RealTalk MS
RealTalk MS
Navigating multiple sclerosis is easier when you understand the science behind it. Join host Jon Strum each week as he translates complex MS research, treatment breakthroughs, and healthcare news into clear, accessible language. Whether you’re living with MS, caring for a loved one, or looking for answers, RealTalk MS connects you with top neuroscientists, advocates, and the information and insights that matter most to your MS journey.
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Oct. 12, 2026

Episode 476: MS in the Workplace with Dana Foote

Episode 476: MS in the Workplace with Dana Foote
RealTalk MS
Episode 476: MS in the Workplace with Dana Foote
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Season 10 Living With MS Research Insights
What happens when you're diagnosed with a chronic, unpredictable condition just as your career is taking off? That's exactly what happened to my guest, Dana Foote.

Dana Foote

This week, Dana joins us to share her journey from hiding her MS diagnosis as a young auditor at one of the largest accounting organizations in the world to becoming National Managing Partner for Audit & Assurance Operations and a leader in the MS community.

We'll also update you on the status of a disease-modifying therapy that has been submitted to the FDA for review as a potential treatment for relapsing MS and primary progressive MS.

We're sharing details of the National MS Society's recent $8.9 million investment to support 15 cutting-edge research projects.

We'll tell you about a study that shows physical therapy can produce confirmed disability improvement for people living with MS.

And we'll remind you that with MSToronto 2026 just one week away, you can still register for Patient Community Day.

We have a lot to talk about! Are you ready for RealTalk MS??!

This Week: Managing MS in a demanding, high-stakes work environment :22

The FDA grants fenebrutinib Priority Review status 1:22

The National MS Society announced $8.9 million in new research investments 4:53

A study shows ongoing physical therapy can lead to confirmed disability improvement 9:12

We're one week away from MSToronto 2026. Will you be part of Patient Community Day? 13:40

Dana Foote shares her corporate journey from a young auditor diagnosed with MS to National Managing Partner for Audit & Assurance Operations at KPMG US 15:40

Share this episode 33:20

Have you downloaded the RealTalk MS app? 33:36

Next week 34:21

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REGISTER: ECTRIMS Patient Community Day 2026
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RealTalk MS Episode 461: A New Disease-Modifying Therapy Has Been Submitted for FDA Approval with Dr. Jiwon Oh
https://realtalkms.com/461

STUDY: Physiotherapy and Confirmed Disability Improvement in People with Multiple Sclerosis
https://msard-journal.com/article/S2211-0348(26)00949-1/fulltext

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RealTalk MS Episode 476
Guest: Dana Foote

WEBVTT

00:00:16.420 --> 00:00:19.840
It's October 13th, and we have a lot to talk about.

00:00:20.810 --> 00:00:24.870
When you build a career in a demanding, high-stakes corporate environment,

00:00:25.370 --> 00:00:30.620
the expectations around stamina, pace, and presence can feel relentless.

00:00:31.440 --> 00:00:36.180
What happens when you're diagnosed with a chronic, unpredictable condition just

00:00:36.180 --> 00:00:37.940
as your career is taking off?

00:00:38.770 --> 00:00:43.090
Well, that's exactly what happened to my guest, Dana Foote, National Managing

00:00:43.090 --> 00:00:47.090
Partner for Audit and Assurance Operations at KPMG US.

00:00:47.750 --> 00:00:52.240
Dana is joining me today to share her experience that began as a young auditor

00:00:52.240 --> 00:00:58.280
at a Big Four accounting organization by hiding her symptoms and keeping her MS to herself,

00:00:58.710 --> 00:01:03.440
all the way to leading an employee resource group focused on employees with disabilities.

00:01:04.140 --> 00:01:09.370
Doing all that while rising to National Managing Partner, managing a multi-billion

00:01:09.370 --> 00:01:11.170
dollar national audit practice.

00:01:11.790 --> 00:01:16.620
But before we get to my conversation with Dana, there are a few other things

00:01:16.960 --> 00:01:18.060
that you should know about.

00:01:22.100 --> 00:01:28.190
A few months ago, in episode 461, I shared that drug manufacturer Roche had

00:01:28.190 --> 00:01:34.230
submitted the very positive clinical trial results for fenebrutinib to the FDA for approval.

00:01:34.920 --> 00:01:39.750
The FDA has officially accepted Roche's application to review fenebrutinib for

00:01:39.750 --> 00:01:43.650
both relapsing MS and primary progressive MS,

00:01:44.240 --> 00:01:50.100
and they've granted it priority review, which shortens the FDA's standard 10-month

00:01:50.100 --> 00:01:55.450
review cycle to just six months, putting an approval decision on the calendar

00:01:55.450 --> 00:01:58.010
for late March or early April.

00:01:58.770 --> 00:02:02.830
Now, if approved, fenebrutinib would mark two important milestones.

00:02:03.380 --> 00:02:08.520
It would be the first BTK inhibitor approved to treat both relapsing forms of

00:02:08.520 --> 00:02:11.020
MS and primary progressive MS.

00:02:11.730 --> 00:02:17.640
And it would introduce the first high-efficacy oral option specifically authorized

00:02:17.640 --> 00:02:19.390
for primary progressive MS,

00:02:19.830 --> 00:02:24.270
giving people living with MS the convenience of taking a daily pill instead

00:02:24.270 --> 00:02:27.970
of going through all the logistics involved in scheduling an infusion.

00:02:28.580 --> 00:02:31.130
So let's talk about how this medication works.

00:02:32.010 --> 00:02:35.470
MS involves two separate types of nerve damage.

00:02:36.070 --> 00:02:40.530
There are acute relapses driven by flare-ups in the immune system,

00:02:41.060 --> 00:02:45.830
but there's also the slower, compartmentalized inflammation deep inside the

00:02:45.830 --> 00:02:51.100
central nervous system that silently drives long-term disability progression

00:02:51.100 --> 00:02:53.360
in the absence of relapses.

00:02:54.230 --> 00:02:58.840
Phenobrutinib blocks an enzyme called Bruton's tyrosine kinase,

00:02:58.840 --> 00:03:04.940
or BTK, which is necessary to the survival and function of B cells and microglia.

