Voice Over
Welcome to Living well with MS. This podcast comes to you from Overcoming MS, the world’s leading multiple sclerosis healthy lifestyle charity, which helps people live a full and healthy life through the Overcoming MS program. We interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own. Receive monthly tips and ideas about living well with MS by signing up for our newsletter at overcoming ms.org/newsletter. And now here’s your host, Geoff Allix.
Geoff Allix
Welcome to the latest edition of the Living Well with MS podcast. Joining me on this edition is Dr. Michelle O’Donoghue. Michelle O’Donoghue is associate professor at Harvard Medical School, and a cardiologist at Brigham and Women’s Hospital in Boston. She’s been following the Overcoming MS program for over a decade, and alongside George Jelinek and Sandra Neate, was an editor of the new Overcoming Multiple Sclerosis Handbook. So welcome to Living Well with MS.
Michelle O’Donoghue
Thank you so much for having me.
Geoff Allix
And to start off with, could you share a bit about your MS journey from diagnosis through to discovering Overcoming MS?
Michelle O’Donoghue
Sure, so now it was, I think about 13 years ago that I was diagnosed with MS. You know, and and looking back, I might have had some symptoms before that time. But of course, like many people, I ignored them. And the first time I really became aware of there being a problem, it was really quite evident at the at the time. So I was flying back from a medical conference that was held in Sweden. And during that flight, I started to lose the vision in my right eye; it started coming down a little bit like a cloud. Unlike many individuals who have pain with an episode of optic neuritis, I actually did not. It was really just vision loss. And it progressed over the next 48 hours such that I completely lost vision in that eye, 100% of vision loss. So of course, I sought evaluation that led to an MRI. And immediately on my MRI it was apparent that I had several lesions, many of different ages. And so this is a process that had been going on for a long time. And, you know, as a physician, with the vision loss, it did occur to me that this could be a diagnosis of Multiple Sclerosis. But I have to say that I was somebody who had not struggled with any serious medical issues before that time. So it was hard for me to really accept that possibility. And at the same time, once I did receive the news, based on my MRI results, it was devastating. You know, some people may not have a picture in their mind of MS before their diagnosis. In contrast, I had always had a fear of developing multiple sclerosis, it’s sort of odd, but you know, I suppose that I had seen individuals in my life, friends of the family, and personal friends who had had a challenging journey with multiple sclerosis. And you know, and I think that for those who do struggle with their multiple sclerosis in terms of some of the symptoms that they may be experiencing, it’s challenging, because it’s something that’s very evident to people. And it was something that had scared me in all reality. At the same time, I also recognize that there are so many with MS who don’t have visible symptoms. And that is certainly an equal struggle as well.
Geoff Allix
I think that’s something hopefully that’s changing, because my father had MS. He was always mobile. I mean, he died very young, but he was, he wasn’t in a wheelchair. He was mobile until the end. And so I kind of knew that that was a possibility. But still, even then I thought the normal MS is you’re going to be a wheelchair straightaway. Because you didn’t see all the people who are coping because they’re invisible. And certainly on television in the UK anything showing anyone with MS would be they would certainly be in a wheelchair. I spoke to someone the other day, a friend, work colleague and I said if they want to speak to me, that’s fine. And he was newly diagnosed and he said, when they said MS, he said though he was devastated. He just said “Well, how long have I got before my wheelchair?” And they said actually, no, you probably won’t be, you’ll probably be fine. Well, not fine, but you know, you’ll probably live healthily taking medication, there’s loads of people who are doing well. And I think now maybe because there’s some publicity, around famous people like the Selma Blair, and I forget the names of a couple of other actresses…
Michelle O’Donoghue
Christina Applegate.
Geoff Allix
Thank you. And hopefully, that might change the narrative a bit to say, well, yes, actually, there are, you know, you do need to consider that we might have mobility issues, but equally, we don’t have to. It’s not a given. And so there are people who you probably aren’t aware that have MS, because they’re not publicizing it.
Michelle O’Donoghue
Exactly to the point that you’re making, you know, as we start to talk about the OMS strategy towards managing a diagnosis of Multiple Sclerosis, I think that that, for me was the most powerful part. Because as you were alluding to, I think that when people first get a diagnosis, they envision that it is a course towards progressive deterioration, and progressive symptoms, and then that course can’t be modified. And so for me, it was so exciting, and it gave me so much hope, to feel like there was some ability that I might have to change that trajectory. And that’s a big part of why I adopted the the OMS plan
Geoff Allix
And how did you come across OMS? I’m presuming 13 years ago, it probably wasn’t certainly very public then.
