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medwayfarer 07-17-2012 02:20 PM

First Neuro Appt. Tomorrow
Hi everyone!

I was lucky enough to have my neurologist appointment in August bumped up to tomorrow, and I'm curious as to what to expect.

I am going to make a list of my symptoms (with somewhat of a timeline-I'm terrible at updating it properly) but is there anything else I should bring or prepare?

Thanks so much, and I hope everyone is having a great day!

MSNik 07-17-2012 02:28 PM

Re: First Neuro Appt. Tomorrow
Hi congratuations on getting in sooner!

Your first appointment is alot of questions and answers, this is known as a history and physical. Your doctor, or his nurse, willl be asking you alot of questions about symtoms, when they started, if anything helps them- how long they last- reasons why these symtoms exist....have you fallen? Are you under alot of stress? have their been any traumatic events in your life in the past year? (Deaths, births, anything unusual). Your general health will be discussed, all prior surgeries, etc. So, have any dates or at least years of these things available.

Next, will be meds....if you are taking any supplements, vitamins, herbs, or prescription drugs, make a list of them, and how much you take, bring that along....This includes birth control and multi vitamins! Dont leave anything off the list.

Then the actual neurological exam. Its actually pretty easy. Alot of balance tests, strength tests, (squeeze my hands as hard as you can), gait tests...walk from here to there and back. He is looking to see if you lean to any one direction. Reflex testing, the "hammer" for the Babinski test, as welll as the pinging of the hammer to see how long you feel the vibrations for. Youll also probably get the ever exciting "touch my finger, touch your nose"...its a coordination and reflex test...Not one of these tests do not worry.

at this point, the doctor has a base line on your complaints to date and what brings you into the office...and now the fun begins. Tests, tests and more tests. More than likely blood work to rule out any deficiencies...MRIs to see what is going on radiographically....possibly even nerve conduction or eye tests, depending on your complaints.

And, your off and running!

Its painless. And, its usually very detailed....the most important thing to remember is that you probably will not get any answers at this exam; but you are headed in the right direction.

One thing to he a MS specialist? And, if not, how many patients does he treat with MS each week? IF its less than ten, run. He isnt qualified to make a MS dx...

Please let us know how it goes..

MSJayhawk 07-17-2012 03:20 PM

Re: First Neuro Appt. Tomorrow
Congratulations on the "bump up". I would bring a copy of your journal which you could leave with the doctor to place in your file. I would also bring a copy of the Revised McDonald Criteria to help you follow along. I would also bring a list of questions, no matter how inconsequential you might feel they are, and plan on leaving with answers.

As this is your first appointment, you might bring a calendar to help you schedule the various tests which will follow should the doctor feel the tests are warranted.

Do give us an update! :angel;

medwayfarer 07-17-2012 08:46 PM

Re: First Neuro Appt. Tomorrow
Thank you both MSNik and MSJayhawk. I really appreciate your advice.

MSNik- I am not familiar really at all with the neurologist I was referred to. I believe under the registrar that he does general neurology, and neurocritical care. Would MS be a part of neurocritical? Thanks for the headups though, I'll definitely have a few questions in regards to it tomorrow.

Thanks again!

MSNik 07-18-2012 03:52 AM

Re: First Neuro Appt. Tomorrow
Hi there. I forgot you were in Canada. I dont know if NeuroCritical is part of MS or not, in my mind, Id think no, that it was part of stroke...but I could definately be wrong.

It doesnt matter- its a START! Go there and start getting the ball rolling. Your tests are either going to show conclusive results or not- if its NOT,then youll need to take everything to a MS Specialist for further evaluation, but who knows? This doc might be fabulous in MS wont know till you get there and its NEVER a waste of time to be seen.

Best of luck to you...and please let us know how it goes..


Gullyabb 07-18-2012 04:12 AM

Re: First Neuro Appt. Tomorrow
Good luck with your appointment. My hubby comes to my specialist appointments as a second set of ears. He just quietly listens unless the neuro speaks to him directly. When he wasn't available I brought a friend but wouldn't do that again...

I also let the doctors know that I'd like a copy of any reports for my own records. That's proven to be helpful for me. When the neuro -ophthalmologist got my referral, he received nothing else and I was able to fax him almost everything needed.

Good luck and take notes!!

medwayfarer 07-18-2012 03:53 PM

Re: First Neuro Appt. Tomorrow
Thank you again to everyone for their advice, and well wishes.

I prepared my lists of symptoms, concerns, etc. and felt like I was prepared for this appointment. Unfortunately, I'm left with a less than positive impression.

He quickly said that he went over my file, my referral, and some of the symptoms the last Dr. had noted. He did a few strength tests, (arms and legs), and then a sensation test. He then went on to say that perhaps it was b12/folate problem. Now normally I would understand this, but b12 has already been ruled out previously by not only by GP, but a gastroenterologist as well. This was the only test that he wanted to run as an MRI referral could wait until the next appointment I saw him. (I would assume it's probably at least another month or more to get back in)

I asked him if it was okay to tell him some of my symptoms as I felt that he was about to shoo me out. I got my list out, and proceeded through some of the things, my main thing being my legs (more so the right) and the spasticity. When I told him that it felt like I was unable to move my leg the way I want to because of the tightness and it not allowing proper movement, he looked at me like I was crazy. I felt like I was pulling teeth just to get him to listen.

After listening I guess he did a gait exam, but honestly, it was all of 2 metres long. Am I wrong to think that this is a pretty short distance to really gauge someones gait?

He then went on to tell me that I'm weaker on my right side, have a duller sense of sensation on my right, lack of balance with eyes closed, and that he was going to order a MRI for the head and spine today (Finally-yay!). So that was at least good news, now I just wait to see when that appointment is scheduled for.

He left to fill out the requisition forms, and then never came back so I wasn't able to ask him any questions regarding anything. The receptionist handed me a blood test form and that was that.

Is it wrong to feel that he didn't have a good bedside manner? I feel as if he wasn't very thorough, but I could definitely be wrong.

Thanks for letting me rant!!!

MSNik 07-18-2012 04:13 PM

Re: First Neuro Appt. Tomorrow
Hi. Rant away.

To be honest, it doesnt sound like a complete loss, but he doesnt sound like he has the best bedside least you got the MRI ordered! Now, the most important thing to remember is if possible, ask for copies of your MRI films or CD when you go there- and you want to get your hands on a copy of the radiologists report as well, this will save time down the road when more than likely youll be referred to someone else.

Meanwhile, the tests, although short- did give him the results you quotes, weakness on one side, sensation loss and lack of balance...those, are all pointing towards SOMETHING being wrong. The result, of having him order further testing is GOOD.

Now, you wait for the test and the results. Remember, only you can advocate for knowing something is wrong. Alot of doctors brush things off saying that it isnt "clear cut", but when something is wrong, you have to keep pushing. Youre doing that- and you did very well. Be proud of yourself.

I wish it was more conclusive, but I warned you not to expect in all honesty, it wasnt a total bust! You got the tests ordered...lets hope they show something concusive.

At least the first step is behind you....keep your chin up.

MSJayhawk 07-18-2012 04:23 PM

Re: First Neuro Appt. Tomorrow
Sorry to hear your doctors lack of personal skills. The gait distance was about right, I think. Me neuro's nurse observes me walking into the exam room and my neuro follows up if gait problems were visible. Stay strong. It takes a day at a time to get through this. :angel:

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