plates and top with<br />

remaining coriander.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 19





Around 40% of people with multiple sclerosis (MS) make<br />

dietary changes after their diagnosis 1 sometimes to lose weight<br />

and sometimes with the goal of reducing disease progression.<br />

However, there is very little consistency in the types of dietary<br />

changes people make – these range from healthy changes,<br />

such as increasing fruit and vegetable intake, to unhealthy<br />

changes, such as eating more convenience or snack foods.<br />

People newly diagnosed with MS often feel that they are<br />

not given sufficient dietary advice by their health care<br />

professionals. 2 This may partly be due to the fact that research<br />

on diet and MS disease progression has been limited and<br />

often poor quality; as a result, there are no evidence-based<br />

dietary recommendations specifically for people with MS.<br />

However, interest in this area of MS is growing rapidly, and<br />

many studies are under way that will help to answer some of<br />

the outstanding questions. Let’s have a look at the literature<br />

to date.<br />

Omega-3 fatty acids are very important for brain function,<br />

particularly the active forms of omega-3, known as EPA and<br />

DHA. These are the healthy fats we get from oily fish, fish<br />

oil supplements and cod liver oil. We do get omega-3 fatty<br />

acids from linseed, but only a small portion is converted in<br />

our body to the active forms, so linseed is not the best source<br />

of omega-3. Research on omega-3 and MS dates back<br />

to the 1970s, but trial quality was often poor and results<br />

were inconclusive.<br />

Two studies were conducted recently that assessed whether<br />

fish oil supplements might be effective in reducing MS disease<br />

progression. 3,4 Both studies randomly allocated participants<br />

with relapsing-remitting (RRMS) to two groups (treatment<br />

and control group). Participants in the treatment group were<br />

given a fish oil supplement, while participants in the control<br />

group were given a placebo supplement with no active<br />

constituent. After one to two years, researchers reported no<br />

beneficial effects of the fish oil supplements on MS disease<br />

activity. However, one study did show reduced inflammation<br />

in the treatment group compared with the control group. We<br />

know that inflammation is an important factor in MS disease<br />

progression, so reducing inflammation is a helpful outcome.<br />

These studies were considered ‘pilot’ studies, and included<br />

only a small number of participants (

Oily fish (eg salmon, tuna, mackerel, sardines) is the best<br />

dietary source of omega-3 and vitamin D and eating two serves<br />

of oily fish per week is recommended. Try to eat a variety of<br />

oily fish: it doesn’t have to be fresh, tinned fish will still contain<br />

these important nutrients. Avoid processed meats, which<br />

contain unhealthy additives, and limit your intake of other<br />

processed foods, including biscuits, cakes, confectionery,<br />

pastries, pies, commercial burgers, pizza, fried foods, potato<br />

chips, crisps and other savoury snacks, sugar-sweetened soft<br />

drinks and cordials, fruit drinks, vitamin waters, energy and<br />

sports drinks. These are considered ‘discretionary’ foods and<br />

should be eaten only sometimes and in small amounts.<br />

MSWA now has two practicing dietitians on board,<br />

who would be happy to help you make healthy dietary<br />

changes, simply phone 9365 4888.<br />

1<br />

Russell RD et al. (<strong>2018</strong>) Reported changes in dietary behaviour<br />

following a first clinical diagnosis of central nervous system<br />

demyelination Front Neurol 9:161.<br />

2<br />

Russell RD et al. (<strong>2018</strong>) Dietary responses to a multiple sclerosis<br />

