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TL;DR: 22 year old male from the UK. A friend suggested that I go to the GP and get tests done for MS based on the similarity of my symptoms to a family member of theirs suffering from MS. The symptoms I've noted are:

MAJOR:
- Notable deterioration in hand dexterity and/or strength; increased 'fumbling'
- Moderate fatigue* (feeling completely exhausted after around 6 hours of being awake)
- Noticeable decline in mental acuity over the past few years* (brain fog, 'slow' feeling when thinking, 'tip of the tongue' moments very common)
- Depression
- Blurred vision sometimes (to the extent where my glasses for mild myopia are useless and I am unable to read the screen of my laptop without leaning in)
- Previous instance of eye problem that sounds like optic neuritis (in Feb. 2014, lasted ~3 weeks; severe eye pain when moving or focusing eye), but I did not see a doctor about it at the time

MINOR:
- Minor loss of balance under certain conditions when standing (e.g. yawning with eyes closed, excessive head movement, etc.)
- Foot cramps very common
- Muscle spasms in upper leg, upper arm, and torso are common

*I have been treating the fatigue and brain fog issues with armodafinil without a prescription, which has alleviated a lot of the issues they created and allows me to function relatively uninhibited, but which will probably create an issue upon visiting a GP.

Due to a few issues that might arise if I seek professional help, I am fairly reluctant to do unless it is absolutely necessary (i.e. if people think that the symptoms are significant enough to be worth checking out). If I do go, what should I expect? Is there anything I should/shouldn't do prior to or during the session with the GP?

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Hey all,

So earlier today, one of my friends suggested that I go to the GP and mention possible MS. It's a long story, but essentially I was in a group with this guy late 2014 for a build project for uni, and I've been regrouped with him this year (early 2016) to build a 3D printer. I kept fumbling with really simple stuff, like dropping screws, screwdrivers, etc., at a rate that is probably above normal. He asked if I was OK and I said 'Yes...?' confused by the question. He noted that I didn't fumble anywhere near as much as this during the last project, and asked what seemed like a lot of random and slightly intrusive questions about my medical history and current health (listed later), and came to the conclusion that I should seek out a GP. Apparently his brother had had very similar symptoms before and was diagnosed with MS around the same age as myself (22).

After scoring the internet this evening, I am slightly surprised to find that I match quite a lot of the symptoms for it; aside from the hand weakness/poor dexerity, I suffer quite heavily from fatigue, have noticed a massive decline in my mental acuity over the past five or so years (e.g. I suffer from noticeable 'brain fog' which slows my processing/working to a crawl (a problem in exams), and I very often have 'tip of the tongue' moments where a conversation is brought to a halt because I can't produce a word I am looking for). I have been treating both of these on my own using armodafinil (which, although it has been working relatively well to alleviate these symptoms, will almost certainly become a point of contention if I go and seek professional help), but in its absence I cannot hold any conversations with a moderate level of complexity (e.g. requiring a relatively large amount of thinking/processing to follow or come to an answer) and can barely go six hours without feeling completely drained (tired, greatly weakened, and sometimes (but not always) sleepy).

I had originally put them both down to being symptoms of depression, since this too can cause fatigue, brain fog, etc., which is why I did not go to see a GP about these symptoms in particular (although I have been once about depression and was prescribed some medicine for it, but I missed the follow up appointment because it was the university exam period and haven't been back since (around a year ago), which will probably become another point of contention). However, in conjunction with the rest of the symptoms I seem to be exhibiting, I am beginning to question whether the depression caused those symptoms, or whether the depression is just another symptom of a larger problem.

On top of these, I have been having vision problems fairly regularly; I am slightly myopic and have glasses for it that I use if I am at the back of a lecture theatre, etc., so that I can see the board, but I have noticed that sometimes these fail me, and that my vision becomes so blurry that I find myself having to lean in to read my laptop screen. Also, in February 2014, there were three weeks in which my (I think) left eye had issues that sounds uncannily similar to optic neuritis; over the course of four or five days, my eye went from normal to the point where searing pain shot through it if I tried to move it or focus on anything less than a couple of metres ahead of me, but this tapered off over the following two weeks and I had completely forgotten about it until now. (Again, I didn't seek medical help for it at the time, so I think this might also become another point of contention).

Other than that, I don't have many of the other symptoms (or, at least, not to a notable degree). I sometimes lose my balance a bit if I close my eyes when I yawn standing up or in similar situations; I very regularly get cramp in my feet when I am lying down and/or bend my toe and ankle in a certain way; and I very often get minor muscle spasms in my upper arms, upper legs, and chest; but I am not convinced that any of these are particularly out of the ordinary (although I haven't actually compared their frequency/potencies with anyone else...).

I thought I would come on here and ask whether or not you think it would be worth seeking the opinion/help of a professional, and if so how I should approach/deal with the points of contention (taking armodafinil off-label/without prescription to deal with fatigue and brain fog, missed follow-up for previous appointment, not seeking treatment for previous eye problems)? I am kind of reluctant to go and visit a GP knowing that I will probably end up being reprimanded and/or not believed/taken seriously for all of the above (which might affect whether or not I am considered for medical tests/examinations...?), and am also not looking forward to having to stop use of armodafinil (e.g. if it interferes with medical tests/conflicts with other medication) especially with the exam season coming up again, but if people think that the symptoms are significant enough then I will go and hope that they can look past my contentious actions/inactions.

Thanks!

"would be worth seeking the opinion/help of a professional"

Of course, and if you are not happy with how you are treated by your doctor, find another.

