Making Wellness Work in the Real World

Making Wellness Work in the Real World

Episode 209 – Podcast Transcript

[(0:24)] Stephanie Buxhoeveden: Welcome to the Can Do MS podcast. I’m your host, Stephanie Buxhoeveden. I live with MS and I’m also a clinician and MS researcher. Today, I’m joined by Maggie Rodriguez, an MS certified nurse practitioner at DHR Health Neurology Institute in South Texas. She’s also lived with MS herself for 20 years. Maggie, it’s so great to have you here today.

[(0:46)] Maggie Rodriguez: Thank you, Stephanie. I’m glad to be here.

[(0:49)] Stephanie: Now we’re going to talk about the fact, you know, we’re both healthcare providers who live with MS, uh, so we know this from both sides of the desk. But MS is not the only thing we’re managing when it comes to our health. And when we talk about living well with MS, I think we tend to focus a lot on MS itself. Um, but of course, it’s not the only thing that goes into us and our health. So many people are also managing things like weight control, diabetes, cardiovascular risk, other chronic conditions. So when you’re seeing someone in the MS clinic, how much do those other conditions factor into how they’re feeling and functioning day to day?

[(1:28)] Maggie: So in our clinic, because I am from South Texas, um, we do see a lot of patients with comorbidity. So it does, it does factor into, um, our conversations daily that we’re having with patients. Um, just alone in the Rio Grande Valley from where we’re fun-, we’re from, it is, um, 44% is diabetes and, um, obesity is like 24.4% of the population here. And McAllen, Texas is where we have our clinic. And we have been known for six years running as the fattest city in the United States, which this is our seventh year and we actually went to number two, which is exciting. Um, because I mean, obesity plays a huge role, especially in our population, um, the majority of the patients being Hispanic. And so, um, you know, diet, it plays a big factor, especially hypertension, type two diabetes, cholesterol, um, probably the same things that you were seeing in your practice.

[(2:32)] Stephanie: Oh, definitely. And you know, some of those health conditions can accelerate MS progression, but it for sure makes it hard to tell the difference, right? Like it’s hard to pick apart what’s coming from MS or maybe another health condition, especially since all of these things kind of come together to, to make fatigue, mobility, quality of life harder. Right?

[(2:54)] Maggie: I do. And, and I agree with you, um, you know, and I’m sure you have, and as myself as well, you know, we play the MS blame game. That’s kind of how I, I always state it. Um, it’s like the diagnostic overshadowing. We can miss diabetic and we can miss diabetic neuropathy as MS symptoms, um, because it causes tingling. So it’s really easy to be like, okay, you know what? It is my MS, but it might be neuropathy from years of having diabetes and being misdiagnosed with that as well. Um, sleep apnea is a big one that I see in our clinic. Um, patients are not sleeping real well. So it’s probably my MS is making me not sleep. Not that I have sleep apnea, you know, ’cause I’m overweight and, um, those different factors. Blood sugar swings, thyroid, um, low B12 or anemia also cause a lot of that exhaustion, um, and blood pressure medications, plus a lot of it’s dehydration. And now we’re looking into it. Now we’re dizzy, you know? So I agree with you. It’s definitely, I’ve been in that situation. Sometimes I’m still in that situation where I’m playing this game too of, is this MS or is something else going on? You know, could be my age, could be hormones. It’s just so many factors that play into this.

[(4:17)] Stephanie: Yes, I definitely relate to that. And I’ve seen again, firsthand people assuming it’s fatigue, it’s their MS symptoms. We diagnose sleep apnea. They go on CPAP. They feel like a whole new person. So I think the bright side of a lot of these comorbidities, um, are that they are more treatable than MS, right? We can control those factors. We can, if you’re tingling because of, uh, B12 deficiency, give you a supplement. We can work on your thyroid. We could give you a CPAP machine. So I almost feel like there are more opportunities to control those conditions that have the secondary benefit in MS down the line. Right?

[(5:00)] Maggie: I agree with you.

