How do you know that the doctor is the right one?

[pepperman]

Hello,

Having limited experience, with neurologist and MS, how can you tell if the doctor you have is a good one?

Mine, is I guess, a general neurologist / neurophysiologist based on what I see on the wall. He at first said he didn't want to diagnose MS but after MRI and LP did diagnose me as having a "mild case" of the "good Kind" of MS. Now I assume he meant RR being better than other types.

He does not seem to care about possible issues from the past no matter how recent. I drive a truck and when I mention problems that I think are important he basically ignores them. I have had many mental/cognitive issues and balance/strength issues. He barely acknowledges them as I list them off.

It is as if since I only have 2 spots on my brain MRI and a positive LP with a trace amount of what ever it was they were looking for - there is nothing more to look at.

Tomorrow I am to see him again and am supposed to decide on an MS medicine and I don't even know what they are or, most importantly, how they would effect my driving/working ability. I mean, because of the time I wasted trying to tell him about past and present issues, he briefly described I think 4 medicines but I don't remember anything but 2 were pills, 1 was a shot and 1 was an infusion - think.

I really can't afford to lose my job but he won't explain anything so that I can understand it. I leave his office mad, frustrated and confused. When my time is up he gets up, even in mid sentence, says follow me and off to the check out window we go and he disappears down the hall.

Is this the way it normally goes. He says we are going to grow old together (we are both 47) and be best friends but I just don't see it.

What do you think?

[SNOOPY]

http://www.nationalmssociety.org/Tre...MS/Medications

[SNOOPY]

Hello pepperman and welcome to MSWorld.

after MRI and LP did diagnose me as having a "mild case" of the "good Kind" of MS.

The above quote bothers me about your Neurologist.

There is no such thing as a "good kind" of MS. It usually takes quite a few years to determine if a patient has "mild" MS. It is also to be "mild" until your not

Based on this I would suggest looking for a new Neurologist.

As far as the Disease Modifying Drugs (DMDs), there are many. The link below is a list of them and clicking on each one will offer you some information about them.
http://www.nationalmssociety.org/Tre...MS/Medications

[pepperman]

Thanks for the reply Snoopy!

The thing that really bugs me is that he has done only 1 other test - nerve conduction. Because I made the mistake of telling him I had numbness in my right hand. He determined I had carpel tunnel in both hands.

I have had off and on problems for about 20 years and, because of that, was relieved to finally get a diagnosis that could explain them. I thought it was my imagination that they existed. The only other symptoms he has acknowledged are my hearing loss which is was started the MS diagnosis (much greater % in right than left) and MS hugs.

He shows no concern over:
*Balance issues
*Cognitive issues
*Memory issues - he said if I forget my way home to call him and he would come get me.
*Fatigue - I mainline caffeine just to be able to function.
*Extreme arm pain that mysteriously switches arms - exact same muscle(s) just different arm.
*Right leg limp because I don't move my foot when I walk - which he did comment on.

I am really curious as to what symptom/flare/episode it would take to get his attention.

[hunterd]

it all comes down to who you are comfortable with in the end. It is your choice whether to stay with the doctor or find a new one. It is something that everyone should ask themselves about their doctors. I know that I myself will ask each and every doctor I have what questions I may have. If the doctor does not like the fact that I am asking something that I do not understand that Dr. May not be for me.

[Kimba22]

Hi pepperman,

Welcome to MSWorld!

Tomorrow I am to see him again and am supposed to decide on an MS medicine and I don't even know what they are or, most importantly, how they would effect my driving/working ability

There were only 3 disease modifying drugs when I was diagnosed, and my neurologist explained them all to me (along with possible side effects). Then she sent me home with literature to read from all three drug companies before I made my decision.

Now there are 4 x as many medications for MS. (Although two are basically the same medication). I can't even imagine how overwhelming it is to make a decision nowadays! I wouldn't just "pick one" until you know a little more about each of them, and their possible side effects. I highly recommend the link SNOOPY provided.

Here's s link you may find helpful in making your decision: http://www.msworld.org/forum/showthr...Drug-Selection. We also have a Medications & Treatments forum. http://www.msworld.org/forum/forumdi...amp-Treatments

Is this the way it normally goes. He says we are going to grow old together (we are both 47) and be best friends but I just don't see it.
What do you think?

No, that's not the way it "normally goes." And "best friends?" Please ... You don't need a "best friend," you need a good doctor, who will address your very valid concerns. Not give a callous answer like this:

Memory issues - he said if I forget my way home to call him and he would come get me.

If it were me, I'd be looking for another neurologist.

Good luck,

[pepperman]

Thanks for the replies!!

I really did not know what was considered normal or average in terms of interaction with neurologist.

I never had very good relationships with doctors of any kind. I am not use to these continuas appointments with so much frustration.


I am really afraid of losing my job in this economy and not being able to afford insurance. I have a some what dangerous job with the driving and what I deliver (glass).

I had a problem last week when my foot and lower leg went away. I literally could not tell without looking if I was pushing the brake or accelerator - usually was pushing wrong one. Can't wait to see his non-concern over that.

Again thanks for the replies!!

[Mamabug]

Hey Pep!

I don't think you found a winner for your neuro. Some general neurologists are very well qualified. Personally, I switched to an MS Specialist, due to some fairly a-typical MS symptoms, and my MS, for awhile, being fairly out of control.

Your MS doc, whoever it is, should, at the very least, be able, and willing, to explain things to you in a way that is helpful and understandable.

I'd keep the appointment and choose a med, but, begin looking for a different doctor, who better meets your needs. Perhaps you could attend a meeting at your local MS Society, and meet others with MS. They may be able to recommend a good doc.

Regarding meds, here is some info. There are four injectable meds; they are often referred to as the ABCR's (Avonex, Betaseron, Copaxone, Rebif). They all have different pros and cons. Three are interferons; Copaxone is not. And, interferons work differently in your body than Copaxone, but, until you've tried them, you really won't know which will be most effective for you.

Tysabri is a monthly infusion. And, there are some oral meds out there now.

You may wish to check out some of the links that others have posted. Or, you could look here, in our Medication and Treatment forum, to see what others say about the different meds.
http://www.msworld.org/forum/forumdi...amp-Treatments

Please do some research about them, prior to making a decision, even if you start with just a little bit of reading. And, feel free to ask specific questions of us, because maybe we can answer the things you might most like to know, without you having to do too much of your own research.