At the MS and Neuroimmunology Center, no specialist works in isolation. Depending on patient symptoms, a case team in our primary MS clinic may include a neurologist, nurse, nurse practitioner, infusion nurse, social worker, urologist, psychiatrist, neuropsychologist, neuro-radiologist, ophthalmologist, physical therapist, speech therapist, dietician, sleep medicine specialist or pharmacist.
In addition, a dedicated team of clinical trial coordinators and internationally recognized research labs studying the pathogenesis of MS and related conditions keep us at the forefront of medical innovation and knowledge.
But your training doesn’t end there.
As a fellow, you’ll receive first-hand experience coordinating multifaceted patient care, including opportunities to work in our “one-stop” multidisciplinary clinics, in pediatric neuroimmunology at Nationwide Children’s Hospital and through our neuroimmunology inpatient consult service.
Multidisciplinary clinics
Our MS multidisciplinary clinics centralize interrelated services for easier collaboration and individualized care. By having teams of highly trained doctors, nurses and other specialists working so closely together, we can easily discuss and coordinate any changes in care.
Most important, these clinics make it possible to treat the whole person, not merely a list of individual symptoms in isolation or without recognition of how a chronic disease like MS can affect overall health and every part of a patient’s life.
These multidisciplinary clinics are a valuable training ground for our fellows because of the cross-specialty learning and teamwork that’s involved. Time spent in these clinics only improves your ability to consider and manage all aspects of MS as a clinician.
To address some of the most prevalent physical and mental health issues related to MS, our focused clinics include:
MS Quality of Life (QQL) MS Clinic
In this clinic, we use several screening tools to help us understand the impact MS has on every individual’s quality of life. We assess overall health, fatigue levels, pain, sexual satisfaction, bladder control, bowel control, vision, perceived deficits, mental health and available social support. We also explore diet and exercise, and we share important MS education and information about disease-modifying therapies. We may also use magnetic resonance imaging, aal coherence tomography, bladder scans and blood tests to set baselines.
Once we determine the current impact of MS on a patient’s daily life, we then work with them to identify personal goals and develop a long-term plan for better disease management. For complex, persistent or worsening MS symptoms, we may refer patients to other MS clinics or other specialists across the medical center.
As a result, no two care plans are alike, just as no two patients are alike.
MS Multidisciplinary Symptom Management Clinic
Patients seen here receive even more customized care, starting with a quality-of- life intake assessment that helps providers understand where patients need the most help. Whether it’s managing a patient’s medications, improving balance or reducing bladder dysfunction, we can then refer to experts across the medical center, with some of our most frequent referrals being made to sleep medicine, pain medicine, rehabilitation, psychology, pharmacy and social work.
MS Spasticity Management Clinic
This clinic targets the severe and disabling spasticity that often occurs with MS. Our fellows have the opportunity develop the skills needed for complex spasticity management, including dosing or oral drugs, baclofen pump management, targeted Botox injections and rehabilitative therapy through collaboration with physical medicine and rehabilitation unit.
MS Psychotherapy Clinic
In this program, MS-trained neurologists team up with psychologists to treat patients whose chronic symptoms have led to anxiety, depression or other mood disorders.
Patients learn strategies for coping with their symptoms. They also receive evidence-based therapies best suited to their needs. These approaches include behavioral activation and acceptance and commitment therapy.
Neurosarcoidosis multidisciplinary Clinic
This multidisciplinary clinic is a joint initiative between Neuroimmunology and the Sarcoidosis specialists within Pulmonology. Patients are seen by a specialist from each team, and the clinic also conducts innovative research to better understand and treat this rare disorder. Our fellows rotate within this clinic and gain valuable skills in the management of neurosarcoidosis.
Neuro-Rheumatology multidisciplinary Clinic
Neuroimmunology and Rheumatology experts provide coordinated care for patients with neurological manifestations of systemic inflammation like Systemic lupus erythematosus, Sjogren’s syndrome, Rheumatoid arthritis. This clinic provides an unmatched opportunity for our fellows to learn from both rheumatology and neuroimmunology experts about the management of neurological manifestation of systemic illness.
Aging with MS multidisciplinary Clinic
Because older patients are uniquely affected by overlapping symptoms of aging and MS, the team of specialists in this clinic work together to manage issues related to functional capacity, gait and balance, bladder function, nutrition, cognition, mood, social support and medications. Our goal is to improve quality of life and prevent disability in these older adults with MS.
MS Fatigue/Sleep Clinic
Fatigue is the most common symptom reported by patients with MS, and sleep disorders are more prevalent in MS patients than the general population. This clinic serves patients who need polysomnography or further investigation and ongoing treatment.
Neuroimmunology inpatient consult service
The goal of this service is to assist with the diagnosis, management and transition in care for hospitalized patients with a potential inflammatory central nervous system disorder.
Fellows are involved with inpatient diagnostic workups, imaging, treatment recommendations and appropriate work-up before transitioning patients to the outpatient MS/neuroimmunology clinic.
The MS fellow serves as first-line contact for the consult service and evaluates patients with the covering MS faculty.
In addition to comprehensive training in the management of complex neuroimmunology cases in an inpatient setting, fellows also gain teaching experience while working with residents and students on the neurology inpatient service.
Pediatric neuroimmunology at Nationwide Children’s Hospital
The Nationwide Children’s Hospital (NCH) Neuroimmunology Clinic provides evidence-based, family-centered clinical care for infants, children and teens with autoimmune disorders that affect the central nervous system. Ohio State’s MS fellows work along with a team of NCH pediatric specialists from neurology, rheumatology, psychiatry, psychology and neuropsychology, as well ophthalmology, neuroradiology and physical, occupational and speech therapy to design the latest therapies appropriate for such young patients.
Didactic activities
Clinical experience is enhanced with a variety of didactic activities including:
- Biweekly case conferences
- Monthly journal club conferences
- Recorded MS lecture series by Ohio State faculty
- The Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) didactic lecture series, which runs throughout the year and covers relevant subjects presented by national and international experts.
- Preparation and delivery of lectures to residents and students on assigned topics