00:03:05.540 --> 00:03:10.390
By blocking this enzyme and shutting down this pathway, fenobrutinib targets

00:03:10.390 --> 00:03:15.940
both those acute flare-ups and that chronic brain inflammation simultaneously.

00:03:16.710 --> 00:03:21.750
Now Roche backed its FDA filing with findings from three phase 3 trials.

00:03:22.540 --> 00:03:28.130
Two clinical trials tested fenobrutinib for relapsing forms of MS against Obagio

00:03:28.230 --> 00:03:36.050
across nearly 1,500 adults, and fenobrutinib cut the annualized relapse rate by more than 50%.

00:03:36.710 --> 00:03:40.560
That translates to roughly one relapse every 17 years.

00:03:41.320 --> 00:03:47.400
It also reduced new or enlarging MRI lesions by over 70% and demonstrated a

00:03:47.400 --> 00:03:50.670
positive trend toward slowing disability accumulation.

00:03:51.730 --> 00:03:57.000
The clinical trial that tested fenebrutinib for primary progressive MS evaluated

00:03:57.000 --> 00:04:01.190
fenebrutinib directly against the current standard of care, Ocrevus.

00:04:01.770 --> 00:04:06.990
And fenebrutinib performed at least as well, showing a 12% reduction in the

00:04:06.990 --> 00:04:09.220
risk of confirmed disability progression.

00:04:09.940 --> 00:04:15.370
And this benefit was observed even among trial participants with primary progressive

00:04:15.370 --> 00:04:19.330
MS who showed no active MRI inflammation.

00:04:19.950 --> 00:04:25.540
Now, that's a group that historically hasn't gained much from traditional B-cell depleting infusions.

00:04:26.420 --> 00:04:30.500
As spring approaches, you can be sure we'll be following the FDA's decision,

00:04:30.810 --> 00:04:32.590
and you'll be among the first to hear it.

00:04:33.340 --> 00:04:36.860
Meanwhile, if you'd like to hear more about the fenebrutinib clinical trials

00:04:36.860 --> 00:04:41.450
from one of the principal investigators, I'll invite you to check out my conversation

00:04:41.450 --> 00:04:46.120
with Dr. Jiwon Oh in episode 461 of Real Talk MS.

00:04:46.550 --> 00:04:49.210
And you'll find that link in today's show notes. Thank you.

00:04:53.680 --> 00:04:58.200
The National Multiple Sclerosis Society announced that it was investing $8.9

00:04:58.200 --> 00:05:03.810
million in multi-year funding to support 15 cutting-edge research grants.

00:05:04.380 --> 00:05:09.490
Each of these grants maps directly to the Society's Pathways to Cures roadmap

00:05:09.840 --> 00:05:14.140
that targets three goals that matter most to people living with MS.

00:05:14.650 --> 00:05:20.690
Stopping MS in its tracks, restoring lost function, and ultimately ending the

00:05:20.690 --> 00:05:22.370
disease through prevention.

00:05:23.270 --> 00:05:27.510
These projects represent awards lasting up to three years, funding everything

00:05:27.510 --> 00:05:30.620
from bench science to clinical rehabilitation.

00:05:31.230 --> 00:05:35.110
And I want to point out that these grant applications weren't just evaluated

00:05:35.110 --> 00:05:36.570
by a panel of scientists.

00:05:36.960 --> 00:05:40.680
They were also reviewed by a committee of people living with MS.

00:05:41.470 --> 00:05:47.570
This latest investment is part of the Society's $119.6 million commitment,

00:05:47.830 --> 00:05:52.580
supporting more than 200 active research initiatives worldwide.

00:05:53.130 --> 00:05:57.610
Now, I want to briefly walk you through four standout projects from this new grant cycle.

00:05:58.260 --> 00:06:03.760
One project is aimed at stopping MS by precision reprogramming of B-cells.

00:06:04.400 --> 00:06:11.010
At Seattle's Children's Hospital, Dr. David Rawlings received over $597,000

00:06:11.280 --> 00:06:16.050
to reprogram immune B-cells into a specialized cell therapy.

00:06:16.640 --> 00:06:17.920
And here's why that matters.

00:06:18.910 --> 00:06:23.090
Current disease-modifying therapies broadly suppress the immune system.

00:06:23.850 --> 00:06:29.510
That leaves individuals vulnerable to infections and reduced vaccine responses.

00:06:30.260 --> 00:06:35.570
Dr. Rawling's team is engineering B-cells to affect only the specific harmful

00:06:35.570 --> 00:06:40.230
attacks on myelin while keeping healthy immune defenses intact.

00:06:40.730 --> 00:06:45.850
And they're also planning to test whether these reprogrammed cells can support myelin repair.

00:06:47.110 --> 00:06:51.630
A project focused on restoring lost function is taking place at the Methodist

00:06:51.630 --> 00:06:55.150
Hospital Research Institute in Houston, where Dr.

00:06:55.150 --> 00:07:00.260
Rose Khavari is investigating a treatment called tibial neuromodulation,

00:07:00.260 --> 00:07:03.530
or TNM, to restore bladder function.

00:07:04.430 --> 00:07:08.610
Now, bladder dysfunction impacts up to 80% of the people living with MS,

00:07:09.160 --> 00:07:13.400
and it's one of those symptoms that has a direct connection to your quality of life.

00:07:14.190 --> 00:07:20.960
Dr. Khavari's clinical trial evaluates non-drug at-home nerve stimulation using

00:07:20.960 --> 00:07:27.220
either an FDA-approved wearable sock or a minor implant that stimulates ankle

00:07:27.220 --> 00:07:28.960
nerves connected to the spine.

00:07:29.860 --> 00:07:35.380
Trial participants will receive 12 weeks of therapy alongside advanced MRI brain

00:07:35.380 --> 00:07:41.900
scans to see if retraining these nerve pathways can physically rebuild bladder control.

00:07:42.780 --> 00:07:47.930
Meanwhile, at UT Health Houston, Dr. Stephanie Silveira is leading a randomized

00:07:47.930 --> 00:07:52.560
clinical trial that's focused on restoring lost function through home-based

00:07:52.560 --> 00:07:55.840
exercise training for wheelchair users with MS.

00:07:56.810 --> 00:08:00.490
About a third of the people living with MS use a wheelchair or scooter,

00:08:00.820 --> 00:08:04.930
but these individuals are routinely excluded from clinical trials.

