Author Samantha Irby's Journey as a Young Caregiver for Her Mother with Multiple Sclerosis

Episode Transcript

Dr. Daniel Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa.

Dr. Katy Peters:
And I am Dr. Katy Peters, and this is the Brain & Life podcast.

Dr. Daniel Correa:
Welcome back to the Brain & Life podcast. I'm guessing we have at least a few Sex and the City fans and among our listeners. And our guest today is a bestselling author, humorist and a TV writer, Samantha Irby, who was part of the team for the reboot, And Just Like That... Katy, have you seen either of the shows?

Dr. Katy Peters:
I have not seen And Just Like That..., but it's totally on my cue after I finished my current streaming shows. And I was a fan of Sex and the City and still like to watch it today. It must have not only been an lightning discussion, but also a humorous one.

Dr. Daniel Correa:
Yes, she brings her raw and frank style of humor about life to the show of Sex and the City, and I also enjoyed her book Quietly Hostile. Through her books and many of her essays, she has shared her personal stories and that includes her perspective of living with her mother who had MS in an era where she didn't have much access to treatments to help slow down the progression of the condition.
One of the topics we touched on is how she learned about her mother's diagnosis when she was a kid herself. And I know that you and our listeners are going to enjoy this episode and laugh along with it, I hope. Don't forget to call in by December 1st for a chance to be featured in a future episode. Share what you are most grateful for in 2023. You can do that by calling 612-928-6206.

Dr. Katy Peters:
Or email us at BLpodcast@brainandlife.org. And also make sure to tell us where you are listening from.

Dr. Daniel Correa:
Follow and subscribe so you don't miss an interview with Dr. Joel Salinas. He'll be coming to the show to share with us his own perspective of living with synesthesia.
Welcome back to the Brain & Life podcast. I'm taking a moment to compose myself because we've been laughing a lot already in the pre-show setup. Today I'm joined by bestselling author and humorous, Samantha Irby. She delivers comedy and insight from even the deepest personal tragedies where it is the plain reality of navigating the politics of food and family and living with Crohn's disease and her days with depression, her own obsessive compulsive disorder and her past caregiving for a parent with MS.
She shares raw, unapologetic, hilarious, and relatable perspectives about the journey of accepting all of yourself and your life. You can find her writing on TV shows including her most recent role as the supervising producer on the Sex and the City revival, And Just Like That... and past shows including Shrill and Tuca & Bertie, along with her blog or her books and essay collections, including Meaty, We Are Never Meeting in Real Life, Wow, No Thank You. And most recently, Quietly Hostile. Sam, thank you so much for joining us.

Samantha Irby:
Thank you for thinking that I would be good at this.

Dr. Daniel Correa:
I know from reading your books and many of the stories about you that your mother's multiple sclerosis became a reality very early in your life, but what do you remember about your childhood before you had an awareness of your mother's medical condition?

Samantha Irby:
My dad was an alcoholic, so it was a little chaotic. We lived in this pretty big house that my dad had gotten with a VA loan of all things. I think my mom wanted a do-over baby because she had my sisters when she was so young and then she was 40 when she had me and she's like, "I'm going to coddle and shelter and this is my precious little baby." So it was like I was in a little cocoon in the middle of all of this chaos.

Dr. Daniel Correa:
Before we talk about your mom's time with her medical condition, I don't want to define her in that way, what can you share with us about Grace and who she was both in your life and in the community?

Samantha Irby:
First thing about her, she dyed her hair like bozo fire engine red, and this is in the eighties when colorful hair was like, oh, okay. And she always had very long red nails and she always wore red lipstick. So she had my sisters when she was 16, 18, and 21. She put herself through high school and then nursing school with three kids.
So then when I came around, she was working in nursing, she was working in the emergency room. She was 40. When I was, I don't know, like eight, somewhere in there, maybe earlier, she quit working in a hospital to go into private practice to work with men who had aids. She would do home care. I would sit in the car and she would go in and take care of them and we would drive around and then we'd go home and do it all again the next day.

