CHOOSING A NEUROLOGIST
Once a person gets diagnosed with Multiple Sclerosis (MS) - or even when everything points to - it is important that this person choses a Neuro that you are comfortable with and fell trust. Most patients will get diagnosed while in mid 20's and will live a very long time with this disease.
Even though technology has evoluted in the medical side, specialy the past years, the detection and the correct diagnose of any disease still and will always be a result of the human knowledge and talent. It is true that equipments and technologies are a must to investigate and diagnose Multiple Sclerosis (MS). The precise MRI images, for instance, have been very important to detect and control the disease. When giving a diagnose, it is important for the doctor to listen, watch and analize each patient, functions that no machine is capable of.
To come to conclusion diagnosing a disease, the doctor needs to use it's knoledge, from years of studies, experience and frequent updates. When it is not something easily defined as Multiple Sclerosis, the physician must use a logical deductive reasoning, seeking to find patterns of clinical presentation (history, symptoms and physical and laboratory tests) consistent with the diagnosis of the disease.
In the case of Multiple Sclerosis, the same symptom may be indicative of various diseases, and their analysis is part of the process of elimination of other diseases, until they reach the final diagnosis. The doctor works with recognition systems, making assumptions based on what is statistically likely for a given situation. Technology does not replace the work but is an ally in confirming a diagnosis.
However, the fact that this arsenal is available does not mean a check-up must be prescribed on every consultation. The best thing is: check which exams can actually confirm the diagnosis, taking into account, including, procedures that can bring discomfort to the patient or be extremely costly. After all, it is counterproductive to the doctor if overload with data that do not help to clarify the problem or even make the assessment questionable. Furthermore, the right of choice in procedures that patients will undergo should always be respected.
The patient does have the right to choose their doctor, their hospital and their treatment. The physician has the knowledge, but the decision about treatment must be taken in conjunction with the patient considering the best scientific evidence and also individuality - which ranges from financial conditions to psychological aspects, beliefs and values. The person has to be aware of the treatment alternatives and risks. In the case of risk procedures - surgical or invasive, for example - this information is formalized in writing in a document signed by the patient. That's why it's so important that chosen physician(s) neurologist(s) is an expert in Multiple Sclerosis, constantly updateding their knowledge about the disease, especially about the treatments available.
The treatment is another important factor to consider when looking for and choosing a medical specialist. All neurologists do their best to balance the risks of various treatments for Multiple Sclerosis with possible benefits. Physicians, however, have different ways. There are respected experts who have a reputation for being more conservative, initiating less ivasive treatments and reluctant to use any treatment that has not been completely proven through appropriate scientific studies. Other doctors are more willing to try alternative experimental, unproven treatments, especially in cases where patients are clinically deteriorating.
There is no right answer on how to balance these two medical approaches, it is up to the patient to decide what kind of medical approach with which you feel more comfortable and confident.
Most patients with MS will live a long life with their doctors, that's why they need to feel comfortable talking about potentially uncomfortable topics such as functions of the urinary system and sex. In addition, a patient may not agree with the proposed treatment by your doctor, it should feel free to express it without fear of offending their doctor in anyway.
Finally, patients should always feel free to seek a second (third, fourth, fifth...) opinion. However, especially in the case of a chronic incurable disease (yet) as Multiple Sclerosis, it is important that the patient try to find a single neurologist who will accompany you, you trust and with whom you can develop a long-term relationship. The doctor you choose should get to know the patient enough so that in case of change in clinical status, such as the appearance of new symptoms, and / or examinations, for instance, the appearance of new lesions on MRI, know your history and know how to better indicate the next move, according to what has been accomplished and the personal preferences of the patient.
As stated, the Multiple Sclerosis will accompany you for the rest of your life (until a cure is found), so it is important to be under the care of a good specialist, an expert in the disease. The neurologist who diagnosed you may not be the expert with whom you want to stay. Therefore, seek medical experts in your region and, if not possible, consider traveling to find a good doctor you trust and with whom you feel comfortable. Support groups for patients with Multiple Sclerosis (available through hospitals and organizations) are also useful for obtaining medical references.
Certain behaviors and postures practiced by patients can ensure excellent care from doctors and hospitals, here are some tips:
Consultation:
Ask in an objective manner, punctuality by the physician. To write a letter or email to the doctor is a good and formal alternative;
Let the doctor aware of your health history. If he does not ask, tell it anyway;
Arrange in advance what you want to talk to the doctor. Highlight everything you consider a priority and summarize;
Do not get lost in inaccurate comments. Be objective and list the frequency and intensity of symptoms;
Laboratory tests are sometimes insufficient and clinical analyzes are always important. Make sure of what you need with your doctor;
If the language is too professional, ask the doctor to explain in a simplified form. Do not be left in doubt. Do not be shy about asking as many times as needed.
The diagnostic:
Refuse quick reference. Ask for a dedicated and detailed assessment;
Ask what are all the possible diagnoses;
The cause of the symptoms can only be indicated by clinical and laboratory examinations. Request repeating these evaluations if test results are ambiguous and give different margin or divergent opinions;
Stay tuned for diagnoses that do not match the symptoms manifested. Use the internet to your advantage and to learn. Make sure you are searching for serious and reliable websites as there are a lot of misleading information;
The doctor should be informed immediately if symptoms worsen or change;
If the recommended treatment is unsuccessful, this may indicate that the causes of the problem were mistakenly identified during diagnosis.
The tests and exams:
Make it clear to your doctor that you want to understand what each exam means;
Ask the professional who's helping you if there are other tests for the same purpose that has not been requested;
Make sure the prescriptions from the doctor have been legibly written;
Prior to collecting laboratory specimens, carefully to make sure that the bottles are properly identified with your name;
In case of imaging, or MRI, ask if the injection for contrast is necessary and check the possibility of taking a sedative, if necessary;
Refuse invasive procedures if you are still unsure. Carefully read the consent form.
On admission:
Get to know the professionals who will help you with your care, from the nurses to the responsible physician;
You have the right to require evaluation by experienced physicians, especially if the condition worsens. If your request is not met, make sure it gets recorded in your medical record. And keep requesting a second opinion;
If there is a change in your treatment, make sure you require to be informed in advance;
Inquire about medication schedules and communicate to the doctor if delays occur, difficulties in talking to nurses or be promptly answered when pressing the button for assistance;
Prevent hospital infection. Do not be shy to ask everyone entering your room to wash their hands, that includes health professionals and visits. You can even put a sign on the door;
New catheter incisions will increase the risk of infection. The firm bonding to the skin ensures that these instruments do not move, reducing the need for further punctures. Make sure that the procedure was done properly and safely.
To take the medication:
The right dose administration of your medication is very important information. Make sure that it is adjusted to your age, weight and diagnosis;
In case of hospitalizations, make sure to ask that prescriptions and doses are clearly discriminated in your files;
Ask the doctor that the prescriptions are written legibly and in full, without abbreviations;
Taking two medications at the same time can be dangerous, or at least one can cancel the effects of the other one. Inform your doctor if you are taking other medications and check for drug interactions, make sure it presents no risk to your health since it could jeopardize your care;
After buying a medication at the pharmacy, always check that the name and the product concentration is exactly what was prescribed by your doctor.
SOURCES: Albert Einstein - The correct diagnosis depends on medical reasoning
Albert Einstein - Doctor, hospital, treatment. The patient has the right to choose
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