00:08:05.570 --> 00:08:12.710
Dr. Silveira's study will enroll 100 participants into 16 weeks of virtual behavioral coaching,

00:08:13.290 --> 00:08:17.810
testing whether structured home workouts can boost upper body function,

00:08:18.230 --> 00:08:21.670
improve daily living, and preserve their independence.

00:08:22.520 --> 00:08:27.820
And under the category of ending MS, Dr. Claudia Nobrega at the University of

00:08:27.820 --> 00:08:32.010
Minho in Portugal is spearheading the Harness MS study.

00:08:32.800 --> 00:08:39.110
Now, the Epstein-Barr virus, or EBV, has been identified as a necessary trigger for MS.

00:08:39.920 --> 00:08:45.820
And viral reactivation of EBV has been linked to flares and disability progression.

00:08:46.640 --> 00:08:52.570
The Harness MS study uses receptor-targeted T cells to keep the Epstein-Barr

00:08:52.570 --> 00:08:57.090
virus permanently suppressed without provoking autoimmune attacks,

00:08:57.340 --> 00:09:01.470
which could be a pathway toward prevention and long-term remission.

00:09:02.210 --> 00:09:06.690
We'll keep you updated on these and all of the MS research that's underway as

00:09:06.690 --> 00:09:08.390
these projects move forward.

00:09:12.560 --> 00:09:20.230
In recent years, MS clinical research has begun focusing on Confirmed Disability Improvement, or CDI.

00:09:21.110 --> 00:09:25.300
This means researchers are no longer just asking whether a disease-modifying

00:09:25.300 --> 00:09:27.310
therapy can slow down progression.

00:09:27.800 --> 00:09:32.000
They want to know if it can help people regain function that's been lost to MS.

00:09:32.890 --> 00:09:37.410
A new study published out of the German Multiple Sclerosis Registry reveals

00:09:37.410 --> 00:09:42.480
that non-pharmacological care, specifically ongoing physical therapy,

00:09:42.920 --> 00:09:48.810
plays a critical role in whether people experience real, measurable disability improvements.

00:09:50.000 --> 00:09:55.320
In this study, investigators analyzed data from more than 45,000 patient records

00:09:55.320 --> 00:09:57.140
in the German MS registry.

00:09:57.920 --> 00:10:02.480
To isolate the true effect of physical therapy, they used what's called propensity

00:10:02.480 --> 00:10:08.640
score matching to compare 362 people with MS who received continuous physical

00:10:08.640 --> 00:10:10.720
therapy for at least six months

00:10:11.150 --> 00:10:14.600
against 362 matched people with MS

00:10:15.030 --> 00:10:16.850
who had no physical therapy.

00:10:17.720 --> 00:10:22.900
Both groups were balanced across age, their baseline, expanded disability status

00:10:22.900 --> 00:10:29.740
scale or EDSS scores, how long they had MS, and the disease-modifying therapy they were using.

00:10:30.610 --> 00:10:34.590
They were followed for up to eight years, and the data showed a significant

00:10:34.590 --> 00:10:38.470
advantage for those people receiving regular physical therapy.

00:10:39.450 --> 00:10:45.860
Over that eight-year follow-up period, 16.3% of the participants receiving continuous

00:10:45.860 --> 00:10:50.980
physical therapy achieved three-month confirmed disability improvement,

00:10:51.660 --> 00:10:56.850
compared to 11.1% of those who had not received any physical therapy.

00:10:57.340 --> 00:11:03.530
And the benefit was most pronounced among individuals with a baseline EDSS score of 4 or higher.

00:11:04.210 --> 00:11:08.540
In this group, where mobility and walking limitations are more prominent,

00:11:09.160 --> 00:11:15.270
25.3% of those receiving physical therapy saw confirmed disability improvement

00:11:15.700 --> 00:11:20.250
compared to just 11.5% in the non-physical therapy group.

00:11:21.200 --> 00:11:26.340
People with MS who were age 48 and older also experienced a significant boost

00:11:26.340 --> 00:11:30.420
in confirmed disability improvement when they engaged in physical therapy.

00:11:31.410 --> 00:11:37.210
So how does this happen? Well, the middle ranges of the EDSS scale are largely

00:11:37.210 --> 00:11:41.260
driven by walking speed, balance, and lower limb endurance.

00:11:41.830 --> 00:11:46.230
And these are the exact functional deficits that are targeted by personalized

00:11:46.230 --> 00:11:47.790
physical therapy programs.

00:11:48.480 --> 00:11:52.810
Now, I want to point out that because this was an observational registry study

00:11:52.810 --> 00:11:58.760
rather than a randomized controlled trial, it can't establish direct causality,

00:11:59.450 --> 00:12:05.530
and registry entries don't capture individual exercise intensity or home workout habits.

00:12:06.070 --> 00:12:10.280
Still, this strong real-world evidence reminds us that structured,

00:12:10.280 --> 00:12:14.510
ongoing physical therapy is not just about symptom maintenance.

00:12:14.980 --> 00:12:20.430
It can be an active driver of functional recovery, particularly for older adults

00:12:20.430 --> 00:12:23.330
and those individuals navigating moderate disability.

00:12:23.760 --> 00:12:27.740
And it's important that researchers take these findings into consideration.

00:12:28.410 --> 00:12:33.120
You know, most phase three drug trials evaluating disability improvement don't

00:12:33.120 --> 00:12:36.920
track or control for concurrent physical therapy.

00:12:37.630 --> 00:12:43.790
So if trial participants in one arm use physical therapy more than another,

00:12:44.400 --> 00:12:48.690
well, that rehabilitation effect is going to blur or perhaps exaggerate the

00:12:48.690 --> 00:12:51.770
perceived benefit of whatever drug is being studied.

00:12:52.590 --> 00:12:56.300
Now, based on these findings, there are a couple of things you may want to keep in mind.

00:12:56.920 --> 00:13:01.270
At your next clinical appointment, discuss a referral for continuous,

00:13:01.270 --> 00:13:05.350
individualized outpatient physical therapy tailored to gait,

00:13:05.600 --> 00:13:10.990
lower limb strength, and balance rather than waiting for PT as a response to a relapse.