diagnosis: a qualitative study Eur J Clin Nutr (in press)<br />

3<br />

Torkildsen et al (2012) n-3 fatty acid treatment in multiple sclerosis<br />

(OFAMS Study): a randomized, double-blind, placebo-controlled<br />

trial Arch Neurol 69:1044-51<br />

4<br />

Ramirez-Ramirez et al (2013) Efficacy of fish oil on serum of TNF<br />

α, IL-1 β, and IL-6 oxidative stress markers in multiple sclerosis<br />

treated with interferon beta-1b Oxid Med Cell Longev 709493.<br />

5<br />

Yadav et al (2016) Low-fat, plant-based diet in multiple sclerosis:<br />

A randomized controlled trial Mult Scler Relat Disord 9:80-90.<br />



We hear antioxidants mentioned frequently but do we understand<br />

what they are, and the potential benefits may be? Here we<br />

provide an overview for Members and a delicious recipe.<br />

What are Antioxidants?<br />

Antioxidants are molecules that help to defend our body’s<br />

cells against oxidative damage from free radicals. Oxidative<br />

damage is associated with the risk of several health conditions<br />

including cancers, heart disease, and macular degeneration.<br />

By protecting our cells from damage, antioxidants also help to<br />

slow the body’s aging process.<br />

Some of the antioxidants that we can get from our diet<br />

include: vitamin C, vitamin E, beta carotene, selenium, zinc.<br />

manganese, copper, flavonoids, carotenoids, phytochemicals,<br />

and several enzymes.<br />

Where do antioxidants come from?<br />

There are many different antioxidants. Some we make in our<br />

body, while others come from food, drinks (like tea and wine)<br />

or supplements. In general, antioxidants are better taken in<br />

the form of food, especially vegetables and fruits. Eating a<br />

variety of different fruits and vegetables not only supplies<br />

our bodies with plenty of antioxidants, but also lots of fibre,<br />

vitamins, and minerals. Cooking with herbs and spices will<br />

also help to boost your antioxidant intake.<br />

Including plenty of fruit and vegetables in your diet will provide<br />

you with the protective effects of antioxidants. Eat the rainbow!<br />

Be sure to include a wide variety of coloured fruits and<br />

vegetables as they provide different kinds of antioxidants. The<br />

stronger and more vibrant the colour the better. Try to include<br />

reds, oranges, yellows, greens, browns and blues/purples.<br />

See below for a list of some nutritious vegetables and fruits<br />

that are in season in spring.<br />

Vegetables<br />

Beetroot<br />

Asparagus<br />

Avocado<br />

Chilli<br />

Red onion<br />

Carrot<br />

Peas/snow peas<br />

Rhubarb<br />

Fruits & Berries<br />

Orange<br />

Grapefruit<br />

Lemon<br />

Lime<br />

Mandarin<br />

Mango<br />

Paw paw<br />

Silverbeet<br />

Tomato<br />

Sweet potato<br />

Broccoli<br />

Zucchini<br />

Spinach<br />

Herbs<br />

Blackberries<br />

Blueberries<br />

Raspberries<br />

Strawberries<br />

Apple<br />

Plum<br />

Boysenberries<br />

Capsicum<br />

Brussels Sprouts<br />

Broad beans<br />

String Beans<br />

Squash<br />

Pumpkin<br />

Eggplant<br />

Honeydew melon<br />

Passionfruit<br />

Persimmon<br />

Watermelon<br />

Peach<br />

Banana<br />

Rockmelon<br />

Crunchy Green Salad<br />

Ingredients:<br />

• 15 punnet sugar snaps • 120g rocket leaves<br />

• 1 small head of broccoli • 1 medium zucchini<br />

• 15 green beans • 1 avocado • 2 sprigs of mint<br />

• 3 alfalfa sprouts • 2 tbs olive oil • 1 tbs lemon juice<br />

• Black pepper • Salt<br />

Method<br />

Top and tail the zucchini. Using a peeler, peel the zucchini<br />

lengthways to make long thin strips.<br />

Top and tail the green beans and cut the broccoli into small<br />

florets. Steam the beans and broccoli for 2 minutes and<br />

refresh in cold water.<br />

De-string the sugar snaps and keep whole or cut in half if large.<br />

Slice the avocado.<br />

On a flat platter or large bowl, arrange the rocket and mint<br />

leaves. Add zucchini ribbons, broccoli, green beans, sugar<br />

snaps, and avocado; then top with alfalfa sprouts. Drizzle<br />

olive oil and lemon juice over the salad and season with salt<br />

and pepper.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 21



Fatigue is often referred to as a hidden symptom of multiple<br />

sclerosis (MS). Estimates vary but it is considered to affect<br />

between 60% – 80% of people with MS, the most common<br />

reported symptom affecting people with MS.<br />

Fatigue is not the same as tiredness. Tiredness is a normal<br />

experience for everyone and is usually resolved by getting a<br />

good night’s sleep.<br />

Fatigue on the other hand is the experience of a daily lack<br />

of energy and overwhelming tiredness that is not resolved<br />

by sleep. This level of fatigue can have a severe impact on<br />

a person’s normal day to day functioning and therefore their<br />

quality of life.<br />

So, what can you do about it?<br />

If there is an additional underlying medical cause for<br />

your fatigue, this needs to be addressed by your treating<br />

doctor, however there are some steps you can take to help<br />

manage fatigue:<br />

• Assess your available energy levels – think of your<br />

personal energy like a bucket. If you take something out of<br />

the bucket it needs to be refilled or it will run dry. This may<br />

be tracked over the course of a day or a week depending<br />

on what works for you. You may want to keep a diary for a<br />

week to see if there are patterns or triggers to your fatigue,<br />

what activities fatigue you etc. Also see what activities reenergise<br />

you.<br />

• Be aware of your own warning signs that indicate you<br />

are getting fatigued and act early. Some of the signs you<br />

may have include tired eyes, heavy legs, general tiredness,<br />

stiffness in shoulders, lack of concentration, poor balance,<br />

weakness or feeling ill, unmotivated, sleepiness, increased<br />

irritability, increased anxiety, feeling impatient and so on.<br />

It’s important to rest rather than try and push through these<br />

signs; you will recover quicker.<br />

• Conserve your energy for the activities that are important<br />

to you:<br />

– Plan and organise your work day/week<br />

– Delegate tasks to others when possible<br />

– Schedule in rest breaks before you become fatigued.<br />

Regular short breaks are more beneficial that one long<br />

break after a long period of activity<br />

– Pace yourself – Try not to rush activities at the beginning.<br />

Alternate between sitting and standing when you can<br />

– Use good body mechanics to reduce strain on our body<br />

– work without bending over, when lifting use your leg<br />

muscles to lift not your back, move items in several small<br />

loads rather than one large load, or better still, use a<br />

trolley to transport items, avoid reaching overhead<br />

• Eat Well – fatigue can be made worse if you are not eating<br />

enough or if you are not eating nutritious energising foods<br />

• Exercise – Reduced physical activity can make you feel<br />

worse and more fatigued. If you stay active within your<br />

limits, such as regular moderate exercise, this can increase<br />

your feelings of energy<br />

• Sleep well – poor sleep will make your fatigue worse<br />

• Dealing with heat and humidity which often aggravate<br />

MS related fatigue you can:<br />

– Drink cool water<br />

– Stay inside during hot times of the day<br />

– Wear breathable clothing<br />

– Consider use of cooling vests/neck ties<br />

22 | MSWA BULLETIN SPRING <strong>2018</strong>

• Manage your stress – Feelings of stress can increase<br />

feelings of fatigue. Some suggestions for managing stress<br />

include:<br />

– Adjusting your expectations – if you have 10 things you<br />

want to do, reduce this down to two to three things and<br />

schedule the others for another day<br />

– Talking to family members/friends to help them<br />

understand and be able to help you<br />

– Speaking to other people with MS to get support and<br />

ideas– strategies they use to manage stress and fatigue<br />

– Relaxation techniques<br />

– Recreational activities – can help to divert your attention<br />

from fatigue as well as re-energising you. It needs to be<br />

something you enjoy without requiring large amounts<br />

of energy, such as listening to music, reading, knitting<br />

and so on<br />

MSWA provides information about fatigue and a range<br />

of options to assist you in fatigue management. We have<br />

education sessions depending on your individual needs<br />

ranging from one-on-one advice, short presentations,<br />

half-day workshops and a six-week education program.<br />

These programs are more detailed and help you to better<br />

understand MS fatigue and identify strategies to help manage<br />

it. There is the added benefit of meeting others and sharing<br />

ideas and supporting each other, as you are facing the same<br />

issues.<br />

We also have a Fatigue Management App MS Energise<br />

available that can be uploaded to Apple devices. This is a<br />

self-paced fatigue management program.<br />

Over the coming months we will be offering some short<br />

information sessions on fatigue at various Outreach locations,<br />

scheduling some half-day workshops in both metro and<br />

Bunbury locations.<br />

If we have sufficient interest, we will run a six-week program,<br />

commencing once a week from Tuesday, 16 October to<br />

Tuesday, 27 November.<br />

If you are interested in getting more information on how<br />

to manage your fatigue, please contact the Occupational<br />

Therapy Department us on 9365 8888 to discuss the best<br />

option for you.<br />



We use our cognition every day, in fact, you are using it right<br />

now to read and comprehend this article. But what exactly is<br />

cognition? And is there anything we can do to minimise the<br />

effects of cognitive changes in our daily lives?<br />

Cognition refers to all aspects of memory and thinking.<br />

Approximately 50–70% of people living with multiple sclerosis<br />

(MS) experience some problems with cognition. Whether it<br />

is forgetting a few appointments, finding it difficult to focus<br />

and maintain attention, recognising objects and/or people, or<br />

learning and recalling new information. As it is with the physical<br />

symptoms of MS, the effects of cognitive change are different<br />

for everyone.<br />

Cognitive changes can be subtle and can be mistaken as the<br />

person simply ‘not listening.’ Research shows that most people<br />

with MS who experience a change in their cognition, start to<br />

notice a change when it becomes difficult to read a book, or<br />

follow a conversation with more than two people involved. It<br />

can be said that the most common area of change is the speed<br />

at which a person can take in and process information.<br />

There are several factors that impact a person’s cognition,<br />

other than the changes that occur within the brain. These<br />

include fatigue and tiredness, emotional stress, relapses,<br />

physical restrictions, medication, hormonal changes and<br />

lifestyle changes. When people are depressed or feeling low,<br />

they can suffer memory lapses or problems with concentration.<br />

So, what are some tips that<br />

you can follow to keep your<br />

brain healthy?<br />

• Exercise<br />

• Mental Stimulation – read, do crosswords<br />

• Nutrition – eat well<br />

• Social supports; stay connected socially<br />

• Vitamin D<br />

• Treatment for mood disorders<br />

• Quality sleep is vital for good brain health<br />

• Cognitive strategies; use lists or reminders – be organised<br />

Lack of participation can also impact cognition as the brain is<br />

not being stimulated. This is where our OTs can help!<br />

The MSWA Occupational Therapy department can provide<br />

advice and compensatory strategies to help manage cognitive<br />

changes. As no two people are the same, our OTs will work to<br />

provide an individualised approach focusing on your lifestyle<br />

and priorities.<br />

We are also looking at running five-week cognition group<br />

to provide a more in-depth discussion into cognition. More<br />

details to follow closer to the date!<br />

If you are interested in learning more about cognition<br />

and trialling some strategies to manage change,<br />

please contact one of our Occupational Therapists on<br />

9365 4888 to express your interest.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 23




