Women with MS: Navigating Life With Strength and Resilience
March 25, 2025 | Episode 35
Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast
SPEAKERS: Marcus Thorpe, Speaker 1, Dr. Nicholass, Dr. Nicholas, Lindsey Gordon, Dr. Roberts
Dr. Nicholas 00:14
There aren't many diseases or conditions that not only target mostly women, but also tend to attack young women more than anyone else, that condition can slow you down, impact your ability to handle heat. Some end up unable to walk without a walker, or they're in a wheelchair, and yet, others fight hard and end up managing their symptoms with some new help and thrive. Welcome to The Wellness Conversation an OhioHealth Podcast. I'm Lindsay Gordon.
Marcus Thorpe 00:44
And I'm Marcus Thorpe. We're talking about Multiple Sclerosis. MS is a chronic autoimmune disease affecting the central nervous system, meaning the brain and the spinal cord. And here to talk about this today, OhioHealth chief of MS and spasticity, Dr. Jacqueline Nicholas and one of her MS patients, who many already know from her other hat that she wears. Dr. Mysheika Roberts is the Columbus Public Health Commissioner. Thank you both for joining us for the podcast today. We're really excited. Dr. Nicholas lets start with you. Let's talk about your journey to OhioHealth, obviously leading the MS program. Now, how did you end up here? How did you kind of find MS is your passion, and then let's talk about MS in general too.
Dr. Nicholas 01:24
Yeah, well, thanks. I, very early on, knew that I wanted to be a doctor. I just always loved seeing how doctors and nurses interacted with my family growing up, and I never really knew at that time that a lot of the diseases that they were caring for them were all fell within the realm of neurology. And when I got to medical school, I felt that that was really where I fit in best. I fell in love with the neuroanatomy and the brain and the spinal cord, and I always had an interest in the immune system and how that impacts our health. And then when I got to residency, one of my very first rotations in neurology at the University of Pittsburgh was in an outpatient MS center, and I got to meet all of these amazing individuals who either were newly diagnosed or had MS for years, and really realized that there was a lot of work to be done as far as research and women's health, particularly in the childbearing years and in times of menopause. And my passion just grew from there. And then I went on to return to my hometown of Columbus, and did my fellowship training at Ohio State University in neuroimmunology and spasticity. And then I also did a masters of public health as well, and then stayed on faculty there for a couple years. And when the neuroscience tower was being built here at OhioHealth at Riverside, I had the opportunity to come over and join and to really work from a comprehensive center where it wasn't just me, the doctor, there to help them, but a whole team of people, like therapists, physical therapists, occupational therapists, nurses, social workers, you name it. And so I really felt like I was finally able to offer the care that these individuals always needed, and I've been here 10 years now.
Marcus Thorpe 03:24
Wow, that's amazing. 10 years.
Dr. Nicholas 03:26
So excited to talk with you more, especially because we are focusing on women's health with this podcast, and it sounds like your expertise aligns perfectly with this conversation. And you know our guest Dr. Roberts, very well. Dr Roberts, it's so great to be here with you. You've led us through the pandemic. I interviewed you so many times, and so it's nice to have this conversation with you. Would love to know your back story. How did you find your passion for medicine and specifically in public health?
Dr. Roberts 03:54
Sure. Well, similar. Dr Nicholas, I grew up at a young age wanting to be a doctor. I was a candy striper, and most people don't remember what a candy striper is, but just a volunteer in the hospital. My dad is a physician. He had his own practice. My mom is a nurse. So I came from this healthcare background, and I took a public health class while in college that I really, really loved. And I always remind people I was in college when Magic Johnson came out and told the world he was HIV positive. And I grew up in Los Angeles, so I was a huge Laker fan. So those two things, the public health class, made me decide I definitely want to get my master's in public health. I ended up going to get my master's in public health first, and then going to med school. Coming out of med school, I did a residency in Internal Medicine, and then when it was time to look for a job, I found a public health job running an STD clinic in Baltimore. And then from there, I went to work a few years at the CDC, but I was a CDC employee that was detailed to the state health department here in Ohio. So that's how I got to Ohio. That was a two year program. And then when that program ended, I was fortunate that the previous health commissioner, Dr. Theresa Long asked me to be the medical director. So I did that for many years before I was promoted to health commissioner. So really it's been public health has been a passion, and the only thing I've really practiced in my medical career.
