Redefining Balance with MS

Redefining Balance with MS

Episode 200 – Podcast Transcript

[(0:24)]Stephanie Buxhovenon: Welcome to the Can Do MS podcast. I’m your host, Stephanie Buxhovenon. I live with MS, and I’m also a clinician and MS researcher. Today, I am joined by Dr. Lisa Doggett, a family lifestyle medicine physician, mom of two, and author who’s been living with MS for over 16 years. Hi, Lisa. Thank you so much for being here with us today.

[(0:44)]Lisa Doggett: Thank you. I’m glad to be here.

[(0:46)]Stephanie: We’re talking about balance today, and I’ll be honest, I think balance can feel like a myth sometimes. What does balance really mean to you?

[(0:56)]Lisa: I totally agree. It is a myth. [laugh] Something that I always strive for, but it’s really kind of a fantasy. Um, so I-I-I think we, we have to be realistic about what we can and can’t do. I think balance is really just about trying to figure out how to manage all the different things that we have going on in our lives, um, to the best of our abilities and feeling content, or at least peace with where we are. Um, and that, that can be really hard to achieve, especially with MS.

[(1:27)]Stephanie: Yeah, I mean, I think people assume balance means, like, everything in your life is equal all the time, but it’s really, life is happening. You’re getting these constant trade-offs between work and home and family, and sometimes you just gotta get through the day.

[(1:44)]Lisa: Absolutely. You know, I think when I- when I was first diagnosed, I was diagnosed with MS in 2009, and any sense of balance I had, which was kind of tenuous to begin with, [laugh], uh, was completely thrown off by my MS diagnosis. That was a really, really hard time. I had a lot of symptoms, particularly dizziness, which has been my main symptom really ever since then, as well as some other things going on. I had a really difficult job running a clinic for people without private health insurance. I had two daughters who were two and four at the time. There was just, I mean, balance- the concept, the idea, balance was just a joke. Um, since then, I think things have improved a lot, and I’ve had periods where I’m like, okay, things are going okay, and then, of course, something else will happen and throw me off again. But, um, you know, I think it’s-it’s something where I’m constantly trying to recalibrate a little bit, um, and-and just know that it’s never going to stay that way forever. And I’m kind of okay with that at this point, but it’s taken a while to get there.

[(2:49)]Stephanie: Yeah, I definitely agree, and I tell that to most people who are newly diagnosed, like in the beginning, MS is all-consuming, and there is no balance ’cause it’s just your health and this new thing. And then over time and with confidence, I think we all learn to sort of live in that state where balance is maybe fluctuating.

[(3:10)]Lisa: Right.

[(3:11)]Stephanie: Um, and that’s something I’ve been thinking about a lot lately because I just had my neurology checkup, and it seems like they always ask, “Well, are things stable? Are things stable? Are your symptoms any worse, or are they any better?” And while they’re not worse, I feel like no one’s asking me about effort and what I have to do on a daily basis to keep things stable, to keep things balanced. And I don’t know. Do you feel the same way?

[(3:39)]Lisa: Oh, absolutely. It-it takes a lot to maintain some semblance of [laugh] of a normal life with, um, with multiple sclerosis, um, I-I really have found that it takes me constantly thinking about, uh, my self-care and making sure that I’m doing all the things, right, like eating well, getting enough sleep, managing my stress. Um, those are really the tenets of lifestyle medicine. Um, I became a specialist in lifestyle medicine back in 2003, and that’s been really important for me to incorporate all of those things into my life. But it takes a lot to think about those and to even to communicate those things to other people in my life. Like explaining to my husband and my kids, like, “I need to go to sleep now. I can’t stay up and watch a movie, or whatever you all wanna do, I need to, to take care of myself.” Um, so it-it is a-a huge challenge to be thinking about how to, how to fit everything together and to prioritize things in a way that doesn’t throw off, you know, irritate other people in your life, or also to kind of figure out your own priorities. How does everything fit together?

[(4:47)]Stephanie: Yeah. And it can feel like homework sometimes, but I definitely have found the most important lesson to be if one thing slips, everything falls like a domino. Right. [laugh]?

