October 18, 2021

On the FUMS Podcast hosted by Kathy Reagan Young, two of our favorite people, Kathy and Dr. Gretchen Hawley, talked about many topics, but one that we are always interested in is heat intolerance and tips and tricks to dealing with it. Dr. Gretchen and Kathy both have great tips and suggestions and both talk about their love of the ThermApparel Cooling Vest. You can listen to that part starting at 6:15 or read the transcript below. 

We love to support all of the cool people who support us, check out Dr. Gretchen's website The MSing Link and Kathy's website FUMS. Thanks ladies for the support!

FUMS: 13 and a half years ago when I was diagnosed there really weren't many options available. Remember how those early cooling systems were? Let me tell you, I think I've tried every one of them. I felt either like an umpire or I was smuggling drugs or a bomb. I'm confident that's what I looked like, and they were ugly, huge, uncomfortable and it didn't last long and it was just uncomfortable. 

But I know you and I have both, well I shouldn't say I know, I think that you and I both advocate to use the UnderCool Cooling Vest from ThermApparel. That was a game changer for me. 100% game changer for me! It is hot and humid in southern Virginia in the summer and I was really missing out on a lot. Honestly, I love working out in the yard. I love gardening or just going for a walk or just hanging outside and I couldn't do it and I just didn't do it for the longest time. 

I mean, I tried the big umpire vest, they were awful. But when I found this, it just fit so snugly you can't even tell when I'm wearing it, you can't even tell I've got anything on. Yes and it literally keeps me nice and cool for up to three hours. 

The really interesting thing, and I don't mean to be doing a commercial for them other than to just say it's awesome, it has been a game changer for me, but what I noticed was I didn't feel like I was cool when I was like I wasn't chilly. It wasn't until I got inside that I really noticed the difference because for me I didn't really notice I was necessarily horribly hot until I got into the heat and then I couldn't cool down and that was the problem. So it's like, I come in and I go, Okay, I'm cool, instead I don't need to cool down. I maintain this cool temp and I think that's the difference too. Like don't you don't have to be chilly. You just need your core temperature not to be going up you just need it neutral.

Dr. Gretchen: Yeah, and you know, any time any of my clients have any symptom that starts increasing the first thing I tell them to do is ask themselves is there the potential that I could be overheating right now? Because you likely won't feel hot. You don't. It's weird. 

That's why my go to for the first thing anyone should ever do is sip ice cold water. If you if you are someone that has heat intolerance or if you're someone with cold intolerance sip warmer water because you never know your core temperature could be rising by half of a degree and you didn't know it.

One of my favorite things, as you just mentioned, you know, let me backup. I've been an MS specialist for six years now and even six years ago there was not and it was hard to find a cooling vest that wasn't bulky and didn't weigh five pounds.

My two favorite things about ThermApparel UnderCool Cooling Vests is it's lightweight, because that was really hard to find, and no one knows you're wearing it. So many of the other vests go over or around clothing and people know you're wearing it. Whereas this goes under your clothes, and you're right, I immediately feel cooler. Yeah. If you listeners are ever at a conference or event and ThermApparel has a booth there, go try it on immediately. 

FUMS: Yeah, you know, I went to a friend's daughter's graduation this year, and it was one of those beastly hot evenings. I mean, they tried to make it later. So that it wouldn't be horribly hot, but it was still horrible. But I was nice and cool because I wore my vest. But the funny part was, I mean, you literally couldn't tell I had that on, but the packs go in the back and as people would hug me, I would feel them, like, pat me down and be like, what the hell, what is that? So you can't see it. But it's there and you can feel it. People were like, what is that? So I did a little explaining.

Dr. Gretchen: I love that, without saying it, you basically just mentioned that you were being proactive and that is key when it comes to temperature changes. i.e. intolerance or just seasonal changes, is being proactive if you know that there is a possibility that it's going to be warm, or a possibility that your core temperature could rise. Go ahead and sit by as water or leave your cooling device on.

