Episode 6: Multiple Sclerosis – MS [100 Meters]

Hola my name is AJ, mia Harry, they’ll understand why soon. We are Be Physiology and welcome to Unaware, our official podcast series this is series one, which is titled Be Reel and Harry is going to be so dearly kind and explain to all of you why we’ve called it Be Reel. Be Reel with two e’s reel as in a film reel, because we are analyzing particular characters, situations, and events from movies and relaying them to our professional lives and see if they check out. We’re exercise physiologists, we work with a lot of people with disabilities and we’re looking into the representation of those disabilities in movies. Well said, well said. 

We’re not film critics, we are not philosophers, we don’t know everything but we do come at this with a unique perspective having worked with disability in our fields. Harry, you want to finish this one? Look, we are here to learn, as much as you know people listening we’re trying to grow as EP’s. To bring to our practice but also our everyday lives and if you know we’re going to say something that you might not agree with or it could be confronting or whatever. But I guess that’s just part of the conversation and being part of that conversation is also encouraged. 

So you know comment, drop a like all that stuff it’s very much a virtual dialogue, please reach out for comments. Support as well as we greatly appreciate it. We should put out a spoiler alert as well. We do cover a particular film in each episode we’ll get to which one we’re covering in a moment. But yes we will probably say some things that will go on to spoil the movie so we’ll try our best not to we’ll try not to spoil any endings, but if we do no angry letters. 

Anyway, today we will be covering a movie called 100 Meters which we watched on Netflix, the official sponsor of the Be Physiology podcast. 100 Meters is based on a true story so it’s about a Spanish man, so the film is in Spanish. The Spaniard (I think they like being called Spaniard) man who has been diagnosed with MS and then obviously the title 100 Meters means something. 

So at some point in the film, he’s essentially advised or spoken to as if he’s never going to walk more than 100 meters again. Then he flips it on him and endeavours to complete an ironman. We all know how incredible ironmans are just off the title alone but to get specific about 3.8 kilometres of swimming, 180 kilometres of a cycle, and 42 kilometres of running so pretty intense physical journey. I could do one half of one of those I reckon, swimming right at the top is just like that’s impossible! I’m a sinker! I think I’m going down 800 meters.

Alrighty man so kicking things off the movie starts with him realizing there’s something maybe something a little bit wrong. I think the tingling sensation in his fingers is the first type of thing he feels. He’s unable to tie his shoe, that’s what it is! Tying up his shoes before going into his father-in-law’s house who is going through a traumatic time himself. But he’s starting to lose his fine motor control and that’s the first instance. Before we sort of jump in any further because something that we do bring up with every other episode that we’ve done is the representation of the disability itself and whether or not the actor playing the character has this particular disability. 

Dani Rovera plays Ramon who is the main character of this film, he doesn’t have ms. I was thinking about this and how tricky it would be for somebody with MS to play the journey of MS in a film because of the way that the symptoms present and how up and down it can be, which we’ll go into. This is probably one film where you almost can’t blame the producers for going that route. I mean yes and no, it’s all about its compromise in the end so if a filmmaker wants to take that compromise it’s possible. 

You’re right, it’s very difficult. Fatigue’s a huge factor and we’ll go into more of that later on. But should we go into a little bit of what MS is just off the top of the bat? So MS is a demyelinating autoimmune degenerative disorder and what that means is in the central nervous system some nerves are wrapped by myelin sheaths. Essentially they talk about it in the film, the doctor describes MS pretty well and says cabling without the rubber insulation. Without that rubber insulation you know if it you know, it’s just not conducive to whatever helps to propagate or speed the nerve signal. If the damage is big enough sometimes the signal just won’t make it to its destination. It’s realistically dependent on the degradation of this spinal cord because it affects the spinal cord, the brain, and the eyes as the eye stem (I forget) optic nerve sorry. So all those things can be affected which essentially means that any kind of muscular or sensory disruption can happen. 

