Multiple Sclerosis Support: Holistic Care, Community, and Living Well with MS

What does it really look like to live well with Multiple Sclerosis?

In this powerful and informative episode, we sit down with Dr. Deneb Bates, ND and Yadira LaMazza, MSW from the International Multiple Sclerosis Management Practice (IMSMP) to explore a holistic, compassionate, and community-driven approach to MS care.

Dr. Bates shares how naturopathic medicine, nutrition, and botanical therapies can support people living with MS, emphasizing the concept of food as medicine and empowering patients to take an active role in their health.

Yadira brings a deeply human perspective, sharing the impact of support groups and counseling in helping individuals navigate the emotional and social aspects of living with MS. From newly diagnosed patients to long-standing communities, her work highlights the importance of connection, identity, and belonging.

Together, this conversation bridges science, support, and strategy to help individuals living with MS feel more informed, empowered, and supported.

If you or someone you love is navigating Multiple Sclerosis, this episode offers both practical insight and hope.

Learn more about IMSMP:
https://imsmp.org/

Meet the IMSMP Team:
https://imsmp.org/our-team

 What You’ll Learn in This Episode:

• What a holistic approach to Multiple Sclerosis care looks like
• How nutrition and botanical medicine support MS wellness
• The role of naturopathic medicine in chronic illness
• Why emotional support and community are critical for MS patients
• How support groups help people feel seen, heard, and understood
• The importance of identity, connection, and mental health when living with MS
• Practical ways to feel more empowered in your health journey

About the Guests

Dr. Deneb Bates, ND
Dr. Bates is a Naturopathic Doctor at IMSMP specializing in holistic care for individuals living with Multiple Sclerosis. With a background in biochemistry, ethnobotany, and culinary medicine, she integrates nutrition, botanical medicine, and lifestyle strategies to support wellness. She is passionate about helping patients take an active role in their health through a comprehensive, whole-person approach.

Yadira LaMazza, BA, MSW
Yadira is a clinical social worker who has been supporting the MS community for decades. She founded the Center’s first women’s MS support group in 2006, which continues to thrive today. She also leads groups for newly diagnosed individuals and gay men, providing compassionate guidance and support for navigating life with MS.

