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Neurologist
A neurologist is a doctor who specializes in nervous system conditions. In terms of MS, they do examinations of the nerves and reflexes, (that's always fun). They examine motor and sensory functions, as well as functions of the muscles.
He is also seeing a neurosurgeon, and as the name suggests, they specialize in surgeries of the spine and other nervous systems.
In order to determine if you have MS, (or to rule it out), the nerves of your head and neck will also be examined thoroughly. Your doctor will conduct specific tests to determine your muscular strength and range of motion.
Balance, coordination, and reaction time
Other tests will include checking your balance, and whether or not you have different sensations in different parts of your body. One of the tests that Cir's doctor has Cir do checks his coordination and reaction time. The doctor holds up his finger and tells Cir to touch his nose then touch the doctors finger. All the while, Dr. Carrabine is moving his finger to the left and right.
Cir always passes with flying colors. His doctor is usually impressed with Cir's overall progress, or rather his lack of progression. (I guess with MS you don't really want to progress. And that's a good thing). He always says that if his other patients did as well as Cir, he might be out of a job.
Your doctor or neurologist will probably ask you questions that will help in determining if you have any problems. They might ask you to remember a set of 3 words, or a set of 3 or 4 directions they want you to follow. This is to see if your memory, speech, or language are becoming effected as a result of active lesions within your brain or spinal cord.
The big ones
The big tests that your neurologist will have you take are CAT scans and/or MRI's and possibly even a spinal tap in case the others are inconclusive. Usually an MRI is enough to see any lesions or plaques. Any or all of these will help to confirm whether or not you have MS.
Cir had an MRI that confirmed that he had multiple sclerosis. The first MRI, we never saw. The doctor actually called Cir at work and told him he had found the "white spots". Cir was okay with it, (finding out it was MS), and went back to work after hearing the news. He had expected it all along.
Once your neurologist determines that you have MS, they will recommend that you begin treatment with one of the MS medicines available or some other therapy. They will probably be the main person in your healthcare team as far as all of your multiple sclerosis needs are concerned.
Depending on the severity of your diagnosis, for example whether you have relapsing-remitting MS (the most common) or a more progressive form like Primary-Progressive MS, you may need to be treated for a number of symptoms. Maybe not at the very beginning, however, eventually you may have several doctors treating you at the same time.
A working friendship with your neurologist
It's good to have a working friendship or at least a congenial relationship with your neurologist. You're not going to be best buddies, but you should be able to ask questions and get honest, complete answers. You should also feel that your doctor is working with you and not talking down to or over you.
Of the three that Cir has had, one has been very personable and actually listened to what Cir wanted to do. He didn't force Cir to take medications he didn't want to. He made suggestions and gave detailed explanations. Even when he didn't agree, Cir's doctor would still give his honest opinion and give Cir time to think about and determine how he wanted to proceed.
If you can, find a doctor who is able to meet your needs. One who you are comfortable with. One with whom you have a good fit, then by all means, keep them on your healthcare team.
If they aren't a good fit, consider finding another one. You need to feel comfortable with them because more than likely this relationship will be a long one. You need someone you can trust for the most part.
We think Cir has lucked out with most of his doctors. In the instances when he has decided to change doctors, it was rarely a big deal. Sometimes it was a change of insurance, travel distance, or something that had nothing to do with the actual doctor.
One thing Cir has in his favor is his rapport with people. As a child, his friends enjoyed hanging out with him, and as an adult, he found out that he was really good at selling. He can talk to just about anyone, any age, anywhere, in any situation. This helps to put people at ease when they are dealing with him, doctors, nurses, receptionists...., anyone.
Here's a great article that can help you find a good neurologist. (Opens a new window).
Go back to the Glossary
Go to Living with MS - Healthcare Team
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