[(5:01)]Lisa: Absolutely. Oh gosh, I can relate to that for sure. Yeah, you know, I think we just have to constantly be thinking about our priorities, reprioritizing, being very flexible. I am not, by nature, very flexible. I’ve had to become a lot more flexible. Um, I am really into making lists to kind of keep me on track. Uh, you know, I think also with MS, who knows if it’s MS or aging or whatever, but, uh, you know, I struggle with focus and with staying on track with things, and so lists, um, setting goals, checking in with, uh, with other people around me, um, to make sure that I’m on track, um, and then learning to say no, those are all really important parts of how I- are components of how I kind of keep some semblance of balance. Um, and I, you know, I think we’re constantly negotiating with ourselves, like, do I do this or that? Like my sister, who’s one of the most important people in my life, um, has told me, “You say no to say yes.” And I love that saying because it means that when you are saying no to something, you’re saying yes to something else. So if I’m turning down a-an event or, um, you know, whatever it is, um, I am saying yes to something else, often something more enjoyable or better for me from a health standpoint. I worry a lot about getting overcommitted, and I think it’s helped me to realize that when I turn something down, I am actually saying yes to something else.

[(6:36)]Stephanie: I love that. Yeah. “Say no to say yes.” I think that’s really, uh, an amazing phrase, and I’m using it. I’m stealing that from you for sure.

[(6:44)]Lisa: Sounds good.

[(6:45)]Stephanie: [laugh]. So flexibility and routine, like those are two very important things, right? Both being able to pivot and be flexible, but-but also having these, like, non-negotiable routines in order to be our best selves and live our best lives. So what are your non-negotiables in order to keep balance in your life?

[(7:05)]Lisa: Non-negotiables? Uh, you know, a lot of this goes back to lifestyle medicine for me and the tenets of lifestyle medicine. I’ve kind of alluded to a few of them, include exercise, um, as well as sufficient quality sleep, a really healthy diet, avoidance of unhealthy substances, stress management, and connection with others. And most of my non-negotiables fit into those categories. So, for example, daily exercise, absolutely non-negotiable. I mean, even if I don’t get enough sleep, I am getting up first thing in the morning and doing some kind of exercise. Um, that is my antidepressant, my anti-anxiety medicine. Like I do exercise in order to help me manage stress, in order to help me sleep better. Um, healthy diet, very important as well. Um, I follow a largely plant-based diet. Lots of fruits and vegetables, whole grains, nuts, seeds, legumes, um, really important sleep. I am vigilant about protecting it. I try to get at least seven hours a night, preferably more like eight. Um, seven to nine is recommended for most people. Um, I also have a- have incorporated a habit of mindfulness and meditation into my day-to-day. That’s helped me a lot with my MS, dizziness, as well as depression, anxiety, sleep, all of those things. Mindfulness is really about being present in the here and now without judgment, and it’s a really important practice, as well as the meditation component. Um, I’m a journal writer. I’ve been writing in a journal every night since I was a kid, and I’ve continued that and found that to be a really helpful way to process what’s going on. Um, what else? Oh, I think another kind of important point I’d like to mention is just when I have these routines, it helps reduce that decision fatigue. I’m not having to think in the morning, “Hmm, am I gonna get some exercise today? When am I gonna do that? What is that gonna look like?” I-I’ve already figured that out. Um, you know, I, that’s something that’s part of my day every day. Sometimes I will have to make the decision about what kind of exercise to do, although usually I have that mapped out as well. But when you have these kind of, I don’t- I hate to say rules ’cause that sounds so rigid, but when you have these guidelines for yourself, it can be helpful to, uh, to help reduce that constant struggle to make a decision. And I-I definitely have trouble making decisions sometimes.

[(9:27)]Stephanie: Yeah. And you really have to know yourself and know what fuels you and protect that. Like you said, you protect your sleep. Um, I’m the same way, I think…

[(9:37)]Lisa: Yeah. What are your non-negotiables?

[(9:39)]Stephanie: Oh, for me, I would agree, like daily movement. And I will say last year I really got out of that habit. I was very unbalanced in work and life, and then I realized, um, it’s makes everything, all of my MS symptoms worse when I don’t get enough movement. So reprioritize that and over the last six months and have found just such a huge difference. Um, same thing with me, diet. My personal emphasis is more on, like, fiber for bowel control. Like, I-I am regimented around that at home, and that falls apart when I travel. Um, so the- again, these things-these things are great to have. Um, for me too, I read every day. I’ve-I read on my Kindle. I’ve gone on now more than six years of daily reading streak on Kindle, so that’s a non-negotiable. I cured my insomnia, but it also fuels me.