Transcript

0:00

(Music) Hello, this is Michele Weston with Beyond My Diagnosis. It's great to be back with you. And I wanted to talk today about a chronic condition that affects me, as well as millions of others. And that is multiple sclerosis. And I've asked Dr. Bates, and I call her your dearer. But it's--(Laughter) You do a lot of that, director of social services or social work? Social services. Social services. Yeah, that's right. And Dr. Bates does a little bit of everything under naturopathy. So that's diet and it supplements. And it's looking at a bigger picture from the gut and from what we can do to help ourselves. We were just talking before we started because it's so important to remember what I always say to everyone, that you have a job as the patient with a chronic condition. You do you. Doctors do medicine. And we do us. And that doesn't make them not active parts of our journey, but we decide what our journey looks like. And that doesn't mean it's a heck of a lot of a perfect journey all the time, or it's not hard all the time. Not all hard at certain times. But I think that it's important to have the tools and the strategies to really help yourself. So where should I start? You know, I think that it's-- I've known your dearer for a long time. Yudhira Lamaza is the director of social services at International MS Practice under Dr. Sadiq and a whole team of doctors and researchers here in New York City. And I'm lucky because I can tap into some really amazing people, but we have work to do as the patients. So Yudhira, what have you seen over the years? And I know that Dr. Bates has some interesting stories that she's learned from her patients as well that we can share with people on making a journey with a chronic illness, an easier journey, a better journey, a more positive journey. Absolutely. Well, thank you so much for having us today. Oh, it's always a pleasure to talk to you guys. It really is. But it's-- I mean, I've been here 21 years at the center. And to this day, I still learn something every day when I meet with a new patient. And a lot of it is, you know, when you meet with a patient, like you said, doctors, when they come to see a doctor, it's all about the treatment plan and what's next, what's working, what's not working. And I think the patient always gets something out of what they-- where they can take control over something, right? Or they can-- if they can control their diet, if they can control their supplements, if they can control their exercise. So I always feel that always gives a patient some sort-- some more hope, not just relying on the treatment itself, which the treatment has helped a lot of patients. Absolutely. And that's the treatment. But I think when you have control over things, that's what really-- I think when you put that together with the treatment, the patient usually flourishes and becomes better and mentally and physically. So that's what I've seen here. And I think when you don't have both working together, that's when things may go a little-- not the right, you know, not the right way. Not the right way in the sense-- Not the right way, but-- Yeah, but not-- well, not the right way in the sense that-- you, dear, and I have known each other a long time because pretty much as soon as I was diagnosed, I was with Dr. Siddique. Right. It's just-- you know, nobody has just an easy walk through things. I'm sorry. If somebody tells you that, you know, it was an easy walk at the beginning, it's never. Because there's this huge surprise, and there's an interruption in our lives. We suddenly get thrown-- I don't know. I don't think it's just a curveball. I think it's more like a tsunami. Sorry. Because your entire life is suddenly upended. And you're not sure what this is going to look like. And having MS comes with a huge question mark because, yes, we have DMTs, disease-modifying therapies, which are great, which have changed the course of how most of us experience multiple cirrhosis. But it throws curveballs all the time. And some things stay in symptoms for us, and some things don't. So it's getting used to that we still don't know what multiple cirrhosis is. But we know more about it than we did. And I don't-- for the first couple of years, as I've said, it was very, very hard for me because I used to do 60, 80-hour work weeks as a fashion style director and as an editor. And I loved that life. That life doesn't work for MS. It just doesn't work for MS. So that's what I'm saying is that sometimes we get thrown a curveball, and it's like, how do I reinvent myself? How do I reinstate myself in this condition but still being myself? And how do I make things better? So it's a lot of education. And it's choices. Does anyone make good choices all the time? I don't know anybody who does. But we hope that we get better at knowing what we need and knowing when we can ask for more help than we may have needed before. And I think it comes in waves. Do you find that there are times that people do really, really well and then suddenly something can happen and they're maybe thrown off their game? Yeah, absolutely. It's funny you say that, but I was talking to a patient yesterday and she's going through an exacerbation at the moment. And I was asking her, how do you feel? And she's like, you know, I feel you do. I feel like I'm in a storm. I feel like I'm in a big storm. And I know, but I'm telling myself, like all storms, it's going to pass. And I was like, you know what? That's a good way of putting it. She doesn't have to pass. And when it passes, it's still going to be a little cloudy. I may still have, you know, she was trying to like, you know, talk to herself out of the whole storm. And I'm like, you know what? That's a great way of putting it. It is like a huge storm you're in right now. Yep, it is. And you know, you're just, you're not sure. And those people around you may see it more. Those who have symptoms that cause