FUMS: Right. I love that. Because we're our own best advocate for ourselves, right? We need to be and we need to be taking care of ourselves and thinking ahead really can make a big difference. It's easier to stay cool and get cool. Does that make sense? 

Dr. Gretchen: Mm hmm. I agree. 

FUMS: So, I try and put my cooling vest on a little bit before I go out just so that when I step out, it's not like I'm already there. Like my, core temperature is like “we got this”. Go ahead and go out there. 

Dr. Gretchen: Yeah, and that way, even if your core temperature does rise, let's say it's a hot day out or you're exercising, if it started off at a lower point, it might still rise, but it's still neutral or below. 

 

Full transcript of the FUMS Now Podcast with Dr. Gretchen Hawley

FUMS: Welcome to the FUMS Now podcast show where you'll gain information, inspiration and motivation for living your best life with multiple sclerosis. Find us online. I'm your host, Kathy Reagan Young. 

My guest today is Dr. Gretchen Hawley a doctor of physical therapy and a multiple sclerosis certified specialist after graduating from Simmons University in Boston, Massachusetts. 

She developed an MS physical therapy program alongside a top MS neurologist. Dr. Hawley utilizes the concept of neuroplasticity in her online MS wellness program the MSing Link to help her clients reduce fatigue, get stronger, improve their balance and walk better. Her members feel more energized, empowered, and have more control over their life with MS. She recently added podcast host to her resume. This is her third visit here at FUMS. Hey there, Dr. Gretchen, welcome back again.

Dr. Gretchen: Thank you for having me back.

FUMS: I'm so glad you're here. You're one of my faves. So as I referenced, you're the world record holder here, because this is your third visit. So I just want to let everybody know that was episodes 22 and 74. I'll link to those episodes in the show notes too. But anyway, welcome back. 

Dr. Gretchen: I'm honored to be the world record holder.

FUMS: You are the world record holder, I’ll call Guinness. So I have to tell you that your name and your program keep coming up lately. I mean, you have really made a splash in our MS community, everybody adores you, and you're really making a difference for a lot of people. So why don't you tell everybody about the MSing Link?

Dr. Gretchen: Yes. So, it is the program that I developed so that I could essentially just help more people with MS. It's funny, because initially I started to help the clients that lived nearby. I was an MS specialist and physical therapist in the Boston, Massachusetts area. But there's very few MS specialists there. 

Most of my clients were coming from an hour away or some even two hours away. And what I was finding was that they were so fatigued by the time they got to me. Yeah, just from getting ready for the appointment, getting dressed, maybe even showering that day, getting there the session wasn't as effective, then they had to drive back home, and just the fatigue from all of that would last them two to three or four days. 

I started brainstorming ways that I could help, and the MSing Link online version was what I came up with. But what I didn't realize is that because it's online, the whole world can access it. So it's a way that people virtually can learn what I would normally teach in my physical therapy sessions for my clients with MS.

It's a lot of MS specific strengthening exercises, stretching, balance, walking. And then it's called the wellness program because I've added in guest speakers, where we hear from MS neurologists and other MS experts. We have research updates for yoga classes, so we've expanded to adding a lot of content there. 

FUMS: That's so cool. So I want to break that down. First of all, this was pre-COVID. I mean, this is brilliant, the way this worked out, but I remember so it must have been maybe before you even started this because I remember sitting on my sofa and we were texting back and forth ideas for the logo etc.

Dr. Gretchen: Yeah, it was. Recently I looked through old Instagram posts of mine and I saw that three years ago, on September 8 was the first time that you and I had a podcast episode where I was your guest and I remember that conversation vividly.

One of the things we were talking about was the launch, and this program will be three years old this December. So in a few months from now, so yeah, it was just before the launch.

FUMS: That's so cool and obviously pre-COVID. But boy has this worked out nicely. I mean, other people are just figuring out that they can take their stuff online, and you've been doing this. It's such a gift to so many people, and like you said, you know, you maybe didn't consider it. But I mean, anybody from anywhere in the world can benefit from it.