[(5:01)] Stephanie: Yeah. Now, of course, um, this is where wellness advice often gets frustrating because telling somebody, well, eat healthier and exercise more isn’t particularly useful if we don’t talk about what that actually looks like in life. Um, so what do you see in your patients in South Texas that are barriers to them trying to make those changes in their health and wellness?

[(5:24)] Maggie: So I kind of look at like, there’s four different things that, um, that I look at in my practice living in South Texas and the first is MS symptoms, right? Um, because fatigue and we’ve all been there where, um, it makes you, you’re tired because of the fatigue. So I don’t want to cook when I get home, I feel exhausted. So now that plays a factor because what happens, you stop and you pick up something to eat and now you’re eating processed foods and that would probably make you feel maybe have more fatigue. So, um, heat sensitivity, um, especially like, ’cause there’s no walks during the summer here. I mean, literally, I don’t, even in the morning, like at five in the morning, I have patients telling me it’s just too hot outside. So that, um, that is a barrier. Um, balance mobility. Um, it starts to limit shopping and exercise. And also the internet. Like now we’re ordering our food and it’s coming to our front door. So we’re not even going to the grocery store and we’re not checking labels anymore. We’re not, we’re not looking at anything at the grocery store. We’re just ordering online and getting it done because we’re exhausted. Um, here in South Texas, family and work, um, is huge because we have a lot of patients that are caregivers as well. Um, we have like the biggest number of adult daycares and they’re keeping their parents or their family members, you know, that are elderly. They go to the daycare during the day. Well, what’s happening is now they’re picking them up afterwards and they’re having to take care of them all evening, not just their children, but their parents as well. And they’re having to cook for them. And so it becomes, it, that is a huge barrier, especially where we live. Um, because then their health just goes to the bottom of the list and they’re meeting everybody’s needs, but their own. Um, cost and access to things. Um, they can be expensive. Dietitians are expensive if their insurances don’t pay for it. Um, gyms are expensive. And, you know, it’s that failure if I don’t, you know, if I paid for something now, I don’t go to the gym. So that, that turns into, you know, depression. So, um, those are the different type of things. Um, bilingual, um, stuff that we can just, you know, we kind of take that for granted sometimes with, you know, language barriers because not everything is in different languages. So that becomes a barrier as well. Um, and the biggest one is just information overload. I, I felt that way when, when I was going to see, um, my doctor and I feel that sometimes it can be overloading. And so trying to like, take it apart and say, you know, what’s going to work for you or me or my family, I think, um, that becomes a barrier too, because they get anxious, they get scared. And then it has happened to us all where we’re just like, we’ve already, you know, there’s already failure there because we’re not, we’ve already set ourselves up for failure because it’s just too much. And so, and then we feel guilty and overwhelmed. And I’m sure that’s kind of what you probably experienced too.

[(8:35)] Stephanie: Oh, yes. And that’s usually my biggest piece of advice is we’re all busy. This is a universal truth, right? And every single person listening to this who lives with MS experiences one of, or more of those barriers that you’ve just described. And I’ve definitely seen a difference in my ability to maintain a healthy weight as my mobility has changed, as I have to put more energy and effort just to get through my work day. And that doesn’t leave much in the tank for exercise and certain behaviors that I’ve been able to stick to more easily in the past. Um, and I think one thing I always tell people is just pick one thing. There’s a list of 20 to 30 things we should all be doing to live our most perfect, healthy lives. Just tackle one, just cook three meals at home a week, get one walk in a week. To work on one small task because exactly what you described resonated so much with me. Like you try to do it all at once perfectly. And inevitably you’re setting yourself up for failure and failure leads to feeling discouraged, leads to giving up and not putting yourself first and falling back into those old habits. [(9:55)] Maggie: I agree, diets, it’s, you know, we’ve all been there. It’s been a rollercoaster, right? And then to add MS to it, it is a big barrier. Um, I agree with you completely.