the need for canes or walkers, wheelchairs, things like that, that is more an announcement that there is something physically wrong. But many of us do not have something that physically announces, "Hello, I have a chronic condition." Is that easier or harder, do you think, you guys? Yeah. I've had some people say that they were grateful their disabilities were so visible because it made it easier for other people to understand. Yeah, yeah. And Yudhir and I have talked about that because when it's not seen, especially New Yorkers, I mean, especially New Yorkers, because New Yorkers are very bold. And they will, this is how I think after 25 years of being out in a New York city world, people want to connect here, even though we're very busy. And sometimes we can be abrupt and abrasive when people are in our way in a very small city with a lot of people. So people do experience us that way sometimes. But I think that it's very interesting because people will say, "Oh, I had surgery on my ankle and you're just like, I didn't have any surgery. I have MS. It has nothing to do with surgery." But they're trying to connect. Do you know what I mean? They're trying to find a space to say,"Oh, I know what it's like to not be able to walk into limp." And it's just like, and sometimes it depends, I'm sure, with all of us. Sometimes we answer very nicely, which I try after all these years to answer nicely. But sometimes I don't. Sometimes I get them had a bad day and I sort of say, "Well, I haven't had any surgery. So do you have MS?" And I really will sometimes say that and they're just looking at me. I say, "Because I have MS. So it's not about surgery." And you want to sort of sometimes, which I do much less because you guys know that. I'm not as abrupt and abrasive as I used to be. You soften with things as you get older and as you learn that, as I just said, people are just trying to connect. They're trying to find a way to walk about something to think, "Oh, that's really bad that you have this or you have that." Yeah, I bet you it's easier with a wheelchair, but I bet you one of my dear friends since we're kids in elementary school, Lori would trade not having a wheelchair and walking sticks any day, but she's had MS since 1983. So as we know, anyone before really 1995 when we had the ABC drugs, the Abenaxin, Betaserin, Anacopaxin as injections and so forth, it's different. It's different for people because thank God we have something that literally can hold many of us in place with these disease-modifying therapies. It helps us not have as many exacerbations, not have as many added symptoms, and some stay. And I think that's also probably, is it easier or harder to have the same thing stay? I don't get surprised as I knock on wood that I haven't had a big surprise for a long time. I know what I have. I have drop foot. I have incontinence. I have some cognition stuff. And those are my biggest things that I have that I have to deal with. So we make choices on how we're going to handle things. And you just learn to live with it. Maybe it's that you learn to tolerate it. Maybe that's what it is, is that you learn to tolerate certain things. You know, people always say, "Well, why don't you wear your brace on your leg all the time?" Well, me, I'm just a pain in the butt and I don't like to wear it all the time because I can't wear all the shoes that I want with the brace. It becomes a fashion conversation at times. But I think that many of us find common ground in that we choose to live our lives within a chronic condition. And I don't say disease or illness as a daily thing because I think after such a long time, it doesn't feel like a disease or an illness. I'm not ill. I have a chronic condition. That's what I have. And the chronic to me is that it happens all the time in different ways and different levels. And you just want people to find ways to stay as healthy as they can. Dr. Bates, when I met with you first, I was so glad that Dr. Sadiq finally listened to all of us who were screaming about supplements and diet and all of the things that we were reading because we had swank diet. There's a million different plans and ways out there. But I think some things rise to the top. And that is with most neurological conditions, you're dealing with keeping the swelling down in your system. So the quieter it is, the less active your symptoms are. And what do you think has been probably the most interesting for you working with IMSMP in regards to how people have figured out how to adjust and shift their diet? Hopefully it's not a huge change, but I'm sure for some it's a grave change because once you start to go, I just remember when I started to play with the swank diet, you know, the most important thing was inflammation. So you have really think to yourself, what bothers me? And that's why I'm saying the patient has a role, person with the chronic condition has a role. And that was, I noticed that when I had too much sugar, my hands hurt. And so you have to go, oh, this is something. Why does that happen when I'm eating more sugar or red meat is not great for me. Not a lot of red meat is great because it causes that same inflammation in my system. Have you seen anything that people have come to you to say, this is what I've noticed when I've adjusted my diet? And have we gotten more finessed in what helps us in regards to our diet? Not the diet like dieting. I said that the diet, your new, how about this? Dr. Bates, what do other people do with their nutrition? They probably eat, right? I think food is pleasure. Food is pleasure. We're supposed to enjoy it. It's not just for punishment. So I like to think of naturopathic medicine as the science of healing for science of disease. So much better. We need both of those things always. And I like your redefinition of MS as a chronic condition. But I really do think of it as how do we approach this with the science of healing, right? How can