Dr. Daniel Correa:
In your first book Meaty, you shared a lot of the detail about your mother and your relationship with her and that transition to starting to take care of both your parents. It seems that divide of your childhood and time with the family and starting that transition started around when you were nine years old. Can you share with us what happened?

Samantha Irby:
She was diagnosed with multiple sclerosis in 1978, a couple years before I was born. They certainly did not have the medications and treatments that we have now. Thank you, science. So when she got pregnant, she went to her OB and the OB was like, "You're old and you have multiple sclerosis. You should not be having this baby."
And my mom was like, "Well, but this is the time I can enjoy having a baby rather than dropping the baby off at daycare and going to work or school" or whatever she had to do with my sisters. And she was like, "I'll risk it." And she had me and her multiple sclerosis was in remission. She didn't actively have the disease. And then when I was 10, she was in a car accident, not wearing a seatbelt, and she flew across the front seat, hit her head on the rear-view mirror and seemed fine, came home was fine.
It was just the two of us at that point in an apartment. And then a couple days later she woke up and was sitting on the edge of the bed just drooling. I thought she was just getting her bearings or something. So I, because I'm 10, I'm like, "Oh, it's a day off from school. I'm going to eat a salad bowl filled with Cinnamon Toast Crunch and not take my pajamas off, not put on shoes."
And so she was sitting there. At first it's like, well, it's half an hour. Well, it's been an hour. And then I go in and look at her again and she still is drooling. She doesn't seem to be hearing what I'm saying. So I went and got the neighbor and the neighbor called an ambulance, and it turned out that she had a blood clot in her brain from where she hit her head in the accident. And then when they went in to get the clot out, that brought her MS out of remission. So then it was just like long slide downhill from there.

Dr. Daniel Correa:
At that point you were used to being a little kid and still having your mom helping take care of you. Leaving the hospital, was it already at the stage where you needed to help her?

Samantha Irby:
Quickly she started to break down. It wasn't like one day she could talk, next day she couldn't, but it felt like that. Over the next couple of years, it was like she could walk, she could walk, she could walk, she couldn't walk. And so the next few years we spent together, it was hard. And I don't want to get too much credit as the person who took care of her because when you're in middle school, you only care about your friends and what's happening at school the next day and who did what at what party that you weren't invited to.
So I didn't cast all that aside to tend to my mother. I still went to school every day, I still cared about all the stuff you care about, but it was just me and her and I was doing the things that needed to get done. But at first, it's on me to go to the store. It's on me to go pay the light bill at the currency exchange so our lights don't get shut off. So it was on me to sort of keep things going. Getting the laundry done, doing that kind of stuff. And then as she progressed or worsened, it was like, she can't do the stuff I can't do. It's time for her to go into a nursing home.

Dr. Daniel Correa:
Sam, going back, what do you actually remember about learning about multiple sclerosis as a condition that your mom was living with and not just, "Oh, she went into the hospital and came out having a few more challenges."

Samantha Irby:
I'm going to read you a little section from an essay I wrote called My Mother, My Daughter, which is in my first book, Meaty. "Here is how multiple sclerosis is explained to you when you are a young child. 'Okay, Samantha, I want you to think of your brain as a series of wires. Can you picture it?'.
I remember wanting very badly to impress the neurologist because I needed him to understand that I was totally responsible enough to be in charge of my mom's care, even though I peed the bed the last three nights and cried in the bathroom when no one had anything nice to say about my diorama. So I nodded, assuredly. 'Now this disease your mom has is called multiple sclerosis.' He waited while I repeated it back to him.
'And what it does is it attacks the coating on those wires. It just eats it up like candy. Right now it's working on the wires that control Grace's legs, and that's why she's having trouble standing up and walking around. And eventually, it will eat the coating on her arm wires and her talking wires and her thinking wires.' It had been two years since the brain damage left behind by having her head cracked open had accelerated the aggressiveness of the MS.
I watched her pushing a borrowed walker around his office, her brain, a makeshift arcade that housed only an outdated Pac-Man machine. Chomp, chomp, chomp, chomp. She bumped clumsily into the chair I was sitting in. Chomp, chomp, chomp, high score." So that was my introduction to MS, which is a really good way of explaining it. Even now, if someone asks, "What is MS?" I'm like, "It's a disease that eats away at your brain wires." It was really clarifying for me as a kid, and also it was good preparation for how her systems would slowly shut themselves down.

