MS Treatment: Old School vs New School Multiple Sclerosis Neurologist
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- čas přidán 29. 12. 2019
- I recently interviewed am OLD SCHOOL and a NEW SCHOOL Neurologist regarding their approach to MS Treatment. What they shared might surprise you! Start watching right now!
The Boster Center for Multiple Sclerosis accepts all major insurance carriers and accepts consults from around the globe, both in office and via telemedicine. www.BosterMS.com or call 614-304-3444 to schedule!
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COMMENT with your thoughts and questions below! I look forward to reading and responding!
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INTERVIEW TABLE OF CONTENTS: MS Treatments
1:30 "When is the right time to start a person with MS on meds?"
3:20 "Should we treat mild MS with disease modifying therapies?"
5:16 "Why are some Neurologists still prescribing injectable DMTs?
7:19 "Why not start off treating early and aggressively?"
10:01 "Different opinions on the meds use to treat MS today?"
12:55 "How do you decide when to change DMT?"
15:15 Case Study 1
17:09 Case Study 2
19:14 Thoughts on New Treatments for MS
21:01 Hematopoietic Stem Cell Transplants (HSCT)?
22:05 Closing Remarks
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NOTE: Make sure to talk to your provider before ANY treatment decision. We hope to educate, empower and energize those impacted by Multiple Sclerosis. This channel consists of a collection of formal lectures and informal video clips about MS to help education others. These videos do not provide medical advice and are for informational/educational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any of our videos. They are just to help educate you about the condition guys!
Amazing differences between the mindsets between the old and new neurologists; I wonder the old school neuro's responses to the three inflammatory questions. I had been treated by an old school and new school neurologist, so seeing it in extremes is eye opening.
Happy New Year, Dr Boster, looking forward to learning more about MS with you
old school would claim those questions are intended only to insight fear...
My "old school" neurologist told me to get a hospital bed and wait for the big one to hit. I grabbed my medical record and walked out! 20 years have passed and I was on Copaxone for 10 years and now Tysabri for 9. Still going strong!
Good for you!
I have to say, my first neurologist, the one who diagnosed me, was an old military doctor and was quite aggressive with treatment. After the few tests to confirm it was MS, he prescribed Solumedrol right away, then put me on Avonex. This was within a week after first seeing him. I was so grateful.
I'm not trying to be contrary, just pointing out that not all old school doctors are the same.
Thank you for your continued educational vids, they are much appreciated.
This video was really good. The old school neurologist is who I saw, at my first appt. At this very first appt, he “ suspected MS. He said it was “ a clinically isolated case”. And..”Let’s just wait & see what happens”.. I wish he wouldn’t have waited! My daily life has been affected tremendously.
When I was diagnosed in 1999, I asked my then neurologist (who is now retired) if it was safe to get a flu shot, and he said "he didn't recommend it". My current neurologist encourages it!
Dr. B, you are so funny when you play the role of "Old School Neurologist"! 😂
I really do like this approach for how things have change din treatment. I am luck enough that I was diagnosed and immediately was set up with a neurologist that is very forward thinking in my treatment. I can't imagine how hard it is if you have an old school neurologist, and being told that you are more or less a time bomb and there is little to nothing you can do to fight your best fight other then "see how it goes".
Thank you for filming the "interview" :)
Excellent work, Dr B. I was diagnosed with MS about 8 months ago. Nearly 4 months ago, I lost my mum to secondary progressive MS - it was a DVT in the end. Please keep going with these videos, it gives me (and more importantly us all) hope. I just want to say a big thank you.
Lol- I loved this. Glad I have a new school Neurologist who started me on Tysabri after the diagnosis was confirmed.
Thanks for these videos!
Very creative teaching, Dr. Boster. Well done. Thanks so much for great information, as always.
Dr. Boster my previous neurology doc was definitely old school. You are the best.
Love Learning From Dr. Aaron Boster's Videos 🤓 THANK YOU!!!
Thank you. This was the vid I needed. ❤️
Very informative, innovative, and entertaining! You rock, Dr. B!
Thank you for your expertise, enthusiasm, and creativity in how your communicate with the public! I am glad I jumped ship a couple of years ago and left my not so old, old school neurologist and went to an MS Center. I probably would still be on Rebif today if I hadn’t (been on O for a year now). “Mild” disease still can be very impactful on one’s quality of life.
Love these videos! So glad i have a " new school" neuro!
yeah!
What a great video that shows clearly what the patient centered care model looks like vs the old medical model. I know which I prefer and it's not old school for me. Thanks for another great video!
