Evaluating Multiple Sclerosis Symptoms and Treatment
If you have multiple sclerosis (MS), getting the right care and partnering with your health-care team makes a world of difference in your quality of life. In fact, "80 percent of people with MS can see their disease fully controlled or managed with proper treatment," says Keith R. Edwards, M.D., director of the Multiple Sclerosis Center of Northeastern New York, Empire Neurology, P.C., in Latham. To ensure you're in that 80 percent, see a neurologist who specializes in MS.
Follow the appointment schedule your doctor recommends so he or she can monitor your health on an ongoing basis and make treatment adjustments as needed. Most important, have a doctor you trust, understand and feel comfortable asking questions of.
Before Your Doctor Visit
Start a folder where you keep copies of all your referrals, test results (like blood work) and anything else related to your diagnosis. Dedicate a specific notebook to questions and comments you'd like to share with your doctor. In it, list the medications you're taking and their dosages.
Also, think about inviting a friend or family member to join you during your consultation. Another set of ears may help you better retain information.
While You Wait for Your Doctor
When you're in the waiting room, take a few minutes to note any additional questions you've thought of, and write down any symptoms or problems you don't want to forget to mention.
Seeing Your Doctor
Tell your physician about any changes in your condition since the last visit, especially if you're having symptoms that used to be well controlled by medicine. "Too often, patients accept increased symptoms as a normal part of the disease, allowing them to get worse," says Dr. Edwards.
Also, don't be shy about taking notes during your visit and asking for things explained in simpler terms.
7 Questions Your Doctor May Ask about Your MS Symptoms and Treatment
- What are your symptoms? Tell your doctor how often they occur and how severe they are; this helps best determine the right therapies for you.
- Do your habits or activities affect your symptoms? Exercising in the heat, for example, can spur flare-ups. Making simple lifestyle tweaks can help.
- Are you experiencing any side effects from your medicines? Your physician may be able to change the type or dosage to reduce unwanted reactions.
- How are your medications working? If they're less effective than they were in the past, your doctor may want to adjust your dose or try another drug.
- Do you have any memory problems? Your doctor can evaluate changes in memory, attention span and/or concentration with cognitive testing.
- Are you feeling down? Depression is very common in people with MS, but often goes undiagnosed. If you're blue, ask what therapies may help.
- Do you have a solid support system in place? Managing your condition is much easier when you can rely on a close network of friends and family.
Common Tests for MS
You may undergo some (or all) of these exams.
- Magnetic resonance imaging (MRI)This uses powerful magnetic fields and radio waves to produce highly detailed images of your body. Through an MRI of the brain and spinal cord, doctors can look for lesions that are characteristic of MS.
- Blood testsDoctors may order these to rule out other conditions with similar symptoms, such as Lyme disease.
- Spinal tapThis (often outpatient) test is also known as a lumbar puncture. Here, your doctor numbs your lower back and collects a sample of cerebrospinal fluid with a needle. If the fluid contains certain proteins or a large number of antibodies called immunoglobulins, multiple sclerosis may be the culprit. These antibodies are found in most people with MS, but they can also appear in other diseases.
- Visual evoked potential test (VEP)With the help of electrodes taped to your head, VEP measures the time it takes for the nerves of the eyes to respond to specific visual stimulation.
- Routine testsOnce you are diagnosed with MS, your doctor will order certain tests for you on a regular basis. These tests will help your doctor monitor how well you are responding to therapies and whether your disease is progressing. Common tests include follow-up MRIs, neurological exams (reflex, coordination, sensitivity to touch) and cognitive functioning tests (which evaluate your memory, attention and concentration).
After Your Doctor Visit
Ask for a printed copy of any instructions your doctor has given you. Get a copy of your medical records for your files, too. It's also important to set up your next appointment, since noticing and attending to symptom changes promptly can make a dramatic difference in MS progression.
In the first one or two years after diagnosis, your doctor will likely want to see you every three to six months. After that, your visits may be anywhere from every six months to annually.
From our sister publication, RemedyMD (Fall 2011)