[(10:35)]Linda: Great.

[(10:35)]Stephanie: Um, and I have a, I have an artistic side, so I don’t do it every day, but, but creative time every week is, is a non-negotiable, I feel like…

[(10:46)]Linda: I love that too.

[(10:47)]Stephanie: Yeah. It just clears my mind. I think same thing with mindfulness and, and journaling, something that brings you back to center. Um, and I feel like I get a lot of my best thinking done while I’m actually doing something creative.

[(11:00)]Linda: Oh, that’s great.

[(11:02)]Stephanie: Yeah. And I think, you know, it’s-it’s- some people I think struggle with taking so much time for themselves in a single day to pay attention to things like exercise and diet and reading and creative habits. Um, and especially when you’re working in a demanding job where you’re a mom or you have life going on, it feels selfish. But you and I were both also medical professionals, in addition to living with MS. And the way I think about it is all of these things we know play a key role to brain health and your neurological reserves. So really, all of these things, we’re reducing our risk for getting other health conditions. We’re protecting our neurological reserve, we’re prioritizing these things, which, down the line, are gonna mean MS outcomes are better.

[(11:52)]Lisa: Absolutely. I think, yeah, one of the points you just made is that when we take care of ourselves through lifestyle changes and ha and good healthy habits, we reduce our chance of getting other chronic diseases. And I like to say MS is at one chronic disease, like MS is more than enough. So, uh, I really think that it can be something that’s overlooked. MS can overshadow our risks and our other chronic conditions, but it’s really important not to lose sight of those because they can increase the chance of disability and significantly reduce quality of life if you’ve got something else going on besides MS.

[(12:29)]Stephanie: Yeah. Let’s talk about work a little bit. You know, you were diagnosed in your mid-thirties, you were a doctor at the time, right? So how did you navigate work and-and balance after being diagnosed with MS?

[(12:42)]Lisa: My goodness, it was such a challenge. Um, it was actually- this is what I write about in my book a lot, actually in my memoir, um, about my crazy experience of running this clinic at the same time that I was dealing with my own diagnosis and then had these really young kids. Um, it was-it was incredibly stressful. So I kept working, uh, through my diagnosis. I, of course, I took off some time around the diagnosis and just to kind of process and get things settled. And I had to take medica- get started on medications, and go to lots of doctor’s appointments. So there was a little bit of a pause there, but, um, I kept working. Um, I think that was helpful for me. It kind of was a distraction, and I had great community at work, so I was really helped by being around my colleagues every day. Um, and as well as my patients. I-I really found great benefit and joy being with my patients, and I learned a lot from them. So I think that if you’re able to work, um, and you already are working, it can be really helpful to continue, although it can, again, it’s-it’s a prioritization because that definitely threw things off and made my life-work balance not great. Um, eventually I pivoted away from a traditional clinic setting as a family physician, and I moved into more of an administrative role where I worked from home primarily. And that was a lot less stressful. One of the things I learned about myself when I was working at the clinic is that I am very triggered by being rushed. Being rushed is like the most stressful thing for me, and in a primary care clinic, like, I’m always rushed. So it was really not the best environment when I was trying to manage stress. Um, and being in a more of an administrative position, uh, allowed me- I was working at, um, on some state-level projects here in Texas and some national projects too. And that was still rewarding, still allowed me to contribute to be in a physician role, but it was also, uh, kind of helped me be in an environment that was more controlled and not as crazy busy.

[(14:53)]Stephanie: Yeah. I can’t imagine trying to run family clinic and, and manage MS symptoms through it. I think most of us are diagnosed with MS in our twenties and thirties when our careers are-are starting out. Um, it tends to be the busiest years of your career as well. And I know for me, I had, like, a very rigid idea of what career success looked like.

[(15:20)]Linda: Yeah.

[(15:20)]Stephanie: Um, and same with, you really had to reexamine and say, like, “How can I still work and do something that I find meaningful that challenges me, but also gives me flexibility to work around my symptoms?” And that has been a game changer for me. Um, but pulling the trigger on that was really, really hard because it felt like giving up and admitting defeat. And I had a mentor say to me when I was considering this career change into something that would be a little bit more flexible, he said, “You can always go back. You can- if you regret your choice, you can go back.”

