I'm so excited to welcome Dr. Mandy Jacques, PT, DPT, MSCS, a physical therapist and Multiple Sclerosis Certified Specialist, for an in-depth conversation about electrical stimulation (e-stim) for multiple sclerosis (MS). We talk about the Neubie device from NeuFit, how it's used, and how it fits into a real-life exercise routine.

Here's what we cover 🔑:

→ What is electrical stimulation for MS? E-stim sends a gentle electrical current through pads on your skin to activate your nerves and muscles. When MS disrupts the wifi connection between your brain and your muscles, stimulation can give that signal extra support while you move.

→ What makes direct current e-stim different? Dr. Mandy explains what sets the Neubie's direct current apart from other types of e-stim, and why that matters for people with MS.

→ Foot drop, spasticity, and fatigue. How targeted stimulation is used for foot drop (aka toe drag), spasticity (muscle tightness or stiffness that makes movement feel harder), MS fatigue, and overall mobility.

→ Using the Neubie at home or in a clinic. The practical steps for getting started, so you know what a session actually looks like.

→ Neuroplasticity and MS-specific exercise. Why stimulation works best alongside movement, plus Dr. Mandy's advice on safe, effective exercise strategies to help you get stronger and walk with more confidence.

This episode is for you if:

✅ You deal with foot drop or toe drag
✅ Spasticity makes your legs feel tight or stiff
✅ Fatigue limits how far you can walk
✅ You've been curious about e-stim but didn't know where to start
✅ You want to understand why a tool works before you try it

E-stim isn't a magic fix, and it looks different for everyone with MS. But the right tools, paired with the right exercises done consistently, can help you see what's possible in your daily life. Progress, not perfection. You've got this 🧡

Resources mentioned in this episode: 

NeuFit for Patients - https://www.neu.fit/patients/

Dr. Mandy Jacques is a  physical therapist and MS certified specialist, and I can just say from experience, that is a rare combo. Dr. Mandy has spent the last five years at NeuFit working with people with MS, first in the clinic and now leading the department that helps people use the Neubie device right in their own homes. 

Where to reach Dr. Mandy Jacques & NeuFit:

YouTube: https://www.youtube.com/@NeuFit/videos

Website: https://www.neu.fit/patients/

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

If multiple sclerosis (MS) fatigue has you sleeping eight hours and still waking up empty… this episode is for you.

In this episode, I'm sharing my own recent experience with unexpected rest (the kind you don't plan for) and why understanding the seven types of rest changes how you manage MS fatigue. Not in a "just take a nap" way, in a "here's what's actually draining you and here's what refills it" way.

Here's what we cover 🔑:

MS fatigue vs. regular tiredness. These are not the same thing. Regular tiredness responds to sleep. MS fatigue often comes from a nervous system working overtime… when nerve signals have to travel damaged pathways, your body burns more energy to do the same task. That's why you can sleep well and still start the day at half a tank. Just because others don't feel it doesn't mean it's not real.

Why sleep alone doesn't fix it. Sleep covers one kind of depletion. If your energy is draining through your senses, your emotions, or your mental load, more hours in bed won't touch it.

The seven types of rest. Physical, mental, sensory, creative, emotional, social, and spiritual. I walk through what each one looks like day to day with MS, how to spot which one you're low on, and what actually restores it.

Strategies you can start today.
→ Sensory rest: 10 minutes with the lights off and no screen before dinner
→ Mental rest: write tomorrow's list tonight so your brain stops rehearsing it
→ Physical rest: lie down flat for 15 minutes instead of sitting upright, so your postural muscles fully let go

Rest and your nervous system. Recovery is when the work sticks. Neuroplasticity (your brain's ability to build new pathways to your muscles) does a lot of its building during downtime, not during the effort itself. That wifi connection between your brain and your body gets stronger while you rest.

Forced rest days and the guilt that comes with them. If a rest day feels like falling behind, this part is for you.

