The Doctor Is In

Yesterday was my semi-annual (?) bi-annual (?) let’s go with “twice yearly” neurology appointment for multiple sclerosis.  The visit in a nutshell?

1. The doctor asked how I was doing.  I said fine.
2. The doctor read the sheet I filled out when I arrived for the appointment, on which I stated that I was having no problems.
3. The doctor asked if I was having any MS issues.  I said no.
4. The doctor said I was in good shape.

And how many years did he have to go to med school?

OK.  So maybe I’ve oversimplified.  Left out a few things.  Such as:

Sobriety testing. I walk in a straight line, touching my heel against my toe for each step.  Also, I close my eyes and touch my nose.

Pain tolerance study. Also known as “We have ways of making your talk.”  He drags a sharp object against the bottom of my bare feet to see if I cry out in agony.

Clown school curriculum. He hits various parts of my body with a rubber hammer.  One of these days I’m thinking that because of my uber-strong reflexes, I  might kick the guy (shades of the Three Stooges), but he’s pretty careful about standing back before he whacks.

Strength training. Like arm wrestling but for assorted muscles.  He pushes and I push back.  I’m thinking about enrolling in some intense boot camp training so I can amaze him by pushing back with super power force.

I guess I passed all the tests, because, as he said/I said, I’m in good shape.

(I’m actually very fond of my doctor.  Because he’s so nice whether things are going well or not.  And because he’s so knowledgeable when he needs to be.)

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That is really just part one of my HEALTH ASSESSMENT which involves evaluating what a person can judge just by looking.  But that’s like seeing a nice, red, blemish-free apple.  Can you really say how the apple looks on the inside?

Hence, part two, the MRI of the brain and spine, which can reveal nasty white lesions, the hallmark of multiple sclerosis.  I haven’t had one in two years, since I changed my medicine.  Does that make it bi-annual?  Semi-annual?  Let’s just go with “once every two years.”  He suggested doing it in the fall.

Ideally, part one, the general assessment and part two, the MRI, both show that a person is doing well.  On the other hand, if they both say there’s trouble, well, that’s bad news but at least the two methods agree.

The ultimate frustration comes when a person knows he’s having symptoms but the MRI comes back clear.  People start looking at him like he don’t know what he’s talking about.  Like he’s full of hot air.  Like it’s all in his head.

It’s not a good thing.

“Houston, We Have a Problem”

Sometimes people’s early experiences with MS involve some decisive big event that reveals to them, and perhaps additional people as well, that something is wrong.  This may involve hands and fingers that cease to function.  Richard Cohen tells in  Blindsided of dropping a pot of coffee in an office full of people.  Fictional Julienne Gillis in Breakdown Lane by Jacquelyn Mitchard relates dropping a sheet cake at a baby shower, after which she stumbles into the mess.

These are pretty impressive, but how about a commentator on the PBS television program Antiques Roadshow holding a vase from the Ming Dynasty, only to have it slip from his suddenly nonfunctional hands and crash into a thousand pieces?  Or a member of the White House kitchen staff dropping a bowl of tomato bisque on the First Lady’s lap at a state dinner?

My big event wasn’t big for anyone except me.  No physical mishaps were involved.  It was, in fact, nothing more than a fleeting facial expression.  Only me and the doc were there; it was the first time I’d ever met him and I’m sure he wouldn’t remember it at all.  I’d had an MRI to determine if a tumor was causing my tinnitus (it wasn’t) and subsequently was told to show the results to a neurologist.  He conducted the whole physical exam, asked a boatload of questions, and even examined the first couple of MRI films appearing to be as convinced as I was that while there may have been an assortment of things wrong with me, MS wasn’t one of them.

As soon as he picked up the fateful film, however, he looked like he’d been hit with a ton of bricks.  His whole demeanor changed.  He got down to serious business and started writing prescriptions for  tests that would be required.  The official diagnosis didn’t come until all the i’s had been dotted and the t’s had been crossed, but judging from the look on his face at that moment, I knew exactly where we were headed.  Those tests weren’t designed to figure out what was wrong with me, but to convince my insurance company to pay for MS medications.  It’s one Valentine’s Day I won’t soon forget.

Correction: The declining cognitive abilities thing is hitting me hard.  Valentine’s Day was when I received the phone call instructing me to make the neurology appointment.  The doctor visit actually happened a couple weeks later, on Washington’s birthday.