00:13:11.560 --> 00:13:16.280
And ask your physical therapist to record objective baselines like the timed

00:13:16.280 --> 00:13:19.310
25-foot walk or two-minute walk test.

00:13:19.730 --> 00:13:25.270
And track those times every three to six months to evaluate whether your rehabilitation

00:13:25.270 --> 00:13:29.290
program is driving real, measurable mobility gains.

00:13:30.170 --> 00:13:35.620
Now, if you'd like to review the details of this study, you'll find that link in today's show notes.

00:13:40.250 --> 00:13:45.340
Next week, I'll be in Toronto, Canada for the largest MS research conference in the world.

00:13:45.760 --> 00:13:49.430
The joint meeting of the America's Committee for Treatment and Research in MS

00:13:49.430 --> 00:13:52.430
and the European Committee for Treatment and Research in MS,

00:13:52.600 --> 00:13:58.060
or MS Toronto 2026, begins Wednesday, October 21st.

00:13:58.470 --> 00:14:02.910
And part of the conference is especially for people affected by MS.

00:14:03.780 --> 00:14:09.200
Patient Community Day is a live, in-person, and online event where you'll see

00:14:09.200 --> 00:14:14.130
some of the top MS experts in the world explaining the research that was presented

00:14:14.130 --> 00:14:17.320
at this joint meeting in easy-to-understand language.

00:14:17.990 --> 00:14:21.630
You'll even be able to submit your own questions and have them answered by some

00:14:21.630 --> 00:14:24.950
of the best and brightest MS researchers in the world.

00:14:25.520 --> 00:14:31.550
I hope you'll take a moment to visit ectrimspatientcommunity.eu and register

00:14:31.550 --> 00:14:37.450
for what I know is going to be an amazing program, and you'll find that link in today's show notes.

00:14:38.570 --> 00:14:43.610
Sometimes, I step back from all the science and consider the human side of MS.

00:14:44.450 --> 00:14:49.810
I don't think I'll ever forget seeing my wife burst into tears when she received her MS diagnosis.

00:14:50.390 --> 00:14:55.180
And I think she probably experienced that same mix of shock and fear that a

00:14:55.180 --> 00:14:56.600
lot of people experience.

00:14:57.280 --> 00:15:01.320
You immediately wonder how this chronic condition is going to impact your future,

00:15:01.640 --> 00:15:04.120
your family, your job, everything.

00:15:04.830 --> 00:15:09.130
And your imagination tends to present you with the worst possible outcomes.

00:15:09.910 --> 00:15:14.090
Outcomes. Dana Foote was a young auditor at one of the big four accounting organizations

00:15:14.090 --> 00:15:15.990
when she was diagnosed with MS.

00:15:16.420 --> 00:15:22.550
And even when it meant hiding IV steroid bags up her sleeves at the office, Dana persevered.

00:15:23.000 --> 00:15:28.280
And today she manages a multi-billion dollar audit practice as national managing

00:15:28.280 --> 00:15:32.360
partner for audit and assurance operations at KPMG US.

00:15:32.970 --> 00:15:35.660
In a moment, we'll meet my guest, Dana Foote.

00:15:40.370 --> 00:15:44.290
When you build a career in a demanding, high-stakes corporate environment,

00:15:44.290 --> 00:15:49.710
the expectations around stamina, pace, and presence can feel relentless.

00:15:50.450 --> 00:15:54.490
But what happens when you're diagnosed with a chronic, unpredictable condition

00:15:54.920 --> 00:15:56.610
just as your career is taking off?

00:15:57.250 --> 00:16:01.480
That's exactly what happened to my guest, Dana Foote, National Managing Partner

00:16:01.480 --> 00:16:06.950
for Audit and Assurance Operations at KPMG US. Welcome to the podcast, Dana.

00:16:07.690 --> 00:16:09.080
Thank you, Jon. Great to be here.

00:16:09.720 --> 00:16:14.150
When you were diagnosed with MS early in your career, what were the professional

00:16:14.150 --> 00:16:16.740
uncertainties that first ran through your mind?

00:16:17.460 --> 00:16:22.110
I was just two years into my career in 1998 when I was diagnosed with MS.

00:16:22.110 --> 00:16:26.710
And I think a lot of uncertainty ranged in my mind of, what is this?

00:16:26.710 --> 00:16:33.170
Me at MS in and of itself is uncertain. I had visions of wheelchairs and inability to do my job.

00:16:33.500 --> 00:16:39.850
I did travel quite a bit for work early on, so I truly believed it was the death sentence to my career.

00:16:40.420 --> 00:16:45.300
If someone is working and they are diagnosed with MS, one of the initial thoughts

00:16:45.300 --> 00:16:49.320
they do have is about disclosure, and it's usually a scary thought.

00:16:49.760 --> 00:16:53.870
I'm curious, how did you decide when and how to disclose your diagnosis?

00:16:54.670 --> 00:16:58.440
When I was first diagnosed, I didn't talk about it. I had one boss,

00:16:58.880 --> 00:17:02.820
immediate boss that I worked with that I knew because I knew him in college.

00:17:02.820 --> 00:17:05.670
So he knew I was going to doctor's appointments and things like that.

00:17:05.670 --> 00:17:09.830
But otherwise, I didn't talk about it with anybody at all and was nervous who

00:17:09.830 --> 00:17:14.780
was going to get in the way of my progression. So I was promoted to partner

00:17:14.780 --> 00:17:18.680
in 2007, so several years after my diagnosis.

00:17:19.000 --> 00:17:23.130
I didn't disclose it broadly until that time after I'd made partner.

00:17:23.580 --> 00:17:28.790
The decision there was I was blessed to be able to be promoted to partner at KPMG.

00:17:29.290 --> 00:17:33.180
And I thought this was my opportunity to lead by example. and thus I made the

00:17:33.180 --> 00:17:35.800
decision to disclose in 2007.

00:17:36.640 --> 00:17:42.630
And how did that feel after several years of not sharing that information and

00:17:42.630 --> 00:17:45.540
then finally being able to? How was that experience for you?

00:17:46.050 --> 00:17:49.270
The experience was good. I'll answer that in a couple of ways, Jon.

00:17:49.270 --> 00:17:52.430
Maybe I'll tell you a little bit about how I went about the disclosure.