This episode is for you if:
✅ You sleep well and still wake up exhausted
✅ Rest days leave you feeling guilty or behind
✅ Brain fog hits hardest by mid-afternoon
✅ You've been told to "just rest more" without anyone explaining what that means
✅ You want to understand why something works, not just be told to do it

Rest isn't the pause in your progress. It's part of it. Progress, not perfection. You've got this 🧡

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

If you've ever walked out of an MRI appointment still wondering what's actually happening inside your body right now… this episode is for you.

In this episode, I'm joined by Jennifer Chester, a neurology nurse practitioner who works with Octave Bioscience, to talk about a blood test (available in the US) built specifically for multiple sclerosis (MS). Not a diagnostic test, and not a replacement for your MRI. It's a way to measure MS disease activity between scans, using proteins in your blood.

We get into what biomarkers actually are, how the test works, what the number means, and how to bring it up with your neurologist without feeling like you're overstepping.

Here's what we cover 🔑:

🔬 What a biomarker actually is. A biomarker is anything measurable in your body that tells you something about what's going on inside it. Cholesterol is a biomarker. Blood sugar is a biomarker. In MS, researchers have identified specific proteins that show up in the blood when there's inflammation, myelin breakdown, or nerve fiber damage happening. Measuring those proteins gives your care team information they can't get from asking how you feel.

🩸 How an MS-specific blood test works. The Octave MSDA (Multiple Sclerosis Disease Activity) Test measures 18 different proteins in a standard blood draw, then factors in your age and sex to generate a disease activity score. Why 18 and not one? Because MS isn't one process. It's immune activity, inflammation in the nervous system, myelin biology, and nerve fiber damage happening at different rates in different people. A single protein only tells you about one of those. A panel gives a fuller picture.

📊 What the number actually means. The test produces a score from 1 to 10, along with subscores tied to those four biological pathways. On its own, one score is a snapshot. Tracked over time, it becomes a trend line, and the trend is where the useful information lives. Your neurologist is looking at whether your number is holding steady, climbing, or dropping while you're on a particular treatment.

🧠 Blood test versus MRI (they're not competing). This is the part I want you to hear clearly. An MRI shows lesions, which is damage that has already occurred. A blood-based biomarker test is designed to reflect biological activity that's happening now, at a level that may not have shown up on a scan yet. Jennifer explains why the test is intended to complement imaging and your clinical exam, not replace either one. More data points, not fewer.

❓ "Is this MS, or is it something else?" If you've ever had a new symptom appear and spent three weeks trying to figure out whether it's a relapse, an old symptom flaring in the heat, stress, perimenopause, or a virus… you know how exhausting that guessing game is. An objective disease activity score gives your neurologist one more piece of information to weigh alongside your history and your exam. It isn't a yes or no answer by itself, and it can't tell you what a symptom is caused by. But it can help your team sort signal from noise.

🗣️ How to bring this up with your neurologist. Jennifer walks through what that conversation can sound like, what to ask, and why it's completely reasonable to bring a testing option to your provider rather than waiting for them to bring it to you. You are allowed to ask questions about your own monitoring plan.

💵 The practical stuff: coverage, cost, and timing. We talk through how the test is typically ordered, what to expect around insurance coverage, and how often testing tends to be repeated. Coverage and cost vary quite a bit depending on your plan and where you live, so this is a "confirm with your own provider and insurer" situation rather than a one-size-fits-all answer.

This episode is for you if:

✅ You've had an MRI come back "stable" but you don't feel stable
✅ You're not sure whether a new symptom is a relapse or something else entirely
✅ You're on a disease-modifying therapy and you want to know if it's working
✅ You want more information about your MS than a scan every 12 months can give you
✅ You like understanding the science behind a recommendation, not just being handed one

 Jennifer Chester is a nurse practitioner with over a decade of experience in MS care who now works at Octave Bioscience, helping bring a brand-new blood test to people with MS, and it's one that can actually measure disease activity in real time. (One important note, this text is only available in the US). 

