Multiple sclerosis is a tough disease, but there is basically three things that you need to do when you are taking care of patients with multiple sclerosis. We have learned this in our MS Center t...
Multiple sclerosis is a tough disease, but there is basically three things that you need to do when you are taking care of patients with multiple sclerosis. We have learned this in our MS Center through extensive research and follow-up of patients over many years. One, you need to be picky about the diagnosis. Two, you need to follow up patients actively to make sure that what you are doing is working or to see whether or not it is not working. Three, you cannot blame every single symptom that a patient with MS has on MS. Those three are absolutely critical. You need some examples here. One is that every year we see five or six patients who are on the shots for MS and who turn out not to have MS. They turned out to have another disease that caused their symptoms. For instance, the most common one that we see is sleep disordered breathing or sleep apnea, fatigue, and either neuropathy or a problem with carpal tunnel with entrapped nerves as they go through the wrists. The second one is that you have got to follow your patients actively and aggressively. We try to see our patients with multiple sclerosis every three months. We are able to get them in either the day or the next day after they begin having problems. We put them on a little graph that is called the Multiple Sclerosis Functional Composite Graph that looks at their thinking, their ability to manipulate their hands and fingers, and their ability to walk. In this way we can assess whether or not they are staying the same, whether or not we are treating the multiple sclerosis adequately and stabilizing the disease. There is not a cure, but we have many things that we can pull out of the quiver to treat that disease. The third thing is, do not blame everything on MS. We are the ones who found a number of years ago that patients with multiple sclerosis have a markedly increased incidence of sleep disorders. A lot of them have sleep apnea, a lot of them have increased motion of their limbs at night that disrupt their sleep, and a lot of them have spasms at night. You treat these all very separately, very differently, and what I always say to patients is that you can treat MS until you are blue in the face, and if you are missing something else like a urinary tract infection, sleep apnea, carpal tunnel symptoms, or a pinched nerve in the neck, then you are not doing everything that you can to maximize the quality of life of that patient. At our Institute we try to live by those three principles and I would say \"How\'s that different from the rest of medicine?\" It\'s not. That\'s the way that medicine should be practiced in every single discipline. It is nice that we have five clinical care coordinators and certified nurses that take care of research studies. We are doing 12 to 14 of those studies at all times trying to give our patients access to cutting pharmacological treatments in multiple sclerosis. Cutting edge kind of therapy that is not available yet. It is nice to have a certified and accredited imaging program. It is nice to have a couple of Ph.D.\'s masters level type people who do basic research using animal technology and other kind of cell culture technology in multiple sclerosis. It is nice to have all those things, and we have them, but the critical elements here are: One, be very picky about the diagnosis of MS because you can do something about it if you make the right diagnosis. Two, you need to be able to follow your patients actively and change what you are doing if it is not working. Three, you cannot blame everything on MS.
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