New to MS World

[timelord12]

Hi, I'm new to these forums. I've been experiencing an attack for 8.5 months now, but I saw my neurologist yesterday and he says that's impossible, it's not an attack. I thought attack, flare-up, exacerbation were essentially the same terms, but according to him they're not. Do you guys agree?

I had my first - ahem, attack - when I was 17 and was diagnosed when I was 18 (1986 and 1987). My current attack began with incredible fatigue and has involved week-long periods of being unable to walk properly in which I need a cane to get around. There have also been bouts of burning arms, itching, muscle spasms and long periods of sleeping.

I had an MRI in April and he said there was little change from my previous MRI so my symptoms must be depression/anxiety related so go talk to my GP. If that is the case, which is entirely possible, that is great but I found the talk rude and demeaning and I'm still angry by his manner. when I asked about medications for the anxiety he said he wasn't a psychiatrist. I'm sure I'm not the only member of this forum who has encountered similar insensitivity.

[JerryD]

I'm sorry that you feel disrespected and have had some bad experiences with your health care team. You would be better served if your doctors were on the same page. Maybe, you need to talk to your PCP about this. You may need to find some new health care docs. I wish you well. Good luck

[SNOOPY]

Hello timelord12 and welcome to MSWorld.

I thought attack, flare-up, exacerbation were essentially the same terms, but according to him they're not.

I have always known the terms to be interchangeable.

From the National Multiple Sclerosis Society:

An exacerbation of MS (also known as a relapse, attack or flare-up) causes new symptoms or the worsening of old symptoms

http://www.nationalmssociety.org/Tre...aging-Relapses

Some Drs., not just Neurologist, have a bedside manner that could be improved upon. A Neurologist can prescribe medications for anxiety, however, a Psychiatrist would be a better choice as the medications used is their specialty.

Maybe a new Neurologist would be an option. This could offer you a second opinion of your current situation and you may like the second opinion Neurologist better than the current.

[jreagan70]

I've been experiencing an attack for 8.5 months now, but I saw my neurologist yesterday and he says that's impossible, it's not an attack. I thought attack, flare-up, exacerbation were essentially the same terms, but according to him they're not.

Hi timelord:

You're correct that attack, flare, flare-up, relapse and exacerbation all mean the same thing. I think the confusion comes from understanding -- or misunderstanding -- what those terms actually refer to.

An attack, flare, flare-up, relapse and exacerbation refer to the actual act of, and event of, the immune system attacking and damaging myelin. Here's the critical point. In MS, the immune attack lasts only for a few weeks -- sometimes as little as one week, sometimes up to three or four. After that, the immune system stops attacking and the attack is OVER. It's done in that time. The attack becomes past tense.

The effects of the attack, though, can last for days to weeks to months to forever, even though the actual attack is long over. I'm sure that's what your neurologist meant when he said that it's impossible for you to still be having an attack. Your actual attack was over months ago, even though you're still experiencing leftover symptoms.

So, with the way MS works, it's impossible for you to still be having an attack eight months later. What you're experiencing are the long-term effects of the attack. But the attack is over.

It's possible for you to have had another attack since having one eight months ago, but that one too would be over in weeks.

What your neurologist doesn't appear to be correct about is the leftover effects of an attack. You absolutely can still be experiencing effects of the damage that was caused by your attack (past tense). Your physical symptoms don't have to be caused by depression or anxiety.

The other thing I want to add is this. You may have been offended by your neurologist's manner, but it isn't anything to be angry about or to take personally. People are who they are. Your neurologist is who he is, just like you are who you are. If you don't like his manner, then let it go and find a new neurologist who is a better match for your temperament. Life is too short to be looking for things to be offended about.

And finally, your neurologist was not being insensitive by declining to prescribe an anti-anxiety medication. Anxiety treatment is outside the scope of a neurologist's specialty. So he wasn't doing anything improper by declining to prescribe and having you see another doctor who does deal with the treatment of anxiety.

I, like many others, have been through several neurologists who had abrasive personalities and poor chairside manner. But here's another critical point. I didn't leave them specifically because of their personalities. I left them because they lacked sufficient understanding of MS to give me proper medical care.

I believe that their attitudes led them to believe that their insufficient understanding of MS was acceptable, and that they could use that to emphatically and improperly place blame on their patients who came in with situations they, as doctors, weren't capable of handling. But it was their ineptitude that led to me leave them, no matter what caused it. I'll gladly, and have, put up with a doctor whose personality doesn't ring my bells as long as I'm getting the technical competence I came to them for.

To me, bad doctors are like a food at a buffet that you didn't like. It isn't worth getting angry or complaining about a food you didn't like, and talking about it over and over. Just don't take any of that food the next time you go through the buffet line, and choose something that looks like it will be more to your liking.

[hunterd]

WELCOME TO MSWORLD TIMELORD!!
I am also here to throw my support by way of the national MS Society. Your neurologist sounds rather opinionated , as many doctors are, not just neurologists, but any MD may fit into this category. I have had different doctors that have a little worse bedside manner than a monkey.
It sounds like ( as jreagan said) each and every one of your support team (drs) need to be on the same page, and until that happens, no matter what someone will be wrong. I wish you the best!

[timelord12]

Thank you so much for the replies. I think jreagan70 you've explained the terminology in the clearest manner I've ever had it described! Thank you too SNOOPY(love the avatar), I think both of you have helped solidify my decision to find another neurologist. I've spent 11 or 12 years with this particular doctor, and have had many problems (missing tests, non-returned phone calls, appointments for tests not booked properly, insurance documents lost several times) that I'm fed up. I also had for the first time ever my parents join me for the appointment, and they couldn't believe how arrogant and rude he was. I won't get into it, but he was an ***. He didn't even want to listen to my symptoms, but did the standard 10 minute neurological exam and then pronounced my symptoms the result of depression. They could very well be, but I need to have a doctor I trust and not somebody who relies solely on my last MRI (I know this is a very important tool) and discounts all my lived experience of the symptoms. I also appreciate your cautionary advice about not switching simply because somebody has an abrasive personality, but I thin it's time!

[timelord12]

Thank you for the responses, just saying these few things have made me feel much better, truly.