Where to reach Jennifer & Octave Bioscience:

YouTube: https://youtube.com/@eventsoctave?si=vHCktRGw5NBq8q_g

Facebook: https://www.facebook.com/OctaveBioscience?mibextid=wwXIfrhttps://www.linkedin.com/company/octave-bio/

Website: https://www.octavebio.com/

Resources mentioned in this episode: 

Conversation guide for your doctor: https://www.octavebio.com/patients

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

If walking is taking more out of you than it used to… this episode is for you.

In this solo episode, I'm walking you through how to choose the right mobility aid when you have multiple sclerosis (MS). Canes, trekking poles, walkers, rollators, and wheelchairs. This isn't a ranked list of products. It's my top strategy for figuring out what your body actually needs, so you're not spending money on something that sits in the closet.

Here's what we cover 🔑:

The one question to ask before you choose anything. Most people start with "which device is best?" That's the wrong starting point. The better question is what specifically is happening when you walk. Are you unsteady side to side? Is one leg dragging? Are you fine for the first ten minutes and wobbly after that? The answer points you toward a very different device in each case, and I'll walk you through how to figure out which bucket you're in.

Base of support, and why it changes everything. Base of support is the area between your points of contact with the ground (your two feet, plus anything else touching down). The wider that area, the more stable you are. This is the reason a cane feels like it does something and a walker feels like it does more. Once you understand this one concept, the whole category of mobility aids starts to make sense instead of feeling like a wall of options.

Canes and trekking poles. A cane adds a third point of contact and widens your base of support on one side. Trekking poles do something different: they keep you symmetrical, upright, and swinging both arms, instead of shifting your weight toward one hand. If your unsteadiness shows up on both sides, or you're mostly looking for confidence on uneven ground, poles may be a better fit than a single cane. I'll explain when I'd suggest each one.

Walkers and rollators. A rollator gives you a wide base of support, hand brakes for control, and a seat. That seat isn't a small detail. Having a place to sit means you can go out without calculating whether there will be somewhere to rest, which for a lot of people with MS is the actual barrier to leaving the house. We'll talk about the trade-offs, including how a rollator changes your posture if the height isn't set correctly.

Wheelchairs, scooters, and the Alinker. Using a wheeled device for part of your day doesn't mean you stop walking. For many people it's the opposite: energy saved on the long distances is energy available for the walking that matters most to you. The Alinker is a walking bike that keeps you upright and at eye level with the people around you while your own legs do the moving. I'll share my honest thoughts on where it fits and where it doesn't.

Matching the device to the day, not just to the diagnosis. Your symptoms may not be the same at 9am and 4pm, or in July versus January. A lot of people with MS use more than one device: poles for the neighborhood walk, a rollator for the grocery store, a scooter for the zoo with the grandkids. That's not inconsistency. That's energy conservation, and it's a strategy.

Getting the fit right. A device that's the wrong height sends you right back into the postural habits you're trying to get out of. I'll cover the basics of height and positioning, and why it's worth having your physical therapist or healthcare provider check the fit before you commit.

This episode is for you if:

✅ You're tripping more, or you've had a fall (or a close call) that shook your confidence
✅ You've been putting off getting a mobility aid because of what you think it says about you
✅ You already own something that isn't quite working and you're not sure why
✅ You've noticed you're skipping outings because the walking involved feels like too much
✅ You're the type of person with MS who has always been independent and wants to stay that way
✅ You want to understand why something works, not just be told to buy it

A mobility aid isn't a step backward. It's a tool that changes what your day can hold. The right one, fitted correctly, can mean more distance, more energy left over, and more of the things you actually want to do. Progress, not perfection. You've got this. 🧡

Resources mentioned in this episode: 

 MS Mobility Equipment Guide -  https://www.doctorgretchenhawley.com/ms-mobility-equipment-guide-podcast

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

300 episodes ago, I hit record for the first time and hoped a handful of people living with multiple sclerosis (MS) would find something useful in it.

Now there are people in 27 countries doing these exercises. Some of you have been here since episode 1. Some of you found us last week, three days after diagnosis, at 2am, looking for anything that made sense.

This one is for you.

I'm not teaching a new exercise this week. I'm sharing what's actually worked for people in this community, and pointing you back to the episodes that keep helping the most people.