Yes, it’s so variable in terms of the broadness of what can happen. Some people will lose their sight, some people will have alterations in their sight, some people will lose their feeling in their left hand, some people will lose the ability to move their right foot. It’s just so up in the air. There’s a line in the movie that puts that into perspective very quickly and that is ‘we have no idea what will happen and we have no idea when it will happen. It’s what the doctor says to Rahman when he’s initially being given his diagnosis and that typifies MS I think in any instance. You have no idea how it will come about and there is a very interesting way that it’s described in the movie as well. 

This is jumping ahead a little bit but seeing as we’re on the topic it’s described as this is a many-faced disease, is this what you’re getting at. There’s the guy in the treatment room and he said that oh so every time, oh yes, no no, the main guy says ‘every time that my foot itches or something I’m afraid my heart’s going to stop’. So it’s just like tiny little things like that just could be the end. There’s also another one guys, it points out how insidious the disease is. It just looMS over you like a shadow and you one day might think you’re getting better and everything’s all right but the disease is still there. It’s always there, it’s sitting and waiting. Even this having that you couldn’t imagine the mental strain that would put, the anger that would have not known but I guess some common effects to the body (so I said before) motor and sensory disturbances, visual disturbances, fatigue is a huge thing as well. Any kind of neuropsychological changes as well some people’s personality can change a bit and thermosensitivity are like the big ones. Not being able to regulate your heat very well I’m sure we’ll touch on that throughout the rest of the podcast as well because that will play a big part in what we think of or where the film goes. It’s also worth mentioning that there are different types of ms. 

There are four types so there is a primary progressive which is essentially just an upward slope of symptoms, there’s relapse remitting which is you’ll have these peaks where you relapse so I’d like to think of it as a downward slope. I know all the graphs seem to go up but in terms of your function, you’ll have a big drop in your function and then that’s the relapse. Then it’ll remit up but not up to the place where it relapsed from. Get halfway up the relapse and then plateau out again and then all of a sudden relapse and then come up and then plateau out again, that’s the most common one as well. About ninety per cent of people and I don’t know if it’s ever said in the film but based on how the film plays out I assume that relapse is remitting you. I think it is. 

There is also secondary progressive which is the merging of those two things where you basically start relapse permitting and then eventually there is just this continued degradation of function. Then finally there are progressive relapses, so you were talking about how we relapse and then we come back up and then plateau, with progressive relapsing you relapse you come back up and then you steadily keeps declining and then you relapse again so that’s the rarest and probably the most severe case I guess. 

Regardless, I mean we (I was about to say the symptoms are the same but that’s not true) just said how variable the possible symptoms are. Yes, but the possible symptoms are exactly the same. The way that they typify is essentially how they progress with respect to breaking down the body or degrading physical function or sensory functioning. So when in the movie the big thing that I noticed is that it kind of went through these stages. He would lose his fine motor at the start then he would have some visual disturbances, like blurry vision. Then he talked about how he woke up and he couldn’t taste normally and that was a sign of that relapse. Then it kind of moved on to larger muscles that he couldn’t innovate properly. But as time goes on through the movie, we’ve watched a few filMS now that obviously disability is almost its own theme in a lot of these films. I’m starting to see a theme in the way that these filMS are played out and usually the first you know it’s very quick with the way that a movie introduces a disability and tries to showcase what the disability is and how it presents. 

But I thought that this film did a really good job of showing the continued progression of MS but also the stages of how it initially comes to be and then starts to manifest in the body. I mean they even go through the diagnosis like you said when the doctor speaks in the film to Ramone and she explains it that information is like it’s easy to take in and then going through the diagnosis you see Ramon go for an MRI which is where they would be looking for lesions. Which is essentially the breakdown of those myelin sheets that Harry was talking about earlier. I didn’t know there’s, right after that you see Ramon has these goggles on, I had to look this up to find out what this was. 

