United States Department of Veterans Affairs
Multiple Sclerosis Centers of Excellence

Stay Well with MS

Jodie Haselkorn, MD, MPH - Seattle VA

Christina Hughes, MD - Seattle VA

It is important to get Yearly general primary care and specialty care evaluations. Staying well with MS depends on taking charge of your general health as well as keeping on top of your MS. Because people with MS can still have medical conditions like high blood pressure, high cholesterol, heart disease, diabetes, and cancers, it is important to have a yearly primary care evaluation. This visit should include a comprehensive medical history review and general medical examination.

During these visits, your primary care provider can manage any health problems you may have and also plan for any routine health screenings. Bring all of your medications, including the ones prescribed by a non-VA provider, a naturopath, or those purchased over the counter. Also, bring any medical records and test results that are not VA documents.

Primary care providers work closely with MS specialists to provide comprehensive care for you. To successfully manage your MS, it is important to be seen annually by an MS specialist as well. This is generally someone in the neurology, rehabilitation, or spinal cord injury department with additional training in MS who is capable of performing a full evaluation of your needs. This specialty evaluation should include a comprehensive neurological history review and examination.

The evaluations can be done in a single outpatient visit, multiple outpatient visits, or in some instances as an inpatient. Your MS evaluation is a great opportunity to find out what is new in the management of MS and to stay ahead of problems that limit your activities or ability to participate in society. A careful determination of whether MS is impacting other aspects of your health, and developing the best management strategy for you, will improve your health and general well-being. If you don't know your MS specialist, or don't have an upcoming appointment, ask your primary care provider for a referral.

You can help prepare for an efficient, productive MS visit. Write a list of your most important questions and identify which are priorities ahead of time. As with your primary care visit, be sure to bring all medications and non-VA medical documentation with you to your appointment.

Some common questions your MS specialist may ask are:

  • How active has your MS been over the last year?
  • Are you having any memory, speech, or cognitive difficulties?
  • Are you experiencing fatigue?
  • How are you sleeping?
  • Are you experiencing any depression or anxiety?
  • Are you experiencing any pain?
    • Where and when?
  • Are you experiencing any spasticity or muscle spasms?
  • Are you having any swallowing or breathing difficulties?
  • Are you experiencing any bladder difficulties such as incontinence, urgency, or difficulty voiding?
    • How many UTIs have you had this year?
  • Are you experiencing any bowel difficulties such as constipation or accidents?
  • Do you have any sexual or intimacy concerns?
  • Are you experiencing any vision difficulties?
  • How is your mobility?
    • How often do you fall (or nearly fall) and why?
    • What type of assistance or equipment do you require?
    • Have you ever taken dalfampridine (Ampyra)?
  • How often do you exercise?
  • Are you able to take your disease management agent (interferon beta 1a (Avonex, Rebif), interferon beta 1b (Beteseron, Extavia), glatiramer acetate (Copaxone), natalizumab (Tysabri), fingolimod (Gilenya), or mitoxantrone (Novantrone)) as prescribed or are you having difficulty?
  • How is your ability to perform self care such as bathing, dressing, transfers, eating, meal preparation, and other chores?
  • Are you experiencing any difficulties with work?
  • Are you up-to-date with your vaccinations? Annual Flu Shot, Pneumonia and Pertussis Vaccines
  • What type of social support do you have from family, friends, and your community?
  • How much tobacco, alcohol, or other substances do you use?

Attention to these and other details can maximize your independence and quality of life. Taking the time to care for your primary and specialty needs is a great way to minimize difficulties you and your family may experience with MS and your health.

Updated: November 2012