Here is a brief update on the progress of our expanding<br />

facilities and development of new and existing sites at MSWA.<br />

WILSON – the full refurbishment was completed at the end of<br />

July. We had five months of construction and building and at<br />

times it was very dusty and noisy. The result is a fresh, open<br />

look and feel that is lovely to be in! There has been some<br />

movement of staff to new office locations within Wilson, to<br />

promote efficiency and enable larger teams to be centrally<br />

located. We have gained a larger physio gym, new massage<br />

rooms and 36 extra desk spaces.<br />

Members returned to their outreach programs from 31 July.<br />

It is good to see them back here once again. The whole site<br />

has taken on a fresh new look and somehow everything looks<br />

bigger, and it all matches! Please feel free to visit us and have<br />

a look.<br />

KELMSCOTT – The fit-out of new premises in Kelmscott<br />

is well under way, we expect to be open for business by<br />

mid-September. These premises will offer office space for<br />

meetings and consultations, counselling, and physiotherapy.<br />

Parking is easy as it is situated in a group of shops, at 2938<br />

Albany Highway, Kelmscott. If this may be of benefit to you,<br />

please speak with your therapist for details and the relevant<br />

program times.<br />

BUTLER – construction is making very steady progress and<br />

already is at lock-up. This site will be completed at the end<br />

of the year and opening early 2019. The large services hub<br />

is really taking shape and the high support accommodation<br />

units will benefit from separate communal spaces for<br />

entertainment and dining.<br />

ALBANY – great news, we have a site under offer, and are<br />

awaiting the outcome. It is a long process, but we will provide<br />

details when possible to do so. This will include both high<br />

support units and a service hub.<br />

BUSSELTON – ongoing negotiations; delays have gone<br />

beyond our control but should be resolved soon.<br />

SHENTON PARK – we are awaiting the Governments<br />

allocation of the title before we can progress but we will be<br />

building high support accommodation units on this site.<br />



The Occupational Therapy department will soon have a<br />

pressure mapping system to supplement services provided<br />

for seating and positioning for those using wheelchairs.<br />

The highly sensitive mat allows the therapist to accurately identify<br />

areas of the body that may be at risk of developing pressure<br />

injuries when seated in a wheelchair or recliner. The mat is placed<br />

on the seating surface and, when the individual sits, a real time<br />

image of pressure distribution is displayed on a screen allowing<br />

the therapist to identify areas of increased pressure.<br />

This assessment allows the occupational therapist to do the<br />

following;<br />

• Identify the need to review the current seating surface<br />

• Select or eliminate different seating surfaces during trials based<br />

on individual need and the outcome of pressure mapping<br />

• Justify the need for<br />

different seating surfaces<br />

and provide an accurate<br />

measure for funding bodies<br />

to consider when applying<br />

for funding of equipment<br />

• Discuss with the individual their own risk of pressure injury<br />

and develop a plan together<br />

• Record reliable data to develop an effective pressure<br />

management plan if required<br />

If this is something you would like to access, please<br />

speak with your allocated Occupational Therapist or<br />

contact the department on 9365 4888.<br />

This valuable addition to our equipment has been made<br />

possible through our MSWA fundraising efforts. Thank you!<br />

24 | MSWA BULLETIN SPRING <strong>2018</strong>


AND MS<br />


Being employed has benefits beyond just purely financial – it<br />

can improve quality of life, provide social interaction and give<br />

us a sense of purpose.<br />

Over the years MS studies showed that people with multiple<br />

sclerosis (MS) were much more likely to fall out of employment<br />

than people with other chronic conditions and the general<br />

population. The financial impact of reduced employment for<br />

people with MS places a substantial burden on individuals,<br />

families and the wider community.<br />

A paper published from the Australian MS Longitudinal Study in<br />

2013 provided insight into the causes for loss of employment;<br />

it wasn’t just about accessibility or unsupportive employers,<br />

but poor symptom management was shown to have a real<br />

impact of staying in the workplace. Hidden symptoms such<br />

as fatigue and urinary problems were likely to have a negative<br />

impact on staying in the workplace.<br />

Recent Australian research has shown that more effective<br />

disease-modifying therapies are associated with increases in<br />

the amount of work, work attendance and work productivity.<br />

At MSWA we provide information and individual support for our<br />

Members regarding many aspects that can impact on them<br />

remaining in the workplace, reducing hours or re-entering<br />

the workforce after a break. Our Health Education Officer<br />

arranges evening information sessions with guest speakers<br />

from Maurice and Blackburn, speaking about disclosure<br />

of your MS, your workplace rights and how to access your<br />

superannuation insurance policies if you need to exit the<br />

workplace due to your MS. Other issues regarding income<br />

and benefits can be discussed with our social welfare team.<br />

Depending on what funding you have available for services,<br />

our OTs can refer you to Job Access for a workplace<br />

assessment to improve your workspace and provide advice<br />

on any adjustments, aids or equipment that may be of<br />

benefit, or direct you to services that can look at these issues<br />

for you. Job Access are also able to advise on and organise<br />

Government funding to support workplace modifications and<br />

the purchase of equipment that may be required. Funded<br />

OT services can also provide advice on accessing disability<br />

employment support agencies, who are funded to assist<br />

people to return to the workplace and /or re-train.<br />

Our MS nursing team can support you with effective symptom<br />

management strategies and information and advice about<br />

your MS. We can also link you with expert providers.<br />

There are so many supports available and the MSWA<br />

team is here – we are just a phone call away – 9365 4840<br />

or email us at Get-in-touch@mswa.org.au<br />


Life was carefree and easy for Matt Nichols, a healthy young<br />

man who worked in a glass factory with the world at his feet.<br />

But in 2007, after telling his doctor he had been experiencing<br />

fatigue and dizziness at work, Matt was stunned to learn he<br />

had multiple sclerosis (MS).<br />

“When my doctor confirmed my diagnosis, I didn’t know<br />

what to think. I found it very confusing. Someone suggested<br />

I call MSWA and they were fantastic. Their nurses helped<br />

me understand the condition and since then, I’ve felt very<br />

supported.” Matt said.<br />

Now 44 years of age, life is starting to look up for Matt. He<br />

currently works as a cleaner four nights a week and cares for<br />

his six-year-old daughter, Willow.<br />

Willow is his continuous source of inspiration. “She’s full of<br />

positive energy and always there to give me a hug when I<br />

need it. I’m hoping that one day, I won’t need my crutches, so<br />

I can hold her hand while walking down the street.”<br />

Over the last 11 years, Matt has<br />

faced other symptoms such as<br />

fatigue, memory lapses and heat<br />

intolerance. It was his struggle<br />

with heat that prompted his move<br />

to Busselton in 2014.<br />

“Moving has had a really positive effect.<br />

You wouldn’t think that between Perth and Busselton there<br />

would be much of a difference climate wise, but just those<br />

few degrees make a big difference for me.”<br />

MSWA’s presence in the South West region has had a huge<br />

impact on his life and has supported him throughout his<br />

MS journey. Matt accesses physiotherapy, massage and<br />

counselling at MSWA’s local facility.<br />

“MSWA have been there for me every step of the way. I’m<br />

currently using crutches to get around, so having one<br />

facility catering to all my needs, means it will be easier<br />

to access my vital services under the one roof.”<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 25


