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Thread: How should I approach a new doctor?

  1. #1
    Senior Member willingtocope's Avatar
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    How should I approach a new doctor?

    Okay, so I've made an appointment with an Internal Medicene Specialist (with a minor in Geriatics) for next thursday. Brand new guy for me, and as far as I can remember, I've never been to his hospital/clinic before. The reason I'm going is that I'm still not convinced I've got MS. I want a fresh, unbiased, pair of eyes to look at me. Since my symptoms started 4 years ago (at age 62), I've seen 5 or 6 different neurologists. Each one DX'd me accordinding to their speciality, begining with cervical arthritis with ataxia, then spastic hereditary paraplesia, and ending when I was 64 with "well, we don't see anything else, so it must be MS" from the Mayo. MS was confirmed by the Univ of Iowa based on "well, the Mayo says MS, so it must be MS".

    Obviously, I've got to show this new guy my records, but I want him to think outside what it says on paper. What magic words do I say to him to make him go "hmmmm, maybe we should look at..."?

  2. #2
    Senior Member TomRL's Avatar
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    Interesting question as I will be seeing a new doctor next week. I plan on going in with a list of questions (some I think I already know answers to). I am hoping to see how much give and take there will be.

    If you have concerns about your diagnosis, tell him/her about it. If you have specific reasons for you doubts, speak up. See what reaction you get.
    Tom

    "Blessed are the pessimists, for they hath made backups." Exasperated 20:12

  3. #3
    Quote Originally Posted by TomRL View Post
    If you have specific reasons for you doubts, speak up. See what reaction you get.
    I agree with Tom. Your objective is to make the penny drop into the slot - if the doctor is savvy and experienced, your specific reasons for doubting the diagnosis might bring about a "cha-ching moment."

    From what I've read in your posts, your most prominent doubts involve the age at which you were diagnosed, and the fact that no clear-cut picture of your condition has emerged, despite a visit to the Ivory Tower (Mayo) - the authority of which many doctors are reluctant to question. In addition, each specialist you've seen recognizes only his neck of the woods: You need someone to take a broader view of your history, supported by a comprehensive examination.

    Tell the new doctor frankly that you need a new set of eyes - set him a challenge, but in a way that will intrigue rather than threaten him. Do not make it sound as if you expect him to denigrate the findings of other doctors - tell him that you only want the facts, whatever they seem (to him) to be, and possibly a fresh start.

    Good luck with this, and keep us posted!

  4. #4
    Super Moderator Sue Pendleton's Avatar
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    Maybe show him your films with no radiology reports and ask what his first impression is?
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  5. #5
    How to approach a doctor

    with a wallet full of cash

  6. #6
    Senior Member willingtocope's Avatar
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    "Why are you here?"

    "I'm looking for a doctor willing to investigate alternatives for my symptoms".

    "You have MS. You're in denial. Get over it. We've got an excellent MS rehab facility here (75 miles from your home), go see them. Just to make you feel like we did something, we'll run some baseline blood tests and check for infection...but...you're in denial...you've got MS. So what if 1% have their first attack after 62...you're one of the lucky ones."

    Waste of time.....

    ...sigh...

  7. #7
    Oh, man. I was wondering what happened. Yes, a waste of time...same old, same old. I am so sorry that this one turned out to be as dyed-in-the-wool as the others.

  8. #8
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    Quote Originally Posted by willingtocope View Post
    "Why are you here?"

    "I'm looking for a doctor willing to investigate alternatives for my symptoms".

    "You have MS. You're in denial. Get over it. We've got an excellent MS rehab facility here (75 miles from your home), go see them. Just to make you feel like we did something, we'll run some baseline blood tests and check for infection...but...you're in denial...you've got MS. So what if 1% have their first attack after 62...you're one of the lucky ones."

    Waste of time.....

    ...sigh...
    That is frustrating! Other than age, is there any other reason to think that it is not MS? Have you had a lumbar puncture done? While there are many false negatives (people who have negative results, but really do still have MS), it can sometimes still be helpful if the diagnosis isn't so clear cut.

    Does your symptom history fit MS? I assume they found lesions on your brain and/or spinal cord in the MRIs if they gave you a diagnosis. But it doesn't sound like a confident diagnosis when they tell you that it must be MS because they can't figure out what else it might be!

  9. #9
    Senior Member willingtocope's Avatar
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    Quote Originally Posted by retto76 View Post
    That is frustrating! Other than age, is there any other reason to think that it is not MS? Have you had a lumbar puncture done? While there are many false negatives (people who have negative results, but really do still have MS), it can sometimes still be helpful if the diagnosis isn't so clear cut.

    Does your symptom history fit MS? I assume they found lesions on your brain and/or spinal cord in the MRIs if they gave you a diagnosis. But it doesn't sound like a confident diagnosis when they tell you that it must be MS because they can't figure out what else it might be!
    LP's done a year apart. 2009 here, 2010 at the Mayo. One done here (and sent to the Mayo for analysis was clear...one at Mayo show O-bands. MRIs done in Des Moines (open) and Mayo (sausage tube). Radiologist in Des Moines saw nothing...Mayo reported 3 possibly 5 areas "without acuity".

    Last "attack" was Thursday night after I had gone to bed. Woke up about 2am...fever, and chills that caused so much spasitcity and shaking I thought I was have a seizure. After an hour or so, fell back to sleep and woke about 7 with mild fever, no chills. Did my circus act to get out of bed, but too weak to stand. Needed paramedics to move me into living room. I was walking (shuffling) again by 2-3pm. In and out of bed on my own Friday night.

  10. #10
    I don't know what "without acuity" means as a way to describe the lesions found at Mayo - did they explain it? It sounds like your MRI and LP studies were equivocal, two sets negative and two positive - it could almost be your choice which set to believe, and I understand why you're not convinced that you have MS. It is a diagnosis of exclusion, after all, when others entities have been ruled out - and that in itself is troubling.

    The National MS Society sponsors a forum called MS World, and a couple of years ago there was a thread about the high number of people diagnosed in their 50s and 60s. Apparently, the advent of better MRI technology has enabled doctors to diagnose MS in broader populations. But diagnosis remains a grey area in so many ways. To me, MS is primarily a label that's useful when forms have to be filled out and prescriptions written. With few exceptions, there's precious little that can be done for any of the "MS mimics," so in my more cynical moments I consider precise diagnosis a wash at best, an oxymoron at worst.

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