MDNews - Long Island

picture of the patient using a wheelchair is no longer an accurate view. We have multiple options where disease-modifying therapy (DMT) is concerned, and there is a fit for everybody." ADVANCED DIAGNOSTICS Making an accurate diagnosis of MS as early as possible is a critical first step in successful disease management, and the Stony Brook MS Comprehensive Care Center is equipped with experts and tools to ensure that these diagnoses are accurate and timely. "Our neuroradiology division is key, as they have protocols in place to evaluate patients, and they perform optimized MRI scans of the brain and spinal cord," Dr. Coyle says. "We also have a weekly neuroradiology conference where we go over the imaging studies, and it is valuable to get the input of other physicians." In addition to MRI imaging of the brain, optic nerves and spinal cord, each patient who seeks a diagnosis at Stony Brook MS Comprehensive Care Center will undergo a robust evaluation that includes blood tests and analysis of cerebrospinal fluid. Patients may also be seen by Stony Brook clinicians specializing in areas that may be related to MS, such as neuro-ophthalmology and urology. "Having easy access to specialists is the beauty of being at an academic medical center where you have expertise in multiple areas," Dr. Coyle says. "That is why an MS center can provide optimized care to individuals with MS." CRITICAL TREATMENTS Administering disease-modifying therapies as early as possible is of critical importance for patients with MS, as there appears to be a therapeutic window of time when these therapies offer the maximum amount of benefit, according to Dr. Coyle. "We have developed multiple therapies that actually decrease damage to the central nervous system from the MS disease process," Dr. Coyle says. "It is important to be up-to-date and knowledgeable about these options. With this information, we are positioned to engage in shared decision-making with each patient, analyzing patient factors, MS disease factors and DMT factors to come up with the best choice of treatment." Because some patients may be hesitant to take a particular therapy for fear of possible side effects, Dr. Coyle takes care to educate her patients about the irreversible damage that MS can do to the central nervous system if left untreated. She also explains the benefits of each therapy and that they are well-tolerated. If a particular therapy is bothersome to a patient, resulting in side effects such as flu-like symptoms, another therapy will be used instead. "This is a disease that involves ongoing, permanent accumulat- ing damage to the central nervous system, the brain, the spinal cord, the optic nerve," Dr. Coyle says. "The individual with MS is at great risk to age badly, even though you may not see it initially. I make sure that my patients understand that even though they may feel great, there is ongoing damage happening beneath the surface. Why would you not intervene early on to get that under control with minimal, hopefully, or no damage to the central nervous system?" In addition to counseling her patients regarding the best pharmacological interventions to manage their MS, Dr. Coyle pays close attention to providing guidance related to lifestyle choices that will optimize quality of life for patients. "There is increasing data to support how important following a wellness program — meaning optimal body weight, not smoking, good sleep and good nutrition — is to helping the individual with MS age better," Dr. Coyle says. "It should be considered a separate disease-modifying therapy, in my opinion, so we must communicate that to all patients." Dr. Coyle also focuses on providing her patients with important information about comorbid conditions that may exacerbate MS complications, such as obesity and type 2 diabetes. She also reviews strategies to reduce the likelihood of developing these conditions and how to manage them if they are already present. n For more information, visit neuro.stonybrookmedicine.edu/centers/ms. " Multiple sclerosis is a major disorder, and decisions about MS and treatment are most key early on. Do not hesitate to draw on the knowledge of MS experts to do the very best by your patients. That should be considered best practice." — PATRICIA K. COYLE, MD, FAAN, FANA, PROFESSOR AND VICE CHAIR OF CLINICAL AFFAIRS, DEPARTMENT OF NEUROLOGY, RENAISSANCE SCHOOL OF MEDICINE AT STONY BROOK UNIVERSITY, AND DIRECTOR, STONY BROOK MULTIPLE SCLEROSIS COMPREHENSIVE CARE CENTER M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 0 21 1 3

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