we help anybody do better? How can we help their bodies heal? How can we help their cells heal, their brains heal? How can we make them less autoimmune? So... And when you say autoimmune, what does that mean if people don't understand that this is an autoimmune disease? And yeah. So autoimmune means our immune system is attacking our own cells. And fundamentally, something has gone awry, right? We should not attack ourselves. We should be our own best friends. Hello, friend. So... And there are things that I do think make people with autoimmune conditions more autoimmune. I do think about the work I do in the world of naturopathic medicine, which is diet and lifestyle and supplements. I think of it a little bit more as the dimmer switch than the on-off switch. Oh, okay. So sometimes the disease modifying therapy can be the on-off switch. People can get on an MS disease modifying therapy. Sometimes that switch just goes off and the disease gets quiet. But I do think for most people, the lifestyle acts as the dimmer switch, right? We can turn it up, we can turn it down. And we can do that depending on how we eat, how we live, how we stress, how we talk to ourselves, right? The internal dialogue, which can turn up or down that dimmer switch of stress, make us much more prone to doing on our own stress juices, and therefore more prone to attacking, you know, being revved up to attack ourselves. So to get to your question, what have I seen that helps? I certainly see times when individualized diet helps. And what I mean by individualized is, can we identify food triggers that really are inflammatory to that person? I mean, we all should eat an anti-inflammatory diet kind of no matter what. It doesn't matter if you have MS or not. That's a good idea. But for people with MS, other neuroinflammatory diseases, which I'm going to include mood disorders in that, so to talk about anxiety. When our brains are inflamed, those situations are going to be worse. So how can we reduce neuroinflammation? And you were talking about eating sugar and your joints hurt. Well, that's so much more tangible, I think, right, is to feel that pain in your joints and say,"Oh, I did something wrong. This doesn't feel good." But our brains are a little more subtle or confusing in how they talk to us. And that might be a bad mood or depression or our cognition being off, right? So those are some signs of neuroinflammation, kind of the more gentle signs. But those are the things that I look for to get better when we do a lot of lifestyle changes. It means we're getting things more in tune for that person. And in terms of neuroinflammation and how to approach it, there are supplements. There are foods that are less inflammatory. But I do really think about the gut-brain connection there, right? Yeah, the gut is going to influence the brain. Because we do. I mean, we're into 2026. And we know that there are foods that set off our bodies. And we also know that our moods are affected by things, which is important to understand. Why do I say sugar? Well, sugar, for me, I mean, it has a double-edged sword for me because I had bariatric surgery as well. So I really don't love the way that I feel when I have a lot of sugar, which I don't have a lot. But sometimes it's just something so silly. Like last night, I had some blueberry lemon sorbet. I hadn't had a big dinner, but I had gone out for a going away party and had one martini and probably two or three bites of something. And yet, when I went to take that bite of just like a spoonful or two of sorbet, my body was not. I was like, no, I have no interest in this. You can just put that back in the freezer. But it's paying attention, like listening for the signals and learning them and working with a team that will not just mirror you and say, yes, that is something that happens when we do this or we do that, but it's also being your own detective. Well, that's a great way to put it. I think a lot of what I do is helping people learn to tune in in the right ways to make sense of it. Because especially when we're talking about the gut, food, and your mood, and your brain, it's so multifactorial that until you learn how to tune in, it's really hard to make sense of it. A million things have gone on. Why would you connect to these dots? You do need some training for that. Yeah. And you also have to have patience with yourself. Right, Adira? Absolutely. We don't all have patience with ourselves over the years, hopefully. I mean, according to Dr. Sadiq, I've gotten much better. I'm very different than I was 25 years ago. That's for good because I lived in a very fast-paced world in magazine publishing, and I was much more short and abrupt and abrasive, not because I'm a New Yorker, but I grew up in Detroit. I grew up in the Midwest. So you have to just look at things and go, all right, how am I going to handle this? Where am I not helping myself as much as I could? Mm-hmm, absolutely. That's a big thing also with stress. When you have stress, and you have MS, it can exacerbate some symptoms, and people are sometimes, "Why does that happen?" I mean, well, you're going through a divorce, or you're having stress at work or financial problems. It does happen where the body reacts to that, or even not sleeping. We had a podcast over the holidays, and I said how sleeping is also healing as well. It's something that we all need, but especially when you have MS. I think your body, you're always planning around your symptoms, planning around what's going on that day. You need sleep. Sleep is healing as well. Especially to the brain. Especially to the brain, right? Right. Actually, while we sleep that are glymphatic, so some kind of takes out the garbage of the brain and cleans it out. So it's such a big deal. It is. Yeah, and we don't. That's why it was here, getting more sleep. At least we're all trying, I think, just with MS for at least seven hours of sleep. But many of us are