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It is not at all uncommon when someone is diagnosed with a chronic illness for them to focus on the manifestations of that illness to the exclusion of all else. If a new symptom crops up, that individual often goes straight to social media or the Internet to try and justify it as a worsening of the illness with which they have been diagnosed. This seems to be especially true of multiple sclerosis as it tends to act differently in different individuals. But not all symptoms can be (or should be) blamed on MS.

There are guidelines that have long been established for “preventive care.” We have PAP smears to catch cervical cancers before they become invasive or life threatening. Colonoscopies to prevent colon cancers and mammograms to detect early treatable breast cancers are the norm. We think nothing of vaccinating our children when those are recommended but how often do we, as adults keep our tetanus vaccines current (every 10 years unless there is a dirty wound then five years)? Are we getting our annual flu shots or, if we are older than 50, our shingles and pneumonia vaccines? We now have COVID-19 vaccines to add to the mix and will (at least it looks like) be advised to get boosted every year from now on.

Routine care is not just something that is done to or for us. Each of us is responsible to routinely care for ourselves in the form of a good well-balanced diet, regular exercise, doing what we can to reduce stress in our lives and manage what cannot be eliminated. We have hobbies that help us to feel joy and satisfaction in our lives and we tend our spirits by engaging in faith-based practices. We nurture friendships and develop relationships that make us and others feel needed, wanted, and valued. We have jobs that provide for our families and give us the satisfaction of knowing we are contributing members of society and give us a sense of accomplishment. Routine care for those of us with MS also involves stopping smoking and avoiding second-hand smoke and taking a disease-modifying therapy to keep the MS from becoming more active and further damaging our central nervous system along the way.

While lifestyle changes (diet, exercise, no smoking, limiting alcohol, getting adequate sleep) can promote a sense of well-being and keep us working longer and being more productive, without a DMT on board, we are only doing part of the job of the routine care that is necessary to not risk becoming wheelchair-bound while we are still in our prime of life. 

We have a responsibility to ourselves and to those who love and care about us to be aware of our routine care needs and guidelines and be conscious about accessing that care when it is timely and needed to prevent other illnesses or conditions that, living with a chronic illness, can negatively affect our quality of life and ability to function at our fullest potential. I often hear from individuals that by changing to **** diet (fill in the blank), they have stopped their MS in its tracks. That, my friends, is the “normal” description of relapsing forms of MS that 85 percent of those with the condition live with. We have periods of normalcy that can last for months or even years between relapses That in itself can lull someone into a false sense of security and rightness when there is an improvement that seems to be timed to an intervention. 

All of these forms of “routine care” are necessary to protect us from falling victim to other illnesses or conditions that can further erode our sense of well-being and comfort and make it harder to function.

In summary, routine care for persons living with MS includes:

1. Getting tests and vaccines at age-appropriate times in one’s life and keeping up with annual vaccine recommendations.

2. Making or tweaking lifestyle changes that promote optimal health. These include:
 

• Whole-food diets without processed components, and high sugar or salt content.
• Doing some form of regular physical activity or exercise. 
• Reducing and managing stressors.
• Finding enjoyable pastimes and enriching work.
• Smoking cessation is a must.

3. Getting on and staying on a disease-modifying therapy is essential to long-term management of MS and prevention of disease progression.

4. If there are conditions that run in your family (diabetes, high blood pressure, thyroid or kidney disease, or certain cancers) be sure your doctor is aware and at least annually tests to be sure no interventions are needed at the time.

Routine care appointments are often scheduled during an annual physical or around the date of a birthday or anniversary to help remind us what is needed.