[(10:05)] Stephanie: Yeah. And I think culture is really important here too, right? So food isn’t just about nutrition, but it’s about family and tradition and celebrating and connecting. Um, I’ve used some weight management programs myself. One thing I’ve definitely noticed is that a lot of those programs assume you have a particular way of eating and it doesn’t necessarily translate to every family or every culture. What have you seen in your patient population?

[(10:31)] Maggie: I, I agree with you. So especially here when, you know, um, we don’t want them to feel like they have to skip celebrations or, you know, we, but we want to make sure that they understand that a celebration is a celebration. It’s not something that… It’s something that you should be doing, um, periodically with your family at birthdays or here we do big quinceañeras and, and, you know, family gatherings like that, but it’s something that we need to not do every day. Um, so, you know, if, if I tell a patient, um, I don’t ever want to tell them that they’re never going to be able to eat their grandma’s tamales or, or skip the family carne asada, which is like a big barbecue, because at that point they’re done. I’ve completely lost them because they’re in their head, it’s rolling. And they’re like, I’m not going to walk away from my grandma’s tamales because that is Christmas time. We get together and it’s like a 24 hour thing and we’re making like 300 tamales. And so, you know, and so what can we do with what they’re doing and then make it better? Right?

[(11:40)] Stephanie: Yeah.

[(11:41)] Maggie: Um, so I like to ask like to my patients, like, okay, what is your typical day look like of eating? And what does it look like for your family as well? Like, do you sit down together? Does everybody eat together? Um, you know, are you juggling living, having your parents live there? Are, do you have children that are at that active age where, you know, people are doing, um, private baseball, private this, and we’re stopping at McDonald’s and, and we’re just trying to survive. And so I want to know what a day looks like in their life. Then I can kind of go back and say, okay, well, maybe this is what we can do, you know, maybe changing some of their foods or giving them options. ‘Cause I think the biggest thing too, is sometimes as providers, and it has happened to me too and I, I can say that I’ve probably done this, like, you know, you don’t have a lot of time with patients. So I’m just like, okay, well, you need to change your diet. You know, we do it with like our stroke patients, diet, exercise is the same thing. Right? And I even tell them, like, I know you’ve heard this a million times, you know, but like, just really, this is something that’s very different. And so really trying to help them migrate, like… And I will tell them, like, you can keep the same, you can keep the foods, but maybe change proportions and methods that, you know, and how you’re cooking with it. So like less rice or tortillas, maybe more beans and vegetables. So now we’re having the protein. Um, maybe bake, grill or air fry instead of frying everything ’cause everybody down here fries everything. And maybe adding peppers and onions, you know, to their, their meats instead of, you know, other things, you know. And a lot of, um, a lot of families down here, they cook with nopales, which, um, is like the cactus, which is great because actually there shows like, you know, health benefits from it and that’s okay. So when they say stuff like that, then you, I encourage that. I’m like, yes, get the nopales and let’s, you know, try to have more vegetables and add more fruits and, and that kind of stuff to their diet.

[(13:48)] Stephanie: Yeah. I’m also a big believer in cook once, eat twice or ideally like three times. So I’m really only in the kitchen cooking once or twice a week. Um, and then saving either components of it that I can mix and match. So I feel like I’m not eating the same thing over and over. So I’ll pick like a vegetable, a grain, a lean protein, and then I’ll just mix that in different ways with different spices and different sides throughout the week. And I, we had somebody on the podcast last year, uh, two friends who, you know, everybody always asks, well, let me know if you need anything. Well, they decided what they needed was to meal prep together to cook together once a week. And then they’d each be set for the week. And that was like a fun social bonding activity. And they had healthy meals that they could stick in the freezer or prepare ahead of time to set themselves up for success. One was living with MS. One was just living with other health conditions and she needed to get healthy. And they made themselves both accountable and they made it into a fun group activity, which I personally loved.