WITHIN<br />


“Learn the rules like a pro so you can break them like an artist.”<br />

Salvador Dali.<br />

I visited the annual Year 12 art students’ exhibition at the<br />

Perth Art Gallery recently. The displayed works were amazing.<br />

They were meaningful, beautiful and so, so skilful. I was very<br />

impressed.<br />

I’d like to be an artist. Goodness knows I’ve tried over the<br />

years but there comes a point in your life where you have to<br />

face the truth: Monet I am not.<br />

When I was a child I would sit at the kitchen table with water<br />

paints and butcher’s paper painting boxy figures with stick<br />

legs and large eyes. During my teens in the seventies, I turned<br />

to macramé and crochet, starting ambitious pot plant hangers<br />

and crocheted bikinis. One year I convinced my mother to buy<br />

me a large quantity of purple raffia for what was supposed to<br />

be an incredibly beautiful wall hanging. That never-finished<br />

purple tangle ended up buried in the depths of a hall cupboard<br />

until it was finally thrown out when my mother moved house.<br />

University, marriage, multiple sclerosis (MS) and motherhood<br />

got in the way of my artistic career for a couple of decades, but<br />

I did attend a mosaic tiling course with a friend at some point<br />

during that period. I decorated a plant pot with multicoloured<br />

tiles, and gave it to my mother for her birthday. I know her<br />

well enough to know that the enthusiasm and thanks she<br />

expressed were not genuine. Next time I visited her I searched<br />

around for ages until I finally found it at the bottom of her<br />

beautifully manicured garden behind some shrubs. Neither of<br />

us ever mentioned it again.<br />

I picked up a paintbrush again in my 40’s when I attended a<br />

social painting group. I daubed acrylic paints on canvas in an<br />

attempt to recreate scenery from photos, but the results were<br />

not inspiring. I have not hung these pictures on my wall, but<br />

have them hidden behind some boxes in the spare room. I<br />

enjoyed the conversation and morning tea, though.<br />

When I was invited to join an art/craft group at MSWA I<br />

wondered if my time in the spotlight as an artist was finally<br />

coming. The group is called ‘Embrace the Shake’ and is<br />

intended to encourage creative expression in a supported<br />

environment among people with MS who have a tremor, or<br />

other difficulties with their hands. Actually, my hands are<br />

fine but they didn’t seem to mind me joining in anyway. I<br />

have discovered that it takes more than good hands to make<br />

a masterpiece but we have fun and we have cake for<br />

morning tea.<br />

I have a few excellent artists in my extended family.<br />

My elderly mother painted some very pretty watercolour<br />

flowers when she was younger. My brother-in-law, as well<br />

as being an excellent photographer and cameraman, paints<br />

lovely landscapes. A niece and a couple of nephews are<br />

skilled at drawing and are creative visual artists. Obviously<br />

the artistic DNA avoided me when I was born.<br />

I have had one moment of artistic success. Our group had<br />

an outing one day into the bush where we discovered some<br />

paperbark trees. We cautiously stripped a bit of bark off one<br />

that had fallen over. Back at the art room I selected a piece,<br />

added a couple of squiggles with black pen and put it inside<br />

a frame I found, and lo and behold – a landscape! I have my<br />

bark painting on my sideboard in my living room, and just nod<br />

modestly when guests and visitors compliment me.<br />

Art is good for you, apparently. “Art develops the whole<br />

brain. It is proven that art increases attention, strengthens<br />

focus, requires practice, develops hand-eye coordination<br />

and interacting with the world using mediums and tools.”<br />

(Obxartstudio.com) I did some research and there are lots of<br />

quotes by famous artists. Jackson Pollock of Blue Poles fame<br />

stated that “Painting is self-discovery.” Don Miguel Ruez said<br />

“Every human is an artist.” That may be true, but I note that<br />

famous Impressionist Henri Matisse once said “Creativity<br />

takes courage.” I know that is true.<br />

I don’t think I am going to make my mark on the world<br />

through painting. I think I’ll stick to writing. But I will<br />

keep going to our art group. I enjoy the morning tea.<br />

26 | MSWA BULLETIN SPRING <strong>2018</strong>




MSWA has arranged and provided me with so much<br />

assistance, in so many forms, since I joined 22 years ago. I’ve<br />

had lots of support workers who have helped me be good at<br />

whatever role I was enacting at the time. I’ve grown fond of,<br />

become grateful to, and been respectful of them, as I’m sure<br />

they must have come to be of me, and now some of them hold<br />

places in my memory like friends, or family members.<br />

When I was alone at home, my children had married and<br />

moved out, my husband had died, I was swanning about in<br />

a place that was far too big for just one person. The support<br />

workers would come more frequently because I needed their<br />

help more frequently. It dawned on me that a ‘care facility’<br />

would do everything the carers were doing, and I’d be able to<br />

go out and come back, the bed would be made, the washing<br />

would be done, the food would be cooked, and I would not<br />

have had to supervise any of it.<br />

My support worker comes here now as ‘social support,’ and<br />

the staff here do all the other stuff. It suits me very well.<br />

Some support workers at home had been coming for years.<br />

One even came to be ‘social support’ at this facility when I<br />

had moved here. My transition away from home, because I’d<br />

chosen to do it, was not as confounding and worrisome for<br />

me, as it seems to be for so many of the other residents here.<br />

Ageing alone separates the individual a little bit from the<br />

mainstream of society and then, for them to be locked into<br />

a place like this, for their own safety of course, is so far from<br />

their understanding. It’s so often a topic of conversation with<br />

them. Even those residents that are now spoon-fed and in<br />

a ‘transporter chair’ will sometimes grizzle that they could<br />

manage at home alone and will talk of their inability to fathom<br />

why they’ve been incarcerated.<br />

I speak with them about it as if I am dealing with a child.<br />

Because of their attitude, I then file them in the category of<br />

those residents whom I’m not going to include as a close<br />

friend. I still like them, but it’s one-way traffic. They’re out of<br />

time with life’s background music.<br />

One resident who has Parkinson’s, but is walking, came with<br />

me to a nearby coffee shop. We made our way there, me in my<br />

power-chair, and her holding on to the back of it. We crossed<br />

two roads then arrived and enjoyed our cake and cuppa.<br />

The young table attendant then helped us negotiate safely<br />

past other tables and chairs, back out onto the footpath. Doris<br />

resumed her position behind my chair and the waiter said,<br />

“well, there you are ladies, all set to go. What are you going<br />

to do today?”<br />

I thought, “we’ve just done it!”<br />

I said, “well, Doris and I spend a lot of time in the laboratory,”<br />

he just nodded his head. He knew it wasn’t true and I hope<br />

he realised that his question was not suitable for Doris<br />

and I. He’s always very nice to me now and I usually go there<br />

for morning tea with my support worker and he always serves<br />

us with a pleasant alacrity.<br />

I am proud of the way my support worker and I can get around.<br />

We can go almost anywhere. The world is becoming more<br />

wheelchair-friendly. It’s my oyster! Comparatively speaking,<br />

we are so good. I heard recently of young sportsmen, soccer<br />

players actually, who each needed to be sedated and wrapped<br />

up like parcels in order to get back on track and go home. I’m<br />

sure they’d be impressed with our form.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 27


