I have SPMSi; I asked my neurologist what was my EDSS score and he responded by saying it would take a lot of time to determine it and that it wouldn't make any difference. He said that I was probably 2.5. Well, he only sees me sitting when he comes into the exam room. I assume he knows that I use a rollator simply because it's right beside me when he comes into the exam room. He never taps a knee or watches me stand, much less walk (or attempt to walk). So I looked up EDSS scoring on the internet to determine what I thought was my score and it's reflected in my signature. Then I read on a recent post regarding stem cells that a treatment depended upon the EDSS score that the neurologist said. So I'm thinking it's very important that my neurologist "shape up and determine my score" and get it into my chart -- who knows, it may become important some day- it seems so basic -- just thinking about his attitude makes me so mad.
So, I have a few questions. (1) Regarding persons on this site with PPMSi reporting their EDSS score; does this score reflect their disability when they are experiencing an exxacerbration? (2) Should I insist on my neurologist determining my EDSS score?
Am I making sense?
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Mary Ann
SPMSi. Dx 1991. EDSSi 6.5. Weldon CAPii; 3/08 NAC 2400, Doxy & Azith. 7th metroii pulse 12/08

I am constantly amazed at
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NACi and glutathione push for years all supplementsi in protocol)IV vitaminsi b1-12,F10/29/07 roxy300,doxy200,rifampin300aziyh mwfMS flagyli 1day 500x2 11/23/20074th pulse 2.8.081500mg 8days 7/08 finished 10th pulse on 300 rifamp bid, doxybid 7/2008
My second neuroi (the big
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The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems. Mohandas Gandhi
Mary Ann I kind of wonder
Mary Ann I kind of wonder if your doctor uses the EDSSi scoring routinely because it is not at all complicated, but the sure as shootin' is going to need a minuete to do it. It is not that hard o determine the numbers as the scale is heavily weight for ambulation/walking ability so if you use a rollator to get around you cannot possibly be a 2.5 which is "Mild disability in one FS or minimal disability in two FS (functional systems)". AN edss of 6 is "Intermittent or unilateral constant assistance (cane, crutch, brace) required to walk about 100 meters with or without resting" That's football field length with no cane or crutch if we are talking being a 2.5 vs a 6! How can he possibly say that a person who uses a rollator is a 2.5, unless you could walk that far without it but use it for fun? Yeah right! That's completely bizarre as you saw when you looked at the scale yourself.
see one HERE
As for stem cells and other treatments in the future and their requirements, if they needed an EDSS reading at the clinic they will do it certainly. You might get better results at an MSi clinic as far as these things go, but they will not be at all keen on the abxi! We do have to self advocate, gooed job being proactive.
marie
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On CAPi since Sept '05 for MSi, RAi, Asthmai, sciatica. EDSSi at start 5.5.(early cane) Now 6 (cane full time) Originally on: Doxyi 200, Azith 3x week, Tinii cont. over summer '07, Revamp of protocol in Summer '08 by Stratton due to functional loss; clarithromy
I don't know that the lack
I don't know that the lack of a EDSSi score equates to medical incompetence on the part of the doctor. Kim's been to her local neuroi for years and when I asked him about it he said that he had never measured it because it's usually done in a research environment. This made sense to me.
I can see where it's going to require a lot of time to do this (doctors require all sorts of documetation before they can conclude anything) and at the end of the day, we generally pay attention to symptoms not scores. I'm not saying that the score is unimportant, but I think we here are more interested in it's composition and how you determined it on your own.
In the case of Kim's score that's in her sig - I used This Site which pretty much talks about how far you can walk as a measure. Perhaps, this would be a good thread here at CPnhelp, a thread titled "How did you determine your EDSS?"