Here's what we cover 🔑:

The stories you've sent me. Progress with MS almost never looks like a before-and-after photo. It looks like standing up from the couch without using your hands. Getting through a grocery store without scanning for somewhere to sit. Walking your dog to the end of the street and back. I'm sharing some of these in this episode because when you hear someone describe your exact symptom and then describe what helped, it changes what you believe is possible for you.

Why MS-specific exercise is different. Generic exercise programs train muscles. MS-specific, physical therapy-based exercise trains the signal… that wifi connection between your brain and your muscles. Repetition with intention is what strengthens that pathway. It's why 10 focused minutes can do more for your walking than an hour of the wrong thing.

📚 The MSing Link book and membership. What made me write it, what's inside, and how the membership works for people who want live feedback on how they're actually moving instead of guessing from a video.

What 300 episodes have taught me. Mostly this: people with MS are not out of options nearly as often as they've been told they are. Not everything about MS can be changed. Some things are permanent, and I'm never going to pretend otherwise. But there is almost always something you can work on.

This episode is for you if:
✅ You're newly diagnosed and looking for a place to start
✅ You've been living with MS for years and feel like your progress has stalled
✅ You want to hear from other people with MS who understand what your day actually looks like
✅ You're not sure which episodes to start with out of 300
✅ You want strategies you can use this week, not someday
✅ You need a reminder that small progress still counts

Thank you for 300 episodes. Thank you for the emails, the questions, the wins you send me, and the ones you didn't think were big enough to mention (they were).

Here's to the next 300. You've got this.

Progress, not perfection. 🧡

 Special Promo for this episode: https://www.doctorgretchenhawley.com/offers/7d8oE6Cn/checkout

Resources Mentioned in the episode: 

The MSing Link Episode 1, What Is An MS Specialist & Why Did I Become One?, Apple || Spotify

The MSing Link Episode 249, Spilling the Tea: My Interview on the Messy Podcast with Christina Applegate & Jamie-Lynn Sigler, Apple || Spotify

The MSing Link Episode 173, Early Symptoms of MS & MS Prodrome w/ Dr. Barry Singer, Apple || Spotify

The MSing Link Episode 246, MS Walking Problems? Real Results from MS‑Specific Exercises & Expert Insights, Apple || Spotify

The MSing Link Book: Amazon

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

If MS has your legs feeling tight, heavy, or slow to respond… this episode is for you.

In this episode, I'm joined by vibration therapy expert Debbie Pelletier to answer the questions I get asked most about vibration plates and multiple sclerosis (MS). Not in a "here's a fancy piece of equipment" way. In a "here's what's actually happening in your body, here's how to use it, and here's what to check before you spend the money" way.

Here's what we cover 🔑:

What is vibration plate therapy, actually? A vibration plate sends rapid, repeated movement up through your feet and into your muscles. Those quick changes in length trigger your muscle spindles (the sensors inside your muscle that track stretch), which fire a reflex response and pull more muscle fibers into the action. It also floods your brain with sensory information from your feet and legs… which matters a lot when MS has dulled that signal.

Oscillating vs. vertical: why the difference matters for you. Oscillating plates tip side to side around a center point, like a seesaw, so one foot rises while the other drops. Vertical (or linear) plates move the whole surface straight up and down. They load your body differently, they feel different, and one may suit your balance and symptoms better than the other. Debbie breaks down how to tell which is which when you're shopping.

Can you use one if you're brand new to exercise or have mobility concerns? Short answer: often yes, with the right setup. We talk through seated use, holding onto a stable support, standing with a chair in front of you, and how to position your knees so you're not locking them out.

How long should you actually stand on it? We get specific about session length, how to build up gradually instead of starting at the longest setting on day one, and how often per week makes sense alongside your strength work.

Where it fits (and where it doesn't). A vibration plate is one tool. It can help prime your muscles before you exercise or take the edge off tightness, but it doesn't replace the exercises that build strength and retrain the wifi connection between your brain and your muscles. We talk about how to stack the two so the plate is supporting your routine, not standing in for it.