Dr. Daniel Correa:
And progressed.

Samantha Irby:
Yeah.

Dr. Daniel Correa:
Yeah. Your story there also helps to illustrate that there's such a difference too, in how different people live with MS and their own progression at different eras of treatment or access to care. Sometimes the reality of how one person lives with and progresses with their MS compared to others can be so different.

Samantha Irby:
Right. It's all different.

Dr. Daniel Correa:
And unfortunately for your mother, it's so progressive and so fast. I mean, it sounds like, yeah, that two year period from recovering from a single hospital stay to very soon after, you were really seeing major limitations in her abilities. The reality of it early on was just doing some more chores and taking care of yourself and a few things around the house. It sounds like in those following two years and the subsequent six more years, it was a rapid transition of that dynamic of child, parent, caregiver and relationship. Where did it go and what did you learn in that time?

Samantha Irby:
I had always known that we were poor, but nothing is harder than being poor and sick living on social security and Section 8. I think it really crystallized for me what we didn't have. Evanston, Illinois truly is the best place to be from, but one thing about growing up there is there are a lot of kids who have a lot more than I did.
And I'm grateful because their parents pay taxes so I got a really good high school education and went to a beautiful school with two swimming pools in it and asked for nothing in terms of what I had access to in school. My mom couldn't even afford to keep a phone on. So when people are like, "Hey, can I call you?" I'd be like, "No." And I didn't have money to hang out after school. I had to go home and make sure my mom was okay for the many hours I had been at school.

Dr. Daniel Correa:
I'm wondering when you learned that you had Crohn's disease and also through your own challenges with mood disorders and mental health, how have you put some of the learning you did from your mother and her challenges into practice for your life?

Samantha Irby:
When I first got the Crohn's diagnosis, I didn't understand how my life was going to change and I mostly felt like, "Poor me. Why me? Yet another thing." And I mean, if we're being honest, I still feel like that. I think a thing that you learn quickly when you have a disease that nobody wants to talk about, they don't know about.
So I got diagnosed in 2008, now there's commercials on TV about Crohn's and everybody thinks they know what it is. But then everybody was like, "Ew, what's wrong?" And I'm like, "I don't want to talk about my colon, but I'll tell you about my colon if I have to." I stopped throwing my pity party and just was like, "Okay, this doesn't go away. Let's deal with it. Let's tell everyone we can about it." And then I started doing that.

Dr. Daniel Correa:
I wanted to go back to Grace's journey with her medical care and her condition. She eventually had significant mobility issues. For our listeners who haven't read your books, seen your videos or interviews, you also come from an African-American background, and as you said, you guys were living at significant socioeconomic challenges. What do you remember about the challenges and barriers and access to the care that your mother needed?

Samantha Irby:
Well, the limits of Medicaid, I will say now as a person with good health insurance through my wife who has that, "I work at a school insurance," I mean truly, I would have her drop me off at the hospital every week. They cover everything. That was not my reality as a kid picking and choosing when to go to the doctor or when you can afford to accrue more debt. I will say that because we had no income other than social security, there were no hospital bills getting paid.
And when you can't get yourself anywhere, I couldn't drive, we didn't have a car, my mom can't get around, it's like, "Is this worth calling an ambulance for?" And when she finally had a fall the last time I ever saw her not in a hospital or nursing home setting, we didn't have a phone, and so we had moved into this apartment that was down the street from the fire station so that if something happened, I could walk down there.
We couldn't even get her a wheelchair. I think that's part of the reason we couldn't afford to live in a accessible building. We lived in a walk-up. The last apartment we lived in, we were on I think the second floor. And it's like, she can't live in a building she can't get in and out of. What if there's a fire? And some things you can do at home, like my brother-in-law put a seat in the shower so she could stay clean.
I have many experiences with several types of raised toilets and toilet raisers. She did have a walker, but again, these are just sort of cobbled together fixes rather than, "Hey, I got this thing that makes my quality of life better." It's like, "Well, we can't move to a place with a shower you could walk into, so good luck sitting on this chair and swinging your legs over into the tub."

