It’s doctor day.  What does that mean? Well when you’ve had ms for 18 years it goes something like this….first doctor is going to look into my eyes.  Then the finger gets lifted follow with my eyes to the left, to the right, up then down. Stick out your tongue.  Next comes the finger tip touching by your thumb to index, middle, ring, pinky.  Then door knobs twisting wrist back and forth. Touch your index finger from your nose to doctors finger at a distance. Now it’s the reflex check, knees elbows, and ankles. While we are here lets scratch the bottom of the feet. Maybe the tuning fork on the ankle bone and on your fingers. Now I make a muscle and resist hard as my arm gets pulled then lift my leg trying to keep it up while it’s being pushed down. Maybe we’ll see the pin next poking various places, do you feel this?  Finally let me see you walk.  Ugh, you can see all this gets to be pretty routine after 18 years. Worse even more so when you know how your body is going to react.  What does any of the tests mean?  The eye test is all about optic nerve damage possibly resulting from optic neuritis.  They are looking for blurred vision or any other eyesight issues regarding neurology.  The finger tip touching, door knobs and nose touching that is looking at muscle coordination or ataxia. Ataxia is a general term used to describe abnormal movements and incoordination.  The reflex check. The hammer on your reflexes points knee, elbow or ankles, they are looking for symmetry on both sides of the body. Is their no response or an exaggerated response. The signs of this show neurological damage.  The scratching of your foot my favorite one. When you get scratched the normal response is your big toe curls down.  If the toe fans upwards or shoots upward this is known as the Babinski response which indicates neurological damage. The wonderful tuning fork and the wonderful human pin cushion test are both checks on sensitivity to check one part of the body against other parts. The muscle push pull is checking weakness in the muscles right side against left side. The walking test is checking gait issues. I should also include here would also be balance tests on most patients.  Some doctors ask you to remember words they say at the beginning of the appointment to repeat at the end, checking cognitive abilities. These little tests as repetitive as they are really do give a lot of information.

The sadness sets in when your tests have shown the damage for so long the stop doing them. I don’t get the scratching on the bottom of the foot or the tuning fork.  I’m not a pin cushion anymore. We don’t check my balance its bad we know.  The muscles I usually do ok in the arms not in the legs. The eyes the damage was 18+ years ago hasn’t changed. It is what it is. Sometimes I don’t get what is the point but 2 times a year I do the NYC specialist and 2 times a year my neurologist of 18 years. Same tests. Same results.  Still makes me sad each time.