What to know before you buy. Frequency range, amplitude, weight capacity, platform size, handles or no handles, warranty, price range, and the features that sound impressive but don't change your results. Bring a notebook for this part.

Safety and who should check with their doctor first. There are situations where a vibration plate isn't the right call, or needs medical clearance first. We name them clearly so you can have an informed conversation with your provider.

What the research does and doesn't show. Whole body vibration has been studied in people with MS, and some findings are encouraging for spasticity and muscle activation. But the studies are small and the results are mixed. I'll tell you honestly where the evidence is strong, where it's thin, and what that means for your decision.

This episode is for you if:

✅ Spasticity or tightness in your legs is part of your daily life
✅ You've seen vibration plates online and can't tell if they're legit or hype
✅ You're wondering if you can use one from a seated position or with a mobility aid
✅ Fatigue makes long workouts feel impossible and you're looking for tools that work with your energy
✅ You want to understand why something works before you try it

A vibration plate isn't a shortcut, and it isn't magic. Used well, it can be a useful piece of a plan that's built for your symptoms and your goals. Progress, not perfection. 🧡

Debby Pelletier  is a vibration plate specialist and clinical educator with nearly two decades of experience developing safe progression-based protocols both for home and clinical settings.

She's a LifePro trainer, has been featured in Consumer Reports, and supports hospitals and doctors globally who are using vibration therapy. She knows this technology inside and out, and she's super passionate about making it accessible and understandable for everyday people.

Where to reach Debby:

YouTube: https://www.youtube.com/@debbypelletier

Facebook Group: https://www.facebook.com/groups/586296542104578

Website: https://debsvibe.com/

Resources mentioned in this episode: 

LifePro: https://lifeprofitness.com/DEBBYLP

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

If MS symptoms feel heavier in the summer… or after a hot shower, a walk in the sun, or a workout that didn't used to wipe you out, this episode is for you.

In this episode, I'm walking you through heat sensitivity and heat intolerance in multiple sclerosis (MS). Why heat can make fatigue, brain fog, spasticity, and walking difficulties ramp up, what's actually happening inside your nerves when it does, and what you can do about it. Not in a "just stay inside until October" way. In a "here's the mechanism and here's your plan" way.

Here's what we cover 🔑:

What heat actually does to nerve signals in MS. MS damages myelin, the coating around your nerves that helps signals travel quickly and cleanly. Even a small rise in your core body temperature can slow those signals down further, or block them entirely along nerves that are already working hard to get the message through. That's why heat doesn't create new symptoms so much as it turns up the volume on the ones you already have.

Uhthoff's phenomenon (aka the temporary worsening of MS symptoms when your body temperature rises). This has a name, it's been documented for over a century, and it's not in your head. I'll explain what qualifies, why it's considered a pseudo-exacerbation rather than a relapse for most people, and why that distinction matters for how you respond in the moment.

Why symptoms often ease back down once you cool off. For many people with MS, heat-related changes are temporary and reverse as core temperature drops. Knowing that can take some of the panic out of a bad heat day. It doesn't always mean nothing can be done about it, and it doesn't mean you should white-knuckle through it. It means cooling down is a legitimate intervention, not a rest break.

How to actually cool your core body temperature. Not just "drink water." I'll get specific about pre-cooling before activity, which parts of your body give you the most cooling for the least effort (hands, feet, neck, and face have blood vessels close to the surface that help dump heat quickly), and how cold liquids and ice work from the inside out.

Which cooling products are worth it. Cooling vests, neck wraps, cooling towels, fans, cold packs. Some do real work, some are mostly marketing, and some are worth it only for specific situations. I'll walk through what to look for and how to think about the cost, including the fact that some MS organizations offer cooling equipment programs.

How to modify your exercise routine in hot weather. Time of day, room temperature, seated versus standing options, shorter bouts with cooling breaks built in, and water-based movement. The goal isn't to stop exercising in the summer. It's to keep the neuroplasticity work going (that wifi connection between your brain and your muscles) without overheating in the process.