NEWS<br />


<strong>2018</strong> MSWA Annual Dinner Auction<br />

On Thursday, 16 August the Board of Directors hosted the<br />

MSWA Annual Dinner Auction at the stunning Fraser’s State<br />

Reception Centre.<br />

This event allows MSWA to thank our supporters while raising<br />

much needed funds for Western Australians living with multiple<br />

sclerosis (MS) and all neurological conditions. The event is not<br />

possible without the ongoing support of our community and<br />

donors, and thanks to their continued efforts, we raised just<br />

under $100,000 dollars, breaking last year’s record.<br />

It was a beautiful evening and State Reception Centre, Kings<br />

Park played host to 300 guests including Members, dignitaries,<br />

sponsors and staff. The night included a panel interview with<br />

MSWA CEO Marcus Stafford, MSWA Member Chloe Baker<br />

and MSWA funded researcher Professor Prue Hart. They gave<br />

the audience an insight into life with MS and the world-first<br />

research offering hope to people living with MS.<br />

Our main auction items had a great response and got the<br />

bidding war started. To name a few, there was a luxury<br />

escape to Larry Cherubino Winery in Margaret River, a holiday<br />

for two to Europe, and an exclusive tour of the Channel<br />

Nine Studio followed by dinner at Point Bar and Grill with an<br />

on-air personality.<br />

We were very pleased to announce the MSWA Annual Dinner<br />

Auction 'Commitment Award' winners. Central Park won the<br />

business category award for their incredible commitment to<br />

our annual Step Up for MSWA, and the <strong>2018</strong> World MS Day<br />

activities. While the individual category award was presented<br />

to Andrea & Vlad Martinovich who have been supporting<br />

MSWA since 2011.<br />

MSWA Individual Commitment Award winner, Vlad Martinovich and<br />

MSWA President George Pampacos.<br />

Guests checking out auction items.<br />

Once again, thank you and congratulations on another<br />

successful night which brought together MSWA Members,<br />

Clients and the Western Australian community.<br />

MSWA Ocean Ride – Sunday, 25 November <strong>2018</strong><br />

Now in its ninth year, the MSWA Ocean Ride – Powered by<br />

Retravision is the only community bike ride event of its kind<br />

within the metro area.<br />

The event has grown in numbers of participants, and now<br />

includes five ride distances to cater for all ages and capabilities,<br />

as well as a special Members’ Ride for MSWA Members.<br />

Join us today and put your body - and bike - on the line!<br />

Your support will make a difference to Western Australians<br />

living with MS and all neurological conditions.<br />

To find out more visit www.mswaoceanride.org.au<br />

28 | MSWA BULLETIN SPRING <strong>2018</strong>




Sometimes all we want to do is run and hide from reality.<br />

We want to pretend we have no responsibility, no disability, no<br />

housework and no bills. Imagine if life could be just a simple<br />

and fun fairy tale? Well thanks to community theatre it can be.<br />

Once upon a time in this instance, was a colourful and<br />

mythical story on the stage of Mandurah Performing Arts<br />

Centre, when Stray Cats Theatre Company presented Shrek<br />

The Musical. A cast of experienced and skilled actors brought<br />

the Dreamworks classic to an excited audience of all ages.<br />

For those who do not know the story of Shrek, here is the<br />

simplest overview I can offer. Shrek is an ogre – fat, green and<br />

smelly (consider him our disability). Donkey is a humorous,<br />

sarcastic and loveable ass who makes everything in life funny<br />

(even the tough times). And Fiona the princess is the beautiful<br />

damsel, trapped in the tower awaiting a prince to rescue her,<br />

so she can fall in love and live happily ever after. Oh, to be that<br />

beautiful princess!<br />

The production was led by Director Karen Francis, Vocal<br />

Director Kristie Gray and Musical Director Vanitha Hart.<br />

Larger than life actor, Nicholas Gaynor brought the character<br />

of Shrek to life and his onstage presence teamed perfectly<br />

with the comedic Donkey, portrayed by Jiojo Nawanawa. And<br />

of course, that beautiful princess played by Lisa Taylor.<br />

An ensemble and lead cast of more than seventy people<br />

presented a professional, well executed production and should<br />

be very proud of their interpretation of Shrek The Musical.<br />

Act two saw Shrek and Donkey become friends and on the<br />

King’s order, set off to rescue the princess; she is horrified<br />

to discover her knight in shining armour is an Ogre. Alas, as<br />

the story unfolds and love’s true kiss brings them together –<br />

Princess Fiona also turns into a fat, ugly, smelly ogre.<br />

So why did I review this musical theatre show for our <strong>Spring</strong><br />

Edition? Because Shrek reminds me of living with multiple<br />

sclerosis (MS). Life is not a fairy tale, but we can find<br />

goodness and laughter.<br />

Disability can be perceived as smelly and unlikable and<br />

somewhat ugly! I feel like nobody understands me, and I am<br />

sure I am not alone when I think, “I am living in a swamp land,<br />

somewhere completely unfathomable to others.”<br />

Of course, to other ogres like me, they see my world as<br />

just fine!<br />

And then the ‘disability’ meets someone ‘normal’ and they fall<br />

in love. Love sees past the physical self and into the heart of<br />

the ogre, and even though I feel like an ogre, I know inside I<br />

am a still a princess.<br />

Why not visit www.manpac.com.au for a full listing of<br />

their <strong>2018</strong>/19 season and escape reality for just one night.<br />

Mandurah Performing Arts Centre is a quality venue with<br />

ACROD parking bays, all access toilets, theatres and foyers.<br />

The adjoining boardwalks also have ramps and railings<br />

for ease of access for you to enjoy the beautiful estuary<br />

and nearby cafes. The venue also honours the Companion<br />

Card WA Program which makes for a hassle-free, night of<br />

entertainment for you and your carer/companion.<br />

When will your ‘Once Upon A time’ become a reality.<br />

Discover community theatre soon.<br />

SPEECH PATHOLOGY WEEK <strong>2018</strong><br />


Speech Pathology Week takes place on Sunday, 19 to<br />

Saturday, 25 August <strong>2018</strong>. The theme for Speech Pathology<br />

Week in <strong>2018</strong> is:<br />

Communication access is communication for all!<br />

More than 1.1 million Australians have communication or<br />

swallowing disorders which adversely affect their ability to<br />

undertake everyday activities and participate successfully in<br />

social interactions.<br />

Speech Pathology Week seeks to promote the speech<br />

pathology profession, the work done by speech pathologists<br />

and the role they play in the lives of Australians with speech,<br />

language, communication and swallowing difficulties.<br />

During Speech Pathology Week the MSWA speech pathologists<br />

will be talking to Members and Clients at Outreach about the<br />

profession and services that can be provided to them.<br />

The department will also be running weekly word finding<br />

groups throughout the year. These sessions are designed for<br />

people with neurological conditions and will focus on;<br />

• The provisions of educational information in word finding<br />

difficulties<br />

• Group sharing and discussions<br />

• Strategies to assist with word finding difficulties<br />

• Practical activities to use at home<br />

For further information on groups or other speech pathology<br />

services please contact the department on 9365 4888.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 29