Dr. Gretchen: Right. As of right now. The last time I checked, we had missing link members in 12 different countries, which is just so cool.

FUMS: That is so cool. I love that. Okay, and so is it like a subscription model, like a membership to join? It's like joining a gym, right? 

Dr. Gretchen: Yeah, so there's a monthly membership, as well as semi-annual and annual and one of my favorite things about it is also the accountability. Not only do you get access to all these exercises, and things that can help with your walking and stair climbing and all these activities, but also the accountability to hold you consistent and on track with them, which I think is a huge, huge piece that a lot of people don't think as much about,

FUMS: Yes, 100%. I always say accountability is the missing link. In a lot of things, though, especially like you I work from home, I'm home alone, I have the intention of working out and I have nobody watching me. So sometimes it doesn't happen. But I always say like, you know, Weight Watchers works. Because you have to get up in front of everybody and weigh in every week. So there's that accountability, and you're like, Oh, I can't go there and not have lost any more or gained God forbid. So I think accountability is huge and it's a big motivator. So kudos to you for doing this. Your name just keeps coming up and you're doing lots of great things for our community. Thank you. 

I happen to know that heat intolerance and seasonal temperature changes on the body are specialty topics of yours. Let's talk about that a bit. It's mid September, as we're recording this, and oh-my-god, it's still intensely hot here in Southern Virginia and the heat kills me. I'm foggy, I'm fatigued, I'm achy, I basically just feel like shit when it's hot and humid. I know most people with MS share this side effect of heat intolerance. Why is that? Why does heat affect us so much?

Dr. Gretchen: Yeah, and one reason that I love talking about this is because a lot of people know that they have heat intolerance or that they feel worse during temperature changes or seasonal changes, but they don't know how easy it is to actually fix it and reverse it. 

FUMS: When I was diagnosed I remember vividly my doctor saying, kiss hot showers goodbye. Like you can't do that anymore. He was not wrong.

Dr. Gretchen: Yeah. Yeah, and it's different for everyone too, for some people, that's a big one. For some people hot showers are fine, but hotter temperatures outdoors, that completely changes the game. 

Truly what heat intolerance is, is anything that causes your core temperature to rise by at least half of a degree, which is not much at all. That could be a hot shower. It could be the humidity. It could be the barometric pressure. It could be exercise. It could be stress, a lot of people forget that stress makes our bodies warm and our bodies respond to that so there's lots and lots of different things that can cause illness. 

Also especially this time of year, depending on where our listeners are living. Seasonal changes can also cause very similar symptoms to heat intolerance and or cold intolerance. 

So as you mentioned, it's still pretty warm here. Let's just say theoretically that tomorrow it drops to 50˚F, so so much cooler. A lot of people will tell me “oh my gosh you know I would assume that I'd feel great because it's so much cooler but it's been a bad day for me.” 

FUMS: It's not so much the temperature right?! I've noticed that the barometric pressure really helps me as well. It's so strange. Yes. Aren't we lucky? We're just little barometers. So what do you tell your patients to do about heat intolerance? Like I'm looking for tips and tricks here, please?

Dr. Gretchen: The first thing that I always share, because this is the easiest and quickest strategy, is to sip ice cold water, not room temperature water, it has to be cold. If it's room temperature or even just lukewarm, it doesn't have the same effect. All it needs to be is small sips. I talked about this recently where a lot of people who have bladder issues, whether it's incontinence frequency or urgency, the last thing they want to do is sip water, right and mind that for heat intolerance. I literally mean like the smallest step possible just lots of tiny, tiny little sips so it won't really affect your bladder, but it will cool your core temperature down. That's my favorite. Everyone can do that, it’s free, you don't need to purchase anything yeah, so that's my favorite. 

But then there are also strategies of first and foremost figuring out what's causing it. If it is stress, do something to manage the stress. Meditation, taking five deep breaths. If it's exercise, cooling products is one of my favorites or if it's the temperature outside, cooling products again. There's lots of wraps, wristbands, hats shirts, there's so many different things out there right now. 