[(16:00)]Lisa: Absolutely. Yeah. No, just to-to kind of add to that, and so for me, ultimately, I did go back in a different role to provide patient care again. And I- throughout the time that I was doing all administrative work, I was actually volunteering still, but that was much more limited. Um, and as, and-and then, um, I ended up getting certified in lifestyle medicine, found a position where I could see patients part-time and practice lifestyle medicine. So kind of what you’re talking about, like you can, you can find ways to go back. You can find ways to go back in a different way, which is what I did. And I think that, you know, just be on the lookout, be open-minded, be flexible, um, and-and maybe keep your toe in the door [laugh] just to, like, have a way that you can find a path back if you need to.

[(16:50)]Stephanie: Yeah. A lot of what we’re talking about, finding balance requires trial and error, and you have to try some things and if reevaluate and see if they’re working or not working.

[(17:01)]Lisa: Right, exactly. Yeah. So I-I think that it’s an experiment. I-I encourage my, I still run a, a wellness program for people with MS, and I encourage them to think about experimenting a little bit on themselves, not with medicines or substances at all [laugh], but actually just with trying new things with exercise or sleep, for example. And so I think that’s really important for me. I experimented with meditation and found that to be incredibly valuable as a tool to reduce my symptoms, um, which I wasn’t even really expecting. But I think it is helpful to try lots of different iterations of things, different activities, different habits and patterns and routines in order to figure out what’s gonna give you the closest thing to balance that you can get.

[(17:48)]Stephanie: Yeah. And now we’ve talked about parenting a lot on this podcast, but not necessarily in the context of balance. And you’re a mom of two, so how is that for you, being a mother who works and lives with MS?

[(18:02)]Lisa: Well, it’s a lot easier now. Uh, my daughters are now 18 and 21. Um, I was very, very overwhelmed when they were little. Um, my husband’s a pedia-pediatrician, he works in a hospital, and he was gone a lot on weekends and in the evenings. So I was alone with my kids quite a bit and, and struggled tremendously during those early years, especially when I was having MS symptoms, was alone with these kids. They were not easy kids. They are delightful young women now, but they were really hard when they were little to-to deal with and fussy and demanding and wanted all my attention. Um, and so that was really hard, and I think there was a lot of guilt that I had at that time too. Like, I’m just not able to give them what they need, and I really need to be playing with them, but I also need to be making dinner, and I’m also dizzy and feeling terrible and need to just go, like, take a shower, [laugh]. So, um, I think that those early years were so, so hard. I did come up with some strategies to help. Um, I think, first of all, um, asking for help, which was not something I necessarily did often before, uh, became essential. Um, I learned to ask for help for with my kids.

I asked for help from friends who didn’t have kids, um, from family who were already frequently jumping in to help, but were even more available and, and-and eager to help out once they knew I had this MS diagnosis. Um, but I-I got friends to come over in the evenings and help with bath time and dinner. Um, I encourage those who don’t necessarily have that kind of network to maybe hook up with other parents who have kids of similar ages, and you can kind of trade off childcare. I did that some[?] as well. I think that building a support network for me was really, really helpful. Um, and, and then calling on that support network, not being afraid to ask for help, um, and just accepting that I couldn’t do it all. Another thing I did is I, um, hired a college student to help with my kids at, um, at, actually, I’ve had a couple different college students, but one of them in particular was great. She was a costume designer, and she taught my daughter- my older daughter, to sew. Um, and I do not know how to sew. I don’t even know how to turn on the sewing machine, but she got, brought in her own sewing machine and taught my daughter, who I was five or six at the time, how to sew. And that is still one of her favorite hobbies at age 21. So, you know, you can really, there’s-there can be some benefits that you don’t even expect from bringing in others to help with your kids.

[(20:39)]Stephanie: I love that. And I think, uh, doing it all is also a big myth. That’s impossible.

[(20:46)]Lisa: [inaudible] Oh, right. [laugh]. You know, I think, I guess one other thought about having little kids with MS is just, it can be so draining and so hard, so much frustration and guilt around not being able to give your kids all they need. And, and I just wanna reassure other parents who are in that position that it will pass and the kids will be okay. And in fact, the kids might end up with even more compassion and understanding for people who have challenges, who have disabilities, um, than they would have otherwise. So you may not be able to do everything that you had had as part of your vision for parenting before you had kids, but that’s okay. And there will be other opportunities that come from, um, that diagnosis of MS that you may not have ever expected. Um, and there will be some benefits to your kids, again, that you probably never would’ve thought of.