Where does the time go, I can’t believe I’m shouting out hello<br />

to you all again for the <strong>2018</strong> <strong>Spring</strong> Edition of the <strong>Bulletin</strong>.<br />

I’m not sure about you, but my feet hit the ground running at<br />

the start of the year and I’m having trouble with the rest of<br />

my body catching up. Luckily spring is on its way, and it will<br />

be time to stop and smell the roses, which hopefully means<br />

things might slow down a little.<br />

So much happens over the months between <strong>Bulletin</strong>s, it<br />

is hard to remember it all. National Volunteers Week just<br />

happened when I last wrote to you, and both events in Perth<br />

and Bunbury went well. It was very special having our CEO<br />

Marcus Stafford attend the volunteer luncheon in Bunbury<br />

recently. This event is usually low key and a bit more casual<br />

compared to our Perth event. The luncheon was held at<br />

Backbeach Café and had a real vibe and lots of noise in the<br />

background; such a beautiful venue which appears to be<br />

extremely popular with the locals.<br />

I thought I would share some statistical information regarding<br />

National Volunteers Week all over WA. Did you know, in WA<br />

alone, there were 235 celebrations held to recognise and<br />

thank volunteers and 16,129 volunteers attended these<br />

events. The breakdown of these celebrations looks like<br />

this; Kimberley Events four, Pilbara six events, Gascoyne<br />

two events, Midwest eight events, Goldfields nine events,<br />

Wheatbelt 19 events, Peel 14 events, Southwest 23 events,<br />

Great Southern seven events and Perth 131.<br />

Let’s not forget those who couldn’t attend an event or live<br />

in areas where an event wasn’t possible. We Western<br />

Australians, should be proud of all those people who put<br />

others before themselves and give back to the community.<br />

We are especially fortunate at MSWA to have over 250<br />

people volunteering with us in both our Member Services and<br />

Events teams.<br />

We had one of our annual Members camps at Moore River on<br />

28 May, which went off with a bang as usual. Our numbers<br />

are getting larger for this camp every year, which is great to<br />

see. Lots of fun, activities, laughter, great food and games.<br />

Again, I had the privilege to attend this camp as did three of<br />

our MSWA volunteers. I would like to thank Rosalind, Mike<br />

and Jacqui for coming along to help. The difference you make<br />

is immeasurable and we appreciate the time you take out of<br />

your week to attend, as it isn’t a day here and there, it’s for<br />

the long haul – four days and three nights.<br />

Jacqui came from Bunbury and had a long day travelling each<br />

way. It is great having volunteers attending camp and if any<br />

of you are ever interested in volunteering on camp or know<br />

of anyone who would, please contact me and we can discuss<br />

it further. As I always mention, I would like to thank the staff<br />

that attend, especially our cook, Kylie and her lovely assistant<br />

Rhonda. It was the first time for both of them and feeding 25<br />

hungry people is a feat all on its own, let alone doing it three<br />

times per day.<br />

The biggest news I would like to share, is that the<br />

refurbishments of our Wilson facility are all completed, and<br />

it is looking pretty fine. Thank you to all who have been<br />

affected throughout this transitional stage; the flexibility and<br />

enthusiasm in which volunteers, Members and staff have<br />

dealt with the upheaval has been amazing, and as you can<br />

see, it was worth the effort. ‘No pain, no gain,’ isn’t that<br />

how the saying goes? In no time at all it will be like nothing<br />

happened and we will be wondering what all the fuss<br />

was about.<br />

I would like to make a special mention to Lesley Pitt and Lynn<br />

Hoonhout for coming in over the final week of preparation of<br />

the unveiling of the Wilson facility, to set up the craft area for<br />

our volunteers and Members. Many of the staff have been<br />

working hard bringing it all together and have gone over and<br />

above their normal duties. Thank you all, it is the team spirit<br />

that keeps us motivated and working towards one goal. As my<br />

husband likes to continually remind me, there is no number<br />

one in team.<br />

Trish Watson from our events team would also like to<br />

share a few words:<br />

It has been a busy year for the events team. We kicked of the<br />

year with the new Albany Ride, which was well received along<br />

with the long-standing Albany Swim in February.<br />

This was followed in Perth by a fantastic World MS Day, we<br />

had a great turnout for the Street Appeal along with the Hip<br />

Hop Yoga in the park.<br />

Step Up for MSWA saw a record number of people take up the<br />

challenge to climb to the top of Perth’s Central Park building.<br />

These events would not be possible without the help of a<br />

dedicated bunch of volunteers, so we would like to take this<br />

opportunity to say a big THANK YOU to all the Members and<br />

staff who came along to support our events.<br />

30 | MSWA BULLETIN SPRING <strong>2018</strong>

We have our MSWA Ocean Ride coming up in November, so if<br />

you would like to lend a hand feel free to contact Trish Watson<br />

on 6454 3116 or for any general questions about events,<br />

please call 6454 3131.<br />

Thanks Trish. It’s fantastic what our events team does to<br />

promote awareness of multiple sclerosis (MS) and also<br />

raising funds to support research and people living with a<br />

neurological condition. These funds enable MSWA to make<br />

their lives that bit better as your work is amazing.<br />

Last and certainly not least, I would like to personally thank<br />

every one of our volunteers at MSWA. You are an inspiration<br />

to us all, and the difference you make, is HUGE, no matter<br />

how much time you give. Remember the statement ‘give a<br />

little, change a lot’ that’s all it takes to make a difference in<br />

someone’s day or their lives. For this, I truly thank you from<br />

the bottom of my heart.<br />

As always, my door is open, and I hope to see you. If<br />

you would like to discuss any further volunteering<br />

opportunities or if you have any feedback don’t hesitate<br />

to call me 9365 4888 or send an email to volunteer.<br />

coordinator@mswa.org.au.<br />

That’s all for now, take care, enjoy the warmer weather and<br />

see you around.<br />

Until next time<br />



After a few months of renovation, our Wilson Outreach is<br />

now back to business as usual. With the new fresh looks of<br />

our lounge, craft room and dining area, the rooms are just<br />

fantastic.<br />

Since the craft area will be back under Outreach supervision,<br />

we are thinking of making full use of this area. At the moment,<br />

every Monday we have the ‘Embrace the Shake’ group<br />

occupying the room, followed by card making on Tuesdays<br />

and art/paintings on Thursdays.<br />

Now, we hope to add ‘Artsy Crafty Day’ on a Wednesday; I<br />

have already been talking with some Members and they are<br />

keen to join in.<br />

At the moment we have a few<br />

‘Artsy Crafty’ ideas such as<br />

mosaic, alcohol ink art and<br />

paper quilling, but those are<br />

only a few of the exciting<br />

ideas so far. Any ideas are<br />

most welcome!<br />

We always welcome new<br />

Members to come and visit<br />

us at Wilson Outreach and participate in our activities or<br />

to come for socialising or even just a coffee!<br />

Please feel free to contact our Wilson Outreach<br />

Coordinator, Nicola Ryan at nicola.ryan@mswa.org.au if<br />

you have any queries or you wish to come in and see<br />

what it’s all about.<br />



Our group will once again have a syndicate to buy our tickets<br />

in the next MSWA Mega Home Lottery. With most Members<br />

sharing in the purchase of eight tickets we are once again<br />

filled with optimism!<br />

Angie and John are excited about having their Japanese family<br />

(including two young school-aged children) staying with them<br />

for a year while their son studies at ECU. The granddaughters<br />

have had a challenge coping with a new school, different<br />

education system, English language etc. It’s been good for<br />

Grandma’s multiple sclerosis (MS) brain to keep up with all<br />

this new learning alongside the children.<br />

Member Helen is counting the days before she heads off for<br />

a Canadian holiday of a lifetime. Her new double-duty walker<br />

that converts to a wheelchair will prove invaluable! Looking<br />

forward to some great photos, Helen.<br />

Craft is popular with<br />

Members – activities include<br />

everything from key rings<br />

to 3D photo frames. Cheryl<br />

and Graeme enjoy putting<br />

together mind-bogglingly<br />

tiny mini-jigsaws each week,<br />

while Graham and Jacqui have<br />

a go at Rummikub.<br />

Get better soon Jerry – we miss your infectious laugh!<br />

A big hello to a few of our former Members (Michelle,<br />

Doug, Peter) who are now part of the new Mandurah<br />

Outreach group. Welcome to new Member here, Michelle.<br />

We hope you enjoy the fun and activities and friendly<br />

vibe of our Friday Outreach.<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 31



