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Does a person's height have anything to do with the effects of medications such as Baclofen?3/29/2022 Here is My Question:
Does a person's height have anything to do with the effects of medications such as Baclofen? I am very short and wonder if the medicine lasts longer for me and I should take it less frequently. Answer: The size of a person, which is partially governed by height, can affect the volume of distribution and half-life of many medications. Doctors and pharmacists should be well trained in these particulars. This is particularly important for medications with a small "therapeutic window". For drugs with small therapeutic windows the concentration in the blood stream must be kept within a relative narrow range to be effective without causing side effects or toxicity. Baclofen does not have a small therapeutic window and the effective dose can vary dramatically from one individual to another for a variety of reasons. We therefore start with low doses and gradually increase the dose until a desired effect is observed or unacceptable side effects occur. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego
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Here is My Question:
Do I need to go to the hospital for new symptoms of MS if I don’t have a neurologist? Answer: You should contact your primary care physician, if you do not have neurologist to determine if a trip to the hospital is necessary for any new or recurrent symptoms. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
Does MS make you loose hair? Answer: MS is not associated with loss of hair (called alopecia). Loss of hair has many causes including some of the medications used to treat MS. Contact your primary care physician for further information. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego #multiplesclerosis #MS #hairloss Question:
Can I get a nose piercing with MS? Answer: There are no problems, related to the diagnosis of MS, of any body art including piercings and tattoos. Some tattoo dyes may have ferromagnetic properties that can heat up in a magnet and cause irritation. Piercings do not create a problem unless they cannot be removed during the MRI procedure. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
The one neurologist in town that did a lot of tests on me, now refuses to do any follow up appointments. My question is, where can I seek another neurologist when I’m having all the symptoms of MS and it’s debilitating my day to day life? Answer: A physician has a continuing responsibility of care until they discharge you back to your primary care physician (PCP) or you establish care with another specialist in the same field. Please check with your PCP to see if the neurologist sent a final consultation note with recommendations. If the neurologist did not send such a note, your PCP should request that this be done. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
My legs are feeling stiff and hurt after sitting or laying down. I'm also a bit off balance. I first felt knee pain, then stiffness. Thank you. Answer: It is very common for people with MS and people with arthritis to experience stiffness and discomfort in the legs after prolonging rest sitting or lying down. It helps to stand, walk, and stretch every 20 minutes. There are many reasons this problem can worsen from time to time. For instance, this program is often worsened by colder weather. I would suggest discussing this further with your doctor. If no obvious problem discovered, I would suggest stretching more frequently before starting new medications Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
I have asked for reasonable accommodations at my work. I teach. One semester it was provided. The last three it was not. I have asked repeatedly and they said they would process it, but it had not been handled. I have a lecture podium and a really tall chair with wheels. I’m 5’4 and have weakness sometimes. I have straight up fallen trying to get into the chair in front of my class. My department says they would handle it, but nothing ever gets done. I have noticed they’re putting pressure on me in other areas that are ridiculous and irrelevant…inconsistent with how they treat my colleagues. I sent ANOTHER request for my accommodation (chair without wheels and a lower desk….totally not unusual). I also contacted my union representative. What gives?? What can I do?? Answer: Discrimination in the workplace against those with disabilities is usually more subtle. Meet with your union representative and approach human resources together. Make sure the supporting documentation from your MS specialists meets all your workplace needs. Unfortunately, you may need to find an attorney who handles workplace discrimination law. Remember, you are a protected class. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
I have a lumbar puncture (spinal tap) procedure scheduled one day prior to me receiving the second half of my first Ocrevus infusion. Does it matter if I have a spinal tap the day before receiving my Ocrevus infusion? I am a college professor who has tried to schedule all doc appointments & procedures during my students spring break week to avoid having to cancel more classes for my appointments. I had a severe relapse recently and had to alter my class formats and take time off. I would like to avoid taking more if possible. Thank you. Answer: It should make no difference when you undergo the Lumbar puncture if it is being done to diagnose MS. Ocrevus does not cross the blood brain barrier well and does not typically affect intrathecal (within the CSF space) production of immunoglobulin, at least not in the short term. The CSF lymphocyte count may be lower but nothing else that we analyze routinely in clinical practice for MS diagnosis should be affected. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
My MRI is stable. What does that mean? Answer: A stable or non-active MRI in clinical practice means there are no new or enlarged T2 lesions (White spots) identified and no new enhancing lesions after the administration of contrast. Therefore an "active" scan does not meet this criterion and is not stable. To interpret this information, remember the following:
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