Did you? Is it like a sensory deprivation thing? It’s called an evoked potential test so it measures the speed of neural messages. I think it’s sensory input so I think there will be some sort of trigger like a stimulus, whether it be something down in the lower end of the body or through your eyes and then they measure how long it takes for you to respond to that. So when I looked at that I was just like what is this really cool piece I was like goggles, cool swimming already training. There was the spinal fluid which I thought was an injection but more likely is actually like taking out some of the spinal fluid to measure for like antibodies and testing and stuff like that to see whether or not there are like these biomarkers that are typical of ms. Because this is all in the initial stages so this goes through at the start of the film but in looking at that evoked potential test and what was going on with the spinal fluid. I realize that the way that MS is diagnosed is essentially through differential diagnosis. They essentially try to rule out other conditions so from what I read there isn’t necessarily a marker that determines whether or not somebody has. There are no levels in the blood. You will have scarring on your brain but that a lot of people can have scarring on their brain or small lesions and scarring in the brain and that doesn’t mean they have ms. Some antibodies break down the myelin sheath so I think that that’s what they look for in that spinal fluid. But outside of that, I think initially they’re just trying to rule out other things. So I thought that was interesting. I didn’t know that that’s the process. 

No, that’s cool. It’s always interesting to see those little things especially the sensory tests and things like that similar to spinal cord injuries with the tactile testing and everything. With a sharp and soft touch and everything, it’s always very interesting to see how they classify and diagnose someone. I guess they did a pretty good job of that in this film. They say right at the back of that, that according to your report or the doctor says to Ramone according to your report you shouldn’t be able to walk which I was thinking. I wonder what they see in that report because we’re not GP so it’s not necessarily our job to understand right off the bat what she means by that. I mean I was sort of thinking is she looking at neural lesions or is she looking at the biomarkers? I have no idea, in my experience I think it has to have something to do with the actual. Because essentially you have a nice smooth beautiful sheath around a nerve and then when there’s a degradation of that nerve there’s holes and strips and cuts and transverse pull-offs that happen to the myelin sheath. If there is no myelin sheath below a certain level, if there’s nowhere for the message you can get conducted down then theoretically you shouldn’t be able to send a message down past that lesion so maybe you had a very severe area like his lumbar region where he had a lot of demyelination. They were usually if in this situation you people can’t walk, so I think and I think that might be my guess but unto me, I’m going to give you 100 back in there. 

They also talked about how they’re like okay we’ve got to get you in for injections straight away. So injections are a thing of the past. Recently there’s been (can I cut you off for a second before you go in) because I know these I remember even when I was doing practicum which was your work and there was a client with ms. There was a word that she used that said it’s like a jungle juice sort of, maybe like a cocktail or something. Something like that for this medication that they were using, is this part of the injection? Or is that something completely different? Because she was talking about how that’s something that they were (I think it was definitely) part of a treatment. 

I think the treatment was purely injections back in the day or just insane the last 10 years or something but in the last few years, a lot of it’s now being able to take just tablets. You can take tablets so you don’t have to inject yourself every day so that’s what’s happening when he’s lying down on the bed at one stage and his wife just out of nowhere he’s like pop adrenaline this guy diabetic dude. His body rejects the first phase of injections because he goes back out. I’m pretty sure he’s the one where he tries to walk across the road and he just stops and he forgets how to walk across the road. I don’t know how because it’s so variable. I’m gonna have to agree with it but I don’t know how accurate that would be in terms of if you’re just forgetting how to walk in the middle of the moment unless he was just trying to soldier through it or whatever. If you forget how to walk a lot of the time you’ll forget how to stand as well and there’s one big gripe I have with the movie would be not talking about falling very much at all. There aren’t any falls in the movie. 

