So...I got the 15 minute initial consult

[BG52]

Saw a neurologist for the first time today. She came in and we introduced ourselves (my wife was with me). I started to ask her a question about muscle pain, and she cut me off. She said "Let me look at your MRI first before we talk. You can look too!".

Now, my appointment was at 10:00AM. A nurse took us to the exam room at 10:15. The doctor came in at 10:40. I understand that doctors can run late. My GP has several times. I've caused him to run late several times. It happens.

But my medical records and MRI disc have been sitting in a file in her office for six weeks. This is the first time she has looked at the MRI. She says so.

She picked the series that start at the base of my skull and goes up. 14 slices. she takes 30 seconds to click through the 14 pictures, pointing out a small hyperintensity in two of the pictures and then says "Well, you definitely don't have MS". I said "have you read the report? the lady that wrote the report mentioned irreularities in three parts of my brain and you just diagnosed me in 30 seconds showing me two spots..."

She got mad.

So she read the report. The third irregularity is either blocked blood vessels that caused a tiny part of tissue to die, or a mini-stroke. The "could be indicative of migraine headaches or Multiple Sclerosis if applicable to patient symptoms" was just filler thrown in at the end of the report.

"You don't have MS, and you should be glad of it!"
*sigh*
I asked her if she could help me with some of the symptoms, regardless of the disease. THEN she gave me the reflex test, the muscular strength push/pull tests, very fast and sloppy, and tells me to either see a Endocrinologist or a Rheumatologist.

Hands me a paper to give the receptionist and tells me there is no need for me to see her again.We go out and as I hand the billing paper to the receptionist I look at my wife's watch and it is 11:00. My doctor is back on schedule.

So I don't have MS.
Honestly, I don't think I do.
My GP thinks it's highly possible.
My wife thinks I do have MS. She wants me to go to an MS specialty clinic a little further down the road. I want to get treatment for symptoms I have. But I'm happy to assume my 30 second diagnosis is correct.

We go to see my GP a week from now, to discuss skin issues, muscle pain that keeps me awake, and my 30 second diagnosis. I'll see what he thinks.

I just wanted to vent and say "me too".
I was scheduled for an hour consult.
I got 15 minutes of bad attitude from the specialist for asking questions.    

[jujuminx]

Sounds like a frustrating experience.  I am not sure why some doctors seem to lack the most basic social skills and not realize that they are dealing with people who are scared, hurting and want their doctor to care. You deserve more than a glance from her.

I don't know your medical history so I cannot speak to her competence.  What I can say though is it is important to feel confident in your doctor and your diagnosis.  

If you feel you got the short stick, see another neurologist. If you just want to move on and explore the alternatives she suggested, do that.  You are in the divers seat here!  Do what you think you need to do to move toward better health.

Good luck.

Julie

[essdipity]

Hi. You got a stinker of a neuro. Over the years we've had a great many discussions here about neuro personalities or lack thereof. It's a specialty that seems to draw more cerebral (!) doctors without decent communications skills, and some who are on ego trips for whatever reasons. Yours seems to fall into the latter category.

Not to say all neuros are like this, by any means. That's not fair to the many who do interact reasonably well with their patients. But if one is first-time neuro patient and the doctor is a jerk, for that patient it's 100%.

I don't know whether or not you have MS, but more important, that doctor doesn't know either. It's not unusual for the neuro not to have looked at a new patient's records, test results, etc., prior to the office visit. I don't like this, but it's reality. It's also pretty common to have a neuro scan quickly through the actual MRI. They know what to look for, having seen thousands. And beware of the neuro who doesn't even bother to look, but relies solely on the radiology report. Every neuro who sees potential MS patients should be able to be able to read MRIs.

So that part of your visit I can't really quarrel with. What I do take great exception to, other than snotty and dismissive attitude, is her hurried and careless neuro examination. This is the cornerstone of her kind of work. I wouldn't care how far behind in her schedule she was, that is just not acceptable. Not that you as the patient can do much about it, maybe write a scathing letter where it might do the most good.

I would definitely keep the PCP appointment and also get started with the MS specialist, gathering records, etc. It generally will take a couple of months, even more, to be seen, and you can always cancel down the road if that seems wise. Same for endocrinologist/rheumy, if you can stomach and pay for that many consultations.

As for Hashimotos, I've had it for 35 years and have been medicated the entire time with no issues. New patients might need a while to get meds adjusted correctly; a relative few will have something more complex going on meriting in-depth endo attention. But if you're among the big majority taking thyroid supplement over the years and have been monitored regularly for thyroid levels without problems, then I'd doubt what you're writing about now is related to thyroid.

Good luck.
ess

[supermum_ms]

For reasons only they can understand, it's not actually uncommon for a neurologist to be lacking in the personality department, questioning any aspect of their area of medicine, opinion or speciality is a recipe for an abrupt or rude and dismissive reaction......

To be honest, it's very likely that this neurologist is correct despite her reaction to you, MS is not the most likely or commonest cause of "white matter lesions located  frontal, parietal, left temporal" for someone in your age group. Due to their location it's very unlikely that those lesions are what's causing the symptoms you've mentioned.....  

If you additionally include your diagnosed medical history of Hashimotos etc, and the type of symptoms your experiencing eg muscle aches and pain in your whole body, fatigue, libido etc. There would have to be a higher probability, that your symptoms are not from an additional neurological condition but related to your pre-existing medical condition(s).

From what i know of Hashimotos it's fairly common for someone with Hashimotos to further develop another medical condition eg diabetes, rheumatoid arthritis etc  or already be diagnosed with some other autoimmune condition, so seeing an Endocrinologist and or an Rheumatologist is actually sound advice with your medical history. I definitely believe it's worth following up on, if there is something associated to Hashimotos going on....

Cheers.........JJ