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-   -   Common Neuro Care... (https://www.neurotalk.org/multiple-sclerosis/82219-common-neuro-care.html)

AaHaA 03-23-2009 08:45 PM

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:

msarkie 03-23-2009 08:55 PM

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?

AaHaA 03-23-2009 09:08 PM

Quote:

Originally Posted by msarkie (Post 485612)
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!

legzzalot 03-23-2009 09:12 PM

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.

Erin524 03-23-2009 09:30 PM

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.

Dejibo 03-24-2009 08:03 AM

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.

dmplaura 03-24-2009 09:36 AM

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).

azoyizes 03-24-2009 10:06 AM

Something's strange with this guy. Follow your instincts, and shop around for a new neuro.

I'd guess that every other visit, my neuro does at least part of a neuro exam. He usually comes out to get me in the waiting room, which I figure is when he is better able to see me get up and ambulate. The exam rooms are small, and there's just no room to walk around with him, me, my rollator, and Montana my service dog in there.

I've never been asked to take off anything but my shoes, and have never had to take off everything and put on a paper gown for a neuro exam, except for a LP. That is strange, Erin.

Anyway, best of luck finding a doctor who will work with you! :Good-Luck:

SallyC 03-24-2009 10:55 AM

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:

lady_express_44 03-24-2009 02:03 PM

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


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