There’s one in the triathlon but I mean people fall over in triathlons all the time but it’s a factor in the movie that so many people do die from falls every year. It’s the leading cause of death in elderly people. I think it’s the leading cause of death, period. Is falling breaking your hip I think once you fracture a hip bone I don’t know if it’s the hip specifically but I think once you get over the age of I’m throwing the stud out there I’m half right in some way but over a certain age once you fracture your life expectancy goes within 12 months. It’s very significant. It’s very serious, my grandfather is 91 years old and he’s still climbing up on chairs and ladders and I think he’s slowed down a little bit but it’s always very scary to think that he’s confident about his hips. No issues turn around he’s shimming up a tree or something like that but you know that’s just him that’s what he does. 

No, the movie really touches on the fact that he’s not falling, he’s just getting stuck in these positions and maybe he’s on the ground that he can’t get up. That’s the other way. That’s right, later on in the movie so I just thought that was something to definitely touch on and i’ll bring it back up at the end. It’s important to know that falls are a huge part especially confidence because if you fall over you know the people that i’ve worked with in the past the amount of times that i’ve had people call me up and say Harry I can’t come in today I had a fall yesterday and my whole thigh is bruised and I can’t walk properly anymore. As soon as they can’t walk properly because of that huge bruise they’re being more sedentary and then the tumbling effect starts to happen and then you won’t see them for two months, then they get back and the condition has worsened by a good amount already. It’s the falls man, the falls need to be a little bit more to the forefront. I know he’s relatively young, he’s 35 in the movie but he’s still a tall man. It’s a long way to go down so a tall man with big ambitions. You’re right you’re damn right if you wanted to fall he’s going about it the right way I guess in terms of starting that training off. 

You’re right I also noticed when they went to the hospital, he’s getting introduced to the treatment rooms and they have all the tilt tables and standing frames and hoists. There’s a plethora of things as it looks like there’s almost two rooms. The first room that you walk through and there’s an ambulance team when I first saw there was the ambition I thought whoa and then he continues through when there’s this other smaller room the rehab section or whatever and they had a rewalk or a mechanized treadmill walking machine. You kind of strap yourself into these things, hit go and the legs mechanically walk at the speed of the treadmill so you get all that good weight down through your bones. You’re trying to teach yourself to initiate those steps again, take the weight through your legs and everything that comes with gait training. It was cool to see that they actually kind of showcased what some of those machines and bits of technology look like. They kind of have all the gizmos and gadgets set like everything that you might expect to see was showcased in the room. I wonder if they went into? I think I went to a local called method acting ladies and gentlemen method producer. Well done, actually something you were talking about before as well which is the way that you don’t really forget how to walk in the middle of the street. That does come up in the film where I think he’s going to pick up a mug in front of his father-in-law and he’s explaining that he’s essentially got to tell his arm to move to then tell his fingers to grip to then pick out the mug. The father-in-law who at this stage they don’t have the greatest of relationships so why don’t you just tell your brain to pick out the mug? That goes a long way to help you understand that people don’t understand about the disease. This movie essentially is and I think they did a really good job. It’s a tribute to help you understand what the disease is and how it can affect you in your personal and your professional life as well. I think out of all the movies that we have done I think this movie actually did the best job at really pinning or trying to showcase that Understanding something is the important thing. 

If everyone on this planet was to watch that movie we’d all have a better understanding of someone with multiple sclerosis. That’s all sad I think they make a point of talking about that at the end of the movie in terms of it’s dedicated to that particular principle and it’s actually a true story. Right at the end so you don’t know the whole time and then right at the end it starts showing glimpses of actual footage of Ramon and Inmar and the father’s name is Manolo. He’s a great character by the way and acted well. It was good he was great so it’s a true story as well which is greatly impactful because you don’t know until the very end. Then you start thinking back, you think wow I knew it was a true story but only because we’d looked it up previously or maybe I’d looked it up. Someone’s behind on their homework. No, that’s interesting we both would have had two different perspectives because the whole time I’m sitting there thinking wow this is pretty crazy this happened down and then my record right here blown away. The curtains get pulled back and I thought oh my god so as he’s moving through his progression of the disease he’s also moving through his training with his father-in-law. Used to be a PE teacher and started training him on how to become fit enough for iron man. Very Mr Miyagi, that’s my mind there’s some wax on wax off definitely and I love it. I actually made a note of this where it’s initially his training starts in gardening but there is so much specificity around what you might do while gardening in terms of trying to build up your physical capacity. 

