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March is National MS Education and Awareness Month®. For those of us living with MS, we know that it is a chronic condition that must be managed beyond your yearly visits to the neurologist’s office. The challenge is maintaining the discipline that it takes to manage the condition in good times and in bad.

For me, this is not always an easy task. My work takes me on the road quite often. As a result, I live out of airports, hotel rooms, and takeout food. Trying to manage my MS with my lifestyle is a constant challenge. The stress and fatigue of the road is intensified with my lifelong battle with MS. Here are five tips that I use to try to manage my MS beyond the neurologist’s office.

1. Keep a symptom journal – Our bodies are our single greatest tool. When you have MS, sometimes that tool does not respond the way it would before being diagnosed. Listen to your body. Much like pain is a signal to our brain that something is wrong with our body, numbness, tingling, and other MS symptoms are signals too. When these signals persist over a couple of days, then it may be MS-related. However, when you live with MS, you can experience pseudo exacerbations which are small relapses that can come and go. Being aware of these signals can let you know that something is wrong. The same is true for brain signals. Whether it is brain fog or increased fatigue, your mind is signaling to you that something may be wrong. Keeping a symptom journal can help you track the length and severity of your mind and body signals and will guide your next conversation with the neurologist.

2. Maintain a balanced, healthy diet – When I was younger, I could eat anything and it wouldn’t stick to my ribs. Now, I am approaching middle age and the pounds do not melt off the way that they used to. The problem is that the heavier I become, the more it affects my MS – from numbness and tingling in my lower extremities to increased fatigue. There are many diet options available for someone living with MS. Some work for some people, but none work for all people. My neurologist gave me great advice in regards to diet: “When in the grocery store, shop the outside aisles.” Whether it is fruits and vegetables, dairy or protein, all of the fresh food is located on the outside aisles of the grocery store. The inside aisles are all the packaged foods loaded with preservatives. Eating fresh, having fruit and vegetables as snacks and watching your carbohydrate intake can put you on the path to eating a balanced, healthy diet which will help in managing your fight against MS.

3. Physical activity – Movement is also key to managing MS. This does not necessarily mean going to the gym and becoming a workout warrior. For some of us, that is not an option. Physical activity can include walking, biking, or swimming. This kind of physical activity is critical to managing MS. You don’t want to stress yourself, but at the same time you have to keep moving. The more you move, the more you will want to move. For me, when I lost the ability to walk, it took physical therapy in the pool and in the gym to learn how to walk again. My wife got me a dog and I promised her that no matter what my MS was doing, I would walk my dog twice a day. It has been 10.5 years since my diagnosis and I haven’t missed a day. In fact, I went from short strolls to more than two miles a day. Not only that, now I am riding my bike, swimming, and have returned to the gym. It all starts with that commitment to start some sort of physical activity. Once you start, you will find the more you do the more you can do. It will become part of your routine and help you manage your MS.

4. Maintain a sleep schedule – Sleep is when your body heals, becomes refreshed and recharged. Yet, many of us living with MS have some kind of sleep disorder. Your body has a natural cycle called your circadian rhythm. Sleep is an important part of your circadian rhythm. For me, I go to bed early and wake up early because I have the most energy early in the day. When I stick to my sleep schedule, I feel more productive and less symptomatic. When I don’t adhere to my sleep schedule, my fatigue increases to an unmanageable point and it takes longer for me to recover. Maintaining a sleep schedule and getting a full eight hours of sleep will help you manage your MS beyond the neurologist office.

5. Drink water – There is no shortage of drink options out there, but the best for maintaining your health is to make sure that you drink plenty of water. Even though it doesn’t have the sugary sweetness of the other options, there is no better drink for you. Drinking your daily requirement of water helps keep your body functioning properly. It also aids in digestion, curbs hunger craving, and gives you energy. For me, I have to force myself to drink my daily requirement of water. If you are keeping a symptom diary, recording your water and food intake will help you track your water consumption. Once you start drinking the appropriate amount of water each day, you will notice a big difference in how you feel in your fight against MS.

While these are five tips that I use to manage my MS outside the neurologist office, this is just a part of an overall wellness plan. MS is a lifelong fight. By keeping a symptom journal, eating right, participating in physical activity, maintaining a sleep schedule, and drinking plenty of water, you will find that you are proactively managing your MS.

MS is unpredictable. If you start to implement these changes into your life, be patient. Some days are better than others. If you do the best you can with what you have that day, you will be successful. Just know that you are not alone. I will be right here with you in the fight to live well with MS beyond the neurologist.