DR BOSTER-
THIS WAS SUCH AN ENLIGHTENING SPILL ON SUCH A GRAVE DISEASE. GLAD TO SEE YOU INCORPORATED MY QUESTION-FROM "NEWLY NATURAL"
you're welcome and I'm glad you liked it!
Loved this😂
Great info🤓
Thank you Dr B🤗
TY LW! It was fun (but complicated) to make!
Thank you Dr B .You make me smile it was helpful and funny.
Your awesome!! Thanks for this!
you're welcome. Please he me share it broadly with others!
Aaron Boster MD yes please
My first doc was definitely old school. Started me on Rebif. It made me soooooo sick. I learned from you that injections are not as effective with African Americans AND I learned that a wash out period wasn’t necessary. Anyway, after three weeks on Rebif, he said I should stop but wait a month before starting Tecfidera-my choice. He recommended Copaxone 🤕 I started Tecfidera, but now my lymphocyte counts are super low so I think my NEW neurologist will switch me to Ocrevus.
LOVED THIS !! THANKS SO MUCH !
;) Thank you Jody!
Great 😊. Happy new year dr B and the village 💕
Great video!
I believe my neuro WANTS to be more new school, but is apprehensive because he's only been practicing 5-6 years. We seem to be balancing the cutting-edge new grad/new school mindset with cautiousness. Being a baby MSer myself, I'm ok with that. I've worked in healthcare long enough to be comfortable having those difficult conversations should the time come that I need to advocate for myself with him.
Absolutely on point! ✌🏾
I appreciate that!
DOC , I LOVED THIS VIDEO. It was awesome. Would love to see you really interview other MS doctors. I see Dr Christopher Laganke , he is my doctor. And would love for you to interview Dr.LaGanke . Would love to see other doctors like yourself , their prospective. I love your content and thank you for caring enough about us to properly inform us on MS. Finally some MS content i can learn from. THANK YOU, THANK YOU, THANK YOU.
Both entertaining and informative video, something not easy to accomplish. I have been on Copaxone for 10 years with no new disease activity, clinically or MRI. I still question if I should move on to one of the newer more effective DMT's. Thank you for today's video.
Dr. Boster you're just plain silly...but in a serious way.😜Thank you for taking the time to educate us, even in a way where this knowledge can be easy to digest. I believe my Neurologist is very much New School. We are all very grateful for your support.
This help alor! Thanks 😊
I'm so glad!
Lolol I'm not even half way thru n im laughing. Needed that. Thanks doc. BTW I have an appointment with your friend Dr. Krieger 3/12/21. Looking forward to it
Great video!
TY Roslynn!
If you weren't such a great neurologist, I might suggest a career on the stage. Thanks for this. After viewing many of your video's, I think it's time to talk with my husband and neurologist about upping my treatment to something more effective. I recently was referred to a "specialist," who said that since my disease wasn't very active (meaning the most recent MRI showed no new lesions), I should just stay on Copaxone, even though I have developed vertigo as a new symptom.
I was Dx August 2012 with PPMS. I was struggling with symptoms 1-2 years prior. Until 2017 when Ocrevus came out I was told there weren't any medication for PPMS. Without knowing if it would've made a difference I wish I had known about Ocrevus then. I would've been more than willing to enter a clinical trial with a drug that was so close to being FDA approved.
Greetings from Montrea againl! Happy New Year with health and happiness!
My dilemma... I live in Canada, where I have access to government health care as well as private health care through my hubby's job.
If you have private health care, you are obligated to use it. In both cases however, they ask you to start on a weaker drug before hitting the big guns.
I'm currently on Tecfidera and happy I didn't have to start with Copaxone, but disappointed that I couldn't get Ocrevus.
QUESTION… what is your personal opinion about TECFIDERA?
🤣🤣🤣🤣🤣🤣. Old school needs to take a nap!
amen!
I was first diagnosed in june from MRI (had both old and new lesions in different areas of the brain). Then I had a lumbar puncture and there were no oligoclonal bands and my neurologist drew the diagnosis back. Wasnt offered meds. When I got a second attack in november I saw a different neurologist who specializes in MS. He put me on Mavenclad. I just finished my first 5 day pill dosage yesterday and I have high hopes for this treatment. Only thing is that it's so new there isn't a lot of information on it. Do you have any thoughts on this drug? I'd love to see a video from you about it. Happy new year and thanks for your videos.
Thanks for the video Dr B.
I just wanted to ask..
When available..
Can neurofilament blood test help to "predict" the evolution? That would be awesome.
yes we believe this is where the field is heading!
