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Hello. Hello. Thank you so much for joining me today. Today I want to share something personal that happened to me recently that reminded me of such a strong thing that I teach a lot of my clients with Ms. But it's easier said than done and it's something that I often forget to do myself. It's something that can be helpful whether you have Ms. Or not. And this was just such a great reminder of this lesson. So I'll dive into the story and then share the lesson with you.

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The big question is, how does someone with Ms. Actually improve their mobility, Strength, energy independence? The list goes on. My name is Dr. Gretchen Holley, physical therapist and multiple sclerosis specialist. Welcome to the Missing Link podcast. Tune in as I share the top strategies and exercises to help you gain control over your life with ms, using research driven insights and advice from top industry experts. Whether you're newly diagnosed or have had.

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Ms. For over 30 years, whether you.

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Have relapsing Ms. Or progressive MS, this podcast is for you. You're sure to feel empowered and inspired after each episode.

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Ready?

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Let's dive in.

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On Mother's Day of this year, which was about early to mid May, I was hit with strep throat. I haven't had strep throat in 17 years. And the last time that I had strep throat, it was completely different symptoms. And so this sounds silly to say, but I had no idea it was strep throat. My throat for the most part, actually felt fine. My biggest symptoms initially were just intense dizziness if my eyes were open. So I basically just stayed in bed for two and a half days with my eyes closed. Couldn't watch tv, couldn't read, couldn't work for my laptop or anything. Just feeling very dizzy and fatigued. I had the chills, the sweats, you know, you name it. And then after about two and a half days, I noticed as I was leaving a voice message to my twin sister that my throat started feeling garbled. You know, like it sounded like I had big, big golf balls in the back of my throat. I was like, um, this isn't right. This kind of sounds like strep throat. And so I got a mirror and I looked at my throat and sure enough, there is white. Sorry if this is too detailed. I hope I'm not grossing anyone out, but there's a bunch of white spots everywhere in the back of my throat and I'm like, okay, this is strep throat. So fortunately, my husband was home with my daughter. I called my mom and I was like, can you please come bring me to urgent care. I need help. Like, this is not going well. So I go to urgent care. They test me. They indeed say that I do have strep throat. So they gave me amoxicillin. And I was on amoxicillin for a total of 10 days. However, on day three, my daughter comes home from daycare with an awful cold, runny nose, constant runny nose, wheezing, coughing. And sure enough, I pick up her cold. Now, because this story isn't about her, I'll stick to me. But she's doing much better now, thank goodness. We both had this awful cold for several days. She starts getting better and I'm not. And I was taking any type of medication that I thought would be helpful. So I was taking Dayquil at night, I was taking Nyquil. At one point, I took a full box of Mucinex. I didn't really feel like that was helping, so I took a full box of Sudafed and was just still feeling so congested in my nose. I could not breathe through my nose. It was a deep level of congestion and I was coughing. If you heard me, you would not want to be around me. And I was just really struggling. And this went on for two weeks and I was really struggling. It just. I honestly felt hopeless and discouraged and defeated. Like, what gives? Like, this is supposed to just be a cold. What is happening? And meanwhile, the annual Ms. Conference was coming up and of course I'm going to go. And so I did end up going to the conference, but between the lectures, I was taking breaks to go to the bathroom and use my nasal sprays and doing my neti rinse and taking more medication. Even though nothing was helping, I just felt like taking something's better than nothing. So the last day of the conference, I was like, I can't do this anymore. And I walked to a CVS in Arizona and the pharmacist recommended I try Flonase. And so I got Flonase. And thank goodness, that was the first thing that made me feel like I was on the mend in some way, shape or form. I still wasn't well, but I was starting to see a glimmer of hope there, but not enough where I was just going to only do Flonase. So on Friday, I was still in Arizona at this conference, but I called my doctors and I was like, hey, I need an appointment ASAP on Monday morning. So I get home, I go to the doctor and they're like, yeah, you're not great. And this cold should not be lasting this long. We want you to get chest X rays to make sure that this isn't pneumonia or bronchitis. Turns out I have bronchitis, so fortunately for me, I'm just so glad that they found something. And I actually. Not that I'm comparing this story and this experience to having Ms. At all, but I felt so relieved to have a diagnosis because it meant we could now do something about it. So they gave me a steroid to take for five days straight, and then also a Z pack for five days as well. And I've heard from lots of my clients with Ms. That getting their diagnosis actually did bring them some relief. That's not the point of this story, but I just thought that that was an interesting point. However, even though this was a really awful experience, I did feel a turning point at some point when something shifted, when I started looking for the tiniest signs of improvement. Because it can be awful being in that downwards, mental, downward spiral of feeling that defeat, that discouragement, hopelessness, like it's not a good feeling. And at some point along this process, I was like, you