My Journey to SPMS and Bahn Mi with Pickled Veggies & Garlic Aioli

blue-and-silver-stetoscope-40568And just like that, I am on a new path with my MS.  I finally have written acknowledgement from my Neurologist that I have transitioned into Secondary Progressive MS (SPMS) from my previous state of Relapsing Remitting MS (RRMS). I’ve known it for awhile now but its finally official.  And while it sounds scary, I actually feel ok with it, I have no idea why, but I do.

Multiple Sclerosis doesn’t look the same for everyone and unfortunately the reality is that MS is progressive in the majority of cases.  Most people, like me are diagnosedphoto-of-person-walking-on-deserted-island-934718 copy initially with RRMS but up to 85% move to SPMS after about 15-20 years of having the disease.  I was diagnosed in 2005, so I am right on track for the transition.  You hear a lot about RRMS, but people seldom talk about SPMS. The transition is usually slow, but generally causes symptoms to get worse overall which can lead to more noticeable symptoms or disability. You can go from having RRMS to SPMS at any time, but the process is gradual and, in most patients, slow. In fact, there’s often a grey zone between RRMS and SPMS when you’re moving into the progressive phase of MS but are still having occasional MS relapses.

I have been struggling though with something new since November of 2019 and the doctors have now put a name to my struggle; Occipital Neuralgia and I will tell you that I woman-in-gray-tank-top-showing-distress-3812745don’t wish it on anyone. The American Association of Neurological Surgeons define Occipital Neuralgia as a condition in which the occipital nerves, (the nerves that run through the scalp), are injured or inflamed. This causes headaches that include continuous severe piercing, aching, burning and throbbing or shock-like pain in the upper neck, back of the head or behind the ears.  The pain generally starts at the base of the head and goes up to the scalp on one or both sides of the head.  Patients often have pain behind the eye of the affected side of the head. Additionally, a movement as light as brushing hair may trigger pain. The pain is often described as migraine-like and some patients may selective-focus-photography-of-woman-with-blonde-hair-2291452also experience symptoms common to migraines and cluster headaches. Occipital neuralgia can be the result of pinched nerves or muscle tightness in the neck. It can also be caused by a head or neck injury. Occipital neuralgia can either be primary or secondary. A secondary condition is associated with an underlying disease, (which is likely my case). Although headaches are a common health problem, occipital neuralgia is a specific type of headache. According to the American Migraine Foundation, it is also rare, affecting only 3.2 people out of every 100,000 a year, lucky me right?!

Thankfully though, just last week (after suffering for more than 4 weeks of constant and unrelenting pain and intermittent pain for 9 months) I had a nerve block shot, and whiletall-trees-with-shade-of-light-69825 it wasn’t pleasant at the time and for 3 days or so following the shot, I can finally say that it is improving!  Thank the lord, because it has been exhausting, emotional and downright miserable. I think I have perfected the art of wearing an ice pack on my head and going through my day in a hazy fog though.

I was raised to be sturdy, strong and reliable but MS has sure tested my resolve at times.  Even with all that has been thrown my way, I feel that I have met my MS head on and although I have days that I struggle, I will continue to meet SPMS the same way I met RRMS.

As of right now, I am not having relapses like I did with RRMS. I have exacerbation of symptoms, but I am no longer recovering from damage. For example, I have numbness concrete-stairs-2606650in my right foot that has not gone away. I occasionally have trouble swallowing and finding my words, I get double vision if I have done too much or become overly tired, I have increasing fatigue, my speech is sometimes slurred, I have dizziness and nerve pain and my gait and mobility have changed, it may sound like a lot, but honestly, I am doing amazing and things could be so much worse.  I have recently started a new medication to help with my walking (and its working great so far, I no longer feel like I am carrying around a 100 lb bag of cement on each leg). The transition to SPMS has allowed me to actually stop taking some of the medications I was taking before, which is a win in my books. I am now managing symptoms rather than actively preventing new damage, although new damage is still a possibility and is something that we will keep an eye on and deal with it should we need to, but for now it’s status quo with no DMD (disease modifying drug).   For me though, the worst thing about a SPMS diagnosis is the unknown about the deterioration and slow decline because there is no idea how to know what will happen and how far the disease will go.

Multiple Sclerosis and chronic pain continue to be unsuspecting and sometimeswhite-printer-paper-with-be-kind-text-on-plants-3972441 (1) unwanted teachers to me. I am determined to continue to survive and thrive by learning to co-exist with my new diagnosis. Life has gotten slower. I am physically slower, some days I need a cane, and some days I can do nothing more than chill, yet there are other days I can handle 9 holes on the golf course or a walk around the block. But I am often reminded to be gentler and kinder to myself. Chronic disease and chronic pain can rob us of the ability to do just that.  Isn’t it funny how the things we can easily show to others are often lost on ourselves?   The best part is that I see my life as amazing, and I am humbled by my blessings. I try to practice optimism, faith, hope and gratitude and there are days I fail, but the point is that every morning when I wake up, I try. 