FUMS: 13 and a half years ago when I was diagnosed there really weren't many options available. Remember how those early cooling systems were? Let me tell you, I think I've tried every one of them. I felt either like an umpire or I was smuggling drugs or a bomb. I'm confident that's what I looked like, and they were ugly, huge, uncomfortable and it didn't last long and it was just uncomfortable. 

But I know you and I have both, well I shouldn't say I know, I think that you and I both advocate to use the UnderCool Cooling Vest from ThermApparel. That was a game changer for me. 100% game changer for me! It is hot and humid in southern Virginia in the summer and I was really missing out on a lot. Honestly, I love working out in the yard. I love gardening or just going for a walk or just hanging outside and I couldn't do it and I just didn't do it for the longest time. 

I mean, I tried the big umpire vest, they were awful. But when I found this, it just fit so snugly you can't even tell when I'm wearing it, you can't even tell I've got anything on. Yes and it literally keeps me nice and cool for up to three hours. 

The really interesting thing, and I don't mean to be doing a commercial for them other than to just say it's awesome, it has been a game changer for me, but what I noticed was I didn't feel like I was cool when I was like I wasn't chilly. It wasn't until I got inside that I really noticed the difference because for me I didn't really notice I was necessarily horribly hot until I got into the heat and then I couldn't cool down and that was the problem. So it's like, I come in and I go, Okay, I'm cool, instead I don't need to cool down. I maintain this cool temp and I think that's the difference too. Like don't you don't have to be chilly. You just need your core temperature not to be going up you just need it neutral.

Dr. Gretchen: Yeah, and you know, any time any of my clients have any symptom that starts increasing the first thing I tell them to do is ask themselves is there the potential that I could be overheating right now? Because you likely won't feel hot. You don't. It's weird. 

That's why my go to for the first thing anyone should ever do is sip ice cold water. If you if you are someone that has heat intolerance or if you're someone with cold intolerance sip warmer water because you never know your core temperature could be rising by half of a degree and you didn't know it.

One of my favorite things, as you just mentioned, you know, let me backup. I've been an MS specialist for six years now and even six years ago there was not and it was hard to find a cooling vest that wasn't bulky and didn't weigh five pounds.

My two favorite things about ThermApparel UnderCool Cooling Vests is it's lightweight, because that was really hard to find, and no one knows you're wearing it. So many of the other vests go over or around clothing and people know you're wearing it. Whereas this goes under your clothes, and you're right, I immediately feel cooler. Yeah. If you listeners are ever at a conference or event and ThermApparel has a booth there, go try it on immediately. 

FUMS: Yeah, you know, I went to a friend's daughter's graduation this year, and it was one of those beastly hot evenings. I mean, they tried to make it later. So that it wouldn't be horribly hot, but it was still horrible. But I was nice and cool because I wore my vest. But the funny part was, I mean, you literally couldn't tell I had that on, but the packs go in the back and as people would hug me, I would feel them, like, pat me down and be like, what the hell, what is that? So you can't see it. But it's there and you can feel it. People were like, what is that? So I did a little explaining.

Dr. Gretchen: I love that, without saying it, you basically just mentioned that you were being proactive and that is key when it comes to temperature changes. i.e. intolerance or just seasonal changes, is being proactive if you know that there is a possibility that it's going to be warm, or a possibility that your core temperature could rise. Go ahead and sit by as water or leave your cooling device on.

FUMS: Right. I love that. Because we're our own best advocate for ourselves, right? We need to be and we need to be taking care of ourselves and thinking ahead really can make a big difference. It's easier to stay cool and get cool. Does that make sense? 

Dr. Gretchen: Mm hmm. I agree. 

FUMS: So, I try and put my cooling vest on a little bit before I go out just so that when I step out, it's not like I'm already there. Like my, core temperature is like “we got this”. Go ahead and go out there. 