00:17:52.430 --> 00:17:57.490
I made that decision like I just talked about, but I heard on a firm-wide meeting

00:17:57.490 --> 00:18:01.330
that they were starting an employee resource group for people with disabilities

00:18:01.330 --> 00:18:02.520
and children with special needs.

00:18:03.020 --> 00:18:07.290
So I raised my hand. I knew the lady that was starting it that was in HR and

00:18:07.290 --> 00:18:09.050
I sent her an email and said, let me know if I can help.

00:18:09.800 --> 00:18:13.660
Next thing I know, she called me and said, yes, we want you to help.

00:18:13.660 --> 00:18:17.830
And by the way, could you co-chair and basically be the co-founder of the group?

00:18:17.830 --> 00:18:22.230
So then I had someone else call me, Laura at HR and saying, Dana,

00:18:22.230 --> 00:18:25.300
we need to make this announcement. And I'm like, oh, I guess that means I need

00:18:25.300 --> 00:18:27.110
to disclose why I want to volunteer.

00:18:27.580 --> 00:18:31.910
So that's when it hit me of this is a big deal. So it was a little overwhelming

00:18:31.910 --> 00:18:34.040
at first to go public with it in such

00:18:36.380 --> 00:18:40.650
A wide ray of everybody hearing it and seeing it. But it really did feel good.

00:18:40.650 --> 00:18:43.980
And it's nice to be able to talk about it more openly now.

00:18:43.980 --> 00:18:48.620
And the other way I would answer the question is, I am happy that I waited a

00:18:48.620 --> 00:18:52.470
while because by the time I disclosed, I felt like I had established myself

00:18:52.590 --> 00:18:56.870
in my profession where I was trusted, I was reliable, people knew I did good work,

00:18:57.290 --> 00:19:00.380
and then I could have the open conversation of what I was battling.

00:19:00.840 --> 00:19:04.040
I have questioned myself, did I wait too long? I waited nine years.

00:19:04.480 --> 00:19:09.010
That is a long time. I'm not saying the right number for anybody by any stretch.

00:19:09.010 --> 00:19:12.910
So maybe I should have gone a little earlier in my career, but I do think some

00:19:12.910 --> 00:19:16.660
level of time to establish yourself if the opportunity presents itself.

00:19:16.940 --> 00:19:18.760
I know MMS is different for everybody.

00:19:19.400 --> 00:19:22.110
I think that is the right decision. It was definitely the right decision for me.

00:19:22.830 --> 00:19:28.360
High-performance business environments often reward long hours and what seems

00:19:28.360 --> 00:19:30.640
like a relentless pace sometimes.

00:19:30.910 --> 00:19:36.660
In those early years post-diagnosis, how did you begin reconciling the unpredictability

00:19:36.660 --> 00:19:39.240
of MS with the demands of an audit career?

00:19:40.070 --> 00:19:43.680
It's difficult, and I'll tell you, I still am challenged by it a little bit today.

00:19:43.870 --> 00:19:47.910
But thankfully, there's a lot of advice out there with the profession,

00:19:47.910 --> 00:19:52.560
with the medical, with medical doctors, with the MS Society and other resources

00:19:52.560 --> 00:19:57.210
there. So taking care of yourself, I think keeping my brain active is really important.

00:19:57.890 --> 00:20:02.040
I think using the medications that are available to us, I'm a huge supporter

00:20:02.040 --> 00:20:05.860
of that. I've been on four or five of the different disease modifying therapies

00:20:05.860 --> 00:20:08.060
that I've gone through over my time with MS.

00:20:08.570 --> 00:20:11.020
I think sleep is important.

00:20:12.000 --> 00:20:14.810
And yes, that is hard when you work in the kind of hours we have.

00:20:14.810 --> 00:20:18.920
So some other things may have to get cut, like being able to be in so many social

00:20:18.920 --> 00:20:21.940
events as all of my friends around home or things like that.

00:20:22.410 --> 00:20:27.120
So sleep is important. Eating right is important. And then some level of exercise.

00:20:27.120 --> 00:20:30.280
I'm not great at that either, but I do try to get some exercise in there.

00:20:30.730 --> 00:20:34.730
So finding ways to do all of that and be a mom is a challenge,

00:20:35.180 --> 00:20:38.290
but you are going to have to give up some things to make that work.

00:20:38.290 --> 00:20:41.310
And taking care of your health has to be a top priority.

00:20:42.800 --> 00:20:46.960
And to that point, how did you approach having conversations with managers and

00:20:46.960 --> 00:20:53.030
teams when your symptoms flared or when you needed to adjust expectations without

00:20:53.030 --> 00:20:55.830
feeling like you were compromising your standing?

00:20:57.760 --> 00:21:01.850
That's another really hard question. The hardest time with my MS in my career

00:21:01.850 --> 00:21:06.640
was while I was having children. So you do have to come off your MS medications

00:21:06.640 --> 00:21:09.100
to try to get pregnant and when you are pregnant.

00:21:09.610 --> 00:21:13.530
And that is when I had the worst of my MS symptoms. Some of that time was when

00:21:13.530 --> 00:21:16.040
I had disclosed, some of it when I had not disclosed.

00:21:18.520 --> 00:21:22.790
So MS, you can kind of blame it on different things. So before I disclosed,

00:21:22.790 --> 00:21:26.680
I always was telling some story, whether I was dizzy at work or tripping or

00:21:26.680 --> 00:21:27.940
just saying I was a klutz.

00:21:28.700 --> 00:21:32.510
I did have, I'm sure some of you can relate to this, but having to have steroid

00:21:32.510 --> 00:21:37.080
treatments to treat your MS, you can get the steroids in that little junk that

00:21:37.080 --> 00:21:41.500
it's like its own little IV pump. And I'd wear a big sleeve and stick it up my sleeve and hide it.

00:21:41.990 --> 00:21:47.010
So lots of little things I did, but it was so refreshing when I finally did

00:21:47.010 --> 00:21:51.380
disclose because I can just tell the truth. And I think be a role model to others.

00:21:51.730 --> 00:21:55.980
You can be successful in your career and manage it and setting those boundaries.

00:21:55.980 --> 00:21:59.320
I mean, I have to have a doctor's appointment, which I have lots of them.