better with eight or nine hours of sleep if we can do it. Some of us don't sleep well. That's another thing for me. Since I have MS, I used to sleep like the dead. I would go to sleep, and I would sleep very, very soundly. I don't do anymore because I have incontinence, and I am up and down. In fact, I think I bought this apartment because there's a straight path from my bedroom to the bathroom. Do not pass go. Do not collect $200 that I can get there. That's interrupted, but over the years, you get better at not really waking up. You just try and stay in that state of,"I'm just going to the bathroom, and now I'm going right back to sleep." But I don't think any of it is ever easy. I don't think any chronic condition is ever easy. I think some of them come with more agita. Does diabetes come with more? Different. I think with diabetes, it is a lot about the diet and about the physical activity, and also handling stress. Stress raises those levels so that people don't feel well. But it has a lot to do about what nutrition, what diet people are eating. It's a little easier to say, "Okay, I'm looking at my numbers right now, and this is what I need to do." We don't always know, those of us with neurological conditions, what's coming. That shouldn't be saying, "Oh my God, I'm always going to never know what's going to happen next." You know what's going to happen next, especially those of us after 1995. We have a much better grasp on it. I was talking before about Christina Applegate, and I'm just amazed at her because she's been thrown a big curve. This is an actress who was doing her thing, and suddenly she really got hit by her body not being able physically to move. Knock on wood, you may have drop foot, but drop foot you can learn to work with. It doesn't mean you're going to ever run a marathon, but it doesn't mean you're going to go jogging. No. I say that, but that's my story. There may be people out there who have drop foot who dare that one, and they go and they run and they do other things. Each one of us makes decisions how to handle things, but I think what's important is to have as many tools and strategies as you can. Supplements, there's always a big question mark, especially medicine and science. It's like, "Well, we're not sure." It's not proven. It's like, "Well, it's proven." I'll chime in there. Western medicine is really based on what they consider evidence-based medicine, which is a double-blind placebo-controlled trial showing statistical significance. Now, the fundamental problem with that is some things don't fit into that model. And don't think that they don't fit into that model doesn't mean you don't have value. You can't double-blind a diet. You can give somebody a box of food and they can only eat from that, but you're not going to do that for their whole life. Maybe you do it for weeks or months. Or even years sometimes, but not forever. Not forever, though, right? Not forever. With supplements, I do... Look, I always value the science I love when we get more of that validation of supplements, but I am willing to work with basic science. So this is looking in cells or looking in animal models at the mechanism of action of a supplement. Sometimes we have ethnobotanical information, right? How traditional cultures have used herbs or plants as medicine over... Thousands and thousands and thousands of years. We won't look at that. And then to me what it comes down to is risk-benefit-cost alternatives, right? If you have a well-proven alternative that we know is going to work, don't do these things instead. But if we think it has some potential for benefit, low potential for risk, if cost-wise you can afford it, then hey, let's work with these tools. There's some power here that we can put into play. Yeah. And I think you said cost-wise, supplements can be expensive. Yeah, they can. Yeah. And both Dr. Bates and I will agree, it's not the ones you get at GNC. It's not. Sorry, guys. You're not getting them at Walgreens. You're not getting them at the local drugstore unless it is a drugstore like I found that is much more advanced in the sense that they deal with supplements and there is a level of expertise in using different supplements. You know? Hold on a second. Sorry, Dan. I think that CoQ10, it's not just for people who have MS. CoQ10 is great. Taking more CoQ10 is great. It depends on what's going on. Do some people need more magnesium than others? Yeah, sure. Do some people need more vitamin D? What we found that most people need more vitamin D today than they did before. Well, because we used to spend much more time outside. We don't anymore as much as we did unless we have a job that puts us outside all the time. Even so in the winter in the northern latitudes, if you're wearing sunscreen, if you're wearing clothes that cover your skin, if you live in the north, if it's between October and April, you're probably not getting enough vitamin D. If you live in Florida or Hawaii and run around mostly naked, go for it. You're going to get some natural vitamin D. Then you should put some sunscreen on eventually. Those are the things that we've learned that Omega-3s help good oils, as we've talked about a million times now, using good oils like avocado oil and olive oil. Those are great for us. They are better than other things for us because it's been proven. When I got my master's, I read a lot of, as Dr. Bates knows, a lot of empirical evidence on what we know and what we've learned about foods and about minerals and about vitamins and even supplements. Why am I taking berberine, Dr. Bates? When you gave me berberine, it was like, "Berberine? I didn't even know berberine." Well, it helps in the gut and it has some properties that reduce neuroinflammation, probably through the gut. When I went back to my integrative pharmacist, he was like, "Oh, that was a good idea to bring that in." Even he said, "Are you doing this forever? Are you going through