Dr. Gretchen: Yeah, and that way, even if your core temperature does rise, let's say it's a hot day out or you're exercising, if it started off at a lower point, it might still rise, but it's still neutral or below. 

FUMS: Okay, so, neuroplasticity, first of all, that's just a fun word to say, and this is one of your specialties too. I just love this. It's so fascinating to me. Can you share a bit of the science behind neuroplasticity?

Dr. Gretchen: Yes! Neuroplasticity is the ability of our brains to either strengthen the neural pathways that already exist, or create new ones.

FUMS: So basically amazing. 

Dr. Gretchen: Yeah, any any movement that we have, even if it's moving our fingers or lifting our ankle or bending our knees, any movement, what happens is our brain first either has a reflex to move that body part, or we have the thought of bend my knee, or open my hand, whatever it is. 

Your brain first has to have that thought or reflex then you have nerves that run from that part of your brain all the way down the spinal cord and the other nerves in there go to the muscle that causes the action of that muscle to move in that body part moving. 

So with MS the difficulty is in the nerves. The brain usually has the reflex or the thought to move, but that pathway doesn't work great. There's alienation so sometimes the pathway is still there, it's just not as strong because you've been overcompensating with other muscles. In that case, we can strengthen the original pathway. But in other cases there's just too much myelination and your brain will reroute itself, it will try to find a new pathway and make that body part move. 

FUMS: Yeah, our bodies are so freakin’ amazing. Every time I learn something new like this, I'm just like, oh, All hail the body that is. Yeah, we are cool. 

Dr. Gretchen: Yeah, absolutely really, really cool.

FMS: How do you use that neuroplasticity in your practice?

Dr. Gretchen: The number one thing and way that you can get it to work for you is by repetition.There are specifics of which exercises will it be, how will you do the movement, make sure it's easy enough for you etc. But the number one thing is doing the exercise for the movement that you're looking to improve over and over and over again as many times as you can for the next 10 years. 

Some people will start to feel improvements tomorrow. They just needed to know what to do. They just needed to wake up that neural pathway to remind them that's how it should be working. Other people might notice improvements in a few months, or in six months, or a year or two years, which is why I say 10 years. I know that sounds daunting, but my point being just keep going over and over and over again, even if, and especially if there's little to no movement. 

I've had some people, let's use foot drop, because I know that's a common one. I've had many clients who have pretty bad foot drop, where maybe it lifts a little bit, or not at all. They can feel the muscles twitching, but it doesn't lift at all. When I told them to practice lifting their toes, they would say, “Oh, I can't do it, what's next”, and they would almost just write it off as something that they shouldn't do.

But based on neuroplasticity, every single time you attempt to lift your toes, that's a time that your brain is trying to find that pathway to work. If you tried five times to lift your toes, your brain tried five times to get a pathway to work. 

FUMS: Wow. And that's how you build it back. Right? Well back better. I guess that's probably the same thinking that informs athletes, right? Like that muscle memory. I mean, this isn't nerve pathways, but the same idea, like repetition so that you don't even really have to think about it. It's just when you go to do it, you just do it. Right? 

Dr. Gretchen: Right. Absolutely. 

FUMS: Very cool. I wonder, while you were talking about foot drop and lifting your toes how many of our listeners were lifting their toes like I was, I noticed that my toes for going up?

Dr. Gretchen: Yeah, yeah. And that's one of my favorite exercises. Because you can do it anytime, anywhere. You can do it. If you're sitting, you can do it. If you're standing, you can do it. If you're lying down, you can do it anywhere and every time you do that your brain is either strengthening the pathway that's working already, or finding a new pathway.