For me, adaptability is the key, I know that things are going to be different and they’re island-during-golden-hour-and-upcoming-storm-1118873going to keep changing. But I know it will not all change for the worse, and not everything that changes will stay that way.  Although I don’t have control over everything, I do have control over what I put my body through and how I tackle my disease. I know that I’m not always going to handle my changing situation in the best way possible and I apologize ahead of time to my family and friends, but I will continue to do the best I can. I will trust in my experiences and I will trust my doctors.  I will learn from it all and grow stronger through it.  I encourage everyone to do the same – we are all stronger than we think, and we can withstand even the toughest storms in our lives.

In my last post, I promised a recipe and here it is!  Self-Isolation is allowing me to spend more time in my kitchen and more time feeding my soul!  Although this recipe is a bit time consuming, it is one that goes a long way (4 sandwiches the first night and 2 noodle bowls the second night). I hope you enjoy it as much as we did!

Pork Banh Mi Sandwich with Pickled Veggies & Garlic Aioli

These tasty sandwiches will be a favorite for everyone. We used the leftovers as a quick and easy noodle bowl
Prep Time 5 hours
Cook Time 30 minutes
Course Main Course
Servings 4 Sandwiches


Pickled Veggies

  • 1 Large Carrot Shredded
  • 1 Large English Cucumber Peeled and sliced into ribbons (using vegetable peeler)
  • 1/2 Small Onion cut into thin rings
  • 1 Bunch Radishes Thinly Sliced
  • 1/3 Cup Sugar
  • 1/2 Cup Unseasoned Rice Vinegar
  • 1 Tsp Sea Salt
  • 5 or 6 Black Peppercorns
  • 1 Pinch Red Pepper Flakes More or less depending on your spice tolerance

Pork Marinade

  • 1 1/4 Lbs Pork Tenderloin Thinly Sliced (Uncooked)
  • 2 Stalks Lemongrass Or equivalent lemongrass paste to taste
  • 1 Shallot
  • 3 Cloves Garlic
  • 1 Tbsp Sugar
  • 1 Tbsp Honey
  • 2 Tbsp Fish Sauce
  • 2 Tspn Sesame Oil
  • 2 Tbsp Fresh Lime Juice 
  • Zest from 1 lime
  • 1 Tspn Salt
  • 1 Tspn Pepper

Garlic Aioli

  • 1/2 Cup Mayonnaise
  • 3 Cloves Garlic Finely minced (more if you love gralic like I do)
  • 1 Tbsp Fresh Lemon Juice
  • 1 Tbsp Olive OIl Extra Virgin


  • 4 Baguette or 4 crusty buns
  • Cilantro To taste


Pickled Veggies

  • In a heatproof medium bowl, combine the carrot, cucumbers, radish & onion.  In a small saucepan, bring the vinegar,sugar, salt, peppercorns and red pepper flakes to a boil. Reduce the heat and let simmer for 3 minutes, then remove from heat and let cool for 5 minutes.  After 5 minutes, pour over the vegetables and toss to coat.  Cover and refrigerate for at least 1 hour.  Pickled veggies will keep in refrigerator for up to 1 week in the brine.

Pork Marinade

  • Begin by slicing the pork tenderloin very thin (1/4 inch thick).  
    In a blender or food processor, add the shallot, lemon grass, garlic, sugar, honey, fish sauce,sesame oil, lime juice and zest and salt and pepper. Pulse until combined. It's okay if there are chunks of onion or garlic.
    Add the marinade and thinly sliced pork to a medium bowl, cover, and refrigerate for at least an hour, or up to 24 hours. 

Garlic Aioli

  • Whisk all ingredients together in a bowl. Cover and refrigerate for at least 30 minutes before serving.

Cooking Pork

  • When the pork has marinated, heat a large skillet or the barbeque grill over medium high heat until very hot. Add about a tablespoon of oil (if using a pan).  Add the pork strips in batches and sear until dark and caramelized. Sear the pork for approximately 4 minutes (depending on the thickness of the meat), then flip and sear for another couple of minutes. Adjust the heat as necessary, you want to keep it as high as possible without the pan scorching.  Continue searing until all the pork is cooked.  Add more oil as necessary.  Set aside on a plate or put it in the oven in a pan on the “keep warm” setting.

Assembling Sandwich

  • Slice a roll or bun in half. Spread both sides with Garlic Aioli.  Top one side with pork, pickled veggies and a sprinkling of cilantro (you can chop it if you want, but I just tore it from the top of the bunch.) Top with the other half of the roll or bun and eat! Serve with more garlic aioli if you like.

Until Next Time!




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