Living with Multiple Sclerosis (MS) has affected every facet of my life. It is a disease that tests my strength, my professional growth, and my personal experiences. As a mother and a full-time Family Nurse Practitioner (FNP) in Primary Care, my experience with Multiple Sclerosis has presented both challenges and transformative moments, providing a unique perspective that has enhanced not only my life but also the lives of those I interact with. MS is a chronic illness that affects the central nervous system, and with that comes a variety of challenges. Many symptoms are not outward facing, like my optic neuritis which has caused blindness in my right eye due to a lesion on my optic nerve. Other symptoms, such as foot drop, in which a person may trip or drag their foot are more apparent to those around them. When I was initially diagnosed with MS, I was filled with fear and I had many concerns about what my future would look like. However, over time, I have learned that living with MS is not just about coping with my disease; it's about adapting and thriving despite it. Professionally, as an FNP, my experience with MS has been invaluable. I have found myself more patient and attentive, driven by my personal experience of living with a medical condition that has no cure. MS can be likened to those battling chronic diseases such as mental illness, diabetes, and heart conditions and it has deepened my empathy and understanding toward patients. My MS has not been a hurdle; rather, it has been a catalyst for professional growth, enabling me to connect with my patients on a deeper level. Leadership in primary care requires resilience, and living with MS has begun to engrain this trait in me. I have faced blindness, fatigue, and leg numbness, yet these challenges have only enhanced my ability to prioritize and focus on what truly matters. MS has taught me the importance of self-care, a lesson I shamefully admit I put off for too many years. I now regularly promote wellness techniques to my patients and colleagues. By leading by example, my journey with MS has injected my leadership experiences with authenticity and a sense of purpose. As a mother, MS has been a journey of love and strength. It has taught me to embrace my vulnerable side and to embrace the unpredictability of life. My daughter has seen me face challenges but is also witnessing me going to school to obtain a Doctorate in Nursing and a Master of Business in Healthcare. This duality is a powerful lesson for her as it shows her that strength is not the lack of weakness, but rather the ability to persevere despite it. My experience living with MS has shaped who I am today as a mother, an FNP, and a primary care leader. I have MS, MS does not have me, but it certainly has influenced my ability to grow as a professional and as a mother. MS is just part of my story and has taught me that some of my greatest struggles can become my greatest strengths.

I know this essay is about my experience as a mother, but I cannot even begin to fathom how I would be where I am today without my mother. When I was 5 years old my mother returned to school to obtain an MBA. I remember being in the bathtub while she sat next to it with her books spread out on the floor, trying to study in the evenings. Now that I'm a mother to my 5-year-old, I recognize the exhaustion that she must have felt. She was working full-time as one of the first few female medical technologists in New Hampshire, completing a master's program and taking care of two small children. It has been my own mother's ambition and drive that has ignited a spark in me to continue my career, and admittedly there is a part of me that wants to make my daughter proud. I began my career also working in the medical field, first as a Registered Nurse and now as a Family Nurse Practitioner in Primary Care. I've returned to school to pursue a Doctorate of Nursing and a Master of Business in Healthcare because I have felt a strong urge to legitimize my position as a leader in my organization. Like my mother's experience, the senior leaders in my setting are primarily male physicians, and while I have nothing but respect for them I know that furthering my education will allow me to grow in my career as a leader in primary care. Not only do I want to advocate for patient safety and care, but I want my clinician team members to also feel heard. As a Nurse Practitioner, particularly one who is female, furthering my education is key to giving my voice power. There is no sugarcoating my own experience as a mom working full-time and in school full-time. I'm exhausted and at times it feels like the road is too long. It's not easy. My daughter now sees me working next to her while she's in the bathtub and I tell her that I take care of people and those people are my patients, but I also am learning how to be a voice for my colleagues. We talk about how women can do anything, and I truly believe that my mother's example has allowed me to set an example for my daughter. She loves to tell people that "my Mom knows everything because she's a Nurse Practitioner". While I appreciate that sentiment, we talk a lot about the importance of education and doing what you love. When my daughter was 3, I was diagnosed with Multiple Sclerosis. While it has been a setback, it ignited a fire in me to show up, stay motivated and persevere, and perhaps someday my daughter will say, "I'm proud of my Mom". I know I'm proud of mine.