[(14:52)] Maggie: I agree. I think that’s a great idea. Um, you know, you brought up a good point, like eating, like cooking together because nobody wants to do anything alone. I do that with exercise. I’m like, okay, you know, I’m going to find this friend that wants to go out and walk like I do, because then you’re accountable to somebody else as well because you know on Sunday, if you’re going to take out this meat and you’re going to thaw it out, if you’re, you’re always, it’s either going to be you or your friend. And one of you is going to be that person that week. It’s like, nope, I’m coming over. Or are you coming over? And it’s bad if you choose somebody that kind of is not compliant, you know, because you need to kind of choose that person that needs it just as bad as you, because you, like you said, you know, I think that is going to help you the most, is having that support. ‘Cause not just through your journey of MS or, or trying to get healthy, I think just in life is having that support person makes a huge difference in a lot of decisions we make. And even just going to the gym or going out for a walk. I mean, gosh, if I had somebody that made me accountable, I would definitely go. I mean, it can’t just be my dog. It’s like begs me for a walk. I mean, it literally needs to be. And then you feel like you’re helping somebody as well. It, it, it works both ways. Like you said, somebody might have MS, somebody might be having another autoimmune or just needs to lose weight or just needs to get out because of mental health or for whatever reason. So I do agree with you. I think that is, that’s huge. I think that plays a big role.

[(16:27)] Stephanie: Yeah. And speaking of another thing you can say when people say, what can I do? What can I help you with? You mentioned be my exercise buddy. So you mentioned also that you live in South Texas, it’s very hot, which is not a friendly combination when you have MS. So again, what are you hearing from patients as the temperatures are climbing and they’re trying to stay physically active, but facing that intense heat?

[(16:51)] Maggie: So actually today a cold front came in. So my phone was getting alerts and it was like, we’re going to have like 78 degrees for this cold front. And it was like, oh my God, we’re going to get out like maybe a lightweight jacket. But, um, that is huge because like nobody wants to go out for a walk. And so then, you know, what happens with that? Then the next conversation, they don’t want to exercise. So now we’re struggling with, are they doing it because they just don’t want to exercise or is it truly the heat? Well, this year has been the worst summer ever. And it’s not just the heat, it’s the humidity and the heat together. It feels like a sauna. And so like educating them on different, um, things they can use if they’re going to go out in the heat, you know, like cooling fans and, you know, um, like even taking showers, like a cold shower in the, before you go somewhere, you know, taking a cold shower when you get home. I mean, not taking a hot shower, then going out in the heat. And then now we’re have being extra tired, but you know, um, body temperature, when it rises along with the heat outside, it’s not a good combination. It can cause blurry vision, fatigue, numbness. Um, and then they’re, they have trouble walking. They’ll come in and be like, you know, gosh, you know, I started exercising and man, I went out the other night and my legs just, they felt so heavy that they just wanted to give out of me. And, you know, they have strength, but they just felt heavy to walk. And so now they, they’re going back. They don’t want to walk outside anymore. And even I had, um, I have patients too, that have stopped. They have put a halt on physical therapy and going to any of the therapies because they’re like, well, can we just do it when it gets cooler outside? So to me, that’s a problem because now we’re… The one thing that could possibly get us stronger and, and help with, with them feeling better about exercising, now we’re going to, they’re removing that as well because they don’t want to go from their car to the, to inside the building and then having to leave again. And, you know, it takes a lot for the body temperature to re-regulate. And some of us have patience for it. Some of us, we have to go to work so we don’t have choices, but we do have choices in how we manage it. And, you know, like keeping ourselves cool, but making sure that our patients are educated on some of those things that we could do, like going out early in the morning, late in the afternoon, wearing cooling vests, giving them resources to, to be able to like afford that kind of stuff too, because it’s not cheap either, you know? So that becomes a problem as well.