The Tuesday Outreach group in Rockingham is very alive and<br />

well! The Members who attend every week thoroughly enjoy<br />

the lively chatter, each other’s company and the inventive<br />

craft activities!<br />

Recently they have started diamond painting and have also<br />

created button bowls and 3D photo frames!<br />

A beautiful home-cooked lunch is served fortnightly<br />

by Rosemary the cook, and she is supported by Sherril<br />

the kitchen volunteer. The alternate week we share a<br />

morning tea!<br />

Some themes the group have enjoyed this year included an<br />

amazing high tea to celebrate the Royal Wedding, which was<br />

held in March, and Christmas in July with all the trimmings!<br />

Some Members attending<br />

the group have even<br />

organised a mini holiday<br />

together at Treendale<br />

Gardens Respite Facility.<br />

We look forward to<br />

hearing about their stay.<br />

New Members are<br />

always welcome to come<br />

and join the group and<br />

you most certainly won’t<br />

be disappointed!<br />

For further details you can call the Rockingham Centre<br />

on 9592 9202 or email the Senior Outreach Coordinator<br />

Nicola.ryan@mswa.org.au<br />




We have had a busy year so far. With an information day, Ride<br />

for MS and then the Albany Swim, it was a hectic few weeks.<br />

Thanks to all those who participated, volunteered or just came<br />

along to give moral support, it made the day a huge success.<br />

It was really great to meet so many people who came to town<br />

from all over the place to compete. Well done to all.<br />

We have been to Great Southern Grammar and given a talk<br />

about multiple sclerosis (MS) and thanked them for their<br />

continued support with the Swim. We are considering inviting<br />

some students along to Outreach, so they can see what some<br />

of their fundraising has been spent on.<br />

As we like to hear what is happening and what our MSWA staff<br />

can help with, we have had Anne (OT) give a talk on assistive<br />

technology which was really interesting. Until someone lets<br />

you know what is out there and about the extensive range of<br />

apps that are available, you can be missing out. Some great<br />

apps are free – to help with memory, relaxation, organising<br />

your medications, shopping – and the list goes on. If you need<br />

help with anything you just need to ask MSWA staff.<br />

Suzanne our physio also jumped at the chance to talk about<br />

the benefits of exercise and explained that small amounts are<br />

often helpful. Exercise classes have been running on a Friday<br />

morning covering different areas. Strength and balance<br />

is one that has been popular, Pilates, and the pool classes<br />

on Tuesday and Thursday mornings. If you would like more<br />

information please give us a call.<br />

One large spend of our Swim money was allocated for the<br />

Reformer exercise machine which was a little over $4,000.<br />

Suzanne is keen to get a few more Members using it so come<br />

in, have a look and talk to Suzanne to see if it is suitable<br />

for you.<br />

We do send out a Members newsletter in The Great Southern<br />

so if you don’t already receive it and would like to, please give<br />

us a call on 9841 6651 or email us at albany@mswa.org.au<br />

and we can add you to the list..<br />

We really value your feedback so for outing ideas,<br />

guest speakers or activities let us know your thoughts.<br />

FYI whilst we are an MS Support group, we talk about<br />

lots of things, food comes up a lot!<br />

32 | MSWA BULLETIN SPRING <strong>2018</strong>



A big warm “hello” from all the Members and staff at the<br />

Bunbury Hub Outreach Group as we welcome some brighter<br />

weather heading into spring. We are now into our second year<br />

of enjoying our wonderful Outreach area and all the services<br />

this wonderful facility provides for our Members and Clients<br />

here in the south west area.<br />

Apart from our weekly social gatherings and playing various<br />

board games including the popular focus word quizzes, Bogan<br />

Bingo and a trip to the Las Vegas Casino Strip, we have also<br />

enjoyed visits from several guest speakers. They have covered<br />

various topics including a very informative presentation by a<br />

volunteer Dave from the Citizens Advice Bureau, on a range of<br />

situations that may affect any of us in everyday life.<br />

The highlights of this year so far have been firstly, celebrating<br />

World MS Day in late May with a very interesting and<br />

informative presentation given by special guest and MSWA<br />

funded researcher, Dr Lucinda Black on her recent research on<br />

Diet and Living with MS. This was followed by a presentation<br />

from Member Services General Manager Sue Shapland<br />

detailing recent MS research updates and information about<br />

the NDIS soon to commence in the remaining south west<br />

as of October 1, <strong>2018</strong>. The morning was very well attended<br />

with many questions asked with informative conversation<br />

and discussions being had around the room regarding these<br />

topics and the coming future changes of the NDIS. Members<br />

were advised that our MSWA NDIS team will contact them all<br />

in August and schedule information sessions in Bunbury – so<br />

stay tuned.<br />

Secondly, after a presentation by guest speaker Mr Laurie<br />

Blurton from the Bunbury Lawn Bowling Club to gauge interest<br />

in the possibility of an outing to their club, we switched tacks to<br />

holding an indoor bowling morning in our large Outreach area.<br />

This proved to be a great success with Members, Clients and<br />

staff participating together. We had a great laugh, so many<br />

thanks to Nicola Ryan and Wilson for loaning their bowling<br />

mat and gear to the Bunbury Group. Laurie has graciously<br />

offered to acquire a donated bowling mat for our group to hold<br />

future bowling challenges and trophy mornings and to provide<br />

a set of bowls to use. Many thanks to Laurie and the Bunbury<br />

Bowling Club for their time and organisation for the morning<br />

and into the future.<br />

We are now looking forward to once again hosting CEO<br />

Marcus Stafford for our regular MSWA update presentation<br />

in late August. We will have a special morning tea before the<br />

presentation, which is always well attended.<br />

Other activities in the pipeline are a holiday trip to Ireland to<br />

find some leprechauns, four leafed clovers, kiss the Blarney<br />

Stone and attempt some Irish dancing!! We are also excited<br />

to have been invited to return to Chalbury Park B & B gardens<br />

in Harvey by owners and friends Jeff and Karen Wittock<br />

for a garden morning tea. Our first outing to this beautiful<br />

establishment was absolutely fabulous, and to enjoy the<br />

immaculate surroundings in spring was, and will be again,<br />

sublime and uplifting for the soul.<br />

As I close, I would like to thank all our Members, Clients<br />

