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Welcome to the Virtual MS Center!

Ask any question you want about Multiple Sclerosis and one of our experts will answer it as soon as possible.
CLICK HERE TO ASK YOUR QUESTION!

Has Truxima been tested in multiple sclerosis?

2/28/2020

0 Comments

 
Here is My Question:
I am being switched from Rituximab to Truxima for my next (3rd) infusion. I am worried about a change and if Truxima has been tested at all on MS?

Answer:
Truxima is a biosimilar rituximab that was reviewed by the FDA.  It's labeling is Truxima (rituximab monoclonal antibodies).  Rituximab was tested in phase 2 clinical trials for MS and was found to be effective.  There is no material difference between Truxima and Rituxan (the original brand name of rituximab).

A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
0 Comments

I am afraid to have my injection treatment done

2/17/2020

0 Comments

 
Here is My Question:
I am afraid to have my injection treatment done. I am struggling physically and emotionally, and don't feel like my body can take a 6 hour procedure (prolonged sitting is difficult for me). I am also very concerned about side effects and my ability to return to work right after the treatment. I am already dealing with weakness and fatigue that is limiting my current work schedule. Should I prolong getting the treatment done until a time where I feel better?

Answer:

It is impossible to answer your question without further details and knowing your case. Here is what I can say:
  1. It is important with any illness  to try to avoid letting fear interfere with decision making. When I read your question, the stress and anxiety you are experiencing, which is the same thing as fear, is almost palpable. All of us need support to make important decisions. Hopefully your MS team is able to provide this support, if your family and close friends are not supportive.
  2. You must be comfortable with a decision and know the alternatives. This will help eliminate the fear.

I assume in your message you are talking about an Ocrevus infusion. Ask yourself and your health team the following questions:

-Why do I need the treatment now? Can I change the infusion date to a more convenient time?
-WHy do I need 6 hours of infusion time? Can I take half the dose (300 mg) with a shorter infusion?
-What can you do differently with this infusion to limit the side effects experienced during the last infusion?
-Are there alternative treatments we have not discussed and what are their risks and side effects?

I find if you ask the right questions and find someone who can provide the answers, it allays many of your fears and anxieties.

Good luck to you.

(Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
0 Comments

Will having MS interfere with my chances of getting a job in the medical field?

2/8/2020

 
Here is My Question:
Will having MS interfere with my chances of getting a job in the medical field?

Answer:

The diagnosis itself shouldn’t be a factor. However any disability as a result of MS could potentially limit you if the essential job functions are impacted by the disability. As a general rule, I recommend not disclosing the diagnosis to an employer.

A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente

Can Copaxone cause swollen lymph nodes?

2/4/2020

 
Question:
I have swollen lymph nodes on either side of my groin. Is this from Copaxone? My blood tests came back clear and I had a scan that they said there was nothing they could see that was dangerous but that the swelling was definitely reactive. I’m thinking about coming off copaxone!

Answer:

One of the less common side of effects of Copaxone is swollen lymph notes near sites of injections, usually in the groin or inguinal region. There is no reason to stop the Copaxone unless the swollen lymph nodes are painful or the Copaxone is not benefiting your MS

(Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego

​
PLEASE NOTE:  The information/opinions on this site should be used as an information resource only.  This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.

Should I wear a face mask when visiting a hospital if I have MS?

2/4/2020

 
Here is My Question:
I am currently on Rituxan and was wondering if wearing a face mask is recommended when visiting a hospital (family member having surgery, not sick). What circumstances would you recommended patients wear a face mask, if at all?

Answer:
I understand we are immunocompromised, but not in the typical way that we know it to mean (being on Rituxan). Would you be able to elaborate on this?People on rituximab, Ocrelizumab and other anti-CD20 agents do have a slightly increased risk of upper respiratory tract infections (URT) and perhaps pneumonia. The risk of URT infections is higher if you are older (over 50) and/or more disabled (limited mobility or wheelchair bound). It seems prudent to wear masks and/or avoid people with URT infections (e.g. hospital visits)during high activity flu seasons, such as this year, if you meet these criteria.

​(Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego

If lesions are inactive does that mean my wife doesn't have MS anymore?

2/4/2020

 
Here is My Question:
My wife has lesions on her brain and spine but they are inactive. Does this mean she doesn't have MS anymore? That is an excellent question.

Answer:
We define "activity" on an MRI by the development of new or enlarging white spots (also called T2 hyperintensities) over an interval of a year or less or by the presence of typical gadolinium enhancing lesions on an MRI at any time. Scans with any of these features are said to be "active."

Active MRI scans are far more common in younger relapsing remitting people with MS (under age 45) and especially in those not on disease modifying therapies. Once individuals are over the age of 45, it becomes less and less common  with further aging for MRI scans to show short term activity (observed over an interval of a year or less)

The absence of activity on an MRI scan does NOT mean the person no longer has MS or the disease is in remission. There are many reasons for lack of activity on an MRI including but not limited to the following reasons:
  1. Too short an interval from the last scan to detect activity
  2. The disease is treated very well 
  3. The person is no longer in the relapsing remitting phase of the disease, usually over the age of 45
  4. The MRI scan was not technically adequate to detect activity
  5. The radiologist read the images incorrectly
​
(Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego

Is small fiber neuropathy the first sign of Ms?

2/3/2020

 
​Here is My Question:
Is small fiber neuropathy the first sign of MS?

Answer:

Small fiber neuropathy is a peripheral (not central) nervous system injury.  This is not a manifestation of MS, but would reflect a different (or additional) condition. 

A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente

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    PLEASE NOTE: This information/opinions on this site should be used as an information source only.  This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
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  • Home
  • About Us
  • Virtual MS Center
    • Q & A for Virtual MS Center
    • Read About Our Virtual MS Center Staff
  • News & Resources
  • Seminar Registration
  • Health & Wellness
  • Blogs
    • Physician Blog >
      • Healthcare Provider Blog
    • Physical Therapy Blog
    • Patient Blog
    • Caregiver Blog
    • Research Blogs >
      • "Ask Dr. Debbie" Research Blog
      • Multiple Perspectives In Multiple Sclerosis Research Blog
  • About MS
    • What is MS?
    • Diagnosis
    • Treatment
    • MS Tips
  • Symptoms
    • Balance and Walking Issues
    • Breathing/Respiratory
    • Bowel Dysfunction
    • Cognitive Dysfunction
    • Crying/Laughing Uncontrollably (PBA)
    • Depression and Anxiety
    • Dizziness/Vertigo
    • Dysphagia
    • Fatigue
    • Foot Drop
    • Hearing or Smell or Taste Changes
    • Heat Sensitivity
    • Leg Weakness
    • Loss of Hand Dexterity and Coordination
    • Memory and Mutliple Sclerosis
    • Migraines
    • Numbness/Tingling/Altered Sensation
    • Nystagmus and Oscillopsia
    • Pain
    • Sexual Dysfunction
    • Sleep Issues
    • Spasticity/Spasms/Cramps
    • Speech/Swallowing
    • Urination/Bowel Problems
    • Vision
  • MS Clinics
  • MS Topics
    • Pregnancy and Infertility
    • Caregivers and Family Members
    • Employment and MS
    • Medical Costs and Insurance
    • Pediatric Multiple Sclerosis
  • Register With Us
  • Terms of Use/Privacy/HIPAA
  • MS HealthCare Journey