Chronic Illness and the Dilemma of Choice

About a decade ago, I had a massive liver tumor removed. My PT found it, and before I knew it, the surgery was scheduled for the next week.

By: Mariska Breland ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎

A student later asked me if I learned anything from that experience. At first, I thought, “Nope.” But then I realized: I did learn something. And it’s something that’s become even more obvious since my MS diagnosis.

The worst part of living with a chronic condition isn’t always the symptoms — it’s the endless, exhausting dilemma of choice.

Since being diagnosed with MS over 22 years ago, I’ve had to make more decisions than I ever imagined. Should I start a medication? Which one? Should I treat this symptom or wait it out? Are the side effects worth the risk? Should I try a new diet or supplement? Which brands are best? Who should be on my medical team? When a new drug hits the market, should I consider it?

Every day, there are more choices: Is my leg feeling good enough for a walk? How far should I go before I risk making things worse? Should I do rehab today, or does my body need rest? Should I take a nap or push through?

Living with a neurological disease is exhausting — not just because of the physical symptoms, but because of the constant mental gymnastics of decision-making. 

Honestly, I’d rather have a liver lobectomy a dozen times over. That choice was easy: the tumor had to come out. There was no other option.

With MS and other chronic conditions, the options are endless — and so is the pressure to make the “right” choice. It’s overwhelming, and it’s easy to feel like you’re always second-guessing yourself.

But here’s the thing: your suggestions and information are always welcome. I’m always trying to learn more about working with neurological conditions, and I value the wisdom of others. That said, sometimes all the advice adds to the dilemma — because now there are even more choices to consider!

If you’re feeling overwhelmed by the choices that come with MS or another neurological condition, you’re not alone. For more tips on navigating life with MS, check out our MS Master Plan.

For more on decision-making and chronic illness, visit the National MS Society: Living with MS.

Mariska Breland is a prominent Pilates instructor and advocate for those living with neurological conditions. She was diagnosed with multiple sclerosis in 2002 and became a Nationally Certified Pilates teacher shortly afterwards. She is also a breast cancer survivor. Mariska channeled her experiences into creating transformative solutions for teachers and patients. She is notable for her neuro-based workshops, inventing the Fuse Ladder fitness apparatus, and her popular classes on Pilates Anytime. Mariska's current focus is brain-based fitness training and lifestyle guidance for patients and education for providers. She provides resources and strategies for living with neurological conditions through The Neuro Studio.

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