How to keep your progress through heat season. Consistency is what builds new pathways between your brain and your muscles, so the strategy is adjusting your routine, not pausing it. I'll walk you through what to scale back, what to protect, and how to tell the difference between a heat day and a day your body needs rest.

This episode is for you if:

✅ Your fatigue, brain fog, or leg weakness gets noticeably worse in warm weather
✅ A hot shower leaves you more wobbly than when you got in
✅ You've been told heat "affects everyone" and you know what you're feeling is more than that
✅ You've been skipping your exercises all summer and you're worried about losing ground
✅ You want to understand why something works, not just be told to do it

You don't need to hide from summer to protect your progress. You need to know what heat is doing to your nervous system, and you need a few specific strategies you can actually use on a 90 degree day. Progress, not perfection. You've got this 🧡

Resources Mentioned in the episode: 

Dr. Gretchen’s Amazon Storefront (Dr. Gretchen gets a small commission): https://www.amazon.com/shop/doctor.gretchen

The MSing Link Episode 242, How to NOT Overdo Exercise with MS: 7 Strategies by an MS Physical Therapist, Apple || Spotify

Free Walking Webinar: https://www.doctorgretchenhawley.com/Walking-Webinar

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

 If you're living with MS and wondering whether pregnancy is still on the table for you… this episode is for you.

Maybe you just saw two lines on a test and your first thought wasn't joy, it was "what do I do about my medication?" Maybe you're a year out from trying and you want to plan this right. Either way, you deserve real answers, not a shrug.

In this episode, I'm joined by Dr. Christina Chambers, PhD, MPH, a perinatal epidemiologist and professor of pediatrics at UC San Diego. She has spent her career studying what medications and exposures actually do during pregnancy and breastfeeding, and she brought all of it to this conversation about multiple sclerosis (MS) and pregnancy.

We covered the questions people with MS ask most, and a few they're often too nervous to ask out loud.

Here's what we cover 🔑:

What happens to MS symptoms during pregnancy? Many people with MS notice fewer relapses while pregnant, especially later in pregnancy. The working explanation is that pregnancy shifts how the immune system behaves so it doesn't reject the developing baby, and that shift can quiet the immune activity that drives MS relapses. 

How do you plan a pregnancy when you have MS? Dr. Chambers walks through the questions worth asking before you start trying, including timing around your current treatment, what "washout" means and why it's different for different medications, and how to build a plan with your neurologist and your OB in the same room instead of getting two answers that don't match.

What about MS medication and pregnancy / breastfeeding? This is one of the most common questions we get, and the answer is more nuanced than "yes" or "no." We talk about how researchers actually measure what passes into human milk, why some medications look very different from others in that respect, and how to weigh feeding goals against staying well yourself.

What happens to MS after delivery? The postpartum window gets less attention than it should. Research has pointed to an increased relapse risk in the first few months after birth for some people with MS, which is exactly when sleep is shortest and support is thinnest. We talk about planning for that stretch ahead of time rather than reacting to it.

How does anyone know any of this is safe? Dr. Chambers explains where pregnancy safety information actually comes from. Pregnant people aren't enrolled in the drug trials that come before approval, so most of what we know is built from observational studies that follow real pregnancies over time. Understanding this helps you read "we don't have enough data yet" for what it is, which is a gap in research, not a warning label.

Managing MS symptoms through pregnancy and postpartum. Your body is changing shape, your center of gravity is moving, and your MS symptoms don't pause for any of it. We talk about staying steady and staying strong through it, and why consistent, functional movement matters here just as much as it does the rest of the year.

This episode is for you if:

✅ You have MS and you're thinking about getting pregnant
✅ You're pregnant now and you're unsure what to do about your treatment plan
✅ You've been told to "just talk to your doctor" without getting a real answer
✅ You want to breastfeed and you don't know if your medication allows for it
✅ You're planning for the postpartum months and want to know what to expect
✅ You want to understand why the guidance says what it says, not just be handed a rule

Having MS doesn't automatically close the door on pregnancy. It means you need better information and a care team that talks to each other. This conversation is a place to start.