Dr. Daniel Correa:
Yeah, it's tough.

Samantha Irby:
Yeah.

Dr. Daniel Correa:
But I think oftentimes, many of us in all levels of society, forget how much of a privilege it is just accessing your own apartment or getting in and out of your shower and taking care of your own personal hygiene. So thinking back to your mom's time with her life with multiple sclerosis and living with you, if you were talking to the family members with a child that's helping them care and support them with a chronic progressive condition like multiple sclerosis, is there anything you would want them to keep in mind about their child or young family member?

Samantha Irby:
I will say, and this is not a criticism of anyone in my own life, but just to remember that that's a little soft brained person who is absorbing everything and trying to process all of their feelings except they're too young to process, so they're just feeling those feelings.
I think because I was a capable kid who spoke well and was charming, no one thought about my mental health at all, or the fact that maybe this is an act that I'm putting on because you don't want to take away from the sick person who's actually struggling. That physical illness trumps my mental illness, so let me put a brave face on. I would just say to check in with the little guys about how they're feeling and what they're scared of and that the pressure is not on them to be okay when things are not okay.

Dr. Daniel Correa:
Well, Sam, thank you so much for taking the time with us and our listeners to talk about your own story.

Samantha Irby:
Thank you for letting me be on your podcast.

Dr. Daniel Correa:
Are you or a loved one living with a neurologic disorder and wondering where to find reliable, clear answers about what it all means and how to deal with the changes in your life? Then look no further than the American Academy of Neurology's Brain & Life Book series published by the Oxford University Press. In this book series, you'll find expert advice from respected neurologists alongside powerful insights from people and caregivers living with these neurologic conditions.
We know that these insights will help you navigate and live life with a brain condition to the very fullest. You can order these titles covering Parkinson's disease, multiple sclerosis, stroke, migraine, concussion, epilepsy, dementia, and much more from all major booksellers. You can also learn more about this book series and everything from Brain & Life at brainandlife.org/books.
All right, so we're back. Samantha's wit and laughs helped us all hear about the challenges of her youth and being the child of a mother living with MS. For this week's medical expert, we have a special callback. It's been over 80 episodes and I'm so happy to welcome back Dr. Riley Bove. For our longtime listeners, you may remember her from our first episode as a medical expert in multiple sclerosis.
She's an associate professor of neurology at the University of California, San Francisco and a neurologist in the UCSF Multiple Sclerosis Center. Samantha Irby has used her comedy and writing to explore so many aspects of her life, including her own Crohn's disease, depression, and growing up with her mother battling MS and disabling impacts on their life. Thank you so much, Riley for joining us today to help us continue our discussion on MS.

Dr. Riley Bove:
It's so great to be back with you.

Dr. Daniel Correa:
This will be our sixth episode where we're talking about the condition multiple sclerosis, and it's our eighth where we discuss conditions that damage the myelin in the brain and spinal cord. I really encourage our listeners to both go to the website, brainandlife.org and look up some of the condition information we have about multiple sclerosis.
And you can check out those past episodes we have with Courtney Platt as our first episode, episodes where we interviewed different members in the community, interviewed an artist, Lindsey Holcomb, interviewed Karen Duffy about her experience with neurosarcoid, Nancy Davis in our episode talking about MS fundraising and research and Chef Mariana Orozco on her living with MS and incorporating it into her ideas of healing and food.
So Riley, in this interview, Samantha shared her experience with her mother, but also shared that she lives with Crohn's disease. Is there an association between multiple sclerosis and other autoimmune conditions for the person living with MS?