Marcus Thorpe 05:17
It's such a treat for me, kind of like Lindsay, who worked in TV, also worked in TV. So this is my world's kind of colliding. I interviewed Dr. Roberts a lot during my time at NBC4, dozens of stories over the years, and then getting to work with Dr. Nicholas. I handle neuroscience for Media Relations at OhioHealth, so having a chance to do dozens of local and national stories with Dr. Nicholas. So a real treat to have you both here and talk about MS, because it impacts so many people, and it's one of those conditions I think that you don't even know that somebody's going through it. It's not like you can see somebody and go, oh, that person has MS, for sure. I know they're going through something. So Dr. Nicholas, let's talk about MS in general. It does target women more than men, and really, younger women are diagnosed often in their 20s and 30s. What's going on there, right?
Dr. Nicholas 06:04
So absolutely, you know, in MS, we see that the incidence is about three females to every male, and there's been a lot of interest in in understanding this. And what we know in general, we do see often that many autoimmune diseases are more common in women than men. And interestingly, when you look at children who develop MS, which is a very small percent, about 5% the difference between boys and girls in the incidence is equal prior to puberty. So we know that there's a hormonal role here, and we see that when women or girls go through puberty and become women, that that's really where that risk takes off, and there's that higher incidence in females compared to males. What is also really interesting is that we see if a woman becomes pregnant, her risk of having an MS relapse or an attack during pregnancy is actually much less than prior to pregnancy. So pregnancy has this protective effect, and we see these higher levels of progesterone and estrogen that actually make the immune system less inflammatory. If you think about it, when a when a woman is carrying a baby, we don't want her immune system to be attacking the baby developing inside of her. And so, you know, I think that helps to understand why. Maybe the immune system is more calm during that time. But then as we proceed, we see that if a woman when she delivers that baby, there is an increased risk of having an MS attack. And so, you know, we think very strongly that it's hormones that alter that difference there between males and females. What's happening inside the body with multiple sclerosis, you're talking about attack. This is literally the body almost attacking itself. Yeah, so our immune system is really amazing, and it's designed to protect us from foreign invaders like bacteria and viruses, and even we have parts of our immune system that remember those prior infections that we've fought off so that we don't get sick from the same virus again. But what happens in MS is we actually see that our immune system turns against us, and some of those memory immune cells that are developed in the surface of our nervous system, the myelin coding on our neurons in our brain and our spine, might look similar to that surface of the virus. And so our immune cells, our white blood cells, are randomly attacking it, thinking they're protecting us, but it's actually hurting us, and then causing lots of problems. Sometimes there's silent damage. When that occurs, the person may not know. They might just feel a little tired, and then other times, it might be so severe that they have trouble walking or seeing among many others. Dr. Roberts, when did you know or suspect that something was wrong?
Dr. Roberts 09:06
Yeah, so I was in my late 20s. I was one year post med school graduation. During my residency, I was on call one Sunday morning in the medical ICU, and all of a sudden, as I was finishing rounds with the team, I realized that my vision was blurry and I couldn't really isolate it to one eye versus the other. I think one was worse, but they were both pretty blurry, and I finally realized I needed to call someone and get relieved. It wasn't a good idea for me to be in the medical ICU on a Sunday by myself with poor vision. So they brought a sub in. I went home, I rested, but got up the next morning and the vision was no better. It was no worse, but it was no better. So I went to the ophthalmologist office in the hospital, and they evaluated me and said. You need to go across the street to see your neuro ophthalmologist. I got a little concerned, but I followed their recommendations. Went right there. I was able to be seen, and they diagnosed me with optic neuritis, which is a common condition for individuals with MS, but other conditions can also have optic neuritis, so they treated me with steroids. I had some tests done to see if I had MS, some blood work done to see if I had other things, through my primary care doctor and a neurologist, and all the test results came back negative. There was no evidence of MS or sarcoid or any of the other conditions that could present with optic neuritis. And so I went on about my way and my life, and then about six months later, I had double vision in my right eye, and went through the whole thing again, saw the doctors and got treated with steroids. Within a few days, the double vision got better. Had all the tests done again, and there was no evidence of MS or anything else. Did go get a second opinion. I was, at the time, in residency at the University of Maryland, so I went to Johns Hopkins to get a second opinion. They couldn't come up with anything either, and so the neurologist said, what I want you to do is, in six months, I want you to get another MRI, and let's just see what what that MRI shows. So the six months came, my primary care doctor ordered the MRI, and I patiently waited for the results. Although I had access to the results because I was working in the same hospital. I really decided not to be my own doctor, and wanted to be the patient. And I think there was a part of me that was nervous as well. Yeah. So it was about two to three weeks after I got the MRI and I hadn't heard anything, and I woke up one morning and I felt like I was walking on rocks, so I had neuropathy, and it was a Saturday morning, so I had to wait till Monday to go into the hospital. So Monday, I went into the hospital. I ran straight to the neurology office, and I walked in, and I said my name, and I said I just had an MRI a few weeks ago, and I don't know the results, but now I feel like I'm walking on rocks. And so of course, they looked at the MRI, they brought me in an exam room, and they told me that my MRI was now confirmed to have multiple sclerosis. That's how I found out. And it turns out, my primary care doctor who had ordered the MRI had been on a long trip to Europe, so never saw the results.