[(19:34)] Stephanie: Definitely. And I think it’s really about, you were alluding to this, shifting your mindset, right? Getting exercise doesn’t mean you go to the gym for an hour, three times a week. And sometimes, especially in these really hot summers, it’s been very hot in Virginia this summer. There are days when I could go for a walk for 45 to 60 minutes, but at this time of year, it’s little tiny bursts of exercise or what helped me get the activity in without burning out, um, and without spiking my fatigue. So I try to do like habit stacking. Um, so if I’m having a snack, my rule is if I’m snacking between a meal, I’m walking around the house while I’m doing it. So I’m doing laps around the house while I’m eating my, of course, always healthy snack, um, not always healthy, but still it’s about the habit stacking. Uh, same thing with, if I’m watching TV before nighttime, um, I make myself walk on my walking pad while I’m doing that. Right? And if you get five to 10 minute bursts of activity every day, a few times a day, then you’re getting 30 minutes of activity a day, which is amazing. And you’re not going to feel that overwhelming crushing fatigue you get after a really intense, intense gym session. [(21:01)] Maggie: I know. ‘Cause, um, you know, you saying that, um, I, I, it makes me think about like, you know, you can, like it’s air conditioned. So that is one thing, like you, you, you nailed it when you said we can do like three, 10 minute sessions where you just get up and walk around. And so, um, kind of on the side note, I have my younger son, when he comes up from college, he doesn’t want to work while he’s going to college. So he has this app. And so if he walks 10,000 steps and just kind of, um, watches some videos or whatever, he gets paid. He bought us all Christmas gifts last year based on this, but he’s walking 10,000 steps a day. He’s being accountable. He’s getting paid. And so when it was really hot during the summer, when he was home, I, for at first I was like, what is he doing? He was just walking around our house in our kitchen. He was making sure he got all his steps in. And then he would like kind of go outside in the evening. But I was like, what is he just marching? You know? No, he, he was making sure that he got it. It was making him be accountable, but, and he was making money at the same time. So there are like different ways to do that. And I love your habits stacking. That’s great. Like I need to start using that for myself. Um, and, and so like here to you, like, um, like I was, I was talking to you about, um, a while ago about, um, wall mocking, I mean, mall walking. You know, the malls are open super early in the morning. And before this door is open, you can go in and walk around and there’s benches. So if you do get tired, you can sit down. Um, you can take breaks and you, you meet people there and it becomes like a social thing. And that’s something you can go with your friends. And, and then as soon as the mall opens, I’ve had some of my patients tell me they’ll stop and have coffee there at the mall. So now they’re bringing in social, they’re exercising and, and I, and now they’re sharing. So I do think that, you know, there are other alternatives. It’s just that we need to make sure that we let, we inform our patients of the different alternatives that are out there because not everybody knows what, what is available in the areas.