I've had only old school neurologists. Am going down hill fast.
Am getting a new one here soon . I will beg him to put me on one of the higher efficacy drugs.
In my country they have the protocol that you should always start with interferon and then if it doesn’t work try something else. Now we know that it’s better to be more aggressive and start with a good DMT... but since they have this protocol that’s so outdated I have to find a way to pay it somehow... it’s so sad that we can’t be more updated... and intelligent 😆
Side effects are annoying? Try symptoms... I love the fact i started on tysabri. It showed real reluts in real time. I watched my dad move from med to med b4 ocrevus.
right on
Dr. B I am lost. Ms specialist says I have ris. Second opinion not ms neurologist just regular neurologist says he doesn't think I have anything ms at all but doesn't know what's wrong with me. I am tired of being in horrible pain every single day of my life. I am also tired of going to all these doctors. It may not be ms but why can't any one help me? I am crying writing this because it's just all too much. Guess I just had to vent
have you ever had some one with burning face due to an active lesion?
You going to do anything about zeposia?
Curious, often when you talk about ms you refer to the mris.... but it’s been my experience that my mris are interpreted by another dr (the one that makes the report) and my actual neurologist depends on that report. They can’t explain my mri to me or show me where my lesions are. They aren’t even looking at the mri. Just the report. Is this normal? Why are you not like any of my neurologists? Is there a type of neurologist I should be looking for? Specific questions to ask when I’m dr shopping? How do I find one that understands my disease well?
Dr. Boster, I’m curious. With ms, it’s my understanding that your immune system is out of whack and attacking the myelin sheath. If you’re on a DMT, is it smart to increase vitamin c and try to boost your immune system when your sick (fighting a common cold)? My husband tends to get sick pretty easily and will be starting Ocrevus soon. Do we want him to boost his immune system or suppress it and take no vitamin c? Sorry if this seems like a silly question. Thank you for all these ms videos!! My husband and I love watching your videos together!
He's addressed this in his videos and livestream on supplements and vitamins. I recall him saying that you don't want to boost your immune system as it's slready overactive in a bad way. The live stream on vitamins and supplements was a few months ago. You should check it out.👍
Vitamin C doesn't help, that's a myth
🔑🔥🎥
❤️
👍👍👍👍👍👍👍👍
👊💥
Brilliant neurologist please come and live in England or teach English neurologists. Think they would have a different approach to the disease and more helpful. Most of the time we end up being helped by ms nurses rather than the ms doctor. That’s not an issue just the doctors deal with other conditions as well and really don’t have the time to talk you through things properly. Very old school
In their approach. Cambridge university hospital would love you on their team, as would us patients
Well isn't the old school doc just precious?
ha!
Been diagnosed with Ms was the least expected ever thing on my mind I mean I will get headaches here and there on my job but hey since my job was nighttime I use to quickly think that was part of it and when I ended up needing eyeglasses I wasn't that surprised since pretty much my whole family uses eyeglasses but I guess in the end my Ms was slowly cooking we're it got to this point where I am right now....
Few years ago my head doctor saw me and with only suspicious he said back then I think you have Ms but don't take my word at all...he sent me to see who is my current neurologist and she sent me to get a few MRIs and a few blood tests well few days later it was official spots on my brain on the MRIs and spine and my blood tests came low on a couple things that help more the results of my having Ms at first I was declared ppms then last year I quickly jumped to spms BUT I no longer need eyeglasses I only use them for a few months actually then I stopped needing them I do use daily either my walker or my wheelchair....the Ms got me lessions all over my spine and brain so I deal with it people get surprised often when they see I am able to get up and walk but I'm always in the need of holding something in order to keep moving I tried to do it many times before and it was a straight fail so nope....two of my medicines also play a HUGE role....ampyra and baclofen if stop using the ampyra half a day or even a full day my right side leg acts straight stiff like a wooden leg and while I can go a few days with out the baclofen soon or late I get my leg twitching really bad...with baclofen is a ok as is so takes like 3 days with out taking baclofen pills to start to see a decline....leg twitch.... cramps....etc etc so yeah the sooner the better
What if the only available drugs for MS in my country ( Romania ) are injections? I try to focus on diet and fitness. Can't do anything else... Thank you for your videos!
take the best drug available to you, exercise as part of your lifestyle, don't smoke and eat clean and supplement low levels of vitamin D.
How do I have the conversation with my doctor that I want to be off the ABC drugs and take something more effective like Tysabri, Ocrevus or Lemtrada?