Because I think they show him scattering seeds which is a very fine motor skill so that in itself would be really important for somebody who’s obviously losing that sensory innovation or that physical innovation. Then there’s using the pickaxe which is a much larger movement or a gross motor skill which again is super applicable. I think he does a blind touch test at some point putting his hands into the back flower and stuff and he’s trying to guess the sensory. There’s a touching moment I think we won’t spoil that for you but there’s a nice moment in that it’s funny coming from yourself saying that this type of training method actually has a place in someone’s rehabilitation in a way. Because you’re right, there’s a lot of movements there’s a lot of things that he’s doing right at the start that is super applicable to being able to function. It’s activities of daily living is what he’s working on and he’s I guess he’s just trying to build up that base strength and try and get to a level again where perhaps then he can focus more on the running because he wasn’t running at this point. No definitely wasn’t on a bike or swimming either. We look at it from the perspective of being an EP, so we are pretty exercise specific when we can be and we’re huge on specificity. But it’s funny because I agree with you that even him toiling away on the Mr Miyagi stuff in the backyard, in my eyes I’m thinking it’s good it’s still good if you wanted to. Our point is the karate kid was a great movie, I still can’t do that kick properly.

But those little things it’s better than not doing anything that’s for damn sure. You can pay heaps of money and pay someone to formulate a specific program for you which probably would be a little bit better. But as long as you commit to something as long as you commit to being active and moving as much as you possibly can in that situation it’s all gravy. You’re providing yourself a benefit. 

I want to touch back on this, because we sort of moved on. It’s probably my fault for moving on with the conversation anyway. When you were talking about the medications and what not because there’s a point made later in the film where I think she says to the doctor’s ‘have there been any warnings lately?’ He says ‘no’ and then she said ‘that’s good that means that the drugs are working’. Then when he eventually has a relapse they immediately change the medications. 

Now, I didn’t know anything about how this works and I’m not trying to put you on the spot here, but is that a warning something that you’ve ever come across in your work? A warning so from my experiences people have reported to me that they know that there’s one coming so damn they can feel it’s an internal intrinsic feeling. You notice it could be tingling in your foot or something like that but there’s also an internal feeling that obviously I can’t describe to you because I’ve never felt it and trying to get the information out of people is I think it’s very hard for them to describe themselves. But it’s like a run-down fatiguing type feeling and you have that enough times in a row if you’ve relapsed three four times. If you feel that you’re straight away gonna okay it’s happening again. I wonder if you know the answer or if anybody listening knows the answer if you get enough awareness about your own condition to recognize a warning? In the film at least they respond by changing medications once he has a relapse. I wonder if changing medications at the first warning do you know of? No I don’t know, I wonder if we’re on here man? I don’t know. I don’t feel as though the injections you know that particular injection or whatever is already kind of in your system and if you’re gonna relapse you’re gonna relapse. I could be 100% wrong though but that’s a very good question maybe man. 

Another thing to point out actually that isn’t really touching the movie is MS is predominantly female affected so the vast majority of people with MS are young females from onset at the age of around 19 to 25 or something like that. There’s not one woman in the whole movie with MS and there’s a few different male characters.