Michelle O’Donoghue
Well, when I when I first had the diagnosis, you know, again, I was just absolutely devastated that day, I quite literally sat and cried on the bathroom floor of the hospital, which is not the cleanest location. So it was a very challenging day for me, and I went to meet with a neurologist the same day. And there was something that seemed immediately intuitive to me about the possibility that lifestyle choices could potentially play a role. So I recall asking him that very first day, you know, do you recommend a particular diet? You know, is there something that I can be doing to help improve the course. And he at the time, you know, pointed me towards the the work of Roy Swank, and he said, you know, some people believe in this, that that was sort of the way it was put forward to me. But it was enough that I picked up the book and and read that. And it led me to look online for additional resources. And, you know, initially, a lot of the reading that I was doing, unfortunately, affirmed my belief that this was a trajectory that I couldn’t change. So some of the books I read are really quite discouraging. And you know, one of them I remember so clearly, there was some sort of multiple sclerosis coping book, and it basically said, you know, following your diagnosed, following a diagnosis of Multiple Sclerosis, you should always start holding the handrails on on the staircase when you go downstairs. And you know, and here I was, I wasn’t feeling ill, I didn’t have any balance issues, but I was immediately adopting a sick person mentality, you know, that this was,
Geoff Allix
That’s no bad advice for everyone though.
Michelle O’Donoghue
Sure enough, but I think it was more just the concept that it was my fate, and there was nothing that I could do. And, you know, you better embrace that this is your future. So start making preparations now. And that was initially the way I approached my diagnosis. And along the way, I came across Dr. Jelinek’s book about overcoming multiple sclerosis. And, you know, the first time that I read the book, it didn’t initially resonate with me as much as it did when I picked it up several months later. You know, and when I look back, I sort of think to myself, you know, why was it that I didn’t initially embrace his suggestions? And I think that there are many reasons for that. One of which was, I think I was still just in an initial denial in general about my diagnosis. And I was going through the different phases of grief really to cope with that. And my initial reaction was denial. But at the same time, just adopting a philosophy that I’ll just do whatever the the doctors told me to do, I started medication. And you know, I was a very good patient in that sense but then over the next several months, I ended up having another MRI. And during that time my disease was progressing. There were new active lesions on my brain MRI. And this certainly made me very nervous. Also, my vision, and my right eye had improved, but not fully recovered. And that scared me as well. So it led me to start to think a little bit more. At the time, it sort of felt to be outside of the box, in terms of you know, whether or not different types of strategies outside of just traditional medications might be something to adopt as part of my plan moving forward.
Geoff Allix
Do you think actually having a medical background influences your decision to follow something like OMS? There’s sort of parallels a bit, the way George Jelinek talks about his dive into initial diagnosis, and then doing research.
Michelle O’Donoghue
Yeah, I think it does depend on the individual, I would say that for some physicians, it that might actually just sort of keep them very much by the book in terms of just only adopting traditional medicines as as the path forward. For myself, though, you know, I’m a cardiologist and I also conduct clinical trials. And part of conducting clinical trials is taking a very evidence-based approach towards decision making. And that is one of the parts that really appealed to me about George Jeinek’s book was that A) he was a physician, so he understood both the pathobiology as well as what the evidence truly was, and he was able to put it forward in a very rational way. And for me that that resonated, I really liked that he had taken an evidence-based approach that there were references in place that I could turn to if I wanted to better understand the evidence supporting any of his recommendations. And that allowed me to feel like I was also drawing my own conclusions, and not just sort of blindly accepting the recommendations of another.
Geoff Allix
Yeah, I liked the original Overcoming MS book because I’ve got a computer science based background. And that completely works. For me that science basis, was what I needed, but then other people I tell, you’re probably better off with the new handbook. Because if you’re not into loads of references, and science-like speak, then that might be that people just find it too heavy and difficult, but you say actually, what the handbook doesn’t really, you don’t have to worry about all that just there is another book, which has got loads and loads of evidence in it. But the handbook might be easier reading. So I almost point people, depending on their background, which book to go with. Because I think sciency people loved the systematic references. There’s 1000s of references in the book and you and I literally checked some of them out and then okay, this is legit, this isn’t just a person’s opinion. This is proper research.
