Receiving or awaiting a movement disorder diagnosis can bring about a sense of unease and uncertainty. Many patients may become overwhelmed and feel they have lost control over their life. Some may want to ignore their diagnosis and put off seeking care. However, one way to feel more in control is to become informed about your disease and to take an active role in your healthcare, which includes preparing for your first visit to the neurologist.
Please note: If you would like to establish care at Neurology Solutions as a new patient, you must follow the process outlined on our For New Patients page.
The First Appointment
Due to the complex nature of neurodegenerative diseases, new patient appointments are broken into two visits. The first visit is via video. A thorough medical history is obtained. Medical Records are reviewed and any labs or diagnostic testing are ordered.
The second visit is in person. Labs and diagnostics are reviewed and a thorough general and neurological examination are performed. Cognitive, motor testing, and physical therapy evaluations are ordered at this time.
New patient consults are approximately 60-90 minutes.
More Information on the Evaluations
The cognitive evaluation consists of several different tests including a Montreal Cognitive Assessment (a.k.a. MoCA), fall risk scoring, PHQ-9 (depression screening), Katz Index of Independence in Activities of Daily Living, IASL (functional ADL), and Plan of Care. Following the initial evaluation, cognitive testing is performed twice a year.
Motor Testing Evaluation
Depending on the patient’s diagnosis (or symptoms) there are a variety of motor scales available including the UPDRS Universal Parkinson’s Disease Rating Scale, Tremor Scale, and the Ataxia Scale.
Physical Therapy Evaluation
This is where we evaluate the patient’s physical and nutritional needs.
At Neurology Solutions, we like to develop very close relationships with our patients. We typically see our patients for appointments every 2-4 weeks. Many of our patients visit our office on a weekly basis for appointments consisting of physical therapy sessions, infrared sauna treatments, or other treatment activities.
Follow-up appointments are approximately 45-60 minutes. Additional follow-ups will be offered until the diagnosis and management plan are fully understood and implemented.
Patients may be video recorded to capture their neurological status as part of their visit. These recordings may be shown to other medical professionals for diagnostic or educational purposes.
The Cadence of Care — Regular Visits and Relentless Optimization
- First Visit
- Labs and Diagnostic Testing
- Second Visit
- Thorough Neurological Examination
- Evaluations Ordered
- Cognitive Evaluation
- Motor Evaluation
- Physical Therapy Evaluation
- Regular Visits Every 2-4 Weeks
- The team approach
- Constant evaluation and optimization of every treatment in the care plan
- Adjust as necessary
What You Should Do Before Your First Appointment
The following bullet points are some suggestions to help you get the most out of your doctor visits and appointments.
- Prepare to arrive a little early for your scheduled appointment to provide time to complete any necessary paperwork and gather your thoughts before you meet with the doctor.
- Bring the name and address of your primary care physician so he can receive a copy of the medical report following your visit.
- Have your insurance card and doctor’s referral form with you (if applicable). Bring a record of medical test results and reports related to the condition.
- Have a list of all medications and dosages, including supplements, you are taking, as some medicines can interact poorly with others.
- Since some conditions may have a genetic component, find out your family medical history specifically related to walking or coordination problems of family members, including grandparents, parents, aunts and uncles, siblings, and cousins.
- Keeping a log or journal of your symptoms to refer to is helpful in tracking your condition’s progression and helps us adjust the treatments you are currently receiving.
- Be specific in describing your symptoms and how they affect your daily living activities, including estimated periods of time when the symptoms became apparent or worsened. Select the top three symptoms or problems that are most severe to discuss during your appointment.
- Be prepared to answer:
- What other medical conditions do you have?
- Have you had an adverse reaction to any medications?
- How and when did symptoms of your disorder come on?
- How have your symptoms changed since that time?
- What activities does your condition make it difficult to do?
- What makes your symptoms worse?
- What makes your symptoms better?
- If you have recently started a new medication or therapy regimen, be prepared to discuss any side effects or results of the treatment. Have a list of three or four key questions you would like to discuss with your neurologist, so you don’t leave the appointment with additional worries.
- If you think you will have difficulty remembering or understanding your doctor’s instructions, please bring along a trusted friend or loved one to help you take notes and make sure that everything is understood.
What You Should Do After Your Appointments
Many neurological conditions require lifestyle changes. Many neurological medications are started or changed gradually according to instructions provided during your appointment. Let your neurologist know if you are unclear about the instructions and the information you are given before you leave the office! Often, a nurse or other staff member can spend more time with you if needed.
Make appointments for follow-up tests, therapies, or other medical orders immediately. Ensure your primary care physician receives a copy of your neurologist’s report. There may be a list of recommendations to discuss with your doctor.
Begin taking any medication prescriptions immediately, and report any troubling side effects to your neurologist as soon as they appear.
You should be reassessed every six months or with any sudden decline in mobility or change in behavior to best manage your condition. Various resources and healthcare organizations are available to help expand your understanding of your condition and provide support and programs to help you stay active and maintain a high quality of life.
The Role You play in Your Care
Only you know what is going on in your body on a day-to-day basis. Some things may be minor, and some may progress over time. Your role is to provide your doctor with information about your health, health history, medications, and symptoms and to report any specific changes in your condition since your last medical appointment.
One of the biggest challenges for movement disorder patients is to be completely truthful when they talk about their conditions and related symptoms. Many of these patients want to maintain an optimistic outlook on their situation and will sometimes downplay the incidence or the severity of various symptoms. Other patients go to the opposite extreme when describing their conditions. Of course, the simple truth is the best recourse, though telling the unvarnished truth can sometimes be more complicated than it would seem.
Some patients will ask a spouse, a close family member (such as an adult child), or a close friend to accompany them to their appointments and help them recall how they felt or did over the time since their last appointment. In the right situation, this type of setup can work beautifully.
Take it from us: from many years of experience treating thousands of movement disorder patients, we’ve found that a professionally intimate relationship with your physician built on trust and communication can be a decisive factor in maintaining your physical and emotional well-being for the long term. It’s also important to see your doctor regularly and often!
Make Sure Your Neurologist Specializes in Movement Disorders
The treatment of movement disorders is squarely within the realm of neurology — after all, these are diseases of the brain and nervous system. Therefore, any movement disorder patient should see a neurologist for their treatment.
Unfortunately, many movement disorder patients don’t go to a neurologist for treatment. One recent study found that only 58 percent of Parkinson’s-diagnosed patients (Parkinson’s disease is the most commonly diagnosed movement disorder) visited a neurologist for their Parkinson’s-related difficulties and health complications. African-American women, African-American men, and white women patients are more likely to be treated by primary care physicians specializing in internal medicine, family practice, or geriatric care physicians than they are to be treated by a neurologist.
However, that same study found that Parkinson’s patients who visited a neurologist experienced the following:
- A nearly 15% risk reduction in hip fractures;
- A 21% reduction in requiring nursing home care;
- A 23% reduction in the risk of death.
So, “make sure that you see a neurologist” should be at the top of the list for a movement disorder patient preparing to seek medical care.
And while most Parkinson’s patients are thankfully seeing a neurologist for their movement disorder, remember that not all neurologists are the same. If you need treatment for a movement disorder, you need to see a neurologist who specializes in treating movement disorders. Ideally, that movement disorder specialist will be a part of a medical practice dedicated to treating movement disorders, just like Neurology Solutions.
Become a New Patient at Neurology Solutions
If you’d like to establish care at Neurology Solutions as a new patient, click the button.
Here you’ll find everything you need to know.