It’s a possibility that his little area where he is predominantly men with it but it’s just not touched on. Yes, I didn’t know that either. That’s pretty interesting. I said that we would come back to this and that is the heat effect or the way or how important body temperature regulation is somebody with ms. This is only amplified when it comes to somebody having the ambitions of running a marathon because anybody that exercises obviously there is a change in internal temperature. Not necessarily a change but a response internally to try and maintain internal body temperature, it’s why we sweat. I was about to say stress if you’re from Queensland and we’re quick to sweat, it’s annoying. But it is a sign of positive adaptation that we have responded to the environment that we live in. We can sweat more quickly to help moderate our body temperatures. Harry said earlier in the podcast that depending on which area the brain is affected by your MS you might actually lose the ability or you will at least or you may just diminish the ability to regulate your own body temperature. 100% and that’s without external factors. So you might just be sitting in a slightly hot room and that could be the difference between exacerbating just slowly climbing up in heat. It’s training, some of the MS is and it’s not really touched on in the movie at all but it’s super, it’s like walking a tightrope because fatigue temperature control and fatigue and temperature control are the big ones. 

They’re not really mentioning the risk of falls; they’re not really mentioned all that much in the movie in terms of the training. He’s just kind of doing the traditional. I’m running now before I was walking but now I’m kind of half jogging and now I’m running. I mean it does look like they’re in a cold environment in terms of where they’re seeing. True, but even then there are definitely moments where he’s sweating quite profusely. It’s bad in my experiences having someone in a session with me has to have icy cold water with them and fans cranked. The fan could be cranking and they’re pedaling and pedaling pedaling drinking water pedaling pedaling pedaling and they can still overheat. But it’s that fine line between how much you can get out of them without then triggering the fatigue response. Because fatigue management’s huge, because then they go home and they’re just completely wiped for the entire day. You’ve just taken a day away. 

The way that the heat affects somebody with MS is temporary, it’s still not ideal. It’s not good, it’s certainly temporary so let’s just do it anyway. It does significant what it actually does, I think is it further slows down the conduction of those nerve signals. That’s right so it seeMS as though they’re having another relapse sometimes. Temporary reach and a lot of people get scared to exercise because that feeling might be that we’re talking about before that might start creeping in again after you exercise a little bit too hard. Then people go whoa whoa whoa I’m relapsing because I’m exercising. But the fact being after thousands of I think just over a thousand studies now on MS and exercise since the 1980s, zero of those articles have mentioned any negative effects on the progression of MS or positive effects. It doesn’t make the depression of the disease whatsoever so it’s like you’re working within those remitting plateauing type areas. 

For Ramon there’s always gates of time that you can work with sometimes. The relapses happen. You can have 20 in a year or you can have one in 10 years. You never know when it’s coming and it’s always waiting and lurking. I guess as that character said but you got to pick those moments right make sure you’re controlling the temperature and keeping it as low as possible. That’s why hit training is really good so you can app you can get them working hard on how to get the heart rate up. Then just sit down, ice them up when I see the water fan on and just blast them with cool and then get back into it and start again. It’s a cycling method and then fatigue then you have to really kind of know the person. Start relatively conservatively because you don’t know what you get you’re in for and then slowly just not shut up until one day they’ll come back to you and say I was pretty exhausted last time. That’s when you go back in your notes, find out exactly the volume of training you did and then just knock that back a little bit. Then see if that works and then if that’s good for the next little while you then ratchet it up a tiny bit more. It’s just like a ball it’s literally a balancing act where you’re getting reports from the person saying too much or no I’m good and you’re just slowly turning it up so it’s it’s a nice breakdown, That was good, it’s an interesting way to train as well because it makes it so specific to your delivery. Because people can work hard at doing a particular exercise so you have to be very clued on to how hard they’re working while they’re doing that sit to stand if you know what I mean. If they’re holding it longer, if their time under tension is a bit more, or if they’re pushing through with a lot of power all these little factors will add up to the overall total. If you go over the fatigue line then you’ve got to reassess. It’s interesting to work with. It’s also very difficult to work with. I was going to say it’s also probably a condition where trust from practitioner to client and client to practitioner is so important. Part of our job is progressive overload and trying to take the next step in training but as Harry just said, you can make a lot of errors with that or you can essentially take a step too far very quickly. Understanding your client and the client understanding themselves and then trying to tiptoe that line. 

