Re: What's the next step

Thats the problem with doctors and medical *opinions*. :-)

Its tough when you get conflicting opinions from different docs. In
this case, the GP thinks MS, one neuro at the MS center think its not,
but the head neuro thinks it is, and yet another neuro thinks its not.

If I were in your position, I think I would call the MS center and see
what they think, in light of the last neuro's report/opinion. See if
their opinion has changed, or if they still think its MS.

Its just *my opinion* (and you know what they say about opinions), but I
tend to give more weight to the neuro at the MS center I go to, than any
of the other docs. MS is the *only* thing he deals with, whereas GPs
and even general neuros have to deal with a wide range of conditions.

I recently saw a general neuro at a VA hospital. With regard to his
personality and "beside manner", he was a decent guy. His opinion and
approach to treatment, however, was scary, very scary. But thats
another story.

The docs at the MS center can keep up with all of the current MS
research, because thats all they deal with, its their specialty. They
also have more experience at interpreting the signs of MS. In my book,
experience counts.

The other docs may be able to read something related to MS here and
there, but because they deal with so many different conditions, I would
think it would be almost impossible to keep up with everything.

In your situation (without knowing the background of the last neuro), I
would tend to give more weight to the head neuro at the MS center. By
virtue of his position, I'm making the *assumption* (yeah, I know) that
he has more experience than the other doc there.

If you *really* wanted to, if you think it would help you to make a
decision, you could find another neuro, preferably an MS specialist, and
get another opinion.

If you need to, you can call the National MS Society, and they can give
you names & numbers of MS docs in your area. You can find your local
chapter here:
http://www.nationalmssociety.org/site/PageServer?pagename=HOM_FIND_homepage

I see others have mentioned it as well, but I'll just add that I have
been diagnosed as PPMS and have no spinal lesions (so far). As I've
said before, I either have PPMS, or a six year-long, Mother of All
Relapses. :-)

On the other hand, a friend of ours has RRMS. His neuro told him his
spinal MRI literally looks like swiss cheese, and that he was amazed my
friend was still walking.

He's a very active guy, and he's been doing very well lately. At this
point in time, if I didn't know otherwise, I'd never suspect he had MS.
He shows no outward, physical signs at all.

So, while spinal lesions may be more common/prevalent in PPMS, as others
have said, its not the location of the lesions that determine the type
of MS, but the behavior of the disease, whether there are relapses or
just steady progression.

So, thats my $0.02, take it for what its worth, which, with the value of
the US dollar dropping, *really* isn't much these days. ;-)

Good luck.

Alex

mazdotnet wrote:
Hi,

You've seen my posts from the past month about my wife and possibility
of MS (based on my own research on the internet PPMS since her
doctor's seeing 3 spinal cord lesions). Well, here it goes again,
2 years ago my wife's right arm hand became swallen followed by
tingling feeling in her arm for 4-6 months which all went away.
Because it was swallen we thought it's a mosquito bite initially. A
few months after that, her right thumb became numb and has been like
that for a year. Her GP thought the usual 'pinched nerve, Carpal
Tunnel' so made her do some tests which all came back negative. They
saw a small black hole in her brain which after 2 MRI's was concluded
to be a normal brain pattern. So she went back to her doctor which
sent her for MRI of spine. Based on the MRI report he said it's
probably MS and that she has 3 lesions on her spinal cord. On Monday
we went to a well known MS clinic here where the 1st neurologist said
it might not even be MS. He said the spinal looked a little weird but
he said he doesn't think it's because of MS and that it could be a one
time thing. He send us for some other tests (except spinal tap) which
all came back negative. Meanwhile he talkes to the head neurologist
about the MRI results. He also confirmed that those are in fact her
normal spinal patterns. However, he said he found another spot in her
brain which confirms that she has MS and gave her prescription for
Betaseron. So yesterday we saw another neurologist some place
different he went through her entire record (my wife really felt
comfortable with his decision) and said it's not MS. The brain doesn't
have anything and those are her normal brain patterns. The spinal cord
is probably a one time damage from something she has done in the past
and the 2 MRI indicated that the're probably from long time ago. He
said he will get in touch with MS clinic and share his findings with
them and he told my wife to keep taking her vitamins (Vitamine D and
Omega) and to see him back in 6 months. So now here we are with the MS
clinic saying it's MS and wanting to put her on Betaseron and this
neurologist saying it's nothing. So what could it be? What should she
do? Should she go for the medication just to be safe and risk the side-
effects or should she go with the second doctor? I sort of feel a
little better because they're all saying her spinal cord is either
normal or from something else that happened long time ago (she also
has a curved spinal cord) which would minimize the chances of her
having PPMS. Anyone else has had this problem? Would you go for the
medication? I also hear it's good not to wait long and go on the
medication from the start.

Any help would be appreciated :(

Thank you

.