#143: Interview with Dr. Aaron Boster on the 10 red flags when to change your neurologist

Today I'm talking to Dr. Aaron Boster about the 10 red flags when you should talk to your neurologist or maybe even look for a new one. This episode exists in two language versions. The original one is this English inteview. But there is a transcripted and translated German version, where I speak both parts. We go a bit more into details, how a good relationship and care should look like in order to keep multiple sclerosis under control as best as possible. Summary of the ten red flags: Before we go into detail, please list once the ten red flags patients should be aware of when going to their neurologist [05:53] Dr. Aaron Boster: Yeah, sure. So, these are in the order that I presented them. And the context is if your neurologist does one of these things, you should be concerned and consider whether you stay with them. All right. Quote, unquote, number one is being seen only once a year. It's my opinion that that's not frequent enough. We'll come back to all of these. [06:15] Nele: Agreed. [06:15] Dr. Aaron Boster: Number two is not getting at least an annual MRI of your brain. So, if you're not getting an annual MRI, I'm concerned about that. Number three is not showing you your scans. So, just telling you, oh, it's okay. Or, oh, there's a new spot is inadequate. Number four is not checking laboratories because every drug except Copaxone requires monitoring. And so, if they're never ordering labs, then that's a red flag to me. Number five is not screening you for common, invisible symptoms. Invisible symptoms that plague MS such as the up there's thinking of memory, energy mood, you know, the down, there's bowel, bladder, bedroom, other things like pain, like those are invisible, but they're really important. And so, if your doctor's not asking you about them, I'm bothered by that. Number six is not discussing medication adherence because taking medicine is hard and adults aren't always good at it. And that's not a bad thing. That's just something that we must be discussing. So, if they're not asking you about that, that bothers me. Number seven is not watching you walk. So, if they're not going to do a full-blown exam, there's an argument to be made, not to do a full-blown exam, but they at least need to do some physical assessment. And that bare minimum watching you walk informs them significantly. So, if they're not, even if they're only seeing you seated in a chair with no testing, that's a red flag. [07:46] Number eight is offering a first-line injection new here in 2022. And I will put some caveats around that. There are some patients that I have that are super responders to first-line therapies, and I'm not going to take them off them. I'm talking about your newly diagnosed, and they say, okay, we're going to start you off in 2022 with the first line injection. Or if you have a breakthrough disease on a drug and the doctor's offering the first-line injection as a switch, I'm not okay with that. Number nine is if the doctor says, well, go home and pick up your medicine. Here are five pamphlets let me know what you think. And the last one, number 10 is the doctor not taking any efforts to learn about you as a human being. So, it's my contention that if those things are present, you should take pause and explore that relationship. You can find the full transcripted version of the interview at: https://ms-perspektive.de/interview-with-dr-boster-10-red-flags-when-to-change-your-neurologist ++++++++++++++++++++ Many thanks to Dr. Aaron Boster for providing a guideline, what are some main cornerstones in the relationship of neurologist and MS-patient. And please speak up, if you feel something is wrong, and just realized that there are to less checks or insights provided. You always have to bare in mind, that its your life and you deserve to live it in the best possible way and health! So stay informed and make conscious choices. Good luck and all the best, Nele For more information about MS, check out my free German MS-Letter. Here you can find an overview of all previous German podcast episodes.