It’s important that overtraining definitely is a thing and with a disability and a lot of people that we work with it’s relatively hard to over train because they’re innovation to those muscles they don’t have all the muscle groups to use.To then over train I guess in a way but MS is one that you’ve actually got to be very careful on over training someone more than any other condition. Really I think well when you talk about over training in general that’s just the sustained engagement of a muscle group over and over again to the point where the muscle starts to really break down. Exactly where it’s an MS we’re talking about something that’s acute so we talk about what is essentially a one session’s worth of over training that has that effect immediately. Yes exactly and in terms of fatigue management it’s also really important to note that its mental fatigue is huge for ms. It’s not just physically wearing someone out, it’s you can mentally if you make the task with a lot of variables you can wear that person out way sooner have you ever paired a physical exercise with something cognitive. Reaction tests and things like that even asking quiz questions when they sit down and then get back up and do the exercise again. It’s just like a rolling they’re not just sitting there with no stimulus it’s like you’re adding more on top of it. I wouldn’t really do that with MS a whole lot because they need that shut off they need the brain to turn off because the general anxiety and stress levels when you do have MS way higher than the atypical person. It’s really important to regulate just what you’re getting at them so it makes it even harder again because it’s a physical thing. You’re working on those physical components but then you also have to think just how much the brain is working in those sessions as well. It’s huge for MS to not watch tv whatsoever. Meditation actually is apparently very beneficial to someone with MS in terms of regulating their fatigue. Because it just shuts everything off and it helps those anxiety levels come down so they can actually be at a peaceful state. You’re watching tv and stuff they’re still heightened it’s just no tvs no phones no computers nothing. No stimulus just silence and men I guess that’s why meditation is so good. Well there you go. Another huge consideration to make you don’t think about it all that much until it’s right in front of you and that person is just so fatigued. You’re thinking how did this even happen? 

Well again it’s probably another thing you don’t really see in the film as well where he trains physically harder. The end goal is training for an iron man. It’s full-on and you don’t really see a lot of the mental fatigue. In fact I don’t know it’s never really shown at all there’s obviously an emotional factor that is brought about in the film but that mental weariness or that mental fatigue is I don’t think I don’t remember seeing where it ever comes up. No, if you talk about it it’s quite prominent and you do see it in clients that for sure. I don’t know how to explain it other than man. 

Exactly you’re on it that’s exactly right it’s just an overwhelming thing. From what I understand it’s just so much to deal with and to you it just might look like you’re asking them to do five of those and three of those, but it’s just so much for them to actually think about because the process is different. 

We were talking about it before. It’s not just reaching for the mug and picking it up, it’s telling the arm to extend it’s telling the fingers to grip on and then hold on while you flex back and towards your face. All those little factors thinking about breaking down all the moves that you do in a session. It’s super mentally challenging. 

Then again so it’s there’s a lot of considerations when it comes to actually training someone with MS and you have to do your due diligence before kind of getting in the ring with someone. I think also in the film as well the progression of his condition at least in how it’s portrayed throughout the film is quite quick. You do see people with MS where of course there are the symptoms that will come about if you overwork somebody and whatnot. But if you meet them for four minutes on a good day you’d never pick it. You’d never know about it and that’s a testament to how variable the condition is. 

Exactly right so there are moments in this film where you would think that he’s quiet, he’s running with good technique obviously he’s acting but it is a true story so we can’t call paul dustin anything. It’s true I mean that he did the triathlon. We know that much so it’s just the way that he’s running is that the way he was running or is it different disturbances in his gate and things like that. You’re right it’s because they did a really good job because of the title of the movie as well so 100 Meters because the doctor mentioned at the start you’re not going to be able to walk 100 Meters in a year. Then all that was the emotional trigger that went I have to be an iron man for my son. I’m gonna I no there’s no way I’m not gonna walk 100 Meters. So every day he starts just walking 100 meters he’s got to do he’s 100 meters in the day so it was great that was a great little trigger. I thought at the start that I missed it somewhere in the line I thought they were talking about. That was a spanish activity like guidelines. It was like make sure you do your 100 meters and in Australia it’s 115 minutes of moderate exercise per week. They just do 700 meters in a week not all that much but it came back around but no it was a cool way to do that. For the emotional drive to be an iron man and the fact that it’s obviously a true story is that could have very easily been the real life trigger. 

