Common Neuro Care...
 

I had an appointment on Friday with my neurologist (the 3rd I've seen since I was diagnosed last March), and I was sorta surprised by my visit. 1) Is it common to have no physical exam during an appointment--not so much as a reflex tap? 2) Is it common to be denied an MRI? (I haven't had one in over a year, and I'm interested in seeing how things are doing.)

Also, my neuro says that my persistent symptoms are no indication that I'm getting any worse...that these chronic pains and such are only 'symptoms,' and not exacerbations. While I understand the difference (I think), I got the sense that my doctor won't take my symptoms seriously until they're severe. However, I see the presence of symptoms in a "cause--effect" kind of way. My gut says that something's going on, but maybe I'm just being a worrier...anyone have some advice?

By the way, my instinct is telling me to Donald Trump this doc..."you're fired!" :wink:

I don't know what you went in for, but I can't imagine not having any kind of physical exam unless it was just a follow-up. I usually try to give people the benefit of the doubt, but it is very aggravating to feel like you're being blown off. What symptoms are you having?

It was a follow-up appointment, but the last time he did any physical assessment was back in June 2008. It just seems odd to me.

Over the past month or so, I've been experiencing a really sharp pain in my left leg/hip/butt region. Almost every morning and night (right before bed time) I get this sharp pain (think like an ice cream headache). Eventually it'll dull down into a throb that goes down my leg. I've had some nights where the pain was so bad that I had trouble falling asleep. My neuro calls this "normal aches and pains." He told me to take Aleve.

I don't know. Perhaps I'm being hyper-aware, and this really isn't anything to worry about. I would've preferred a kind explanation rather than a blow-off, though!

yeah I would dump him and find a new one. I've never heard of a doctor denying you an MRI if you want one. That just sounds silly. Kinda reminds me of Dr. idunnohaveanotherpill. I dumped him too.

My last 3 neuro appointments I've been to, the neuro didnt do a neuro check for anything. Just talked to me. (which is fine with me...he always has me put on the paper gown for a neuro check anyways...why I dont know, all he does is make me walk and checks my reflexes)

I do think one of the reasons I havent had a neuro exam by my neuro for most of the past year, might be HIS health. He's got some sort of arthritis or something going on, (I think he's also in his mid-to-late 80's) and maybe it's too painful for him to hold some of the tools for the reflexes? This may be why he's been kind of pushing the MS Clinic onto me, suggesting it the past couple of appointments.

I go to the MS Clinic in a couple of weeks. I'm hoping the new neuro there (only been practicing since 2008) knows something about LDN and will give me a Rx so I can try it. I do NOT want an MRI. I dont like them at all, first one set off my claustrophobia and now I really do not want to be inside of one again. Plus, I cant afford it. Crappy insurance.

listen to your gut! if you feel dismissed, and you feel that you are being treated as just number seven of seven hundred, then...its time to see a new guy. Sometimes places are overwhelmed, and cannot commit the time, and energy to pacify new patients, but to not do any sort of hands on exam is not a good start. I hope you find a listener.

Maybe it's different protocols in various areas, but I've never heard of anyone being in a gown for a neurologist exam here, with the exception of a lumbar puncture (for example).

I'm always in my street clothes and remain in my street clothes when I see my neurologist. :cool: He does the same type exam (walking, tapping knees, moving arms outward touching nose etc etc).

Hi AahaA..:) Your Neuro sounds like a jacka**, to me....dump him. Ask your PCP for a new referral. When I pay my hard earned money to see a Doc, I better be his only Patient, at the time.;)

I don't see a Neuro anymore. My PCP takes care of everything now.:)

BTW, my first ever Neuro exam was in gown, then in the hospital and another gown. Follow-up office visits were shoeless but with clothes on.:D

Good luck finding the proper care for you, AahaA..:hug:

I do go through all the neurological testing each time, but that's probably because I ONLY go in once a year. For the 15 yrs prior to 2005, I did all my testing through my GP, and generally that was only required once a year too.

I have had one MRI in 18 yrs, because they already know I have MS. :D I am going to have another only because now that they realize NMO/Devics is a separate disease, they want to have a good look at my spinal lesions ...

Our neuro's are probably the best judge on whether we are in a relapse, the symptoms are due to prior damage (and "permanent") and/or if the symptoms are due to a psuedo-exacerbation. You will likely be able to figure this out yourself in time too . . . but until we have that knowledge, we pretty much trust our neuro's for that evaluation. (If you are not comfortable with your neuro's assessment techniques though, that probably means you don't feel you can trust him either ....).

The sharp pain in your hip/butt down your leg could very well be sciatica. I would suggest that you have your GP assess that . . . but if it is instead related to the MS, he will guide you.

Very often we attribute too many symptoms to the MS, and often the problems don't have anything to do with the disease. That's why I always visit my GP first, he does the testing to rule out other causes, then I visit my neuro only if necessary.

Cherie

from my experience, every time i see my neuro, which is every 6 mos, i get a neuro exam head to toe.

this time he passed on an mri because i've been so stable.

sx's should be taken seriously. if not by your neuro certainly your pcp.
i don't like his attitude. to just be willing to chalk it off to "aches and pains". if it was HIS aches and pain that interferred with his sleep i bet he'd do more than take aleve.

i say get another opinion. keep searching til you find a neuro that will listen and validate. mine does both but also doesn't always offer any new insights or help. and i feel maybe there is none. like for my muscle pain.

but i just don't like your "dr's" attitude towards you as his patient.

I get some kind of exam every visit. Only drs that ever give me a gown are my cardio and gyno.

Shoes and sometimes socks come off but never my clothes. My dr is not big on MRIs that suits me fine. My neuro says not everything is caused by MS and takes any complaints seriously.

good luck
laurie

I thought of sciatica too, from your symptoms. You might try some low-back stretches and ice packs and see if it makes any difference. At any rate, it wouldn't hurt anything.

I had my yearly neuro check up last month.She didn't do any actual hands on but I could tell she was assessing everything I was doing with her eyes. I have been very stable for the last several years and my MRI hasn't changed since 1997! At first she did every year MRI but now it's every 2 which is fine with me.