Whats up with every 6 month appointments?

[Jules A]

I have seen several people who have relatively stable MS say their neurologists are still scheduling them for check ups every 6 months. Whats up with that? I am surprised insurance is paying for it. My MS specialists, I've had several at a well known teaching hospital, have only ever seen me once a year and now that has changed to every 18 months.

If the MS is stable and the patient has been on their medication for a reasonable amount of time it seems frivolous, a waste of money and time, to drag us in if there aren't issues. For what? The squeeze my hand, follow my finger with your eyes and walk the drunk line test? Hopefully they aren't doing repeat MRIs on stable patients this often also.

[Daisycat]

It was a year ago when I was told what I had. At first my old neuro had me coming in every 2-3 months. After March he changed it to every 4-5 months. I have only had one repeat MRI and he had said he would probably want to do them every year and after this last MRI see me every 6 months.

I don't know if it is a medication thing. I know I have to see my PCP every 6 months for my prescriptions (although those are controlled so I know that is different). I was under the assumption (at least for me) I was going in so often since I was so newly diagnosed and still trying to prove they misdiagnosed me.

I am hoping my new one (assuming I stay with him) has me coming in less frequently but I always assumed 6 months was to check in and make sure everything was stable and make sure meds were still working. But since my visits consisted of him being in there for 5 minutes I do not really know.

[502E79]

Hey Jules!

Yeah I hear you. it's spring and fall for my visits but only 3 MRI's (including dx) in 10+ years. I control the MRI visits although in the early stages he wanted to "see" how I'm doing!?! Like the image there actually corresponds reliably to lesion activity.

To explain, I knew I was PPMS years before he dropped the RRMS handle and reclassified me as such.

Enough mini-rant. I comply with the 6 month routine because he got me out of jury duty and I also received a renewable handicapped placard every 5 years.

2 visits a year are picked up and PPMS means I have no copay expenses because of dropping "C" 2 years ago. Kissing that copay goodby! Guess PPMS allows for a different approach....

Jer

[oceanpride]

Not to disrespect the system that I’m very grateful for but , once you get an MS label you also become a cash cow.

[Jules A]

Not to disrespect the system that I’m very grateful for but , once you get an MS label you also become a cash cow.

I was wondering about that also because for minor changes they don't do anything, for major changes the patient would be contacting them asking for an appointment. Certainly once a year is often enough to touch base if the person is stable or not looking to change medications.

I'm not on anything controversial, no schedule 2 meds, so my PCP prescribes everything except the Copaxone for me anyway. I see him once a year also.

[MyGirlsMom]

Agreed! I don’t know why but that has been typical with the three neurons I have had over the past almost ten years. That said, I have negotiated meeting in 9 months and then have called to reschedule at a year. My last neuro didn’t do MRIs unless I had flares or thought something changed. I liked that. That said, I try to manage it best I can....otherwise I just have too many doctor appointments.

Seeing docs all the time and focusing on MS can be negative and I just want to focus on living! My MS will be what it is and it seems that there is really little, in the big scheme of things, that I can do to really drastically change it.

[Tawanda]

The only reason I still go is to get my A/D renewed. I'd rather go through a neuro appointment than a yearly physical where you out on a hospital gown, etc. I am 54 PPMSer and am not even on a DMT. I would totally ditch the "drunk driving" test if I didn't need the A/D. I have one coming up, too. Yuck.

[Jules A]

The only reason I still go is to get my A/D renewed. I'd rather go through a neuro appointment than a yearly physical where you out on a hospital gown, etc. I am 54 PPMSer and am not even on a DMT. I would totally ditch the "drunk driving" test if I didn't need the A/D. I have one coming up, too. Yuck.

What?? Thats a very expensive SSRI appointment.

My PCP doesn't make me take any clothes off. "hey how are ya, any problems, vitals a quick neuro check eyes, reflexes and I'm outta there. And most PCPs will refill antidepressants for a year at a time.

Whoa wait I'm finding a theme here, maybe my Docs just don't want to see me or that much of me as often?

[Temagami]

Is "dropping the C" ditching copaxone? What is A/D?

I go for the 6 month appts. because once on disability, they thrive on data and if you donīt go, they can say that you are not under the care of a physician and try to stop the ins. Also, for some DMTs, you need to update the Rx and having a team who knows you at the practice leads to them following up in a timely way.

[Jules A]

Is "dropping the C" ditching copaxone? What is A/D?

I go for the 6 month appts. because once on disability, they thrive on data and if you donīt go, they can say that you are not under the care of a physician and try to stop the ins. Also, for some DMTs, you need to update the Rx and having a team who knows you at the practice leads to them following up in a timely way.

A/D in this context is antidepressant. I'm guessing C is Copaxone but not sure.

I didn't think about those on disability needing to go to prove they are under a physician's care. I need to research the guidelines as there are guidelines and recommendations for EVERYTHING.

[Tawanda]

What is A/D?

Just my lazy shorthand for anti-depressants.

[Tawanda]

What?? Thats a very expensive SSRI appointment.

My PCP doesn't make me take any clothes off. "hey how are ya, any problems, vitals a quick neuro check eyes, reflexes and I'm outta there. And most PCPs will refill antidepressants for a year at a time.

Whoa wait I'm finding a theme here, maybe my Docs just don't want to see me or that much of me as often?

That's visit one...visit two involves the gown, the treadmill test, blood-work is reviewed and (shudder) a manual breast exam!

[Jules A]

That's visit one...visit two involves the gown, the treadmill test, blood-work is reviewed and (shudder) a manual breast exam!

If you are getting this level of service from the PCP no way would I go to the neuro for the drunk walk and finger no nose, lol. However I haven't ever heard of a PCP physical including a breast exam and would have to draw the line on that.

[pennstater]

My two neuros have always been 6 months, even before Tysabri. When I filed for disability, a big part of it was based on medical records and evidence that symptoms remained, even if unchanged. Then of course, when worsened.

I didn't realize it via symptoms, but for 3 straight visits, he detected increase in balance/gait and sent me to PT since a trend wSdeveloping.

So for me, disability and Tysabri usage reason for 6 month. Also, not on an A/D anymore, neither of my neuros, nor my PCP (an internist) would prescribe an A/D for long term use. Short term for situational depression they will, but not long term. Feel it belongs with the psychiatric specialty. Maybe all supporting each other financially😱

[Tawanda]

If you are getting this level of service from the PCP no way would I go to the neuro for the drunk walk and finger no nose, lol. However I haven't ever heard of a PCP physical including a breast exam and would have to draw the line on that.

Just Googled it..."clinical breast exam" is the proper technology, and yup, that's what they do. It is definitely not enjoyable, but better than a self-exam. They actually know what they're doing.