Michelle O’Donoghue
That was that was some of the rationale that actually went into that the handbook because there were so many questions about, practical day to day decisions and, implementing the OMS program into your lifestyle that Dr. Jelinek and we really were hoping to address for so many people who are trying to find a way to to live with MS. And at the same time to incorporate the OMS program,
Geoff Allix
I’m guessing so being a cardiologist, that healthy diet, low stress exercise are mainstream, aren’t they in for a cardiologist? Presumably you recommend most people with a heart condition to say well actually, are you eating, they call it a heart healthy diet here, which is not massively different to what we eat in OMS and doing some exercise and people stress down. In the US would that be mainstream medicine? Would you be recommending that to patients anyway?
Michelle O’Donoghue
Well, right, but ironically, you know, how many doctors practice what they preach in that regard? That’s the sad reality. I think even as a cardiologist, I mean, there, of course, it’s well understood that diet and exercise are an important part of both preventing and managing heart disease. But so many of the physicians that I work with, they say diet, and they don’t even know what they mean by that. Nutrition is not a big part of what you learn in medical school. And to be fair, I think a lot of the studies that have been published sort of yield mixed results, doctors see the same headlines as the the lay public, that come out every day saying, “Coffee is Great for Your Health,” “Coffee is Bad for Your Health.” You know, there’s so much conflicting evidence out there. And unfortunately, many of them are not well conducted studies. And so I think physicians are often quite as confused as patients are about what to recommend.
Geoff Allix
Do you think you will become more mainstream though, that the healthy lifestyle modification for Western diseases?
Michelle O’Donoghue
I think absolutely. No question in the heart disease realm, but you know, specifically thinking about Multiple Sclerosis. There is now so much more evidence as well, to really implicate the gut microbiome as part of what is triggering the disease. And I think that neurologists are now very aware of that of that aspect. I’ve joked with Dr. Jelinek that, you know, I was amused that a lot of the early studies, were, you know, for instance, collecting fecal samples, on patients with MS. But they weren’t necessarily capturing diet information. But the part that amused me about that is like what goes in the top is what’s coming out the bottom and the two are, are quite intertwined. But I think that the science is now really quite sound and accepted by mainstream neurologists. And the fact that bacteria in your gut do play a role in the disease process. And I think by extrapolation, we believe that that diet plays an important role as well.
Geoff Allix
So of the seven steps, did you find it pretty straightforward to just adopt OMS? Or did you have trouble with implementing some of those steps into your lifestyle?
Michelle O’Donoghue
I mean, in all honesty, that there are still some aspects that that I struggle with. And, I think that for the viewers who are listening, I think it’s important to realize that nobody’s absolutely perfect. And that there are days you’re going to struggle with some aspects. Ironically, I actually found the diet to be the easiest part. And I say, ironically, because I feel like when I discussed the program with others, you know, people who are either have well established multiple sclerosis, or a new diagnosis, the immediate reaction is, “oh, I could never do that I could never change my diet that way.” And then, when you do make those changes, though, you realize it’s actually remarkably straightforward. It just requires a little bit of a change in mindset, with how you approach your meals, you know, because it’s something that you are very young, typically, people have the same type of diet throughout their life. And it’s established very young, at a young age, and so to make a change does seem overwhelming. And yet, once you make it, I think it’s actually relatively straightforward. So for me the diet, once I decided I was going to make that change, I dove in headfirst and haven’t looked back. So there, I’m actually quite, religious as it were with diet. And then the areas where I do struggle, are still about A) getting more sunlight. I live in Boston, where I’m surprised that the sun hasn’t set yet. Getting into the winter months. It’s a it’s an incredibly short day. So it’s hard to find any sunlight. And then the general stress management and meditation. And so I always have to remind myself, you know, that the two are very interconnected. And certainly the meditation is just an incredibly important part of of stress management. And I think also, it’s not just with stress management, but it’s also a very important part of being mindful. So that’s, where I sometimes even have to set an alarm for myself to remind myself of how about meditation, you know, and it because it’s challenging, I have a busy career, but at the same time, for me, I try to prioritize my health above everything else.
Geoff Allix
Yeah, I think the thing with the diet, I think one thing that’s may be beneficial in the western world is that, well, certainly where I came from is, is a heavily processed diet, which is typical, the if it was 20-30 years ago, then actually, if you were eating whole food with meat, then that may be almost harder to give up to me part. But now actually, when I went to a whole-food diet, where everything was cooked, more fresh, cooked and not processed, you actually find the food’s delicious. And I kind of hadn’t been tasting that, because a lot of food had been, you know, not all of it, we cooked a lot of meals, but it was still there was microwave meals, things from in a jar things that were heavily processed food. And so actually eating fresh made food, you actually realize there’s an awful lot of flavor. So I don’t think I’ve missed out on tasty food, I think that’s got better. So I don’t feel like I’m losing out on something was food too. I mean, I think most people actually there, if they go with OMS, I think there’s nothing people are going to do OMS and say, Well, I’m I’m doing it, but I don’t do the diet. That’d be pretty unique. There are people who won’t do it that you said, they’d be like, “I cannot give up cheese and meat.” And so I think they would just be turned off by the whole thing. That’s probably, whereas with you know, if you, if you don’t do mindfulness every day, then you still feel like you’re doing the program, don’t you?