FUMS: Oh my gosh, that is so cool. Okay, let's talk about exercise because that's who you are. Many people ask me what they can do to help their fatigue, literally daily, I get questions about this. How can you help this fatigue issue? I always say the same thing and it is 100% counter intuitive. But for me, exercise helps and I can't tell you how much that pisses me off because I am not a lover of exercise Dr. Gretchen/ I will cop to that truth. But it really helps me and it's so counterintuitive. The last thing I want to do is get up and move. I'm so exhausted, but honestly if I can get my fat ass off that sofa and make myself walk, even just around the room a little bit, I begrudgingly feel better. I know that sounds really weird, but I'm like I, I don't want to. I do want to realize the benefits of exercise and then I don't because that means I have to do it more. But I really do, honest to goodness, I am not as fatigued. If I am consistently exercising and I hate to admit it, but do you find others say that?

Dr. Gretchen: There's actually research proving that light exercise can reduce fatigue and, you're right, it does sound counterintuitive. One thing that I hear a lot is how do you expect me to exercise if I'm already fatigued. I also hear a lot “well when I exercise I get so fatigued.”

Yeah, so the trick is and my recommendation, this is what I find from research so I'm just sharing that, what research has shown is that it has to be light to moderate exercise and oftentimes we do at least moderate if not a little bit more and keep in mind to moderate is different for everyone. For some people moderate might be walking for other people moderate might be sitting down marching their legs.

FUMS: Yeah, or that toe lifting thing you just talked about. It's funny you say the word moderate because last weekend I went to visit my daughter in college and we decided to have a fun day and go for a hike and she lives in Harrisonburg Virginia which is very mountainous and I said girl a I have MS and I'm really out of shape right now because I don't do a lot in the heat of the summer and my treadmill broke. I just got a new treadmill though I will say that, but anyway, so we found a trail that was supposed to be flat and it was around a beautiful lake and I don't know if it was even a mile and it would have been just lovely. But we got on the wrong freakin’ trail. 

Oh my God this was hard. There's no way I could have done that. I would not have, had I known what this was. There's no way I would have done it. My daughter said the same thing and she's 18! We were climbing over downed trees and there were rocks we had to scramble over and everything. It was a beautiful vista when we got there, but I couldn't go on and I kept saying, “This is easy. It was marked as easy. When are we going to get to the lake? When is it going to flatten out?”

Anyway, we got on the wrong trail, but it was great. It was Humpback Rock, if anybody wants to look that up in Virginia, but it's actually called moderate. But I don't even think I'd call that moderate. That's what my point was, This is moderate? This is hard! I'd never do a hard level because to me, this is hard. So to your point, you know, some people call things moderate, that I call hard.

Dr. Gretchen: Absolutely. That’s such a good point, it needs to be moderate for you, or in this case, light to moderate. If it doesn't feel light, well then go even lighter. Don't think of light to moderate as what society might think. For some people, it just means sitting up tall in your chair unsupported, meaning you're not sitting in the back of your chair, and you punch your arms forward. Just nice and slow, put one arm forward than the other, or maybe you add a twist. 

There's so many light exercises that you can do. For the MSing Link, I just recorded a video, I think it was a month or two ag, and the title of it is Exercises to do in Bed. Because you can exercise in a light way, and that can help reduce fatigue. So there's always something you can do. But yeah, essentially, research is proving that to reduce either primary or secondary fatigue, light to moderate exercises is it.

FUMS: Yeah, yeah, and is that where you usually start with people? 

Dr. Gretchen: Yes, you just start with that light exercise, and then see how your body feels. Ask yourself; How did you feel? Were you sore at all? Were you fatigued at all? If so how intense and what was the duration, and then we work our way up from there.

FUMS: I love that. That's so good, and I just want to really reiterate my experience, which is that I don't enjoy exercise, but I find it very helpful. So I want to say to everybody else out there, you may not enjoy it, but honestly, it will help you, it'll help fatigue, it helps cog fog. 

We have a lot of issues sleeping, and I really find such a huge difference if I have done any movement that day I am sleeping better. If I haven't I'm not sleeping well. So exercise is so important. 

Okay, thank you for all that. You have a new podcast and a free five day MS strength challenge. So let's unpack that. First, tell me about the podcast.