[(23:13)] Stephanie: Yeah. It’s all just about being flexible and doing what you can. And now of course we can’t have a conversation about weight management and healthy living in 2026 without talking about GLP-1 meds, um, because people are hearing about them everywhere. And I think a lot of people with MS understandably want to know, is it safe for me? Is there anything different I need to think about because I have MS? So I’m very curious what conversations you’ve been having with your patients about GLP-1 medications and weight loss? [(23:46)] Maggie: Yes. So, um, it’s been a hot topic. I think that’s maybe how we went to number two because GLP-1s, which is great, you know, as long as they’re, um, the patients are being monitored and… Because they come to us first, right? ‘Cause they want a clearance kind of thing. Like, is it okay if I, um, because you are my, um, you’re managing my MS and that is what’s most important. So they want to make sure it’s okay with us, um, to take the medications. And, you know, I, I don’t, I don’t say no or yes right away because I’m very hesitant. And, you know, I first asked him like, well, why do, why do you want to take this? And where did you hear about it? You know, ’cause social media, it’s, it’s just, everybody’s talking about social media and sometimes it can be good. Sometimes it can be bad because now you’re getting information that that person wants you to know, not real information that is, that can be crucial in your, in your health. So, um, you know, I, I just want to know what, what, why is your reasoning to do this? You know, that’s my first thing is why. Um, and then have you talked to your family doctor, have, you know, um, like, what are your goals? Because, you know, the thing with GLP-1s, and I think they’re great because it really does work. But now the problem with GLP-1s is patients are losing weight pretty fast. Well, we already have issues with muscle strength and now we’re, we could have muscle wasting because if they’re not exercising and they’re not doing any PT, okay, so now we’re going to GLP-1 and their joints might feel better because they, they’re losing weight, but you’re not going to necessarily feel completely better because now you don’t have any muscle. And so are they, you know, the next question is like, okay, so if you want to do this and you know, like, what is your protein intake look like? Because if you’re not a good eater and you have bad eating habits, so we need to make sure like, are- you need to replace it with enough proteins. You know, what is the protein look like? Because you’re not going to build any muscle if you’re not eating enough protein. And so those are like scary because I have seen it. I’ve seen it in my own friends where they’ve lost all this weight and, you know, they look great in pictures, but do they feel great? Even patients without MS are, they’re not feeling good afterwards. And, and so that concerns me. And so I just want to make sure that they understand that, yes, you can. I mean, I don’t have anything against my patients doing… I think they’re great because I do believe that it kind of can be that push, you know, to start, you know, them in a weight loss journey to help with obesity and the diabetes and all that kind of stuff. But at the same time, we need to make sure that we’re not compromising the ability to, you know, walk and the ability to do every, to do things on our own. Think about if you had a patient that was taking GLP-1s and they’re muscle wasting, but they’re in a wheelchair. Now they can’t transfer themselves because, and maybe they were transferring themselves as a bigger person, but they might’ve had some problems with transferring themselves before because of weight, but now we’ve lost the weight, but we have no strength to transfer ourselves and the no energy to go to the, to exercise. And like my last one is constipation because GLP-1s, they can cause constipation. Well, you know, as an MS patient and as an MS provider, we know our patients, not every one of them, and not everybody deals with constipation, but now we’re dealing with IBS issues. And so how can we help them manage the constipation? Because it, they just, you know, they’ll, and we don’t want them to go, you know, like several days. So I, um, was reading this, um, article the other day and they were talking about GLP-1s and they were like, one of the first things you should do as a provider is making sure, like having your patient track what, what their, um, their bowel movements, what they look like for one week straight and having them track it because you want to be able to have a baseline. And now what, what’s happening after you start the GLP-1s, because that’s where you’re going to have a good… You know, because they can, when they come in, it’s kind of what happened that week is what they’re telling us about, or just recently, but what does it look like over time? And now that you’re on the GLP-1, we need to inform them ahead of time. You know what? You need to be drinking a lot of water because as it is a lot of MS patients that I see don’t drink enough water. And, um, I’m one of them. So I’m, I don’t want to be a hypocrite on here and say that… It’s been a struggle for me. Like I literally, I’ve even gone to the extent of buying the bottle that has like the, okay, by nine o’clock, by 10 o’clock. And, and I struggle with it. And so we need to make sure they’re drinking enough water. They’re eating enough fiber and, you know, do they need a stool softener with it? ‘Cause we just don’t want them to have other issues because of, of those. But yeah, I mean, I think they’re great when they’re being managed by a team.

[(29:10)] Stephanie: Yeah. Yeah. I mean, the, the takeaway is it’s important to be healthy. They’re definitely wonderful, widely used medications. I think about 10% of people with MS are on a GLP-1 and, but like you said, that muscle wasting, the GI constipation, all of those things are already a problem for those of us with MS and need to be watched very closely. So I think it’s an excellent idea to talk to your neurologist about it if you’re thinking about whether it’s the right choice for you. And I want to end, um, making this like very practical, right? So someone listening might think, okay, I’m supposed to manage my MS, take my medication, exercise, eat better, sleep better, maintain a healthy weight, manage my stress and somehow live the rest of my life. Uh, and like you mentioned, all of those things can be a source of stress just in of itself. So if someone listening wants to improve their overall health but they’re in that space where they’re just feeling completely overwhelmed, where would you tell them to start?