Dr. Nicholas 12:37
What was going through your mind in that moment? I mean, what a frustrating journey, and what an example to just stay on top of your health and advocate for yourself and keep pushing for answers. But what were you feeling in that moment when you finally got an answer?
Dr. Roberts 12:53
There was some sense of relief, but there was also a sense of fear. You know, I had a year because this had gone on for a year, about every six months to kind of prepare myself that this was a possibility. And every doctor I saw said MS was a possibility. It was on the top three of the differential diagnosis. So I wasn't surprised, but it was scary, and for me and my family, it was scary because I had a cousin who had been diagnosed with multiple sclerosis probably about 15 years prior to my diagnosis, before there were a lot of medications, and he did not do well, that was the only image of multiple sclerosis I knew, and my family knew. And so for all of us, it was scary time, because it was a fear that that's how I would end up.
Marcus Thorpe 13:44
I think treatment is an important place to go now, because you mentioned, you know, 15 or 20, so years ago, there were really not a whole lot of options. And I've heard Dr. Nicholas in interviews say you probably don't want multiple sclerosis. That's obvious, but if you're going to have it, now might be the best time to have it, because there are so many options that really do work. How have treatments changed? Dr. Nicholas, over the years when it comes to MS.
Dr. Nicholass 14:10
So they've, they've made significant strides in treatments for MS. Our first treatment actually came out in the 1990s and so as Dr. Roberts mentioned, the understanding of what treatments can do is still not really out there for a lot of people, and some people are very skeptical about their benefits. But I would say that, you know, since that time, treatments have skyrocketed. And so there's, you know, over 25 treatments at this point for multiple sclerosis. Now, the most treatments that we have are for relapsing forms of Ms. That's the most common type of MS. About 85% of people will be impacted by that type. And then there's Primary Progressive MS, where people have a gradual worsening over time, but don't really have. These clear episodes of worsening, and there's only one treatment that's effective for that type of MS, the treatments have significantly improved in terms of their ability to prevent ms relapses or attacks. Are these episodes where individuals experience worsening, such as when Dr. Roberts mentioned the optic neuritis, or the time where she felt like she was walking on rocks. And that's been really remarkable, because when somebody experiences that they may have to not go to work, just like she mentioned she had to come home from working in the ICU. And so being able to prevent that is an incredible improvement in the quality of life, and also preventing further damage in the brain and the spinal cord. And so what we're seeing is that far less people are going on to develop what we call progressive MS. So people that have these attacks in the beginning where they just have periods of worsening, and then in between those periods, they're not noticing any worsening, eventually, at a certain point, may notice that they have this gradual worsening of function over time, but with our really effective treatments, we're seeing that that is not happening as often, and so we still know that we need to do better. We would like to actually prevent MS altogether, or be able to reverse the damage that's done, but right now, the best that we can do is make that early diagnosis and get people on great treatment so that they don't have new attacks and new damage over time.
Dr. Nicholas 16:29
I was surprised to learn, Dr. Roberts, that you had, MS, I remember we were sitting in a pitch meeting for OhioHealth and the content we put together, and Marcus was talking about how you were getting ready to share your upcoming story. And I thought, wow, I just never would have known. Is that a testament to your treatment journey, and what has that journey been like for you?