Dr. Riley Bove:
There actually is, and the pattern's a little complicated. So in general, we see that autoimmune conditions can cluster in families. So perhaps one family member has multiple sclerosis, but somebody else has an inflammatory bowel disease like Crohn's and somebody else may have psoriasis or type one diabetes. There tends to be some sort of pattern of immune alteration that runs in families. And then individuals with multiple sclerosis can also have other autoimmune conditions as well.

Dr. Daniel Correa:
One of the big aspects that really impacted Samantha growing up and even just learning about her mother's condition and diagnosis was just the way she was told about it by the neurologist and the first doctor that was seeing her mother. How do you suggest a person who's living with MS explain the condition in its course with the children and their family?

Dr. Riley Bove:
Children are incredibly perceptive, right? And children notice things about the world around them and without proper information can come to their own conclusions about sort of why they're seeing what they're seeing. And so I think it's really important to be clear with children but also in a way that's really age appropriate, appropriate to the child's comprehension and to where the child is in their own development.
And so it can be helpful for younger children if a person's struggling with difficulty walking or with fatigue to explain it in very simple terms. "Your parent has an owie and sometimes they're tired and they need a little rest." Right? Something that's clear and the child knows that there's an owie, but also that there is something the parent can do about it. So the child doesn't wonder, "Oh, is it something that I did" or "What's happening?"
I think with older children it can be helpful, sometimes I have patients bring their children into the clinic visit and we look at the scans together and we say, "This is perhaps why your parent feels fatigued sometimes and this one is perhaps why your parents' arm is numb. Here are the lesions and here's what we're doing about it with the medicine. Here's what your parent is doing about it."
And then finding ways where the child can be helpful that are age appropriate. So we don't want to burden children. We don't want them to carry the weight of feeling like they have to treat their parent or solve their parents' problems, but it can be helpful to show children that, "Yes, some days you could help out by doing the dishwasher" or something that's concrete and commensurate with the child's developmental age.
I think it's important to be clear with children so that they don't fill in the blanks in a way that leads to distress for them, so that they don't over worry and also find concrete actions where they can be a source of support and help that are really appropriate to where they are with their schoolwork and their emotional development.

Dr. Daniel Correa:
Samantha really shared that it just was a complete shock and there wasn't really a clear sense of being a caregiver and just being a teenager. And I think that's a challenge for many people to navigate either way, but it's great that you bring yourself as a partner in there or offer that to the parents and the individuals that you help care for.

Dr. Riley Bove:
Yeah. And I think the boundary question is very important, right? You want your child to feel like there are things they can do without them feeling like they're the overall burden and responsibility. I think there have been some studies, not enough, but some studies that have looked at the impact of children on parental MS. And mostly kids seem to do really well in terms of development, achievement, things like that.
Where they struggle is if their parent has untreated mental health conditions associated with MS. So if the parent has struggles with depression or anxiety with their MS and it's not treated, that can be really difficult for children. And so I do bring that into the conversation when I'm trying to support my patients in getting the care that they need in all aspects.
I think the mental health one is an important one also to put on the table and not to shush. Because children, again, if their parent is not feeling well emotionally, you don't want kids to fill in the blanks in an erroneous way that's going to hurt them. And if social workers can also help with some of this counseling in a conversation as well, depending on sort of the neurologist's comfort level with the conversation.

Dr. Daniel Correa:
Now, when you're talking with a person living with MS in your office, if they come in with a care partner, how do you discuss where they are currently with their condition and their potential future need for more support and assistance and how things can change over time?

