Praise then darkness, and creation unfinished

I saw my neurologist (Dr. AbdelRazek) today for my semi-annual checkup, and one of the things we discussed was vaccines. He thinks I should get most vaccines, because T cells exist, but doesn't think I should bother with the flu vaccine, because that one isn't very effective in people who aren't taking medication that knocks out their B cells. I didn't ask about the omicron booster specifically, because I didn't think of it: I was asking about a second dose of Evusheld, and whether there's an MS medication that is as effective as the one I'm on now, and doesn't interfere with vaccines. [There is one, Tysabri, which I have already taken as many doses of as I can safely have in my lifetime.]

I told him I'd been tested for anti-covid T cells, and the test found that I do have some, and he was surprised and interested, because he hadn't heard about that test. I used MyChart to send him a link to the faq page for that test, and he thanked me.

He is going to look into a second dose of Evusheld; as far as he knows, the FDA emergency use authorization for that is for only one dose per patient.

I asked the doctor to write a new gabapentin prescription, for the dose I'm actually taking; he did, and Capsule will be delivering it this evening. I told him that yes, at that dosage it works very well, meaning I only have leg spasms occasionally and they are much milder than at the lower dosage.

He says I am clinically stable, based partly on the low-tech neurology, things like moving pegs in and out of slots, walking 25 feet, and having a light shined in my eyes, and partly on my answers to his questions. He is putting in an order for an MRI, head only, no contrast; Mt. Auburn radiology will contact me to schedule that, and if I don't hear from him within a week after the MRI, that means it's good news. My next MRI will be head, cervical spine, and thoracic spine, probably with contrast.

He think my previous doctor's diagnosis of pseudo-bulbar affect was correct, even though I didn't respond to the drug that's commonly used for that (Nudexa). He said the mechanism of action of mirtazapine, the antidepressant Dr. Segal prescribed along with the bubropion, is similar to Nudexa's. This doesn't seem to have any clinical relevance--the treatment I'm on is working pretty well--but I'm noting it here anyway.

[as usual, this is partly for my later reference]