You and Your Neurologist: One of the Most Important Relationships

By: Meagan Freeman

Finding an excellent Neurologist is one of the first things we need to do after diagnosis with MS. It can be very difficult to choose a random name from a list of covered providers from our insurance companies, and without a solid recommendation from someone we know, we often need to take a “test drive.” Patients and providers are much like any relationship we have in life: Some personalities are a perfect blend, and others will never work together. It is incredibly important to seek out a provider who is not only medically competent, but also a good fit for your personality.

I find that some providers are cold and distant, only seeing patients as a disease process. What about the mind? We are so much more than a body. Providers should always see the patient as a mind-body unit, addressing the full scope of chronic illness. Psychological and emotional symptoms are common, and no one should leave an appointment feeling dismissed.

I am a family nurse practitioner, and we are trained from day one to see the humanistic side of medicine, to view the patient as a whole being, rather than the sum of the parts. The body cannot be healed without addressing the spiritual, emotional aspects of the human being. After being diagnosed with MS, I appreciated this manner of teaching more than ever before.

There is an intricate, indivisible connection between the body and the mind, and treating only one while ignoring the other will never prove effective. There is, what we call in medicine, an “emotional overlay,” to almost every physical issue. Whether this means that the condition is purely psychological, or whether the mind is reacting to a physical issue (anxiety, panic attacks, depression,) the mind must always be taken into consideration when treating every patient.

Our society is very quick to assume that modern medicine has all the answers, a secret book of treatments, available only to those who have attended medical school. This magic book contains all of the recipes for treating illness, and is kept hidden, under lock and key. The providers of the world are assumed to have the ability to fix anything, treat anything, and if they do not offer a fix, they are assumed to be withholding treatment intentionally.

I can tell you, this is not the case. One of the most shocking things I learned while transitioning from a registered nurse to a nurse practitioner was the absolute limitation in options we have as providers. We only have a few things to offer, a few laboratory tests, an x-ray or two, a few medications that may or may not be effective. Most medications also go along with an enormous list of potential side effects that have to be taken into consideration. Many prescription medications are not necessary, and can lead to a variety of new problems. The risk versus the benefit of any treatment needs to be considered. Treating physical illness is not only a science, but also an art; and sometimes, providers simply run out of ideas. Every possible treatment option has been exhausted, and there is simply nothing further to offer. I find that patients are shocked when this is the answer. “What do you mean, there is nothing left to do?” Sometimes, the answer is just that, and we are left trying to cope with our “new normal,” whether it is pain, numbness, weakness, or any other symptom.

When you visit your provider, keep in mind that they may not have an answer for every question you have. Your provider is doing their best, I am sure; but the answer “I do not know,” is an acceptable one sometimes. I always trust providers who admit that they do not have an answer, because this is honesty. If your provider says, “Well, if you really want to take something you can try this…” this is code for- “you really do not need this.” Sometimes, in medicine, less is best. The minimalist approach to treatment is wise, and so many patients have been “overtreated” in recent years. Too many medications, wasteful, unnecessary diagnostic testing, and the resulting side effects and anxiety are major issues in medicine currently. Patients and providers need to take a moment and ask themselves, “Is this really a necessary test or treatment?”

Trust your body to be able to handle most minor issues. Your body is an intricate, well-constructed, dynamic machine that is much wiser than we are as health providers. Now and then, the body might need an extra hand at combating an infection, but not always. Listen to your body! Prevention is the key! Get your immunizations, get some exercise, eat healthy foods, and obviously avoid smoking and alcohol. MS aside, we all need the same basic advice on remaining healthy and living the best life possible.

Questions to Ask Your Provider at Appointments:

1. Do you feel that my disease is well controlled with my current medication?
2. If not, are there other medications available that you would recommend?
3. Do you recommend any other treatments for my current symptoms (alternative or traditional?)
4. How often do you recommend appointments and MRI?
5. Is there any new research that has become available since my last appointment?

Try to develop a relationship with your provider, and if you feel dismissed or ignored, it may be time to consider a change. Like any relationship in life, some people just don’t “click.” But in this case, your health is at stake; so don’t be afraid to find the right fit for you.

*Meagan Freeman was diagnosed with RRMS in 2009, at the age of 34, in the midst of her graduate education. She is a Family Nurse Practitioner in Northern California, and is raising her 6 children (ranging from 6–17 years of age) with her husband, Wayne. She has been involved in healthcare since the age of 19, working as an Emergency Medical Technician, an Emergency Room RN, and now a Nurse Practitioner. Writing has always been her passion, and she is now able to spend more time blogging and raising MS awareness. She guest blogs for Race to Erase MS, Modern Day MS, and now MSAA. Please visit her at: http://www.motherhoodandmultiplesclerosis.com.

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About MSAA

As a national nonprofit organization, the Multiple Sclerosis Association of America is a leading resource for the entire MS community, improving lives today through vital services and support. MSAA provides free programs and services, such as: a toll-free Helpline; award-winning publications including a magazine, The Motivator; website featuring educational videos and research updates; S.E.A.R.C.H.™ program to assist the MS community with learning about different treatment choices; a mobile phone app, My MS Manager™; a resource database, My MS Resource Locator; equipment distribution ranging from grab bars to wheelchairs; cooling accessories for heat-sensitive individuals; educational events and activities; MRI funding and insurance advocacy; and more. For additional information, please visit http://www.mymsaa.org or call (800) 532-7667.

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