Michelle O’Donoghue
Dr. Jelinek appropriately emphasizes that all elements of the program are equally important. And you know, that’s where I try to remind myself of that on a regular basis. At the end of the day, too, I think that anyone who’s considering the OMS program, you know, I would encourage them just to recognize that it’s a win-win. I mean, following a predominantly plant-based diet, a whole food, plant based diet, and adopting stress management strategies, and making sure that you deal with any mental struggles that you may have, sort of face those demons. And, you know, I think it leads you to a better place overall. And I think the most important thing for me was that it gave me a sense of hope. And it made me feel like I was a little bit more in the driver’s seat, there wasn’t that same sense that multiple sclerosis had me, rather, I felt like I was able to take control of the path I was on. And walk forward in the direction that I wanted to walk, and knock on wood, everything has been very good for me ever since then. I mentioned that my disease was very active early on. And as soon as I embraced the OMS program, I have, done very well, and I have not had any clinical relapses in 13 years or so, which I consider to be just a tremendous blessing and accomplishment, too.
Geoff Allix
So, there’s another pillar of OMS that we haven’t mentioned yet, and I’ve heard that you had a baby recently. So congratulations on that. How would you tackle the think six step of OMS, preventing family members from getting MS?
Michelle O’Donoghue
Yeah, he’s almost two already. So time flies. I had a baby at an older age, I’m 45 years old now. And, so I had also, I had struggled a little bit with fertility issues as well, and had actually undergone in vitro fertilization. And, during that time, I had stopped any medications that I was on as well, which at the time made me a little bit fearful, because early on, I had taken medication, but, you know, my disease had been very well controlled, in fact, you know, really, essentially in remission over the course of several years, so, that’s when I made the decision to to come off medication. And I feel very fortunate that despite putting my body through the throes of in vitro fertilization and all of that and going through a pregnancy I again, have not had any problems throughout that, that part of my journey, which I consider to be a tremendous blessing. And, as for my baby, little baby Jamie. So, for him, I’m big on vitamin D. And I’m also avoiding dairy products, I do think that the the science behind cow’s milk, and multiple sclerosis as well as other types of autoimmune diseases is actually quite robust. So, when it comes to my own personal diet too I really take a very strong stance against any type of cow dairy exposure I really avoided it at all cost.
Geoff Allix
I’m not it was when it was put to me that because it because in the UK at least, dairies have recognized food group. And it was put to me. It’s they said, No animal on earth has breast milk as as an adult, and they certainly don’t have it from another species, that that can’t be normal.
Michelle O’Donoghue
When you really think about it, drinking an other animal’s secretions is very off putting when you when you actually think about it.
Geoff Allix
Can you tell us a bit about how you met George Jelinek, and then ultimately came to edit the Overcoming Multiple Sclerosis Handbook?
Michelle O’Donoghue
Sure, he was on a on a tour. You know, once I embraced the OMS program, it just felt like the absolute right fit for me. And, you know, it’s funny, I remember the cover of his handbook had had sunflowers on it. And I remember the very day that I had embraced the OMS program, I walked outside, I was on a trip to Canada. And there was just a field of beautiful sunflowers right in front of me. And it felt like one of those moments that it was just a sign that I was on the right path. And so when when he came on a speaking tour to promote his book, now, several years ago, he came to Boston. And I brought my now husband, I might not have been even married at the time. But I brought him to see Dr. Jelinek and I went and introduced myself afterwards. And because of my clinical trial background, I had started a conversation with him about some of the research that he was conducting. And so it became a friendship that we have followed over time. And we’ve had some back and forth correspondence throughout the years talking about his research, and perhaps the best approach for some of the studies he’s been looking into. So with that in mind, when he was about to start the handbook, he approached me about my interest in working with him and Sondra to help edit it.
Geoff Allix
And how was it working with experts from around the globe and put the book together?
Michelle O’Donoghue
It was it was great, it was a very interesting opportunity to have so many different voices and to hear different people’s experiences. And that’s the thing, it does help to have a book written by many different people from the perspective that not everyone goes through the journey, the exact same way. You know, people have different backgrounds, different biases, different ways of of approaching the OMS program. And that’s a lot of what we were trying to incorporate into the handbook.
