Sarah Conrad, a year after being diagnosed with MS, was on the summit of Kilimanjaro. To her right was Lori Schneider, the first with MS to ever climb Everest. To her left were others coping with diseases, from MS to Parkinson's. The air at 19,341 feet is thin, the brain foggy. But for Sarah, life couldn't have been clearer. She had a plan. Exercise. Relieve stress. Sleep. But first, get down that darn scree field.
When I was diagnosed with multiple sclerosis in 2010, I struggled to get my brain wrapped around life this disease. And for a seasoned research scientist, that's not always the easiest thing to do. I immediately started on a DMT, and considered this to be the foundation of my treatment (and still do). I had to trust science. But our mind’s capability of deceiving itself is strong. We believe what we want to believe and with such an unpredictable disease as MS, it is all too easy to fool ourselves.
And so like many people with MS, I’ve tried a wide variety of interventions in addition to being on a disease-modifying drug. I went down the path of faith healing, raw veganism, acupuncture, supplements, Wahls paleo diet, autoimmune paleo diet, helminthic worm therapy (arguably the most science-backed of my crazy treatments). But truly in the end, none of the diets, prayers and supplements seemed to matter much. Certainly nothing that could be determined over and above my own delusional mind wanting to believe I would be better.
So I came up with a more sturdy plan and one backed by loads of peer-reviewed studies. In short, I stopped trying to fool myself. The plan is simple: Exercise, Reduce Stress, Sleep.
...Even just a little, consistent exercise, dramatically reduces my [MS] symptoms.
The first two can be difficult to always control. Sometimes my feet and muscle spasms make good sleep impossible. Or anxiety and fear of the future. Or work travel. In general, I am religious about getting 8.5 hours of sleep per night, but sometimes this is impossible. (Sleep is increasingly implicated directly in diseases such as Alzheimer’s where even one night of poor sleep is linked to higher rates of beta amyloid protein deposits. Sleep, particularly NREM, cleans the brain, directly, through the flushing out of toxins.) Likewise with stress, the largest contributor in my life is work stress, but family stress, health stress, and financial stress can always happen without notice. Meditation, free-journaling, gratitude journaling are the techniques I use to help with that. I highly recommend watching Shawn Achor’s TED talk on the tools demonstrated to buffer against stress. But then there is the final one. Exercise.
High Intensity Interval Training (HIIT) for Multiple Sclerosis
Exercise is pretty much the only thing I can do which I can control on a day-to-day basis. And it impacts all the others. Exercise improves sleep. Reduces stress. But even more amazing is how even just a little, consistent exercise, dramatically reduces my symptoms.
Through trial and error, and because I am lazy at heart, I’ve found the minimal exercise regime to keep my symptoms in check. This is roughly 10 minutes of hard, interval, cardio activity with 5 minutes of stretching four times per week. This may seem like an incredibly low bar, and it is.
That's why it works.
Everyone, truly everyone, has 15 minutes in their day, which means that I will pull this out even at the end of the day and even if I really don’t feel like it.
Even at 11 p.m. In the dark. In the rain.
This minimum exercise regime is that I jog for two minutes to a short hill. Then do three hill sprints, running up the hill as fast as I can (about 20 seconds), and then walk down. Repeat three times and then jog home and stretch. That’s it. You’ll note that there is only 1 minute of hard strenuous activity in this plan, and it’s amazing that it’s still effective. In fact, a study showed that this type of 1 minute of hard interval exercise produces the same metabolic and endurance improvements as 45 minutes, 3x per week, of moderate exercise.
Climbing that MS Mountain
Before this, my minimum workout was 30 minutes—roughly 20 minutes of cardio and a 10-minute stretch. I would squeeze this in here and there in my day, and I would make it easy to do. I’d carry my gym clothes with me in my backpack everywhere. I didn’t worry about having the right shoes or time to shower. If I had 30 minutes between appointments, I would run to the gym. But still sometimes it would fall by the wayside in the busyness of life. I needed something that there was no excuse not to do it. Hence the 10-minute workout. While I do hill sprints, I recognize that may not be possible for everyone reading this. But there is always something you can do. Find the thing that raises your heart rate that you can do safely and do that for just 10 minutes, be it a hand bike or many of the other great adaptive exercise hacks for MSers by Dave here at ActiveMSers.
With all this information, you might think that I’ve always maintained a good exercise routine since diagnosis. You’d be wrong. I am as human as they come. As Shawn Achor says, “Common sense is not common action.” We all know we should exercise more but the latest season of Game of Thrones beacons strong. Ultimately, we are walking bundles of habit. And the easiest way to make a new habit stick is by lowering the activation energy threshold of starting. So rather than trying to immediately go from infrequent exercise to 60 minutes, 5x per week, the research on willpower and habits points to starting small. Try my 10-minute, 4x-per-week plan. Or if that is still a struggle, start even smaller like five minutes and increase from there.
I have found having a specific goal, like climbing a mountain and I don’t want to be the embarrassment in the group, to be a stronger motivator. It doesn’t make sense at all. Why isn’t a future of increased MS decline a significant enough motivator? I have no idea. I feel I have no excuse other than being human.
I can see in real time the benefits. If I miss more than a day or two of exercise, say I go for five days without exercising, then my feet cramping, muscle twitching, and body buzzing all starts coming back. It takes roughly two weeks of pushing through the now more uncomfortable and difficult exercising due to increased symptoms to settle things back down. Yet, I still found I wasn’t exercising consistently without a larger fitness goal that had a set timeline until I stumbled upon the minimum point required to be stable—the 10-minute workout. Now I do keep that up, independent of setting my sights on a mountain. But to go more intense, farther, and to reap the benefits of a more robust fitness routine, I still need to sign up for a climb to train hard.
Until the day comes when we can reverse MS brain damage, exercise is the most easily controllable part of my daily staying-as-MS-healthy-as-possible plan besides taking my DMT. And the day where we see MS brain damage reversed maybe coming in our lifetimes! If you want to get cautiously optimistically excited, listen to this amazing TED talk by Prof Chandran in Edinburgh on some pretty incredible new work coming out on brain regeneration in MS already in human trials, as well as watch the video of paralysis in the mouse model of MS being reversed by a new gene therapy from another research group. I think it’s an exciting time to be alive, but trials and cures always take longer than we think. As a scientist myself I know that things take at least three times longer than you think…. But until that day, remember – Sleep, (lower) Stress, and Exercise. But mostly exercise.
Sarah Conrad is a scientist, dancer, mountain climber, and a person living with MS since 2010. She first climbed Kilimanjaro with an MS and Parkinson’s group led by Lori Schneider, the first person with MS to climb Everest, in 2011 and has since gone on to climb Aconcagua, Chimborazo, Rainier, Cayambe and more. Climbing changed her life as she took on a new desire to accomplish more physically challenging things than she would have done without having been diagnosed. Her motto is now: “The only way for a diagnosis like MS to be ok is to live a better life with it than without it.”
She’d love to hear from any readers here in the comments or by email (sarah.r.conrad@gmail.com) on what exercise routines you have found most impactful for you. And maybe cc Dave while you’re at it (dave@activemsers.org).