You've got this. 🧡

Dr. Christina Chambers is a Professor in the Department of Pediatrics, School of Medicine at UC San Diego. She is Chief of the Division of Environmental Science and Health, and Co-Director of the Center for Better Beginnings. She is the principal investigator of MotherToBaby Pregnancy Studies, and the UC San Diego Human Milk Research Biorepository, two nation-wide longitudinal cohort studies focused on the safety of medications, vaccines, substances, infectious agents, and other environmental exposures in pregnancy and lactation. Dr. Chambers co-directs the HEALthy Brain and Child Development Study (HBCD), a nationwide research initiative focused on developmental trajectories of children in various environments from prenatal life through 10 years of age. In addition, Dr. Chambers leads research and educational initiatives in the U.S. and internationally on the prevention and treatment of children with Fetal Alcohol Spectrum Disorders. She co-directs the Community Engagement, Dissemination and Implementation unit in the Clinical and Translational Research Institute at UC San Diego which supports clinical research development in diverse populations.

Where to reach Dr. Christina Chambers:

MotherToBaby Facebook: https://www.facebook.com/MotherToBaby

MotherToBaby TikTok:https://www.tiktok.com/@mothertobabyotis

MotherToBaby Instagram:https://www.instagram.com/mothertobaby/

MotherToBaby “x”:https://x.com/mothertobaby

MotherToBaby LinkedIn:https://www.linkedin.com/company/mothertobaby

MotherToBaby Pinterest:https://www.pinterest.com/mothertobaby/

MotherToBaby YouTube:https://www.youtube.com/channel/UC0O5nm_E_rS8I1BpO-C4eLw

MotherToBaby Threads:https://www.threads.net/@mothertobabyotis

Organization Website: https://betterbeginnings.org/

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

If planning a simple outing with Multiple Sclerosis (MS) feels like juggling way more variables than it used to... this episode is for you.

This one's personal. I'm sharing a bit of a reality check from my own life, and walking you through the practical strategies I use (and teach) for planning ahead with MS, so you can move through your day, your week, and even the holidays, with more independence and less second-guessing.

Here's what we cover 🔑:

Why planning ahead matters more with MS. It's not about being overly cautious. It's about protecting your energy and your confidence so you actually get to enjoy the outing, the trip, or the walk, instead of just surviving it.

Dual-tasking (like walking and talking). When MS affects the communication between your brain and your muscles, doing two things at once, like walking while carrying on a conversation, can take more conscious effort than it used to. I'll explain why that happens and how to practice dual-tasking on purpose so it gets easier over time.

Choosing the right mobility aid for the day. Canes, walkers, and other supports aren't a sign of giving something up. They're a tool that can help you conserve energy and move with more confidence. I'll walk through what to consider when choosing one for your specific symptoms and environment for that day.

Energy conservation strategies. Your energy is a limited resource with MS, and spending it wisely (not just "pushing through") is what makes the rest of your day possible. I'll share specific ways to plan your outings so you have energy left when you need it most.

Preparing for different environments. Holidays, vacations, and even a walk around your neighborhood all come with their own variables, like uneven ground, crowds, or long stretches without a place to sit. I'll cover how to think through an environment ahead of time so you're not caught off guard.

Cognitive strategies for problem-solving on the go. MS can affect processing speed and working memory, which makes real-time decision-making (like adjusting a plan last minute) more tiring. I'll share a few strategies to make that easier on your brain.

This episode is for you if:

✅ You're navigating fatigue and want to plan around it instead of being surprised by it 

✅ You're considering a mobility aid but aren't sure where to start 

✅ Walking and talking at the same time takes more concentration than it used to 

✅ You're prepping for a holiday, trip, or event and want to feel more in control 

✅ You want strategies that are actually specific to MS, not generic advice

You don't need to overhaul your whole life to feel more prepared. You need a few strategies that work for your body and your symptoms, used consistently. Progress, not perfection. You've got this. 🧡

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink

 If you're a woman with multiple sclerosis (MS) and you've noticed your fatigue, brain fog, or word-finding trouble getting worse in your 40s or 50s… you're not imagining it. And you're not alone in this.