and staff for their great contributions to our group thus far<br />

this year, and always, and for making us who we are today.<br />



Wayne Harris, a much-loved resident at Treendale, sadly<br />

passed away in June <strong>2018</strong>. His parents have bought a lovely<br />

handcrafted wood and glass plant stand for Treendale. It is<br />

a lovely way for us to remember Wayne who was a lively<br />

and entertaining resident and member of our Treendale<br />

community; enjoying a joke, singing along with music and<br />

chatting to all who passed by.<br />

Our Treendale Gardens residential units will be full in August<br />

when a new gentleman moves in. He has regularly visited<br />

us and enjoyed staying in respite and is very much looking<br />

forward to joining us here. The residents continue to enjoy<br />

regular social support from the Individual Options team as well<br />

as regular recreational events in the communal area. Some of<br />

the residents, and our cooks, continue to enjoy working on<br />

our fruit and vegetable<br />

garden and reap the<br />

rewards, with their<br />

meals often including<br />

something homegrown<br />

from the garden.<br />

We still have many wonderful visitors to our respite<br />

house and family holiday unit, who come down to enjoy<br />

the restful atmosphere of Treendale Gardens and the area<br />

in general. We often have space so if you are interested<br />

in a country getaway please give us a call regarding a<br />

booking on 9725 9209, or email Treendale@mswa.org.au<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 33




My wife had major surgery on her shoulder, the tendons worn<br />

thin after years of singlehandedly carrying the increasing load<br />

of caring for me. Fortunately, there is MSWA’s Respite Home<br />

at Treendale, situated adjacent to the Leschenault Inlet at<br />

Bunbury that provided a safe haven for the next three months<br />

while my wife recovered. This was crisis accommodation, not<br />

actual respite, however if Treendale had not existed at that<br />

particular time the nursing-home alternative doesn’t bear<br />

even thinking about, except to say that the Treendale facility<br />

is ‘priceless.’<br />

Treendale is part of, but separate from, MSWA’s high-support<br />

accommodation units. Together it is a nicely proportioned<br />

complex set in well-manicured parklands next to a huge<br />

artificial lake which is the terminus of a natural stream that<br />

winds its way northeast from the Leschenault for a kilometre<br />

or so through the encroaching suburbia. Period-style<br />

footbridges allow access to both sides of the trickling stream,<br />

adding a special character which harmonises the area.<br />

Families of wild ducks are the final touch to this idyllic setting.<br />

If the weather is fine the journey by power chair makes a nice<br />

exploratory trip.<br />

To the east of Treendale, the facility overlooks a wide expanse<br />

of vacant land set aside for future development, and this<br />

land abuts a large blossoming shopping centre anchored<br />

by Woolworths at one end and Bunnings at the other – all<br />

of which is within easy reach by power chair. Treendale is a<br />

relaxing mixture of country life and the slow encroachment<br />

of suburbia stemming from Bunbury, with the architects<br />

obviously trying to balance the environment.<br />

Treendale reflects this attention to detail by the architects to<br />

fade the MSWA complex neatly into this carefully modelled<br />

setting. Considerable attention has been given to the security<br />

fencing however, which is unobtrusive but significant.<br />

Security, lighting and privacy is of paramount concern for<br />

the managers.<br />

This attention to detail continues inside the respite home.<br />

There are six spacious bedrooms, each with an overhead<br />

hoist, television and DVD player, connected to an equally large<br />

shared bathroom. The dining room and television area for<br />

those residents who desire big-screen viewing, is individually<br />

incorporated into a large open-plan room. It is a generous<br />

country-style home subtly incorporated into the larger facility<br />

which is in keeping with the great outdoors yet retains its own<br />

character and homely feeling. A three-bedroom holiday unit<br />

is attached.<br />

The wonderful staff go out of their way to make both Members<br />

and NDIS Clients comfortable. One cannot but feel other than<br />

completely relaxed and at ease in this particularly unique<br />

environment. The meals are country cooking at its best.<br />

Laundry is a daily service.<br />

For everyone involved in the decision-making process to<br />

utilise Treendale is a win-win situation. Carers get a break<br />

and Members/Clients get a holiday in a coastal/country<br />

locality connected to the Perth metropolitan area by a modern<br />

highway. If there is a need for some excitement, dining and<br />

entertainment, the bustling city of Bunbury is a short distance<br />

away using the multi-purpose taxi service.<br />

Since the early days when the facility was opened 8 June 2012,<br />

Treendale’s popularity has been slowly growing as realisation<br />

dawns that this is a first-class facility. It is therefore prudent<br />

to book ahead to avoid disappointment. For Perth residents<br />

transport can be arranged to and from the respite home.<br />

Treendale is a unique holiday experience, offering family<br />

members the added reassurance that the 24 hour 7 day<br />

service on offer is safe and their loved one will be cared for<br />

by MSWA’s certified and fully trained staff. Not as obvious as<br />

research, respite for carers, Members and NDIS Clients has<br />

an important role to play in the continuing fight against the<br />

unknown causes of neurological disability.<br />

If you would like to find out more about Treendale, or<br />

arrange a viewing, please contact Paula Kennedy on<br />

9725 9209 or email treendale@mswa.org.au<br />

34 | MSWA BULLETIN SPRING <strong>2018</strong>

Take a break<br />

in the South West<br />

Treendale is only 20 minutes from Bunbury,<br />

located next to a small parkland with wheelchair<br />

friendly paths and a shopping centre nearby.<br />

MSWA Treendale is our 6-bedroom, 3-bathroom purpose built, accessible respite<br />

home. Our staff are onsite 24/7 and are experienced in supporting people living<br />

with MS.<br />

Located next to our respite home is our wonderful 3-bedroom family holiday unit<br />

where family can get away from the routines, whilst accessing support for their<br />

loved ones if needed. We may even be able to assist you with transportation.<br />

Funding to cover your stay may be available through the Commonwealth Carer<br />

Respite Program or through your DSC or NDIS individual packages. Speak with<br />

our friendly team to chat about your individual needs.<br />

For more information or to book your stay at<br />

Treendale Gardens, phone us on 9725 9994<br />

MSWA BULLETIN SPRING <strong>2018</strong> | 35

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