The challenges of fighting Multiple Sclerosis

When Aucklander Sarah Collins gave birth to her twins, she knew life would be challenging —she already had two children— but she hadn’t expected to find herself so tired and with her legs barely working. After several difficult months, her mother insisted she get help, leading to a diagnosis of Multiple Sclerosis. Sarah joined the 5000 or so other New Zealanders with MS, and she, like many with the disease, was hit in the prime of life. Women are more likely than men to get MS, and it generally makes itself felt for the first time between the ages of 20 and 40.  

One of MS's few constants is its unpredictability. Some people will suffer an attack, and then never experience MS again, although the telltale lesions in the brain remain. In the most severe cases, usually with a later onset, the spinal cord will suffer from the multiple lesions that give the disease its name and it can lead to people needing a wheelchair and more intensive help. By far the majority of people will have what’s called relapsing-remitting (RRMS) – they can, with drug treatments and taking care of themselves, enjoy periods of close to good health. Then as Sarah Collins told Clare de Lore on Newstalk ZB’s Brainstorming podcast, the disease will hit without warning and sometimes with a vengeance.  

“When it bites it’s got a very nasty bite and ... you can wake up one day and [it’s] “okay my legs don’t want to do this today” and I had quite a quite a period, a very hard time for me, with neuropathic nerve pain so at night, I’d feel like I was in the ring with Mike Tyson being beaten up, it was so painful to sleep.”  

Sarah manages her MS through a drug regime, trying to eat healthily and lead a balanced life, and by keeping her brain active through art therapy, which she also teaches, and studying psychology.  

Two experts on MS are Professor Hanneke Hulst who is also the Director of the Centre for Brain Research at the University of Auckland and Auckland neurologist Dr Jennifer Pereira.  

Jennifer says it is difficult to predict how MS will play out for each person.  

“The tricky thing with MS is that it is a huge spectrum of illness, so for some people it's milder, they have fewer relapses, the impact on brain and spinal cord tissue is less, so the disease is less damaging. For those people, it’s less relentless, it can burn itself out over time. Then on the opposite side there are people with aggressive progressive disease that is really hard to manage, so it is a very big spectrum and variable courses.”  

“We do know that the better your general health the better your MS, is so eat well, sleep well, exercise more ... your MS will likely be better over time because your body is healthier. Most people in 2026 will do that in combination with an MS treatment – some people choose to do it without MS treatment. The only thing we know in the dietary world that makes MS worse is processed meat. But there is not known to be anything else particular to diet that is bad for MS.”  

Major cognitive decline and physical impacts of MS can be mitigated if treatment is initiated after the first MS attack, according to Jennifer Pereira. She says New Zealanders with MS are fortunate that drugs for MS are able to be prescribed after the very first episode.  

Professor Hanneke Hulst’s mother had MS and that influenced her decision to study the disease and its associated cognitive decline in some patients. She recalls, as a younger woman in the Netherlands, her mother forgetting she’d told her she’d be out for the evening. That led to multiple missed calls from a panicked mum who also roped in Hanneke’s brother to find out where she was.  

“I realised that she was really afraid for a long period of time – she didn’t realise I had told her we’d be having drinks. Maybe it sounds like a small example, but it adds up on a daily basis that you are missing out on things, that you cannot follow your friends in a conversation.”  

Hanneke says this invisible impact for some MS patients needed further research, hence her professional speciality both in the Netherlands and now in New Zealand. She moved to New Zealand in late 2025 to take up the role of Director of the Centre for Brain Research, and to continue her MS research.    

Keeping friends and family in the loop is important, as she learned in her own family’s experience and, like Jennifer Pereira, Hanneke emphasises brain health – with a twist.  

“Try to eat healthy, sleep well, exercise so that you keep your mind and the blood flow going.  And this is biased with my expertise – keep your brain cognitively active and I’m not meaning that you should do more of the same things, I want you to do novel things. If you can run for 5 km and you go to 6km or 7 km, I am not interested – it’s the same pathway in the brain that is needed for that. I want you to go knitting or painting or read a book if you haven’t done that. The working hypothesis is that by doing that, you create more connections that will make your brain more resilient to future pathology.”  

That hypothesis is being tested in Hanneke’s ongoing research in the Netherlands.  

In the final episode of this season of Brainstorming with Clare de Lore, Professor Hulst, Dr Pereira, and Sarah Collins discuss Multiple Sclerosis (MS).