Dr. Roberts 16:50
I definitely think it's a testament to my treatment journey and the science that has allowed me to sit here fully functional today. And you know, I tell people that I was fortunate in my situation. Some people go years without knowing what their diagnosis is, without even hearing multiple sclerosis being a differential. So to find out that I had MS within a year of my first symptoms was actually at least at that point in time, was pretty remarkable. But I've been on three different treatments in 25 years. So I was officially diagnosed in 2000 I first started on an injectable medicine that I did myself. I injected myself every night. It's called Copaxone. When I was diagnosed in 2000 there were three drugs. They called them the ABC drugs, and I can't remember what a and b stand for, but I was on Copaxone, and I picked that because I thought it would be best for me and my lifestyle. But it was something again, I had to take every night. It had to be refrigerated. So, you know, my friends and family remember when I traveled, I had an ice pack to take my medicine in. Sometimes I'd forget a dose in a friend's house that I'd spend the night with, or something like that. But I did that. I can't remember. It probably was close to 12 years I was on Copaxone, and then I started getting an infusion drug here at OhioHealth called Tysabri. So I had to come in once a month to get an infusion. So that meant I was in the hospital for about 90 minutes, maybe two hours, once a month. And you know, just to show you how non-medical people are, and understand, there were some people, friends and family, who would say, you're really going to go somewhere once a month to get a treatment. You know, how is that going to fit with your lifestyle? And I was like, well, I won't have a lifestyle if I don't do this. You know, that was my attitude about it, so I've never questioned or thought this is a burden. It's something that I feel I have to do if I want to continue to live the life I've been living. And then I had to switch that medication because there started to be some changes in my MRI and some of the symptoms I was having. And so now I take a medicine called okravis. What I like about okravis is I only have to get infusions twice a year, but I'm here much longer, so I'm usually here in the hospital for about four or five hours to get that okra this infusion, but I only come every six months. That's
Dr. Nicholas 19:15
still a commitment. How has your health journey shaped, how you take on the role as a public health director, a leader in public health?
Dr. Roberts 19:25
So, you know, as public health, we talk a lot about infectious diseases, obviously outbreaks, and everyone knows me from the pandemic, but we also talk about chronic conditions and things that we all can do to keep ourselves healthy. And we also talk about the social determinants of health, right? So access to care, transportation, housing, food, MS is a chronic condition, and I believe it is. I mean, Dr. Nicholas has said it is, it is a chronic condition. And so I think it has helped me be a better physician as well as a better health leader living with a chronic condition like MS that I am battling and I am really thriving with as a result of science and the medication options that are out there. So I think it makes me more believable, and I can relate to so many people in our community who are also struggling with a chronic condition, whether it's hypertension, diabetes or a host of other chronic conditions that are out there. And I think it makes me more empathetic as well.
Marcus Thorpe 20:29
I think it's really interesting that you two share so much for a passion, perspective for healthcare, and yet you're like doctor patient too. In this regard, I want you to talk about kind of that relationship with a physician, because it is so critically important. I have heard Dr. Nicholas, through other patients, talk about how she's gone and fought for her patient through channels, with insurance and trying to make sure that these people get covered for the treatments that they need. Dr. Roberts, I know you're a champion for access and making sure that you know, yeah, you grew up with a nurse and a physician in your family, but this is something that everybody deserves, is having access to health care, whether you have multiple sclerosis or you have something else or you're dealing with something else. Can you both talk about the need for passionate people in your spaces to champion for the patient population that might not have the education or the means or the access that should guarantee them what they get.
Dr. Roberts 21:35
Yeah, sure. I mean, I can start, you know, I went into medicine because I had a passion for helping people, and I wanted to help people, and I realized that not everyone in our society has access and has the background that I have, but I don't think that's right or fair. I think everyone, when it comes to health care, should have quality health care, and not just the care, but the treatment that they need the medication that they need to heal and to get better. You know, I was talking to one of my staff members the other day, and it just reminded me of why I do public health and why there are so many great people in public health. It was a home visiting nurse for pregnant women and her one of her moms had delivered prematurely, and the baby was fine. The mom was fine, but because she had delivered a little earlier, she wasn't prepared. She didn't have some clothing and diapers and some of the things that you need as a new mom. So she said, I called around to a few resources, and I'm about to go meet her at the hospital, and I've got a car seat, I've got diapers, I've got and, you know, and you could just tell the passion in her voice, how excited she was to be able to gift this mom with some things so that she could go home with her newborn and feel comfortable. And that's what we need in our world. We need people who are not just there to write a script, not just there to check a box, but are really passionate and care about the people they are taking care of, and want the best for them, and will fight for them.
