#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.