Tag Archives: Neurologist

My new MS doctor – and finally, a diagnosis

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As I mentioned in my last post, Doc Fundamental suggested that we get a second opinion from Famous Doc B.  The four months that I waited for an appointment went relatively fast.  I was very busy with work and my family.  I was also spending a lot of time reading everything that I could get my hands on related to multiple sclerosis and other similar diseases.  But as my appointment approached I started getting more anxious to do something about this probable MS.  After all, it had been a year since I had first seen the doctor about my leg.

I had read a lot about Famous Doc B prior to my first appointment.  My wife and I agreed that if we liked her, we would see if she would take me on as a patient instead of just providing a second opinion.

Famous Doc B was wonderful.  Going forward, I will refer to her just as my ms doc.

My ms doc started with the usual discussion of my history and the typical physical tests.  Then we went into another room to analyze my MRI images on a computer screen.  Doc Fundamental had relied on the written reports by the radiologists of my MRIs.  My new ms doc read those, but analyzed the images herself.  She explained to me and my wife  what we were looking at and the significance of each of the lesions, taking into account the differences between viewing them from the MRIs done with contrast and done without, and what that means.

Doc Fundamental is a good general neurologist that I wouldn’t hesitate to refer someone to.  However, my new ms doc had dedicated her whole career to studying the progression of multiple sclerosis.  Her answers to our questions and her analysis gave me and my wife enormous confidence in her.

And then came the diagnosis that I knew in the back of my mind had been coming for a while.  My ms doc said that I have multiple sclerosis.

We discussed the options for treatment and her suggestions (a topic for the next post).  My wife asked her if she would be willing to take me on as a patient and she said yes.  I was thrilled.  My wife cried.  Not because of the diagnosis; we knew that was coming.  But because I was going to have such a great doctor by my side for the upcoming battle.

As a footnote, it was a lucky call choosing my ms doc over Famous Doc A for the second opinion.  Famous Doc A will only do second opinions now and is not taking on any new patients at all.

And now the marathon journey begins….

What to expect at the Neurologist’s office

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Or what to expect when you’re neurologing.

I have two neurologists and their styles are very different.  For this article I will focus on my first, the subject of my prior post that we will call Dr Fundamental.  We will get to the second one shortly.

Dr Fundamental’s routine is typical from what I have experienced with other appointments.  If you have apprehension about seeing a neurologist, relax.  It’s not painful nor do you have to work hard such as you might at a stress test.  The beginning of the appointment was just a conversation.  Doc F asked me many questions about my experience and history and took copious notes.  Being old school, his office was lined with bookshelves that must have had a thousand books on them.  No doubt, he has read them all.

We then started a physical symptom check.

Stand up please.  Stand still with your eyes closed.  Touch your nose.  Walk down the hallway.  Now walk back.  Walk on your toes.  Walk on your heels.  Walk heel to toe, heel to toe.  Alternating hands, touch your nose as fast as you can.  Squeeze my hand.  Push my arm.  Pull my arm.  Look at the dot on the wall.  Staring at the dot, tell me how many fingers I have up (checking peripheral vision).  Now follow my finger.  Tell me what number you see in this picture of colored dots.  Lie down please.  Close your eyes.  As I touch you with this safety pin, tell me if it is the sharp or dull end.  Dull, sharp, sharp, dull, sharp, dull, dull, sharp…..  Say yes if you feel the tuning fork vibrate as I touch you with it.  Take your left heel and run it up your right shin.  Now reverse. Doc F scratches a key up the sole of my foot to see if it reacts and curls up (the only part of the exam that isn’t comfortable).

What was the result?  I passed with flying colors.  We now had two reports of pretty ugly MRIs but with virtually no physical symptoms at all.  Dr Fundamental said that there was a disconnect but that it happens sometimes.  He does occasionally see patients that have pretty clean MRIs but massive symptoms, and others with bad MRIs that appear to have no symptoms at all.

I fell into the latter category.  The next step was to figure out what had caused it.

A brain MRI and a “fundamental” neurologist

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The MRI of my brain came back and it wasn’t so hot.  They found multiple lesions.  This, combined with the demyelination in my spinal cord from my neck MRI, put concern on the table that this could be something serious.  And yet, I had no symptoms apart from the occasional slight tingle in my leg.  My primary care physician referred me to a neurologist.

When describing the neurologist that he was sending me to, my doctor kept referring to him as “very fundamental”.  He repeated this term over and over and to this day, I am still not 100% sure exactly what that means.  The closest to an explanation that I got from my Doc was him saying that a young neurologist would just see the MRI report and throw me on MS medicine.  However, the neurologist that he was sending me to was “very fundamental”.  OK.  I guess.

I actually really liked Dr Fundamental.  The concern was that he was approximately 70 years old.  The pro with that is that he was “very fundamental”.  I’m going to relabel that as old school.  There were several cons with this, however.  First, I would hope that my disease  treatment will outlive him.  Second, he had his own issues like canceling one of my appointments because he had to go in for a procedure of his own.  Lastly, were occasional comments like “I’ve prescribed the same medication for MS for the last twenty years”.

Don’t get me wrong.  I think that Dr Fundamental is great.  I would refer anyone seeking a general neurologist to him and I am very thankful of the treatment that he gave me.  That’s a topic for the next post.