know, what am I improving at all? This can't all be bad, right? And so looking for the tiny signs of improvement reminded me of something absolutely crucial that I teach my clients with Ms. And I want to share it with you because it's something that, even though I teach this to people, it's easy to forget, but it's something that, if it's on the top of your mind, it can help you feel a lot better. So I was in the thick of being sick, feeling like I would never get better. But instead of waiting to feel better, I started focusing on noticing these micro improvements. So these are the examples that I could think of when I was in the thick of it. So the first one was, I can breathe out of one nostril instead of zero. Like, there was probably a full week and a half that I could not breathe out of either nostril. So as soon as I could breathe out of one happy tears, you know, I was just excited. Like, I was really focusing on, okay, this is a sign of improvement when I was coughing slightly less than the day before or I wasn't wheezing as much, maybe taking a deep breath in didn't make me cough as much as it did the day before. That was a win in my book. Even though I was still coughing like crazy when I only needed saline nasal sprays three times a day instead of four. Because, yes, I was absolutely counting how many times a day I was using those just because I needed them so frequently. And as soon as I got down to three times instead of four, that was a win. When my voice didn't sound like I had two huge marbles in the back of my throat, but it just sounded like I had too many marbles. It still didn't sound great, but it was better when I could eat a few bites without my throat hurting as much with every time I swallowed. That was a win. So the point was I was still not feeling great, but I was looking for any sign that this might be getting better. And suddenly I started feeling more hopeful and focused on these improvements instead of dwelling on how awful I felt. These tiny wins gave me momentum and motivation to keep going even while things still really sucked and I was still feeling awful. It gave me a glimmer of hope which kept me going. And honestly, it's a big reason why I was able to go to the Ms. Conference because I was focusing on positives. Another positive that I found was on my way to Arizona. My ears got so plugged because I was congested anyways. And then just with the flight of going up super high in the sky and then landing, my ears were a mess. As soon as I landed, I couldn't hear myself speak for hours because my ears were so plugged. But on the way home, my ears got plugged, but after one hour I could hear myself. That's an improvement, right? Like, things still sucked, things were still awful, but it was slightly better. Now, again, I want to be extremely clear here. Having a cold for three weeks, you know, strep for one week, bad cold for two, two and a half weeks is very different from living with multiple sclerosis. I am not comparing my temporary illness to your daily reality, but. But the theme of looking for small improvements applies to both situations. Mississippi progress often happens in the tiny increments that are very, very easy to miss. If we're only looking for the big changes or the end goal, if we are only looking for those major improvements, like walking a full mile when we can only walk a quarter of a mile right now, or climbing a full flight of stairs, whereas right now, one step is really hard. If we're only focusing on that end goal, those major improvements, we might miss the small wins that are actually happening. And those small wins can keep you more motivated and excited and consistent with your exercises so that you do eventually see those bigger wins. So I wanted to just share a few examples of some small wins that are real examples from my missing link numbers and a lot of these were posted in our Facebook community, so if you're a member, go look there and you'll be able to see all these. My first example, I'm actually going to read word for word of what Maria Shout out to Maria what she shared in the Facebook community and the other examples I'm going to summarize just for the sake of this podcast. But I loved what Maria recently shared. Just two days ago she said I tumbled this time. I can't blame it on Ms. It was my own fault. I used this little stool to sit on while I opened the cupboard and look for a DVD to watch. I went to sit on the stool but it was too close so I hovered above it to move back. I pushed it back too far. I went to sit down on the stool and ended up missing and landing on the floor. I didn't panic. I knew I could get up off the floor all by myself and I did. I feel myself getting stronger every day. Those Ms. Specific exercises from the Missing Link are working so that alone like the fact that she didn't panic, that is a win. The fact that she could get up off of the floor, that is a win. Some of the other examples from my group are being able to walk a few more steps before needing to rest standing up from a chair with slightly less effort from your arms. Maybe you still need to use your arms and the armrest to help you push up, but you're not using them as much. Maybe you're feeling more balanced when you're standing for a few extra seconds. Maybe you're able to lift your leg into the car without using your hands for the first time in weeks or even months or years. Maybe you're able to make it to the grocery store without needing to hold onto the cart as tightly. You're still using the cart, but you're not depending on it as much. Maybe your small win is that you climb three stairs without scuffing your toe on the steps. Maybe you do scuff your toe on the other step the other 10 steps, but for three you didn't. That's what happened to one of my Missing Link members and she chose to see that as an improvement. Maybe you can walk from your bedroom to the kitchen without touching the furniture or the walls to help with your balance. Maybe you do still need to touch the furniture and walls if you have a further distance to go, but for these shorter distances you don't need to. Maybe you can cook dinner without leaning on the counter the entire time. Maybe