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Multiple sclerosis (MS) is a neurological disease that affects about 400,000 people in the US. It results from an attack by the immune system on the myelin in the brain, spinal cord and optic nerves. Myelin is a fatty substance which covers the nerve fibers much like insulating material on an electrical wire. When the myelin is damaged, normal conduction through nerve pathways is disrupted, resulting in symptoms such as numbness or weakness of arms or legs, loss of coordination, difficulty walking, blurring of vision or disturbance of bladder function. The severity of these symptoms ranges from mild to disabling. Multiple sclerosis most often appears for the first time in young adults and much less commonly in children and in the elderly.
Multiple sclerosis can be very difficult to diagnose properly because the symptoms are the same as those of many other diseases. While no single test exists to diagnose MS, MRI scans are especially important, and tests of spinal fluid and of nerve conduction can sometimes be very helpful. Other diseases which can cause similar symptoms must be looked for and ruled out. In some cases the diagnosis of MS cannot be made with certainty until tests have been repeated over time; looking, for example, for changes in the MRI scans. Even with these measures, the expertise of neurologists who are trained and experienced in diagnosing and managing MS is critical to avoid missing the diagnosis when MS is present or mistakenly diagnosing MS when symptoms are caused by other disorders.
How Mercy Can Help For complete and comprehensive multiple sclerosis care in the Sacramento area, look to the Mercy MS Center.
The Mercy MS Center was one of the first in Northern California to be designated by the National Multiple Sclerosis Society as a Comprehensive Center for MS Care. This affiliation recognizes a unique group of medical caregivers who have a high level of proficiency in the diagnosis and treatment of multiple sclerosis in a setting where specialized resources are available.
Our caregivers include:
- Neurologists
- Radiologists
- Urologists
- Ophthalmologists
- Physical Medicine Specialists
- Behavioral Health Specialists
- MS Nurse Specialists
The efforts of these specialists are supported through the integration of several key specialty services, including:
- Imaging Centers - MRI scans of brain and spinal cord
- Infusion Centers - for MS treatments which are given intravenously
- Rehabilitation - physical, occupational and speech therapists who understand MS
The Mercy MS Center is located on the Mercy San Juan Medical Center campus in Carmichael. The dedicated staff includes John Schafer, MD and Karsten Dengel, MD - two neurologists who share a commitment to the treatment of MS and Edie Happs, MSN, a Certified Multiple Sclerosis Nurse who makes the needs of the patients her priority.
Your First Visit A visit to Mercy's MS Center will enable the team to assess your condition, determine whether any changes are needed in treatment and allow you a trusted, safe place to learn about MS and how it is affecting your life.
To get the most out of your visit with the neurologist and clinic staff:
- Be on time for your appointment - We will do everything possible to see you on time, but if you arrive late you will either be "short-changed," or the patients scheduled after you will be kept waiting past their appointment times. Return appointments are usually scheduled at 20 minute intervals. Some visits require more time, making running late inevitable at times. If you think you need more time, let the office know in advance so that a longer appointment can be scheduled.Bring records - For new patients to the MS Center, bring all records of previous care available. If you have seen other neurologists, try to obtain copies of the consultations, including progress notes, results of blood tests, spinal taps and MRI scans. Making the diagnosis of MS or determining whether it is progressing often involves comparing MRI scans and reports of findings on your examination by doctors in the past. Seeing the actual images of the MRI scans tells much, much more than reading a report. Even small changes from one scan to another may be critical to making a diagnosis or determining if treatment is working. Images can be sent on a CD ROM or via the Internet, so carrying films may not be necessary. The films may still be needed, however, for scans performed more than a few years ago. The office can help arrange for transfer of records and MRI scans with advance notice.
- Make a list of questions or concerns that are most important to you - Putting this list in order of importance is a good idea, since all issues may not be able to be addressed in a single visit. Get the problems that worry you most out on the table right away.
- Think about answers to these questions the doctor will ask at each appointment:
- Have you had any new symptoms possibly related to MS?
- Are you any worse now than in the past - say, six months, a year or several years ago?
- Reviewing current medications is one of the most important aspects of the visit - Many times, medications have been added or taken away or dosages changed between visits. Keep a list of all of medications, the sizes of each pill or tablet and the number of times taken. Better yet, put all medications in a bag and bring them to the appointment. Also, be sure to tell the doctor what you are actually taking and not what the bottle says you are supposed to be taking if, in fact, you are taking it differently than instructed on the label.
- Asking the doctor about articles in the newspaper or on the Internet is fine - Because time will usually not permit reviewing whole articles, plan to leave a copy with the doctor if the doctor does not have a ready answer on the basis of the title or a brief look at the article.
- It's okay to bring a friend, take notes or bring a recorder to the appointment - It is common that patients get occupied thinking of other questions or concerns and may not catch what the doctor is saying. Even when you hear an answer to a question, it may sound different or you may think of other things when you listen to it again later.
- Don't be afraid to ask the doctor - If you don't understand something or if the doctor's answer doesn't agree with what you thought, speak up. Discussion of issues is the best way to learn.
If you're experiencing symptoms of multiple sclerosis, schedule a consultation with the Mercy MS Center today. The earlier MS is detected, the more manageable it will be. Referrals to the Mercy MS Center may be made by calling (916) 536-3670. Referrals by a primary care physician are preferred.
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