00:21:59.320 --> 00:22:02.850
I'm sure you all can relate to that and managing the disease,

00:22:03.310 --> 00:22:09.030
making that a priority. And I don't try to hide what I'm doing and where I'm going, why I'm doing it.

00:22:09.030 --> 00:22:14.530
Many people worry that an MS diagnosis puts an automatic ceiling on their career progression.

00:22:14.930 --> 00:22:18.100
Now, as you moved up the ranks to national managing partner,

00:22:19.210 --> 00:22:25.840
did living with MS help to shape your leadership style and approach to problem solving in general?

00:22:26.960 --> 00:22:30.520
Absolutely, it did. Maybe just to quickly talk about the ceiling.

00:22:30.990 --> 00:22:35.000
I was worried initially on it. I think I maybe said that at the beginning that

00:22:35.000 --> 00:22:38.620
I had some type of ceiling and still do worry about it today.

00:22:38.620 --> 00:22:42.900
But I think I exhibited that you can overcome those ceilings pretty quickly.

00:22:43.230 --> 00:22:46.870
But has it shaped my ability to be the leader that I am? Absolutely,

00:22:46.870 --> 00:22:49.490
it has. I think there's a lot of empathy there.

00:22:49.790 --> 00:22:54.480
So just knowing how I've had to manage through my disease. My mother-in-law also had MS.

00:22:54.910 --> 00:22:58.470
So I watched my husband work with her and how she managed it.

00:22:58.470 --> 00:23:01.090
She was a lady with a great career. She was a pharmacist.

00:23:01.660 --> 00:23:06.810
So I did have role models in that regard. And so I think just any disability

00:23:06.810 --> 00:23:11.380
that folks have and the people that I manage now are audit practices for four

00:23:11.380 --> 00:23:13.530
and a half billion dollar audit practice here in the U.S.

00:23:13.530 --> 00:23:16.860
So you can imagine I've got a pretty, pretty big group of people that I manage.

00:23:17.390 --> 00:23:21.340
I think I can have a conversation with most of them about different types and

00:23:21.340 --> 00:23:25.140
at least have the empathy with most people with whatever challenge they may

00:23:25.140 --> 00:23:30.460
be encountering. So I can come into those conversations with empathy and I think with some humility.

00:23:31.020 --> 00:23:33.330
And that has, I think, shaped the leader that I am.

00:23:34.910 --> 00:23:40.000
One of the things that keeps people with MS in the workplace is accommodation.

00:23:40.600 --> 00:23:44.570
What accommodations have made the biggest difference in protecting your energy

00:23:44.570 --> 00:23:48.300
and health while allowing you to continue to deliver at such a high level?

00:23:49.190 --> 00:23:54.060
Flexibility. So definitely flexibility in my career. Our job is demanding,

00:23:54.210 --> 00:23:58.150
but can I take time off during the day? If I have a doctor's appointment, yes.

00:23:58.550 --> 00:24:02.610
Can I sleep in if I'm having a rough morning and still manage the calendar? Yes, I can.

00:24:02.630 --> 00:24:06.020
And as long as the work gets done, yes, I might be working into the evening.

00:24:06.020 --> 00:24:08.350
I'm more of an evening person than a morning person.

00:24:08.770 --> 00:24:11.840
So that accommodation is important. Obviously, going through,

00:24:11.840 --> 00:24:15.580
I mentioned that most trouble I had with my MS was during my childbearing years.

00:24:15.580 --> 00:24:19.820
So I had maternity leaves to manage through as well as needing to take time

00:24:19.820 --> 00:24:23.030
away because of my MS problems during that time, especially.

00:24:23.530 --> 00:24:26.380
And having that ability to have that accommodation at work.

00:24:26.810 --> 00:24:31.090
And then the last thing I'll mention, personally, I do travel a lot for work.

00:24:31.490 --> 00:24:35.400
And this may seem interesting, but I love my four wheel suitcase.

00:24:35.400 --> 00:24:39.760
So it is my walker in disguise as I'm going through the airport and I don't

00:24:39.760 --> 00:24:43.440
let anybody help me with my luggage. So I definitely am using my suitcase as

00:24:43.440 --> 00:24:46.900
my walker in disguise. So those are the types of things that help me.

00:24:47.310 --> 00:24:51.520
But on a more broad basis, one of the things when I first started our disability

00:24:51.520 --> 00:24:55.500
network at KPMG, which we now call AIM, which stands for Abilities in Motion.

00:24:56.450 --> 00:25:00.660
My strategic plan for starting that was, I call them the two A's,

00:25:00.660 --> 00:25:02.410
so accommodations and awareness.

00:25:02.410 --> 00:25:07.180
So awareness is big. We just talked about that, making sure the stigma of talking

00:25:07.180 --> 00:25:12.130
about having MS was not something people faced as much. And we had an open and caring environment.

00:25:12.610 --> 00:25:17.050
But accommodations was the other one. So I did establish a reasonable accommodations process.

00:25:17.050 --> 00:25:20.350
So anybody that needed an accommodation work, whether it was a different type

00:25:20.540 --> 00:25:24.620
of computer, whether it was a large screen for visual impairments,

00:25:24.620 --> 00:25:26.260
It's anything they could just go

00:25:26.810 --> 00:25:30.800
click the button, no questions asked, anonymous, if it was any kind of technology

00:25:30.800 --> 00:25:32.080
thing that could support them.

00:25:32.620 --> 00:25:36.320
If it was more personalized, whether you need to go on a part-time work arrangement

00:25:36.320 --> 00:25:40.740
or things of that nature, there was a process to easily go request that and

00:25:40.740 --> 00:25:42.080
work with somebody that can help you.

00:25:42.080 --> 00:25:46.050
So I am pretty proud that we got that process in place. It's still in process

00:25:46.050 --> 00:25:49.910
today at KPMG. They had some modifications and enhancements along the way,

00:25:50.360 --> 00:25:53.720
but it started with our AIM group back in the late 2000s.

00:25:55.150 --> 00:25:58.800
I think you've already started to answer my next question. I was curious about

00:25:58.800 --> 00:26:03.820
how your lived experience has influenced how you view inclusive culture,

00:26:04.180 --> 00:26:08.060
disability representation, and employee support at KPMG.