you can stand for a five minute conversation instead of sitting when before you might only be able to stand for one minute. Maybe you can make it to the bathroom before urinating instead of leaking on your way there. All of these are situations where if you're only focused on the end result, you will still feel disappointed in yourself and in your body. But if you're looking for these small wins along the way, it'll have the complete opposite effect. Your brain builds new pathways through small repeated successes, and a big part of that isn't just the exercises that you're doing. Of course that does play a role, but another big part of it is what you are mentally focusing on. Small wins create momentum that leads to bigger improvements. And like we talked about before, small changes add up over time. You might be able to stand for a five minute conversation today. In a month or two or six months from now you can stand for a ten minute conversation. Or maybe last month you could take three stairs without scuffing your step, but now it's six stairs and in a few more months from now it's the full flight. Noticing small progress keeps hope alive during these challenging periods. One of my other recent Missing Link members said that she was celebrating being able to lift her leg 2 inches higher when getting into her car, and that 2 inches led to 4 inches and then 6 inches, and now she doesn't need to use her arms to lift her leg to get in and out of the car. I actually have another podcast episode that is kind of similar to this topic, but it has a different take on it. It's episode number 144 and it's called how to Measure Progress and Stay Motivated. And it's recapping my key takeaways from a book called the Gap and the Gain. I would highly recommend it, but the first step to start adopting this behavior is to check in with yourself, maybe even daily, asking your what felt even 1% easier or better today and get really specific. Think about different areas. It doesn't always have to be strength related, like lifting your leg or not scuffing your foot. Think about your energy. Are your energy levels better throughout the day? For example, can you make it to 2pm before needing a nap instead of noon? Do you feel more alert during an afternoon meeting or conversation than you did a month ago? What about your grip strength? Are you able to open jars or open your pill bottles a little bit easier? Maybe you don't have to ask for help every time. Maybe just sometimes, maybe you're able to walk a further distance before your fatigue kicks in or before your foot drop kicks in. Maybe you're able to balance better, maybe you're still using a mobility aid, but you're not depending on it as much. One of my favorite ways to suggest finding these specific areas is to think about your day from start to finish, from the moment you wake up to the moment you go to bed. What things throughout your day are challenging, more challenging than you'd want them to be? So some things might be very challenging, other things might just be a little bit inconvenient. It all counts. Those are the specific things that you should be looking at at the end of the day. Did any of those things feel 1% or even half of a percent easier today, even though it was still a struggle? And that list actually is going to be a really helpful guide for you to know exactly what exercises you should do as well. But that's not today's theme, so check out the missing link if you want to know more about that. But keep a journal. Write these things down. Because if you're like me, you might not remember these wins. And when you're having a tough day, it might just feel like the world is crumbling. But if you can, go back to a journal or even your notes app and see all of these small little wins, even though they vary day to day with ms, week to week and month to month often will show a pattern. And let's also potentially call out the elephant in the room which is having Ms. Plus being sick is a huge double whammy that can feel so overwhelming. Being sick can make your Ms. Symptoms worse. So looking for these tiny improvements, whether you're sick or not, it could just be irregular symptoms. Looking for those signs that you are recovering from the illness or improving your strength. Because yes, that is possible with Ms. Through neuroplasticity or if you're sleeping better, eating a bit more, symptoms might be improving or at the very least symptoms are maintaining. Fatigue might be feeling a little less heavy. Your spasticity might be slightly less. Look at all these areas. Yes, your recovery might take longer than someone who doesn't have ms, but that's okay. Be looking for these small areas of improvement. So this week I challenge you to become a detective for these small improvements in your life. And also it's okay to get excited about lifting your leg one inch higher or walking five more steps. When I am working with my one on one clients or group coaching, anytime I'm working in a close group, when someone tells me that they can lift their leg one inch higher, I get a huge smile on my face and it is a genuine smile. I genuinely get so freaking excited. That is. I mean, it just makes my heart so happy. It's amazing that 1 inch often leads to 2 inches and 3 inches and what that means in day to day situations is that you're able to walk longer, you're able to climb stairs better, you're able to walk with your family. You're not going to isolate yourself as much. The ripple effect of lifting your leg that one inch higher or being able to walk five more steps is huge. It makes such a big impact and I can see that big picture down the road. But in order to get there, we do have to focus on these small wins and get excited. It might feel silly, but get excited about these small things. These small wins are building blocks towards your bigger goals and progress doesn't always have to look like what we expect expect it to look like, or maybe what it used to look like. Sometimes it's as simple as breathing through one nostril instead of none. So start looking for those small wins today and if you follow me on social media, send me a DM and let me know what your small wins are.