Dr. Riley Bove:
I think it really depends on the care partner and their familiarity with MS and their readiness kind of for the next step. A couple things first that I try to do with my visits when there's a care partner. One is really just assess the patient's comfort level with the care partner, always making sure that this is someone that they want me to share information with. Right? You want to make sure that the person isn't perceived as being detrimental or any way to the patient.
And so I like to assess that first and assess kind of what their understanding is about MS and sort of how it plays out over time. And then just sort of meeting them where they are about the next steps. So there's a lot that we don't know about the future in MS. So certainly for people who are diagnosed younger and in earlier stages and today, I think the messaging is really, really hopeful about the future.
We have great treatments, great prognosis, and hopefully even better, safer treatments down the road. So for those initial conversations, I think it's really a message of positivity and figuring out, just like with the kids, what's the thing that the care partner can really do to be helpful and not to be overwhelming or to sort of do too much, but really something helpful.
So if a patient just had a baby, maybe recommending that the cure partner help the patient sort of with the midnight feed so the patient can get uninterrupted sleep or figuring out how to reshuffle household chores, things like that. I think when we have people who have more disabilities specifically with ambulation and getting around and things like that, I think it's figuring out first patient safety.
So having conversations around how do we make sure the patient is safe in their home? Do we need a home safety evaluation, a physical therapy, occupational therapy evaluation and social work to kind of think about the safety piece? Because often if we figure out that the home is not safe, then that brings in the conversations around what adjustments should be made in the home versus what other arrangements there might be long-term for the patient.
So that can be one helpful way of doing that. And I think another is sort of iteratively or maybe we don't know the future and maybe we don't know how things will play out. I've definitely had patients who came in with their care partner and they were very focused on my patient with the MS prognosis and the burden of that. And I said, "You don't know the future." And the next time the care partner has broken their hip and they've been in bed for months recovering and my patient's the one who was the recovery partner. Right?
So we kind of try to think about the give and take. A lot of patients emotionally worry about being a burden to their loved ones and emphasizing the message of give and take, "Maybe you're also going to be a strength one day," I think is really helpful as well, so that they can feel comfortable accepting the help from their care partner because there's validation that they may also be giving help. I think that's an important part of supporting long-term partner dynamics.

Dr. Daniel Correa:
In a way we should all hopefully have the opportunity to co-care partner for those we love in our households. We're fortunately in almost completely new era in terms of treatment options. It changes the whole paradigm of how someone lives over time with multiple sclerosis, specifically one of these categories are these B-cell depleting medications. How do you describe them to patients in terms of selecting whether they're picking a new medicine?

Dr. Riley Bove:
We are just in this really wonderful place in multiple sclerosis where the tolerability and the effectiveness of the medications has really changed in the past 20, 25 years. And so we are also in a position where we understand much better that the earlier we start medications, and evidence is really pointing to this, the more effective the medications are that we start with, the better people do long-term. And that's just sort of like to borrow from stroke, time is brain, in MS as well.
So we, in general, we now have the benefit of enough years of following patients to really see that these differences play out long-term. So the earlier you start, the more effective you start, the better people will do long-term overall. And so I think a lot of clinicians now really hone in on that point. And so when we think about what type of medication really is highly effective and well tolerated, the so-called B-cell depleting therapies are really up there in terms of a category.
We have three medications that are given every six months intravenously. That's OCREVUS as well as the newer Briumvi and another medication that's not FDA approved for MS, but works very well, RITUXAN. And then we have the monthly self-injectable, which is Kesimpta. And that class of agents is highly effective, really well tolerated, and many patients just do not have any more lesions once they're stable on this medication.
And so what we can then see is a year or two into the treatment, the worry, "When am I going to have another lesion? When is my body going to, it's going to trick me again?" That worry really kind of simmers down and then people can focus on other aspects of recovery and also just on living their lives. And so we really have seen a major change with this type of medications. They're not without side effects of course.
One of the bigger ones is just sort of affecting vaccine effectiveness. But I do want to acknowledge that patients who may have not been started on these high efficacy medications, the patients who were the class of warriors who went on the first set of MS therapies, perhaps less effective and less tolerated 25 years ago, some of those patients, it's bittersweet, right?
You're happy that the field has moved forward, you're happy that you've contributed to moving the field forward, but also it must be hard to see newly diagnosed people benefiting from that in some way. So I want to acknowledge it's wonderful for the field and it's wonderful to see medical progress, but can still come with some grief, I think for people who didn't have those benefits.