Ken
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In pursuit of ABX
Mine did pretty much the
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Rica PPMSi EDSSi 6.7 at beginning - now 2. Began CAPi Sept, 2004 with Rifampin 150 mg 2xd, Doxyi 100 mg 2xd, added regular pulses Jan 2005. Jan 2006 switched to Doxy, Azith, cont. flagyli total 55 pulses LDNi Rifampin 8/08 again NC USA
As an RN I find it
As an RN I find it fascinating that when we go to a doctor and pay him for a service this is one of the few people we are unwilling to fire if we feel the level of service was unsatisfactory. The contract between Dr. and pt is no different legally than any other contractual agreement between parties. I can tell you from personal experience that when go to your MD that you be prepared to demand (within reason) satisfaction. You can legally refuse remittance to your MD if the level of service was not reasonably satifactory. The important thing is to go in prepared and educated about your condition and what it is you wish him to do. He also has the right to refuse services he may deem unreasonable or possibly dangerous. Be prepared to answer his objections and stand your ground. Negotiate! Many will be willing to work with you if you free them from the liability they percieve to be present if things should go south with your condition. Specialties e.g., nuerology, infectious disease, rhuematology may be much more difficult than your GP or internist to deal with and educate. You may start slowly with your first visit to request the lab work and prime him/her about CPNi and the associated infectious agents. Do not expect them to go to the website and read up-thier time is limited. Print out some short articles from the Physician's page. Quest labs does a Chronic Fatique Panel that includes most of the tests needed (your local Lab company can furnish a copy). Ask that the results be relased to you prior to your next visit with the MD. Find someone (RN,Lab tech,etc ) who can help you interpret the results in the light of what is found here. On your next visit discuss the CAPi protocolsi along with articles from the Physicians Page supporting the findings. Offer your MD a letter of release from liablity (I used one I adopted from the MP site which I will attach in a day or two) my doctor who was willing to do this without it -very much appreciated it and put him at ease to do what was unfamiliar to him. Remember this stuff is not taught in med school! People fear what they don't understand.The MD should be your partner, your equal in this, treat him as such and he will respond. Educate him in small doses. Your goal is to move him from his comfort zone to a new place of understanding. Once you and he have agreed to go forward -be diligent in documenting your progress and responses to treatment. Your progess will be his education and others will benefit from it. Paradigms in medicine take 10-15 years to be accepted. Your MDs education will take 1-2yrs.
Remember -medicine is a fee for service business- no service -no FEE!
Onward through the fog!-unknown(it was writtin on an old t-shirt i had)
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Wife with CFSi/FM/REYNAULD'S 15YRS Lab positive for CPni/HHV7&11/EBVi. Son 17yo with FM 3yrs- both on all supplementsi since 8/08 Started CAPs per Strattons modification (clindy/pyruvate/doxyi) started 11/17/08
Thanks for your long
Thanks for your long response. Please don't misinterpret this comment. This MD is a neurologist and he is already perscribing my antibioticsi. I have not seen him since his perscribing. But he appears to have no interest. I do not have the energy or desire to educate him; obviously I'm not too fond of him. He's an arrogant SOB, quite unfriendly and mean (to his nurse at least); that is probably too harse a term; but he does not act like he loves his job! And he's handsome! lol! I have reread your comment and certainly will take it to heart. I needed that. I'll be making an appt with him in the next few mnths. Thanks
I'm still curious about those with PPMSi and their EDSSi score. Is it when they are in regression (as opposed to remission).
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Mary Ann
SPMSi. Dx 1991. EDSSi 6.5. Weldon CAPi; 3/08 NAC 2400, Doxy & Azith. 7th metroi pulse 12/08
Thanks for your reply!
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Mary Ann
SPMSi. Dx 1991. EDSSi 6.5. Weldon CAPi; 3/08 NAC 2400, Doxy & Azith. 7th metroi pulse 12/08
We don't regress. That is
We don't regress. That is what Primary Progressivwe means. And the worst is that, at least with me, it is an ever faster progression.
But having been on this site has been a learning experience in that I believe I have had VERY minor symptoms for decades, and it was only after the hay-unloading incident in 1995, with fire ant bites and being septic for five days that set the acceleration into warp speed. I also realize that the people who diagnosed me listened to what I said about the years of relentless increase of symptoms. At that time I never had a single clue that any of the many tiny things were related to the later disease.
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Rica PPMSi EDSSi 6.7 at beginning - now 2. Began CAPi Sept, 2004 with Rifampin 150 mg 2xd, Doxyi 100 mg 2xd, added regular pulses Jan 2005. Jan 2006 switched to Doxy, Azith, cont. flagyli total 55 pulses LDNi Rifampin 8/08 again NC USA
Thank you! I also was never
Thank you! I also was never given an edssi score but I now know that I'm probably a 6. I don't watch, no less play, football, but I assume that a football field must be several blocks long (like the National Gallery of Art). I can do that with a cane if I am rested.
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PPMSi-misdiagnosed 2001-diagnosed 2006. Also maybe csf and Lyme -- who knows?! Minocycline 7 mos.- resulting bronchitis 5 months. Deserted by Hopkins neurology dept. and going to private md. out-of-plan. Wheldon CAPi 3/2/07 - 200 doxyi; azith MWF. 5 pulses.