00:26:09.600 --> 00:26:13.310
I think it has influenced it. And being a woman, too, that's another diversity

00:26:13.310 --> 00:26:15.580
component, for sure. And how it helped.

00:26:15.980 --> 00:26:20.100
In fact, where I am today is I'm in our Denver office visiting with a lot of

00:26:20.100 --> 00:26:24.370
the ladies here in Denver and just had this conversation from a female perspective.

00:26:24.800 --> 00:26:30.010
So I think it is important to lead by example and tell my story about having

00:26:30.010 --> 00:26:34.870
two daughters and balancing those demands in the workplace, balancing the demands

00:26:34.870 --> 00:26:36.420
in the workplace of having MS,

00:26:36.920 --> 00:26:40.010
I do think has contributed to a welcoming culture at KPMG.

00:26:41.210 --> 00:26:46.440
And I do love my job. I'm not just saying that I'm surrounded by wonderful bosses,

00:26:46.440 --> 00:26:49.890
wonderful peers, wonderful subordinates, wonderful clients.

00:26:50.210 --> 00:26:54.700
So together with all of that, I feel very blessed. And as I mentioned clients,

00:26:54.700 --> 00:26:58.020
I've seen companies that are very good at that and had great culture around

00:26:58.020 --> 00:26:59.990
that openness, and I've seen some that aren't.

00:26:59.990 --> 00:27:05.070
So I think for those of you listening today that do have MS and are thinking

00:27:05.070 --> 00:27:10.640
about disclosure, when you're ready, be that advocate and help create that culture at your workplace.

00:27:10.640 --> 00:27:14.900
Because I do think those welcome opening cultures like that can contribute to

00:27:14.900 --> 00:27:16.150
really successful companies.

00:27:16.970 --> 00:27:21.740
Resilience can sometimes be defined as simply pushing through.

00:27:22.380 --> 00:27:27.140
Has your definition of resilience changed over the years as you've managed a

00:27:27.140 --> 00:27:31.250
progressive chronic condition alongside high stakes responsibilities?

00:27:32.210 --> 00:27:36.480
I'm sure it's been enhanced over time because obviously my role has changed

00:27:36.480 --> 00:27:37.910
and I've continued to have increased

00:27:37.910 --> 00:27:41.890
responsibilities, but I think that my approach to it hasn't changed.

00:27:43.150 --> 00:27:46.410
I am somebody that always looks through the windshield, not the rearview mirror.

00:27:46.410 --> 00:27:51.160
There's going to be hurdles in life and definitely in life with managing MS

00:27:51.670 --> 00:27:55.930
or any other type of disease. So I try to look out the windshield.

00:27:55.930 --> 00:27:58.560
Don't look out the rearview mirror. Don't second guess what's happened in the

00:27:58.560 --> 00:28:01.390
past. There's lots of uncertainty that comes with MS.

00:28:01.970 --> 00:28:07.140
So I try to not focus on what I can't control and instead focus on what I can control.

00:28:07.980 --> 00:28:12.680
And I do think, I'll use the analogy of the cat with nine lives.

00:28:12.680 --> 00:28:16.420
I do feel like I'm the cat with nine lives because I have continued to hit those

00:28:16.790 --> 00:28:18.580
speed bumps and always overcome them.

00:28:18.590 --> 00:28:23.110
And I think it has made me a stronger person with every speed bump that I've hit.

00:28:23.490 --> 00:28:27.330
So I guess I would tell you resilience is important and it's not just one of

00:28:27.330 --> 00:28:30.270
those keep on keeping on, but learn from those experiences.

00:28:31.360 --> 00:28:33.610
But don't focus on looking in that rearview mirror either.

00:28:34.630 --> 00:28:42.110
I think so much of our conversation can be classified as great advice for someone who's been diagnosed.

00:28:42.500 --> 00:28:46.770
Do you have any specific advice to give to a professional who's been newly diagnosed

00:28:46.770 --> 00:28:52.210
with MS, who's listening to this conversation, feeling a little terrified about

00:28:52.210 --> 00:28:55.020
what it means for their career trajectory today?

00:28:55.510 --> 00:28:58.930
I would say positive attitude is probably the best way to look at it.

00:28:58.930 --> 00:29:03.180
And I know that is so hard to say when you're faced with that kind of message.

00:29:03.650 --> 00:29:09.850
But I know there was many and there still is days of tears but at the beginning

00:29:09.850 --> 00:29:13.250
there was a lot of days of tears and thinking the world had come to an end but

00:29:13.660 --> 00:29:17.660
surround yourself with people you trust that you can talk to whether it's through

00:29:17.660 --> 00:29:21.070
the MS Society whether it's listening to some of these podcasts whether it's

00:29:21.480 --> 00:29:23.970
someone you trust at work with family and friends

00:29:24.400 --> 00:29:29.400
but getting folks around you that can help you think through it MS is different

00:29:29.400 --> 00:29:33.560
for everybody and I think that's something And I try to make sure people understand.

00:29:33.560 --> 00:29:36.450
I think I do have people at my work that look at me and they're like,

00:29:36.450 --> 00:29:41.080
she's the national managing partner. She flies around the countries in different

00:29:41.080 --> 00:29:44.980
places all the time, has a hard job. She has MS. She can't have MS. What does that mean?

00:29:45.560 --> 00:29:48.600
There's a lot behind the covers. And I think a lot of people with MS,

00:29:48.600 --> 00:29:52.570
you know, there's a lot behind the covers, right? Take on that challenge.

00:29:52.570 --> 00:29:55.070
Tell your story to the extent you're comfortable doing it.

00:29:55.650 --> 00:29:59.490
And know that those challenges are going to come, but surround yourself with

00:29:59.490 --> 00:30:03.820
love and people that can help you along the way, which has been my strategy.

00:30:04.240 --> 00:30:08.380
Don't compare yourself to just the person next to you that has MS or someone

00:30:08.380 --> 00:30:11.860
else you know that has MS because it is different in every circumstance and

00:30:11.860 --> 00:30:15.670
help those around you that have MS. That's one thing that's been really good for me.

00:30:16.170 --> 00:30:20.510
I served on the MS Society chapter boards. I served on the National Board and

00:30:20.770 --> 00:30:25.060
I loved all those experiences because I was surrounded by people that had MS

00:30:25.060 --> 00:30:28.160
or had loved ones with MS. And so we helped each other.