Geoff Allix
And have you got a favorite part or favorite chapter of the book.
Michelle O’Donoghue
You know, I think that there are parts of the book that resonate with me for different reasons. At the time, I was actually pregnant. And so the section on having children was one that really I spent a lot of time thinking about and is the one that stands out most in my mind. But then I’ve also always appreciated the different practical parts in terms of, you know, telling employers, discussing it within your workplace, and then also the exercise aspect. Because that’s another area where I also have to keep reminding myself to find time.
Geoff Allix
And you’ve mentioned already that on first reading of the Overcoming Multiple Sclerosis book, you didn’t actually initially adopt the programming, it took a second reading for you to adopt it. So if you’ve got someone who’s new to the program and finding the whole Overcoming MS program quite overwhelming, what advice would you have for a newly diagnosed person?
Michelle O’Donoghue
Yeah, I think that, you know, the first part is to keep an open mind. Because, again, everyone I think has their preconceived biases. And you know, when you first read a book that is different from the perspective that maybe you initially had, it’s easy to sort of toss it aside and say, “well, you know, either this is too hard, or I don’t believe in it.” But I guess I’ll just offer that, as a scientist, I think that the evidence is actually really quite sound, to support it. And as I said, it really, ultimately is just a win-win. I mean, you’re doing the right thing for yourself. Even if you don’t, for whatever reason, firmly believe that the program will change your course of multiple sclerosis, it will just in general, improve your quality of life. I mean, there’s absolutely nobody can point a finger and say that, adopting a healthier diet, or more balanced mindset, more exercise and stress reduction isn’t going to benefit you in the long haul. So perhaps, if you just approach it from that angle, rather than becoming too obsessed with whether or not you believe every component, it’s just about, you know, I think that a diagnosis of MS for me was a very important opportunity to take a step back, reexamine my life, think about my priorities, and then decide how I wanted to choose to spend my days. And that’s something that does not happen automatically. For the rest of your life, as soon as you embrace the program, now, it still requires a very active role to make sure that you’re being mindful with the decisions you make. Nobody’s expecting somebody to be perfect. If you can’t adopt it overnight, fine. You know, start with the baby steps that you need to do. For the diet, I did actually do it overnight. And I can tell you that I was not somebody who was eating that way before. And I was able to completely overhaul it. But if that’s not possible for you, for where you’re at mentally, cut out one thing, increase fruits and vegetables, or, decide that you’re going to try cutting out dairy. People always say I could never do that. You can. You absolutely can. It just requires again, a bit of a shift in mindset.
Geoff Allix
And I think if you were the dairy one afternoon, it takes few years, but after a few years, the idea is quite horrible. I don’t I really don’t at all miss it anymore.
Michelle O’Donoghue
Yeah, no question that for me, meat has become that way that the texture of meat. You know, it’s just so unappealing,
Geoff Allix
I mistakenly got given some meat recently, I was at a conference and they had brilliant dietary stuff. So you actually could have any direct diet requirement. They catered for you and they they made a mistake, and they gave me Halal Food. And I thought, and I just bit into an aside, that’s actual meat.
Michelle O’Donoghue
It’s interesting how your palate changes. There are so many options now that were not available 20 years ago, you know, so when I go to the grocery store, I find that there’s actually tremendous selection, if you’re going to sort of a higher-end grocery store, you know, does that involve a little bit of extra cost? Sometimes? Yep. You know, you can absolutely do a very healthy diet on on a tight budget, because things that you can buy in bulk are very easy to do. But I’ve also had the philosophy that, you know, I think some people have have said, you know, would you rather pay your grocer or pay your doctor? And, you know, I sort of tried to flip it around from that perspective, that there’s no greater investment for my own health that I can make than putting healthy food into my body.
Geoff Allix
That’s great advice. And with that, I would like to thank you very much for joining us and and also wish you every amount of luck with a two year old
Michelle O’Donoghue
I have a 13 year old stepson too, though.
Geoff Allix
Okay so you have both. Okay. Well, good luck with that. Yeah. With that. Thank you very much for joining us on the podcast.
Michelle O’Donoghue
My pleasure.
Voice Over
Thank you for listening to this episode of living well with MS. Please check out this episode’s show notes at overcoming ms.org/podcast you’ll find useful links and bonus information there. Have questions or ideas to share. Email us at podcast at overcoming ms.org or you can reach out to Jeff on Twitter at Jeff Alex. We’d love to hear from you. Thanks again for tuning in and see you next time for tips on living a full and happy life with MS.