Fifteen years ago, I went blind in my right eye. I was two weeks into my first job as a new graduate nurse. I was seen by multiple specialists- 'migraine' they said, 'stress', they said. There were no clear answers. Eventually my symptoms improved enough that my life moved on. Ten years later, during my first year in practice as a Family Nurse Practitioner, I noticed when I would tip my head forward my legs would become numb and shaky. Again, I was seen by numerous specialists. 'Stress', they said. 'You're an anxious woman', one provider remarked. And yet again, symptoms improved, and I had no real answers, so I moved on. Last year, I again lost my vision in my right eye. Finally, I had a provider that listened and as a result I had an expedited workup that ultimately led to my diagnosis of Relapsing Remitting Multiple Sclerosis. I will admit, the last year has been challenging navigating this diagnosis, treatments, and costs. One of the biggest challenges has been thinking about how this changes my future as a mother and how it may affect my career. I am now on an intravenous disease modifying therapy, once a month and my symptoms remain stable. During this time of stability, I became certain of what my goal in life is and my diagnosis of Multiple Sclerosis has brought this to light. I am pursuing a Doctorate of Nursing Practice and a Master of Business Administration in pursuit of leadership in healthcare. Being diagnosed with Multiple Sclerosis was a long journey for me, and unfortunately there is a similar story among others diagnosed with MS and other autoimmune conditions. While some providers inherently see an anxious woman worried about her health and write her off, others simply do not have the time to sit and listen to a patient when the workup is otherwise 'normal'. My aim is to lead a healthcare system in which we focus on our patient experiences and dedicate time to listen to them. My aim is to make sure each patient feels heard. My aim is to focus on the value of care our healthcare system provides, rather than the volume. I am not happy to have MS, and I look forward to the day when there's a cure. However, I whole-heartedly believe that my experience as a patient with an autoimmune disease has ignited what is now a fire in me to pursue higher education with the goal to reform and reshape healthcare as we know it.

I am the Mom of Ryla, a 14.5 year old chow/lab/shepard mix. I know her breeds because after 13.5 years of being her Mom, I decided to get a DNA test for her. Turns out, "best dog ever was" not listed as part of her DNA. I think it may have been a collection error... My now husband and I adopted Ryla at the Animal Refuge League in Portland, Maine in 2009. We had been looking for a dog for some time, and were actually there to see another dog at the time. Ryla was being surrendered by her owner, and the minute I saw her I knew she was perfect. Because she was newly surrendered, we were unable to meet or adopt her right away, so the next week when she would officially be available, I stood in line (there was no line because I was there an hour before the shelter opened). I was able to officially meet this cinnamon colored eyed, shaggy black dog with a white stripe down her chest and salt and pepper paws and fell in love. Fast forward all of these years later, and I think about how much a part of our life Ryla is. She was by my side during nursing school, getting married, buying my first house, pursuing my masters degree in nursing, becoming a Family Nurse Practitioner and now going back to school to pursue a Doctor of Nursing Practice and a Master of Business Administration. She has become the best big sister to my human daughter, Ruby, and fierce protector from any chipmunk that dares to come near our home. Most recently, and perhaps most importantly Ryla has been by my side when I was diagnosed with Multiple Sclerosis in 2021. It was emotionally very challenging for me, and sweet Ryla has been a steady and calming presence in my life. I now receive monthly intravenous infusions of a monoclonal antibody to slow the progression of my disease. Those days are tougher days, they leave me fatigued and nauseated and usually couch-bound for the day. Ryla greets me after each infusion with her dinosaur tail whacking against the door and then lays by my side the rest of the day. There is something in her soul that is probably just as effective as the medication I am relegated to monthly, and I firmly believe she helps me get through my battle against MS.

I am a Family Nurse Practitioner in a Primary Care clinic in Southern Maine. My patient population is very diverse in that my patient population consists of all ages, socioeconomic backgrounds, countries of origin, gender identities, and health conditions. Despite my patients being demographically, socially and economically diverse, many of them share mental health conditions. Often these patients do not present with a concern of "depression or anxiety", but rather with vague concerns of changes in appetite, difficulty focusing, struggles in relationships or even chronic pain. In my role as a healthcare provider, I take mental health diagnosis and treatment equally as important as a diagnosis of a 'visible' health condition such as diabetes. It is important, as a healthcare provider, to ensure my patients who are diagnosed with mental health conditions to feel heard, not ashamed and receive high quality treatment. This may vary, but can be a combination of medication, therapy and supportive treatment such as meditation, exercise or breathing exercises. When mental health conditions are treated with high quality care, the outcomes will be a generally improved sense of wellbeing. In terms of my own mental health, the past year was difficult. I was working in the front line during the COVID-19 pandemic, which was incredibly challenging, and I was also diagnosed with Relapsing Remitting Multiple Sclerosis. The difficult aspect of my disease is that stress and fatigue tend to cause flares of my symptoms. For me, this is not ideal as I experience right eye blindness related to a lesion on my right optic nerve. One way to help mitigate my symptoms, aside from monthly intravenous infusions of a monoclonal antibody, is reducing my stress and improving my mental wellness. One way I have been able to improve my mental health is exercise. I found that running, cycling or walking has been very effective at decreasing my stress and improving my sense of wellbeing. There is also a very positive association with exercise and slowing the progression of MS. Additionally, maintaining connections with my family and friends is paramount. While I can't say that I am happy to have been diagnosed with MS, I can say that it has made me value my mental health and the impact it can have on me physically. Being on the side of the healthcare provider, and on the side of the patient, I have come to realize the importance of maintaining a healthy lifestyle, much of which centers around mental health. The mind-body connection exists for people from all different backgrounds and medical diagnosis. In my work, I continue to educate patients on the importance of treatment for clinical mental health diagnosis' as well as providing supportive care to enhance overall wellbeing.