with this?" I said, "I don't know. You all made choices. We change things up. At times, we stop doing certain things." But again, it's that active participation in knowing how you feel. It's saying, "You know what? I don't think this is really working as much as it could have." Learning to recognize certain things. We found out more about that people can get with MS more UTI infections. Why? Are they eating more sugar? Blah, blah, blah. Sometimes the body just doesn't tell us that we have a UTI infection like we do. For urinary tract infections, I used to know before MS when I was getting a UTI infection. It's something of an MS band in the middle of me that I really don't know. It would have to get really, really bad for me a lot of times to notice, except if I'm talking to Dr. Bates and we're also looking at things and she'll ask questions of me, how you felt about this, or even Dr. Sadiq. You start to go, "Oh, I didn't think about that that was a signal that maybe I had a UTI infection." We get more and more information, as Dr. Bates was talking about, in regards to the gut as being the second brain. If that's being the second brain, the infectious disease doctor I work with, Dr. Sadiq, asked me to speak C2 because I get all these UTI infections. That's one of my big infections. That's how I know that my system's a little out of whack. It doesn't mean the MS is going to flare. It just means that I have an infection. We try with autoimmune people to just keep that as low as we can. We think that I just have, as many probably others do, in my gut, it's just moved in. Sometimes you can't have it move out, so you have to get a little more creative and utilize things like berberine. Utilize things. I have a bunch of gut medicine that I take in regards to helping keep that flora as clear as possible. Did you look at it the same way as we did years ago? No. Now, I do preventative once a week. It's antibiotic, but it's like five grams of this powder that's been around for 50 years. It's a very old antibiotic, but it seems to, knock on wood, have kept away a lot more of having UTI infections. Those of you listening or thinking, "Oh, maybe I should try that." This is a conversation now I'm going to say. You know those doctors I was talking about? My father was. We actually have to have a conversation with them. We just don't then just make a decision,"Oh, I'm going to ask for antibiotics and I'm going to take that once a week." No, it's case by case. Sorry. Something like that is case by case. To be able to be aware and awake enough to notice subtle differences, especially with neurological I think is important. I do. I just think that listening to our bodies is what we're looking for. I think that that's what both of you aim to hear in people. What am I listening for? The patient learns to pay more attention when something happens or when something doesn't happen. I mean, that's even better when you're not struggling with things as you used to. As I said, chronic conditions are chronic conditions. We're seeing now today more people with not just one chronic condition but a couple, especially in the United States. We're known for more chronic conditions. Do we know as much? Do we see it as much in Europe? Oh, I think they eat cleaner than we do. Listen, we're the drivers of processed food. We have to own all of that. We have to own processed food. We created that whole thing of McDonald's and instant and I can just buy it as it is and just eat it as it is. Taking the time to be cleaner with our choices is work, right? Yeah, real food takes time. I don't know. We can't be doing things right in our society if we really don't have time to feed ourselves. I think we all need more grandmothers around or something like that. A lot of the best foods for us, it's not that they're hard, but they do take time even if it comes to things like soaking beans overnight before you cook them or soaking your grains so that they're more digestible. I think a lot of people have gone to the Paleo diet because they don't do well digesting those foods, but part of it is soaking them so that they're prepared in the way that our bodies can actually deal with it. It's like sourdough is so much better for us than other types of bread, but still it all takes time. Not everybody likes sourdough and those of us that do, we are fortunate, but you learn to adjust and adapt certain things. I think that that's the most important thing. I think in a headspace, you dearer, we would say it is paying attention to what's going on. Some of us have more colorful families and we get some pushback from our families on certain things because it's hard to understand someone who doesn't look ill, the invisible illnesses that come under MS for many of us. No, we look fine, but we're fine, but that doesn't mean we're always fine. There's stuff that's going on at times is more unmanageable than other times. We hope that as human beings, we just keep learning how to process and develop tools and strategies to help us. I think it makes a difference. I think learning that as Dr. Bace says, can you buy a can of beans? Sure you can. Is that quick at times? Sure. Do we take all the cans of beans and throw them away? No, because some people are not going to do it that way, but we look for things, better beans than others. We look for low sodium if that's something you have to address. We become more educated consumers as well because it's going to affect our bodies. As I said, sugar with me, even before I had bariatric surgery, I was diagnosed with MS before I had surgery. My hands hurt and so I try not to eat that a great deal because it's just better off if I make other choices. I think probably a lot of us would say that we just feel better when we make more educated choices. In a headspace, does it help to be in groups? What have you found in regards to people getting together and talking? Do you find it more especially important