Wednesday, June 8, 2011

The Head Doctor

The other day I finally had my appointment with my neurologist. It had been postponed a month because he was called out of town. I had the choice of seeing one of his associates or waiting for his return. I waited.
It had been 7 months since my last visit.
This visit was easy. My doctor asked how I felt I was doing. I said fine but, added that I felt as though I have had a relapse. I explained my reasoning and then showed him my print outs of my symptoms for the passed 180 days.
He looked over the list. As he read through it he pointed to the most frequent ones and affirmed that these were very common ms symptoms. He continued to read the list some more and said the others aren't ms symptoms.  I wonder at this statement.
He then points to  the nausea and tells me it  definitely  isn't a symptom of ms. And says there may be something else going on. He notes that I am having heart burn as well and prescribes omephazole to help with that. He tells me that I will take one 20mg pill a day for a month to see if that will help to end it. We'll see what happens at the end of the course and go from there.
He then had me get up out of my chair and asked me to sit on the table. He did some strength tests and then checked for sign in my reflexes and eyes. Asking me about any reoccurrence of the double vision. I told him it hadn't returned since the first episode. He looked at my eyes and has me follow his pen. At my ability he says "good".
At the end of these tests he said he detected more weakness in my right hand than before. But, given the circumstances I am doing well.
He then took me out in the hall and had me walk down it and back. When we returned to the office he asked me to sit down again. I got back onto the table and he said no, the chair please. Oops, my bad.
Back in my chair, next to my hubby, he sat back at his desk and brought up my MRI images. He was showing us the different slices and the places of my demyelination. Pointing to the different areas he explains in general what they control.
Then he said according to these images I shouldn't be having any cognition trouble. He pauses. As if in thought.  He then mentions that I might be, if I were having brain shrinkage. Then he asked if I had insurance. I say no.  He asks if I would like to take another MRI and I say no, we can't afford that right now.
He tells me that his newest associate is a ms specialist. That I could get switched over to her on my next visit if I wanted.  He had mentioned her to me before at one of my other office visits. Now, I asked him what he thought would be best. Without any pressure in tone he said he thought it would be a good idea but, it was totally up to me. I told him I thought that would be fine. I am glad I did.
My current head doctor is great. I believe he is very competant but, he had told me early on that  he isn't the best choice for ms related issues. He had also said at one point they are very fortunate to have this new associate in their office. I look forward to meeting her.
The visit concluded and the doctor walks us out to the check out desk. He tells the aid to set up my next visit  with the ms specialist in 6 months. He scribbles some notes on his clipboard and hands it to the aid. I thank him as he disappears around the corner.
The aid sets up the appointment and prepares the bill for me to pay. She tells me an amount that is a pleasant surprize to me. It's half of what I expected. I don't question why. Reflecting on it now, I think I know.
Afterward, we run to the pharmacist to fill my presciption. I love my pharmacists. They also save me some expense.
So I've stated the omeprazole. The first day  had no effect. No change. The information says it could taken up to 4 days to start helping. The second day seems better. We'll have to wait and see.
Since the visit I have been trying to reason stuff out. I keep going over and over the visit. That's what I do. Trying to remember what was said that is useful. Trying to figure out what was said and how it was said. Reliving and figuring out the nuances. Gleaning.
After awhile I bounce what I think against my sounding board. My hubby. My voice of reason.
He remembers the visit as I do. He listened to my concerns. It's the brain shrinkage that has my attention. He knows my history and tells me, my cognition trouble could be something else.
The books I've read do say cognition trouble is apart of ms. None of those books mention brain shrinkage as the culprit.
So here is where I am. I have ms. There isn't anything I can do about that. I can just taken care of myself as best I can. The doctors can help me by treating my symptoms as best they can. I can, hopefully choose the best doctors to help me with that. I can, hopefully choose the best disease modifying medication to help me.
Right now I don't have and can't get the best information about my current condition. So, I can, just deal with what I know and wait to see what transpires.
Isn't that what we all do? No matter our status. We use the best information we can get concerning our current condition. And deal with what transpires.
I know I'll be doing some more research. I know I'll be trusting my Lord to guide my steps.

Research:  Since the doctor said nausea was not a ms symptom, I've hit the books on the dmm that I'm currently on. During the clinical trials they found incidences of nausea in 2% of the patients, more frequent with the dmm than with placebo.
O.k. if  it isn't something else, it must be that. I may not know for sure, but it's something. The nausea and heartburn have been the biggest trouble as of late.

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