[(21:45)]Stephanie: Yeah, I think kids of people living with MS turn out to be just compassionate, lovely human beings. And I’ve had so many patients whose kids go on to work in medicine or in neurology, or they, it teaches them that, you know, life is not always easy and balance is hard to find.

[(22:07)]Linda: Yeah.

[(22:07)]Stephanie: And I think it helps teach them a little bit of resilience too.

[(22:10)]Lisa: I love that. Yes. Resilience, a hundred percent agree.

[(22:14)]Stephanie: Now, having little kids, definitely a season of life where balance is hard to come by, but there are also other times in life that we may choose to break our own rules because we’ve got other things that we wanna do. I know you, for instance, just participated in the MS I50.

[(22:35)]Lisa: Yes, I did. Um, this was my seventh time riding, biking[?] the MS 150, um, in Texas. It’s, uh, through the National MS Society, and it’s a bike ride that’s over 150 miles in central Texas, uh, from Austin or Houston to College Station, uh, over-over two days. So I biked last weekend with my mom. It was really exciting, and yet it threw everything off balance, [laugh]. So it was important to me. It was really, um, just rejuvenating and invigorating in so many ways. But at the same time, I did not get enough sleep. I did not eat that well over the weekend. I got far behind on a lot of the things, like emails, that I would catch up on on the weekend and started the week off, like, way behind with a lot of things that I normally would’ve been able to-to do on the weekend. So, you know, it’s a, it’s-it’s one of those things that you negotiate with yourself. Am I gonna, am I gonna do this activity? Um, even though there are consequences, and yeah, sometimes you’re gonna say, “Yes, I am.” And I know that’s gonna be tough going into it, but it’s worth it.

[(23:40)]Stephanie: I totally agree. I think there’s a lot of things in life that I know I’m gonna quote-unquote pay for, or pay the MS tax for, but choose to do anyway. We love traveling, and that’s a time when I’m breaking all my own rules, but it’s also fulfilling. And, uh, and I know I’ll get back to the balance when I’m [inaudible].

[(24:01)]Lisa: Yeah, tell-tell me about your own example. I think you had mentioned something.

[(24:05)]Stephanie: Yeah, we just did, uh, a big trip, a two-week trip to Japan, so good. And, um, you know, if I’m traveling, I’m not there to be on a strict diet and exercise regimen. I- we were walking a lot, we were walking like twenty thou- 20,000 steps a day.

[(24:23)]Lisa: Amazing.

[(24:23)]Stephanie: Um, it was, it was so good. My legs were killing me, but it was worth it. And, and, uh, you know, I don’t sleep as well in hotels, and I also, when I’m somewhere new, I wanna experience the local food and culture as much as possible. So definitely out of all of my routine, you know, I still maintain things. I still read every day, that’s still- definitely getting exercise. Um, but those are sort of like the life experiences that are so worthwhile. And I feel like if you’re gonna live with MS for the majority of your life, which most of us are, uh, it’s okay to just say yes to life, knowing that it-it’s gonna throw your balance off a little bit. And it definitely took a good week to start getting back to feeling like myself after getting home. Um, but I’ve learned through the years that you have to choose to do some of these things anyway. Or sometimes life happens and-and bad things come up, and it’s not in your control whether you have balance or not. Um, but I’ve definitely learned that whenever possible to just build in that grace period after those imbalanced moments of life. Um, so definitely, like, I blocked my work calendar so that I had more time to spend on tasks, ’cause I knew maybe cognitively or fatigue-wise, I was going to take a little bit longer to get on track. Um, but to me, those are- that’s what life’s all about.

[(25:55)]Lisa: Yeah. And you know, I love what you said about how even when you were traveling, you still had some non-negotiables there. Like, yeah, you gave up maybe a little bit on the food, but then at the same time you-you tried to make sure you were getting that exercise every day. You-you, and then I love the, the grace period, and that reminds me of the kind of idea of giving yourself grace in general. So it’s not even necessarily just a matter of the time, but also just like being kind to yourself when you get back and you’re like, “Okay, like I am feeling behind. I didn’t get everything done I wanted to on the plane on the way back or on the weekend after the MS 150 was finished.” Um, and that’s okay. And I, you know, I still got to do this thing that I really liked, and now I’m gonna have to make up for it, but I will. With time, it’ll be okay.