at the beginning, Dr. Yadira? I actually run. I have a group of women that meet once a week and they all have had MS for over 20 years with some disabilities. A lot of it is about MS, a lot of it is about their treatments, but a lot of it is also just asking, "Michele, how do you feel when you try this device?" Or, "How did you deal with what shoe to wear?" For them, it's more like a community and they feel safe and they feel heard. It could be snow, raining, and they meet every week, which is great. They're a great group of women. I think you need that also. You need that community to talk things out. It's as simple as what shoe to wear with a certain brace. We want to be able to have the community because not everyone, as you dare say, understands. It's not that they don't want to understand. It's just a lot to digest. Absolutely. It really is. It's just a lot to digest. If you look fine, it makes it more challenging because people can't see it. If you always were really quick and had great cognition, it makes it harder for people to understand,"Well, but you do this." It's like, "But I don't do it the same way I used to." To be in a group that helps each other look at things and walk through together is helpful for a lot of people. That really gives them a place to go to ask questions and not have any judgment. It's the same with bariatric surgery. It's still even 16 years later for me that we have a couple of times a month a support group. It helps to speak to others and hear what other people are doing for ideas than just to live in your own bubble. Because if you've not had bariatric surgery, most of the time people don't understand why we eat the way we do. I do not waste anymore eating something. Sorry, Dr. Bates. I will dump something if I don't like it. It could even be coffee. I'll throw it away because I don't have a lot of room in my stomach because it's the size of a banana now. I am not sticking something in there that just isn't valuable to me or doesn't really taste great. It's like, "Nope. I'll find something else." Even a cup of coffee, as silly as that is. I think that what's important is that we just keep talking this through. We're closer than we are farther if you ask the research team over at the Tisch MSN Center within IMSMP. We know certain things it isn't. There's always varying opinions around the world. Is it genetic? I don't know. Maybe it's genetic. Maybe it's Guillain-Barre. Maybe it's this. Maybe it's that. Better that we keep asking questions than not asking questions. I think that the two of you have heard a great deal of a lot of questions over the years. Do you guys have a favorite question that people were sort of ... Or maybe it's a continuous one that people really went, "I could have had a VA on that. I can't believe I didn't even think of that." I mean, a lot of the patients I meet with, they always ask, "Why? Why me?" Sometimes I remember the patient last week that said, "Well, my sister, my mom, and my cousin have MS." Maybe it's just that's the way it is. Then you have other patients that say,"There's no one in my family that has an autoimmune disease. Why me? Why did it happen to me?" I always get that question when I meet with patients. They just wonder. I think we always wonder. I still believe, and maybe it's because I'm a doctor's daughter, that we all have viruses that live in our bodies. Sometimes the switch gets flipped off and flipped on. A lot of stress can set things off. For me, I look at it and go, "I had an enormous amount of stress, and my body was in distress. It must have flipped a switch somewhere when I got that in my 30s." It happens. The question is, I think for all of us, so how do you live with that, and do we make it for me? Because for me, it doesn't get us through our lives. It doesn't mean we don't go through that. I can't imagine somebody not going through a bit of for me because it's like, "Why did this happen to me?" Well, because it could happen to anyone. This time it happened to you. I don't think... Is it like the lottery? I don't know. I don't know. I don't know. I know my friend Lori, who's been diagnosed since 83, has two sons. They've got grandkids now. Life goes on, and people get surprised in how much their lives are better than worse, even with us. That's what I think is the most important thing to do, is to live beyond your diagnosis. It's a diagnosis. That's what it is. But if you can say, "It's my diagnosis, and I'm going to go beyond this because I want to have the best quality of life," that's what we're looking for. Right? Absolutely. Yeah. I think both of you are a great check-in point for that, and I hope that listening to this podcast that people understand that there's lots of ways to help heal yourself as much as you can. That's the conversation we're having. We're having it in the head and heart and the gut today. It's been a pleasure speaking with both of you. Thank you, Deira. Thank you, Dr. Bates. Thank you. Thank you. I have... Always a pleasure. I'll have you back again. We'll talk about another way to look at that, because we never know what's going to happen in that research lab, right? That's right. Have a great day, and we'll see you around the other side. Thanks so much. Thanks for tuning in to this episode of Beyond the Diagnosis. If something we talked about today resonated with you, if you're craving deeper understanding, better support, we just want to know you're not alone on this journey. Make sure to subscribe to my free substack at Micheleweston.substack.com. That's where I share personal insights, expert takeaways, and extra resources to help you stay informed, empowered, and one step closer to the clarity you deserve. And if you found this episode helpful, leave a review or share it with someone who needs to hear it. Your voice helps this message go further. Until next time, keep asking questions, keep trusting yourself, and keep going beyond the diagnosis.