new neurologist: Dr. Sloane

[redbird]

I just saw my new neurologist. I like him (as does Adrian, who came with me). Rather than arrange for me to have the twice-a-year Ocrevus infusions at his clinic, we're planning to switch to a related drug that doesn't involve infusions but monthly subcutaneous injections, usually done in the patient's home, and that doesn't stomp as hard on the parts of the immune system we want to keep. _That_ is the main reason I want to switch, not to avoid the infusions. Even better, Dr. Sloane says that the Ocrevus doesn't wipe out as much of the immune system as Dr AbdelRazek led me to believe. Vaccines are still useful, if not as useful as for someone who isn't on immune-suppressing drugs, and I do have antibodies in my bloodstream, though, again, not as many as without the Ocrevus.

It might be possible for the three of us to relax our covid precautions slightly, though I am making no decisions before talking to Dr. Koster tomorrow.

The new drug is called Kesimpta.

Also: Dr Sloane asked if I'd ever had a sleep study: it turns out that a lot of MS patients also have sleep apnea. When I said I hadn't, he offered to refer me for one, and I said I would think about it, after I see the pulmonologist tomorrow.

And apparently covid tests that use a nasal swab have a higher false positive rate in people on Ocrevus than in the population as a whole.

Dr Sloane also asked whether I was taking the gabapentin for pain, which suggests that he disagrees with Dr. AbdelRazek about whether my knee pain is neurological. I explained that I had originally been prescribed it for pain that my first neurologist thought was neurological, but that by the time Dr. AbdelRazek said MS doesn't do that, I'd discovered that I needed it in order to sleep.

Comments

[calimac]

It is possible, I speak from experience, to have subclinical apnea: not severe enough to affect your sleeping, but enough that the sleep device will relieve the pressure it puts on your system. So it's worth having the test.

[adrian_turtle]

I had thought the main reason not to have a sleep study was the covid risk, so I recently had a take-home study. I don't have the results yet, but it was far easier than I expected, as well as safer. But Redbird spends a lot of time coughing fairly hard, which might not be compatible with using a CPAP. And if you're not going to use a CPAP, it's not really worth testing to see if you maybe marginally need one.

[pameladean]

Oh, yay antibodies; and yay a medication that with less stomping might let you have some more antibodies.

P.

[beatrice_otter]

Hopefully the new drug is better and works out!