Dr. Gretchen: It's really funny, because again, from just over three years ago, is when I was on your podcast the first time. Even as little as six months ago, I wasn't sure that it was something I knew was a big platform that a lot of people were utilizing. But I didn't really have the idea until maybe three or four months ago when people kept mentioning it to me and mentioning that they would like hearing audio tips. 

Whereas so far, I've just been on the MSing Link website, of course, but also Instagram, Facebook, YouTube, but that's all visual as well. I've been receiving a lot of feedback that they just want to listen, they don't really need a whole video on it and that combined with people asking me questions that require a longer response, where it's more than just what I can fit in a one minute Instagram video. So that was the point where I was like, Okay, let me look into this podcast idea a little bit more. I am happy to say we launched one week ago.

FUMS: Congratulations! What's the name of the podcast?

Dr. Gretchen: It's called the MSing Link. So spelled the same way as my online program. It's really exciting. It's a combination of me having solo episodes where I just educate and answer the questions that people ask me on a daily basis and then I also bring in guests, which has been awesome. 

We've had five guests so far. Dr. Aaron Boster as our MS neurologist, we had Mat Embry, R. Judge Shepard, Mindy Eisenberg and B. A. Link. So I'm trying to find speakers from very different realms that can help people with MS. So it's been a really exciting launch.

FUMS: I love that. I love that. Yeah, and the other thing I find about audio too, is it's just nice. If you're not feeling well, and you know, sometimes we have optic neuritis and for all those reasons, it's nice just to lay there and listen sometimes. I also listen to podcasts, like if I'm driving to the store or those days that I can actually walk when it's not too hot out. It is nice and it's nice to bring that along with you. 

Dr. Gretchen: It's been fun too because as soon as I've had the thought of Okay, wait, this might actually be something that I do. I'm a huge believer in anything that I create, even if it's an Instagram post or Facebook or YouTube, it's for the people that are watching it. So I'll create the content for my audience and the way that I do that is I ask a ton of questions. I've been polling my audience on Instagram and Facebook and email for maybe two or three months now just asking questions like, how long do you want the episodes to be? What day of the week do you want it to launch on? What guests do you want to hear from? Everything about this podcast came from people with MS. That's been cool. 

FUMS: Yeah, absolutely. Well, I love that you take us into consideration first and foremost in that so you're building the content for us, that's awesome. Okay, so the strength challenge. Tell us about that.

Dr. Gretchen: I found that there are some preliminary things to get out of the way first before people start an exercise program. The first is neuroplasticity. As we reviewed today it's important to understand that deeply enough where you could explain it to someone else. The reason for that is because neuroplasticity is the reason that someone with MS actually can get stronger, improve your walking. So knowing what it is and knowing how to make it work for you and your goals is so important. 

The Five Day Strength Challenge is geared towards getting the information you need to then start a program. We review neuroplasticity. We also review functional exercise. How to exercise based on what your goals are. We touch on accountability and consistency. So a different topic each day, a slight homework assignment, that's optional, but you can fill that out each day. 

It's meant to prepare you with enough information where if you already have exercises, you can now do your exercises more effectively. Because you'll know how to utilize them and if not, well, then there's The MSing Link program. There's other programs, but The Five Day Strength Challenge is geared towards helping you figure out the basics first. Without that any program you do won't be as effective.

FUMS: That just reminded me of what I have found over the years that’s very effective with my MS, which was like visioning or I was gonna say guided imagery, but it's not guided, it's just guided by my head. But years ago, when I first had my first major, major flare, and I was in bed basically, for six weeks, I felt so done that I just couldn't. I was pissed off that my body was doing this to me. I didn't know what I could do. But I started picturing the lesions on my brain. Back in the day, there was this commercial with Scrubbing Bubbles. And so in my head, I was picturing Scrubbing Bubbles scrubbing off my lesions and it really helped. I felt like I was doing something. 

So in the same way I'm thinking if you understand neuroplasticity, for instance as you were talking about pulling up your toes and how that your nerves are connected from your brain all the way down your spine out. I'm thinking I'm picturing that and I think that really helps to understand. 