[(30:12)] Maggie: So I think just small, realistic, realistic goals. You know, I mean, you know, like we were talking about earlier, you know, if you did three times a day or even two times a day where you walk for 10 minutes or… You know, I always tell my patients to, you know, the thing is when you haven’t exercised or you haven’t maintained a healthy life, you feel exhausted when you get out there and you start doing it. So I feel like if you do baby steps, you’re going to be more successful than if you go out, like, you know, just, okay, I’m going to do this and this is… Because it happens to all of us. I mean, I don’t know how many times I have told myself, I’m going to change this and I’m going to change this. But I set myself up for failure a lot because I need to be realistic with myself. And I just say, hey, you know what, I’ve had this for 20 years. I mean, what has worked for me and what hasn’t? And what has not worked for me is not making goals for myself and little goals, like doing one goal at a time. I have like this list and I’m like, want to nail it first time around. And that’s just not realistic because anything can happen in between. And so I do like, I think, you know, picking little changes here and there that fit your week, that’ll work for you, um, you know, and just simple.

[(31:33)] Stephanie: Yeah.

[(31:33)] Maggie: I think simple is better because, you know, we all have big dreams and we all have big goals and we all, you know, want to do all these things. And what I mean, in social media, really, it’s hard on us, you know, because not even do a GLP-1s. Now we have like peptides and all these different things out there too. And it is scary because, um, even for myself, ’cause I like start looking at things. I’m like, man, maybe I need to get testing for this and this. I, we all do it, right? And so, and that’s because sometimes, you know, we have the knowledge to be like, that can’t be real. So can you imagine somebody who doesn’t have all of the knowledge? And, and so to me, that scares. So I just think real, I just think baby steps, realistic goals. I think you’re going to see bigger success and, and, you know, just making sure a good support system along the way as well. And like you said earlier, getting somebody to come along with you, because I think, like, you nailed it when you said, you know, get another friend ’cause now you’re accountable to somebody. And, and I think like habit tracking, like those stacking, I think that’s great. And I just think little things like that make a huge difference in a patient’s success, you know, in maintaining healthy lifestyle. And, um, you know, it’s just, it’s one day at a time that… It’s one foot in front of the other. And, you know, and remember in MS, in the MS world, you know, it’s not how you look, it’s how you feel.

[(33:04)] Stephanie: Yes.

[(33:04)] Maggie: And people take, you know… And, and I get patients that say that to me all the time, well, you look great, but truly they don’t know how I feel, you know, or you probably get it too, where they’re like, Oh God, I’m so glad you have MS. And you’re thinking in your head, like, I know what they mean, but you know, it’s hard for us too, just because we’re on this side. And I learn from my patients. Just like I’m trying to educate them, they educate me as well. I have some patients that, man, I wish- to me, they’re superstars and I wish to be like them. But a lot of the patients that I’ve come along the way or just people in my life that I’ve met with MS, I’ve, they to be most successful, they’ve started with realistic goals and baby steps.

[(33:49)] Stephanie: Yes. I think that’s really the takeaway. We both want people to walk away with. It’s not being perfect. It’s not about being perfect. It’s about fitting your life, right? And it’s taking care of your health. It really does not require… As you said, there’s so much noise out there. It doesn’t require a perfectly planned out diet. It doesn’t require buying an expensive app or joining a gym or completely reorganizing your life. As you mentioned, it’s about walking around in an air conditioned mall instead of going outside or changing one item on your grocery list to a healthier alternative and talking to your healthcare provider about weight, your blood pressure and your diabetes and other health concerns that you might have been putting off or ignoring because MS in of itself is hard to manage. And like you said, those small changes add up over time and set you up for success. And so Maggie, I want to just thank you for joining me and for bringing your perspective, um, both from your own experience and from your patients’ and your community in South Texas to this conversation.

[(34:57)] Maggie: Thank you, Stephanie, for having me on the show. I, I love this.

[(35:01)] Stephanie: Thank you for listening to this episode of the Can Do MS podcast. If you like this episode, please leave us a rating and review on Apple Podcasts or Spotify. We really appreciate your feedback. We’d also like to thank all of our sponsors for their support of this episode of the Can Do MS podcast. Until next time, be well and have a great day. [END]

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