Shift MS: Talking to someone in practice, is there anything that was talked about that a patient could, or someone living with MS, could adopt and therefore make your job easier in practice?
David Palling, Neurologist: Yeah, I think one of the things that’s come through is that we’re able, particularly with that first MRI, to get a little bit more information as to how someone’s disease is likely to progress, whether they’re likely to have lots of problems or not. And that I think’s really important and I think it’s worth patients with MS being aware of that and perhaps just asking their clinician about their MRI, what did it show and how their clinician interprets those changes.
Shift MS: Okay. And what are the key kind of questions and areas of an MRI scan that patients should be asking or interested in?
David Palling: Yeah, so some of the things that have come out in this conference is actually in that first MRI scan the number of lesions that you have can to a certain extent predict how well you’re likely to do. Ask him where those lesions are, so lesions within the spinal cord, lesions within the brain stem seem to be more important than lesions elsewhere. And the other thing that’s important is if you did have an injection of gadolinium at the time of your scan, if you have gadolinium enhancing lesions, that suggests a different prognosis, a slightly worse prognosis than if you didn’t. And your clinician – and that’s sort of our role, to go back and sit and digest all this information – can think about that, think about you, think about what you want to do with treatment, what your goals are, how you feel about risks and really work together to try and work out what the best thing is for you to do. Another thing that sort of came out is that actually it’s important, even when you’re on treatment, for your clinician to keep an eye on you and see if they think you’re doing well, and one of the nice things now in multiple sclerosis is we have a lot of different treatments and it can be hard to make the right decision and sometimes you don’t make the right decision first time round, so it’s important just to keep on thinking, you and your doctor working together, have I made the right decision here, should I think about another treatment. And I think people with MS can be reassured to some extent that there’s lots and lots of treatments available and even if you don’t get it right first time, it’s important that you and your doctor keep that dialogue going and hopefully get a treatment that suits you.
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