[(26:42)]Stephanie: Exactly. It’s the intentional imbalance sometimes.

[(26:45)]Lisa: Exactly. Yeah.

[(26:47)]Stephanie: [laugh]. So I think, uh, you know, people are probably listening to this might feel a little bit overwhelmed at the thought of trying to find balance, even though that they know it’s important. So where should they start?

[(27:01)]Lisa: Yeah, I mean, I-I-I think it’s important to realize that there are gonna be times, probably in all of our lives, when things are not even close to where we want them to be from a balanced standpoint. Um, and that’s okay. It’s-it’s not your fault. And, uh, it-it’s an opportunity to kind of look inward and think about, okay, what is the bare minimum that I need? What are those priorities that I can re-remind myself about and help to, uh, make sure I’m getting those, at least those basic needs met. Um, start small. What is one little thing you can do? Maybe it’s, you know, I don’t have time to exercise, but I could- I do a 30-minute workout, but I could walk to the end of my driveway or down the, down the street, around the block. Um, maybe it’s, I don’t have time for a 10-minute meditation, but I can take three deep breaths. So just pick something little that can help get to that, get that core need met. I think identifying a couple of priorities, sometimes that can be, um, helped by writing things down, you know, stream-of-conscious journaling or making lists and looking at, okay, what do I absolutely, what are- again, my non-negotiables, maybe talking with someone close to you, a partner, a good friend to help you figure out what are the top priorities in the near term and the long term. Building that support circle, right? So, like, I think if you, if you don’t feel like you have a great support circle, it’s helpful to reach out to people in the community.

Um, it, that could be through an MS support group, which there are virtual, and, and then in many places, in-person options, that could be through volunteering, through taking a class somewhere, like at a community college or, uh, maybe a museum or a library, um, adult education classes or something, even online. Um, those are ways to meet people and that- who have something in common with you, and then build support. If they have a need, you can be part of their support circle, and then they will, are likely to go- come back to you in kind and, and provide support when you need it too. And then we’ve already talked about giving yourself grace. I think that’s really key. If you’re-if you’re really struggling with balance, something’s gotta give and [laugh] it, you know, figure out what-what-what you want that to be. Don’t just let it happen, figure out, be intentional about it. Um, but-but giving yourself some grace and realizing that things likely will right themselves with time, uh, but it may-it may take a while.

[(29:33)]Stephanie: Yeah. I think that’s a, that’s a skill that you really have to, to learn [laugh].

[(29:39)]Lisa: Yeah. Well, and, and you know, I think we get better at that, right? We live with M- MS for the rest of our lives, and-and we-we learn from our experiences, and we learn from our mistakes, and we get a lot of wisdom along the way.

[(29:52)]Stephanie: Yeah. And I think, you know, balance is not this something you achieve, it’s something we’re constantly working on throughout our lives, something we’re constantly adjusting and reassessing. Um, and so I think a lot of what you’ve shared with us, really easy, practical ways of, of finding that balance. And I know you wrote a wonderful memoir, which we’re gonna link to the description in this podcast, but it’s called Up the Down Escalator: Medicine, Motherhood and Multiple Sclerosis. And for those people listening to you, how do they find you and your work and connect with you?

[(30:30)]Lisa: Yeah, thank you. Um, certainly, if you’re interested in my story, the memoir is a great place to start. I-I write a lot about my challenges finding balance in-in those early years of MS. Um, I also have a newsletter, um, that it’s just, uh, like an electronic update that I send out every two months or so, free, no advertising. I don’t share emails. You can sign up for it. I have lots of fun tips and photographs and MS and non-MS health stuff. Um, and then I have a website, so it’s just lisadoggett.com. Uh, and I’m, that’s a- in[?] a way that you can reach out to me personally through that website.

[(31:07)]Stephanie: Thank you so much, Lisa. This is a great conversation. We really appreciate you being here with us today.

[(31:13)]Lisa: Thank you so much. This has been great.

[(31:15)]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 generous sponsors for their support of this episode of the Can Do MS podcast. Until next time, be well and have a great day.

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