I would say it very clearly, it's your body, your life
Lol one little spot!...... One little spot was me three months ago! Was told let’s just keep the same dmt for another 6 months - a year and watch. Well I’ve just had the biggest relapse I’ve ever had 🤷♀️😑 I haven’t had an MRI yet so don’t know what’s going on in there but symptom wise I am not ok. I’m worried that it won’t show on the next mri in March because my primary care dr put me on steroids. I want to change DMTs but I’m worried they won’t let me!!
Lornie 09 that’s horrible that you are suffering so much. If your current neurologist/specialist refuses to check you out, I would suggest seeking new care if possible. Only you can describe exactly what you are experiencing, but your physician has to have the ability to listen and make good choices WITH you, not for you. Keep fighting Lornie!
Darla unfortunately it’s the one downside of public healthcare I’m stuck with who I get unless I can pay to go private which I can’t. It’s a blessing and a curse!
Lornie 09 I’m so sorry. I wish there was more that I could do to help you. Unfortunately, there are many physicians that have “White Coat Syndrome”, and the fact that they are in public healthcare makes that syndrome that much worse. I hope it gets better for you.
Darla thanks 😊 we’ve tried the whole conservative thing that he wanted to do and it’s been detrimental so time to put my foot down lol
Lornie 09 stay strong!
Hi Doc, Happy New Year, I have been diagnosed with PPMS and I am about to start Ocurevus imminently, and I am afraid of the side effects I am 58, I am afraid, they aren't bad are they? Can anyone elaborabote from your community from experience, I don't mean to be a wuss, I am just newly diagnosed and afraid...I briefly went over the side affects with the doctor, thank you for any advice anyone could offer.
Good morning Donna, I was diagnosed in my 50’s as well (almost 3 years ago). Try not to worry about the side effects yet. Not everyone experiences the side effects. If you do experience them work with your doctor. You might be able to mitigate them or change medicines if you are not tolerating them well. Good luck!
village members, can you please help weigh in?
@@AaronBosterMD I have had 5 infusions of Ocrevus and love it , no side effects for me except upset stomach the next day sometimes
Thank you so very much for being here, i am so grateful that I have this community to turn to and do in this time of need, I appreciate all of you more than you could possibly imagine as no one that's in my life...can even imagine what chaos this disease has done in my life...thank you again and the most happiest and healthiest of New Years to you all...
I'm 53, on ocrevus, and experience no side effects at all. The hardest part is sitting there all day during the infusion. They do also give benedryl, which makes me groggy. But thats not ocrevus. Go for it!
You could cry if you see how they manage this disease in my country... they just see the option of interferon... and that's it...
where do you live Soya?
@@AaronBosterMD private message. How can I contact you?
I can already guess what one I’ve got 😂🙄
right on
I'm in that "undertreated"category...
"knowing is half the battle" -GI Joe
After watching this video I'm glad I don't have an old school neurologist.
Talk about stem cells for those old MS’rs that had old neurologists that didn’t know squat about MS around 20 years ago and gave horrible (aka no) advice.
Let me give a tough one.. What would new school vs. old school say about RIS?
..well I actually guess it, old school wouldn't have heard about that :P
Old school would watch and wait. New school would discuss starting DMT.
Dr. Boster, with 21 drugs on the market specifically for MS, do you feel that there are any that have become irrelevant?
Thank you.
IMO yes
My neurologist is a old guy but put me on tysabri right away..granted I asked how many lesions I had and he told me I would say infinite but that would mean theirs no end to them
chet laux I asked how many lesions I have. I didn’t get a real answer
Hey! Isn’t that Jimmy Stewart’s clone?!
lol
Motorized Wheelchair...
Ugh. I'm starting to think I've got the old school dude.
My situation is i am worse now in terms of mobility than I was 3 years ago when I starter on Tecfidera. No new activity on scans though means the Dr. Sees this as the drug is working. I have made the case for trying Ocrevus as it has been shown to slow down progression. The argument against this is that if no activity is showing then Ocrevus will do nothing Tecfidera isn’t doing. Given my deterioration physically is this a fair assessment?
no it's not.
Aaron Boster MD Thanks Dr Boster, without asking you to comment on my personal situation is it possible to deteriorate without signs of inflammation activity and how could Ocrevus benefit me over Tecfidera?
Do all neurologists look the same? My neurologist is a imposter.
👨🦳Dr. Oldie
🤵Dr. New
👨🦱 MS Patient
Old school...You’re fired!
NICE
After watching this I think mine's old-school just showing up for the money
😖
I don’t like “old school” you..........😘
ha!