Dr. Daniel Correa:
There was also just the aspect of getting in to be able to see a specialists that can help you navigate these medical decisions in terms of medication treatment. And not everybody has access. I mean, Samantha described how her mother just couldn't really get in to see a specialist at that time and had limited availability to that. What do we know about that, at least across the United States in terms of access to MS centers and specialty neurologists?

Dr. Riley Bove:
There is a fundamental Darth of neurologists, right? We do not have enough neurologists to care for our patient population. And I think as the number of treatments expands, as the availability of really specialized therapies expands in all of our neurological sub-disciplines, but there really is a need for specialized care in multiple sclerosis. And a lot of patients are not receiving care by MS neurologists. A lot of patients are receiving care by general neurologists.
So access is a big deal and it absolutely affects what medications patients start on and potentially how they'll do long-term. Because general neurologists may reach for the medication that was available during their training or that they have access to the drug reps or that is sort of the easiest for them to manage or also maybe that's linked to their infusion center and maybe is beneficial for them. And so there's a lot of reasons why patients may not get modern first line medications, and I think that is a major barrier.
Thankfully, the COVID-19 pandemic has just really pushed forward the idea that telemedicine is really feasible. We've seen telemedicine adopted across neurology departments. Patients who we might've thought, "Oh, well, maybe they're not cognitively available to get online or anything else," we've seen families be able to just get patients on Zoom and do their telehealth care.
So I think telehealth is really a nice approach to kind of closing that gap and expertise, maybe sending newly diagnosis patients to a one-time telehealth visit to an MS expert that's not always reimbursed by payers. Sometimes they want patients to be seen in person, but telehealth does close some gaps in access to have a little bit more equity across geographic locations and across economic divides.

Dr. Daniel Correa:
That is all incredibly helpful information. Dr. Riley Bove, thank you so much for joining us again on the podcast and helping us kind of navigate some of these questions and understand better what it is to both be living with MS and making some of these decisions in terms of the treatments and the caregiving support that someone may need over time.

Dr. Riley Bove:
It's my pleasure. Thanks for having me back. And if I may just end on one thing. I think one thing that we don't do enough as neurologists for our people living with MS is just congratulate them on what they achieve every day, right? Sometimes I have patients who they've quote unquote, "Only done half of the homework," half of the referrals or consults or exercise or whatever we had decided on last time. And for me, that's huge thinking of how hard it is to do one or two things for our health. Our patients really are sort of day in and day out warriors and champions with this, and I do want to acknowledge all of that energy that it takes for people and their families to manage their MS.

Dr. Daniel Correa:
I completely echo that. Thank you. Thank you again for joining us today on the Brain & Life podcast. Follow and subscribe to this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life magazine for free at brainandlife.org. Don't forget about Brain & Life in Español.

Dr. Katy Peters:
Also, for each episode, you can find out how to connect with our team and our guests along with great resources in our show notes. We love it when we hear your ideas or questions. You can send these in an email to BLpodcast@brainandlife.org and leave us a message at 612-928-6206.

Dr. Daniel Correa:
You can also find that information in our show notes, and you can follow Katy and me and the Brain and Life Magazine on many of your preferred social media channels.

Dr. Katy Peters:
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Dr. Daniel Correa:
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Dr. Katy Peters:
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Dr. Daniel Correa:
We are your hosts, Dr. Daniel Correa, connecting with you from New York City and online @NeuroDrCorrea.

Dr. Katy Peters:
And Dr. Katie Peters joining you from Durham, North Carolina and online @KatyPetersMDPhD.

Dr. Daniel Correa:
Most importantly, thank you and all of our community members that trust us with their health and everyone living with neurologic conditions.

Dr. Katy Peters:
We hope together we can take steps to better brain health and each thrive with our own abilities every day.

Dr. Daniel Correa:
Before you start the next episode, we would appreciate if you could give us five stars and leave a review. This helps others find the Brain & Life podcast. See you next week.

Author Samantha Irby's Journey as a Young Caregiver

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