00:30:28.760 --> 00:30:32.810
So just relationships and networks, I think would be my takeaway to everybody.

00:30:33.760 --> 00:30:38.550
For corporate leaders and managers who want to support employees managing chronic

00:30:38.550 --> 00:30:44.050
or invisible illnesses, do you see something that they typically get wrong?

00:30:44.200 --> 00:30:48.010
And if you do, what should they be thinking of instead?

00:30:49.020 --> 00:30:52.370
I pull up on my own experiences there. So the things I think they get wrong

00:30:52.370 --> 00:30:57.450
is even the best intention people can say things that are just weird,

00:30:57.450 --> 00:30:59.480
right? Or maybe less empowering to you.

00:30:59.960 --> 00:31:03.600
So I think just being able to have that conversation with them,

00:31:03.920 --> 00:31:08.400
I want to be the person that decides what I'm able to do versus having someone

00:31:08.400 --> 00:31:11.630
else tell me, oh, Dana, I don't think you should do that. I don't know if you're up for it.

00:31:12.120 --> 00:31:15.670
So that's something I always felt like I was challenged with throughout my career.

00:31:16.080 --> 00:31:19.370
So even if they're well-intentioned and think they're helping you by not putting

00:31:19.370 --> 00:31:25.780
you up for that difficult responsibility, challenge them. Say, I want to try to do this.

00:31:26.140 --> 00:31:30.110
So I do think even the best intention people can maybe put some limits on you.

00:31:30.110 --> 00:31:34.790
So be your own advocate, be your own voice, and speak up if you feel you want

00:31:34.790 --> 00:31:36.870
to take on that challenge and want to give it a shot.

00:31:38.080 --> 00:31:41.700
You know, I started our conversation by asking you what went through your mind

00:31:41.700 --> 00:31:43.330
when you were first diagnosed.

00:31:44.010 --> 00:31:48.210
Looking back at your career path to date and your MS journey,

00:31:48.950 --> 00:31:53.640
what would you say is the single most valuable lesson you wish you could share

00:31:53.640 --> 00:31:58.000
with your younger self back on that day you received your MS diagnosis?

00:31:58.770 --> 00:32:00.210
Oh, that's hard. I think.

00:32:01.960 --> 00:32:04.660
Luckily, I've been able to pivot it and think about it along the way,

00:32:04.660 --> 00:32:10.920
right? But when I go back to the day, then it was such an awful situation when

00:32:10.920 --> 00:32:13.000
you realize what you're faced against.

00:32:13.560 --> 00:32:17.020
I think it goes back to that power of positivity, look out the windshield,

00:32:17.020 --> 00:32:18.040
not the rearview mirror.

00:32:18.500 --> 00:32:22.130
And so I think I've been pretty fortunate to handle it okay along the way.

00:32:22.630 --> 00:32:26.260
But I think I just would have tried to empower myself. I think back then I was

00:32:26.990 --> 00:32:29.560
so unempowered and so nervous and so worried.

00:32:29.970 --> 00:32:33.360
I still have a lot of that today. I still don't know what tomorrow brings.

00:32:33.360 --> 00:32:34.520
That's why I live every day.

00:32:34.840 --> 00:32:38.570
Enjoy as much as you can every day and go do that one thing that you're excited

00:32:38.570 --> 00:32:42.870
about doing. Don't put it off like a lot of us tend to do if you have the ability to go do it.

00:32:43.340 --> 00:32:46.480
So I think it'd be something along those lines, Sean, if I would just try to

00:32:47.000 --> 00:32:52.060
make myself know that it's okay and empower myself a little more and not worry

00:32:52.060 --> 00:32:54.270
about the unpredictability and things you can't control.

00:32:54.870 --> 00:32:58.600
Dana Foote, I want to thank you for sharing your story and being an inspiration

00:32:58.600 --> 00:33:01.240
to other professionals who are living with MS.

00:33:01.240 --> 00:33:05.960
But I think so much of what you have shared with us today really extends way

00:33:05.960 --> 00:33:10.470
beyond the workplace into everyone's life. Thanks so much for talking with me.

00:33:11.270 --> 00:33:11.950
Thank you, Jon.

00:33:12.910 --> 00:33:17.460
That's going to wrap up this episode of Real Talk MS. Real Talk MS is powered

00:33:17.460 --> 00:33:19.220
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00:33:19.610 --> 00:33:23.660
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00:33:39.350 --> 00:33:44.380
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The app will automatically download the latest episode of Real Talk MS.

00:33:51.550 --> 00:33:55.790
You'll be able to download and listen to past episodes. You'll be able to save

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your favorite episodes.

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And what I'm particularly excited about is that I'll be able to share all kinds

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of bonus content with you, and that content will only be available on the app.

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So I hope you'll take a minute to visit the Apple App Store or the Google Play

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Store and download the free Real Talk MS app, and you'll find those links in

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today's show notes or at realtalkms.com.

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Jan Janisch Hanzlik was the first person to have received CAR-T cell therapy

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in a clinical trial measuring the safety and efficacy of this potential treatment for MS.

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Now, in CAR T cell therapy, blood is taken from the patient or a healthy donor,

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much as you would facilitate a blood donation.

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This blood is sent to a lab where the white blood cells, or T cells,

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are separated out and reprogrammed to carry a receptor designed to fight a particular condition.

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Now, this receptor is known as a chimeric antigen receptor, or CAR.

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Over the course of several weeks in the lab, these fortified T-cells multiply

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until there are millions of them, and then they're reintroduced to the patient

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through an intravenous infusion.

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We met Jan last year in episode 424 of Real Talk MS when she gave us a first-hand

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report on how she was responding to this new treatment.

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During that conversation, Jan promised to come back and share an update on how

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she was responding to CAR-T cell therapy one year later.

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Now, some of you may also recall that just a couple of months ago,

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two major clinical trials for CAR T-cell therapy in MS were paused after three

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trial participants died.

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Jan has some thoughts about those developments as well.

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I hope you're planning to join me next week when Jan Janisch Hanzlik returns

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to the podcast for a conversation you won't want to miss.

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I'm Jon Strum. Thanks for listening. Stay safe and make healthy choices.