This is such a weird offside thing, but it does remind me of when I was giving birth. My doctor was telling me to push and I was like, “I am pushing!” I thought I was pushing and I said, “Could I have the mirror?” and she put that mirror right there and I was like, bam, and I pushed that baby out because I could see what I was supposed to be doing. You know? I was envisioning it, I could see it. So I think what you're saying about understanding how these things work, and that it can make a difference, you can picture it. and I think that's just got to help right?

Dr. Gretchen: Yes! And one thing that I hear a lot and actually now that I'm thinking about it, I definitely have heard this more frequently in the last year or so than other years. But I hear this phrase from people with MS where they'll tell me, you know, I've been doing program x y&z and I'm getting stronger, but my walking isn't any easier. I'm getting stronger, but stairs are just so damn hard, or I'm getting stronger, but getting in the car is hard. They feel like they're getting stronger. They feel like they're getting balanced, but there's not that carryover into their day to day life. 

So their function is still difficult for that and my whole thing is I want you to get stronger so that your walking is easier, so that your day to day activities are your life. 

Challenging? Yeah, totally. So there's a difference and so that's what we review in The Five Day Strength Challenge is how to make that connection, how to get that overlap. Then in the MSing Link, all of the exercises are geared to improve strength, but also your function.

FUMS: Yeah, it's great to be strong! So how do people find you and your program? 

Dr. Gretchen: So many places. My podcast is the newest way that you can find my program, it's on my website MSing Link. I'm also on YouTube as Dr. Gretchen Hawley, Facebook as Dr. Gretchen Hawley. And we also have a Facebook group called MS Wellness and Support. And then I'm on Instagram, as Dr. Gretchen. 

FUMS: And just so everybody knows all that info will be in the show notes. So don't like drive off the road trying to write this stuff down. I got you. 

So that's also excellent. Dr. Gretchen, I learned something every time I talked to you. Thank you so much for coming back for a third time. I really appreciate it and I'm sure you remember this part where we in the FUMS Nation speak to the stupid diseases the way it deserves and we tell it FUMS every day, so if you wouldn't mind, would you please lead us in our salute to MS with middle fingers extended? 

Dr. Gretchen: Of course. 

FUMS: Are you ready?

Dr. Gretchen: I am ready. Okay.

FUMS: 1...2...3... FUMS. Yeah, that was a good one. Appreciate it. Thanks so much for being here. 

Dr. Gretchen: Thanks for having me.

FUMS: Quick shout out to Steve Woodward at for the fantastic work on his podcast, including editing, show notes and ingenious ideas. If you'd like help with your podcast, whether you're just starting out or an old Pro, visit podcastingeditor.com and tell Steve I sent you. 

Thank everybody. I really appreciate you listening to the FUMS podcast show. Be sure to subscribe to it so you won't miss an episode. You can do that right on the FUMS website. While you're there, sign up for the free email list. So you'll be among the first to know of any new findings in MS research, new therapies and products, as well as any blog posts and podcast episodes I release. 

Want to chat with others in the FUMS community? Join us on Facebook at FUMS Now, thanks again and don't forget to talk to the stupid disease as it deserves. Tell it FUMS every day.

Show Notes:

  • Online MSing Link Wellness program has helped people all over the world – and the importance of accountability as an aid to achieving health goals
  • Why heat intolerance affects so many people with MS – along with tips and tricks to help us to deal with it
  • What is Neuroplasticity? And why is it relevant for people with MS?
  • The counter-intuitive benefits of light to moderate exercise
  • Why Dr. Hawley decided to start a podcast
  • Details about how you can sign up for Dr. Hawley’s Free 5 Day MS Strength Challenge

Resources for this episode (clickable links):

** Sign up for The FUMS 6-Pack here: The FUMS 6-Pack.

~ Special thanks to my podcast editor Steve Woodward. Do you have a podcast or are you interested in starting a pod? I HIGHLY recommend adding Steve to your team. Find him at

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