I’m sure it was in terms of how he was motivated. I mean being motivated to run an ironman in general is extremely difficult. Doing it with MS and dealing with relapses is obviously more difficult and even in the film without giving too much away there is this part of the film where he’s progressing nicely and you’re like this is gonna happen. Then you get a reality check where he has an eventual sort of relapse which takes them almost back to square one. I guess well that’s just the nature of the disease as well it’s just so you never really know what you’re in for. I think that’s what really challenges people, it’s just what if I have MS what’s going to happen to me? You can’t exactly rely on what’s happening to the person next to you so well. Even in the film  they almost sort of hint that he doesn’t quite understand his own condition right at the start. I think there’s a line where he’s like I’ll never feel better than this for the rest of my life. Which he’s talking about his physical function at that point in time. Which isn’t true because he does eventually go through a remission. He has multiple remissions I guess and his function improves. That’s understanding your own condition. I think at that point in the film you obviously don’t. Then it goes to show that you’re very capable of things depending on how the condition wants to mess with you exactly. He was lucky in a sense, I think he had three years without a relapse which is pretty good and in those spaces of times he was doing all that intense training that really prepared his function up. Then of course right at the end the movie says he did have a relapse eventually but the movie’s not about this it’s about this movie’s dedicated to helping us understand what MS is and how it affects people’s lives. 

He also essentially tells his work, he’s in sales or something like that. He’s a marketing guru and essentially the boss goes ‘I’m sorry but if you can run, you can work if you run,if you could if you can run you can work’ and ‘I’m not going to be asked low key to be fired, that’s right give me my severance. Yep, I have MS let me move on. It’s tough enough for me already’. That boss says ‘no, if you can run you can work if you want to quit quit.’ But that boss doesn’t understand what MS is truly like, if you did you’d have to at least think about your answer before just saying it to someone like that. It is a degenerative condition and that’s pretty well wrapped up I think. As I said before I think they did a really good job of helping us understand MS and the factors that go into. Not exactly training because there are a few things they miss in terms of heat sensitivity, fatigue, lack of risk of falls. But definitely the real life kind of hardships that you take and also the progression of the actual disease itself was explained and portrayed pretty well I think. I don’t really have anything else to say other than there was something in my eye at the end of the movie man. That’s a huge thing though because the whole thing is like oh my hand’s a bit itchy and then you’re like oh no is this it? Am I going? It’s a huge thing because when you have MS it’s like that all the time. My nose has been running for two days, am I going to have a relapse? Am I going to lose all this function? But it’s easy to laugh about now but it’s definitely something that is always on the top of someone’s thought process. That’s why anxiety is so high in the population and that’s why there’s a lot of other issues that come along with it. I thought it was a great movie. It was a good movie and if you like subtitles and reading and Spaniards and Spaniards, definitely recommend to go check it out. if you are interested in learning a little bit more about multiple sclerosis actually that’s if you wanted to learn about a condition through film this would be a great film to do that. 100 Meters and they spell it the wrong way with ers at the end dude that I was putting my notes down and I put it the wrong way and then I got the red line.

All right well thanks for joining us everyone, it’s always a great experience sitting down and talking about these things with you. If you want to join in the conversation, please drop a comment, give us a bell, like us on Instagram, all that good stuff and we’ll catch you later. He’s been Harry and he’s been AJ and we’re Be Physiology. What’s up alright thanks guys