Marcus Thorpe 23:06
Dr. Nichols, I know that's kind of the format for the clinic that you run, is that somebody comes in and they're seen by everybody on the team all in the same visit, not just the physician, then they have to go home, then they had to find a way to come back in two weeks and meet with the physical therapist or the social worker talk about that's kind of what your vision was as this was being put together.
Dr. Nicholas 23:31
Yeah, I think that it's so hard for somebody who is dealing with a chronic condition and trying to care for their family, and then also work in their job to do all the things that they need to do to stay healthy. And so it's really remarkable to be able to offer those services to them at the time that they're coming in and not having them have to go to multiple different locations to do it. You know, speaking to the piece about, you know, not everybody is starting from a fair place. You know. You know, variable levels of education, backgrounds, understanding and trust in medicine really impact how somebody does with this disease, and it is very hard for them. You know, just even sometimes when their medicine is approved, to actually have it shipped from their specialty pharmacy, because they say they're getting so many phone calls, so having a team to be able to take their concerns and help them get what they need, even though it might take us a couple hours to do it, is really worthwhile, because I think that people can get lost in the system because of all the challenges that are out there with insurance and pharmacies and understanding you know what you're supposed to have and when you're supposed to have it. So I'm really lucky that I get to work with such awesome people, and I think our patients do really well because of it.
Dr. Nicholas 25:01
This has been a wonderful conversation. I feel like it went by so fast. I blinked and, I mean, I could keep talking. I real quickly want to know too. You alluded to it a little bit. Marcus earlier, but that provider to provider. What's that like? I'm just so curious. You know, like, is that, you know, is there a trust thing there? You know, it's hot. You're coming into this with so much knowledge, right? Dr. Roberts, and how do you find that trust in your provider?
Dr. Roberts 25:26
Yeah, so I tell this story frequently. You know there is, there is discrimination and racism in healthcare, and so oftentimes, if I see a new provider, I don't divulge that I'm a physician, just because I want to see what kind of treatment they're going to give me without knowing my background. I think when I first met Dr. Nicholas, I think she'd probably read my chart and saw that. But I really try to be the patient. I think I tried to make that clear earlier. I really try to be the patient, and I'm there for the doctor to pour into me. I'm going to follow their guidance. So I don't think I'm too pushy, but, you know, I do know I recently had my infusion, and I don't always stay for the observation, because I don't drive someone else always drives me. And I remember it was a nurse who was caring for me who had never cared for me before, and I heard her go back to the nurses station saying she wants to leave early, you know, is that okay? And one of the nurses say, well, she's a doctor. I think she knows what to do if something happens, and so I try not to take advantage of that fact. I really try to beat the patient. And hopefully Dr. Nicholas feels that way too.
Dr. Nicholas 26:34
It's been an absolute pleasure and honor to care for Dr. Roberts. And sometimes I think, Oh, she's so much smarter than me. What could I do for her? But it's also fun when you have somebody who is so proactive about their own health, because one of the things that she didn't mention today is that she exercises and takes really good care of her overall health, which is such an important thing with any chronic disease. So it really is enjoyable when you have somebody who's passionate themselves about doing well and a partner in that journey.
Marcus Thorpe 27:09
This is such a personal podcast for me. My mom has multiple sclerosis, and I remember her being diagnosed when I was in my 20s and knowing nothing about MS at all. And, you know, my mom is kind of like my best friend. So I thought it was like, Oh my gosh, death sentence. I don't know anything about this. Is she gonna die? And having the ability to learn more over the years, and especially now that I'm in this position at OhioHealth, and then hearing your journey. Dr. Roberts, Dr. Nicholas, all the things that you've done, it gives me hope. My mom's now in her 70s, and she's still getting around, and she's not in a wheelchair, and she has balance issues, like some people do as they grow older. But I'm super excited about the future, because we are doing great work in this field, and so it's encouraging. And so I'm really proud to be on the show with you all today. It's been really, really fascinating. So thank you.
Dr. Nicholas 28:02
Thank you. Thank you. I love that you said your mom's your best friend. Can we take a moment to call that out? I was just burst out crying. Marcus, oh my god, okay.
Marcus Thorpe 28:11
And I'm her best friend. So it all works out well, we appreciate your time. And of course, everybody listening. We thank you for joining us for this episode of the Wellness Conversation an OhioHealth podcast. Before we wrap up, we invite you to follow us on all major social channels, making sure you stay up to date on any new episodes and other health and wellness topics. If you're looking for more information on any OhioHealth services and locations, including the MS Team, you can go to ohiohealth.com
Lindsey Gordon 28:35
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