In this episode, I sit down with Dr. Rhonda Voskuhl, a leading MS neurologist and menopause researcher from UCLA, to talk about something the MS community rarely hears explained clearly: what menopause is actually doing to your brain, and why it can look and feel so much like an MS flare.

Here's the part that surprised me most. Your MRI can come back completely clean… no new lesions… and you can still feel like your cognition is slipping. That doesn't mean nothing is happening. It means we need to look at what's happening at the cellular level, not just the lesion level.

Here's what we cover 🔑:

Why estrogen matters for your brain, not just your reproductive system. Estrogen receptors sit on neurons and on the cells that support them. When estrogen drops during perimenopause and menopause, those cells lose a signal they've been relying on for decades. That's one reason cognition and energy can shift so noticeably during this window.

What is the difference between smoldering MS vs. menopause-related change? These two can produce similar symptoms (fatigue, brain fog, slower processing) through very different mechanisms. Dr. Voskuhl explains how to tell them apart and why your neurologist may not have brought this up.

Why "your MRI looks fine" isn't the whole story? MRI shows lesions. It doesn't show gray matter atrophy well, and it doesn't show what's happening inside cells that are still alive but struggling. Your symptoms are real data.

What is estriol, the pregnancy estrogen, and why it's different? Many women with MS notice their symptoms quiet down during the third trimester. Estriol is a big part of why. Dr. Voskuhl walks through the research on estriol as a potential MS treatment and how it differs from traditional hormone replacement therapy.

So many women with MS are told their symptoms are "just MS" or "just menopause" and sent on their way with no plan. Both answers leave you stuck. What you deserve is a clear explanation of what's happening in your body and options you can actually act on.

If you've been quietly wondering whether hormones are part of your picture, this one's for you. And if you're the type of person who wants to understand the why behind your symptoms before you change anything… you're going to get a lot out of Dr. Voskuhl's explanations.

 Dr. Rhonda Voskuhl is a professor of neurology at UCLA, director of the UCLA MS Program, and the faculty neurologist for the UCLA Comprehensive Menopause Care Program. She has spent over 25 years researching how sex hormones affect the brain with continuous NIH funding and over 200 publications in journals like Nature and Lancet Neurology. She's also the inventor behind the treatment that is now available through CleopatraRx, a company that she co-founded to bring this research directly to patients across the country.

Where to reach Dr. Voskuhl:

Instagram for Cleopatra RX: https://www.instagram.com/cleopatra_menopause_care/

LinkedIn for Cleopatra RX: https://www.linkedin.com/company/cleopatrarx/

LinkedIn for Dr. Rhonda Voskuhl:https://www.linkedin.com/in/dr-rhonda-voskuhl/

Instagram for Dr. Rhonda Voskuhl:https://www.instagram.com/dr_rhonda_voskuhl/ 

Website: https://cleopatrarx.com/?utm_source=spotify&utm_medium=spotify&utm_campaign=msinglink 

Book a consultation: https://cleopatrarx.com/start-your-treatment/?utm_source=spotify&utm_medium=spotify&utm_campaign=msinglink

Resources mentioned in this episode: 

Article on Menopause and MS: https://www.neurologyadvisor.com/features/menopause-and-multiple-sclerosis-neurologic-manifestations/%20' 

Additional Resources: https://www.doctorgretchenhawley.com/insider

Reach out to Me: [email protected] 

Website: www.MSingLink.com

Social: 

★ Facebook: https://www.facebook.com/groups/mswellness

★ Instagram: https://www.instagram.com/doctor.gretchen

★ YouTube: https://www.youtube.com/c/doctorgretchenhawley?sub_confirmation=1

→ The Progress Method for MS: https://www.doctorgretchenhawley.com/the-progress-method-for-ms

→ Total Core Program: https://www.doctorgretchenhawley.com/TotalCoreProgram

→ The MSing Link: https://www.doctorgretchenhawley.com/TheMSingLink