Sharon Stoll, DO, as told to Keri Wiginton
You should start or stay on a DMT even if you think you’re doing fine. Some people want to go the natural route if they only have a relapse here or there. But no amount of exercise, vitamin D, or sun exposure is going to curtail your disease path. The only thing that’s proven to do that is disease-modifying therapy.
People relapse less often now because we’re able to catch and treat MS earlier. But having said that, I see plenty of people who come in with 10 enhancing lesions in their brain. I’m not going to put them on a medication that’s only 50% effective. I’m going to put them on something that’s 95% effective.
That’s why I think it’s important to see a specialist, even if it’s just once a year or at the onset of your diagnosis. They’ll let you know how to safely take the best drug for your MS. And you can decide what’s right for you.If you have a relapse, you’ll want to talk to your doctor about finding a new medicine. But it’s important to know the difference between a true relapse and a flare of an old lesion.
But it can be hard to tell the difference. It’s a good idea to call your doctor if you aren’t sure and your symptoms last more than 24 hours.I get lots of calls during the holidays. That’s when people have flares and they think they need steroids. I don’t treat a worsening of old symptoms with steroids because I know their symptoms are caused by stress.
For example, if someone tells me they’re falling more or their walking is off, the first thing I’ll check is how fast they can do a 25-foot walk. The app can use built-in phone sensors to gather that data. And smartphones can give more nuanced data points than I can do in the office. The phone can count someone’s steps or gauge whether they veer to the right or left.But telehealth can’t evaluate a new symptom. You might have brand new left leg numbness. That could be a relapse.
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