An MS diagnosis is a diagnosis of exclusion. In effect, other conditions which produce similar symptoms must be tested for and excluded as a possibility before an MS diagnosis can be made. One of these conditions is a vitamin B12 deficiency which is a great imitator of MS as it can even cause MS-like lesions seen on MRI. I would suggest testing for B12 deficiency before even considering MS. B12 testing includes a serum B12 test, red blood cell (RBC) folate, serum or urinary methylmalonic acid (MMA) and serum homocysteine. Do not accept being told that your values are "normal." The lower end of the B12 range (200-850 pg/mL) includes many people who are actually deficient. For anyone experiencing symptoms, you really want your B12 to be between 600 and 1000 pg/mL. Please see the following discussion topic for more information. http://www.thisisms.com/forum/natural-a ... 24857.html

ElliotB wrote:"would be worth seeking the opinion/help of a professional"

Of course, and if you are not happy with how you are treated by your doctor, find another.

I'm not sure how I would go about doing that. I think patient records are shared across all NHS GP surgeries in the UK, and I would feel uncomfortable going to a second doctor knowing that they can read that I have been assessed by a previous doctor and the conclusion that doctor came to.

NHE wrote:An MS diagnosis is a diagnosis of exclusion. In effect, other conditions which produce similar symptoms must be tested for and excluded as a possibility before an MS diagnosis can be made. One of these conditions is a vitamin B12 deficiency which is a great imitator of MS as it can even cause MS-like lesions seen on MRI. I would suggest testing for B12 deficiency before even considering MS. B12 testing includes a serum B12 test, red blood cell (RBC) folate, serum or urinary methylmalonic acid (MMA) and serum homocysteine. Do not accept being told that your values are "normal." The lower end of the B12 range (200-850 pg/mL) includes many people who are actually deficient. For anyone experiencing symptoms, you really want your B12 to be between 600 and 1000 pg/mL. Please see the following discussion topic for more information. http://www.thisisms.com/forum/natural-a ... 24857.html

That is very interesting! There is a massive amount of overlap between the two, especially in terms of the symptoms I am experiencing, and I also have a vegetarian diet which appears to be a risk factor for it (although I have been vegetarian for over 19 years whereas the symptoms are relatively recent, plus I eat a lot of dairy products). I'll definitely mention this if/when I go to the doctor and make sure to ask for a B12 test if they don't offer one as standard. Thanks for letting me know!

Welcome to ThisIsMS, Leyton.

Here are my thoughts (I have no medical background.):

Your symptoms are not normal for a 22-year-old male; they are common to many conditions. I suggest that you make an appointment with a GP, take your written list of symptoms for discussion with him, start with a thorough physical examination and request blood tests – request your own copy of any test results (it is important to have the actual number results).

Do not take any supplements at least 2 weeks before testing. Being in the UK, you are very likely to be vitamin D deficient – in fact, it is estimated that over 1/2 of the world's population is vitamin D deficient. In my opinion, this would be a good first test. Many experts now feel that the vitamin D test (the "25-hydroxyvitamin D" test) should be a routine part of a visit to a doctor, just as blood pressure, glucose, and cholesterol testing is. Initial blood test should also include other nutrient testing: vitamin B12 (any person at any age can develop B12 deficiency – vegetarians are at increased risk of B12 deficiency), magnesium, zinc.

Nutrient deficiencies such as these can manifest neurological symptoms.

I would expect your medical professional to focus on your current symptoms and situation and NOT on past events (unless they relate to your situation today). If you believe your symptoms are serious enough for consultation with a doctor, the GP should treat them seriously. You know your body best.

lyndacarol wrote:Welcome to ThisIsMS, Leyton.

Here are my thoughts (I have no medical background.):

Your symptoms are not normal for a 22-year-old male; they are common to many conditions. I suggest that you make an appointment with a GP, take your written list of symptoms for discussion with him, start with a thorough physical examination and request blood tests – request your own copy of any test results (it is important to have the actual number results).

Do not take any supplements at least 2 weeks before testing. Being in the UK, you are very likely to be vitamin D deficient – in fact, it is estimated that over 1/2 of the world's population is vitamin D deficient. In my opinion, this would be a good first test. Many experts now feel that the vitamin D test (the "25-hydroxyvitamin D" test) should be a routine part of a visit to a doctor, just as blood pressure, glucose, and cholesterol testing is. Initial blood test should also include other nutrient testing: vitamin B12 (any person at any age can develop B12 deficiency – vegetarians are at increased risk of B12 deficiency), magnesium, zinc.

Nutrient deficiencies such as these can manifest neurological symptoms.

I would expect your medical professional to focus on your current symptoms and situation and NOT on past events (unless they relate to your situation today). If you believe your symptoms are serious enough for consultation with a doctor, the GP should treat them seriously. You know your body best.

EDIT: Thank you for your welcome and thorough reply. I really appreciate it. Sorry, my reply was a bit of a ramble. I will summarise it so you don't have to read through a wall of text.

- I took a list of symptoms I was experiencing in with me before to a previous appointment (not for this), and was not taken seriously because of it. However, I doubt I will be able to recall all the problems on the spot from memory (brain fog et al); I only managed to make the original post because I had access to a list of symptoms that I could use to reference which ones I had experienced/am experiencing.

- How would I go about requesting a copy of the test results? Is it OK to just ask, and if they ask why then how do I respond?

Thanks again.

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Thank you for your welcome and thorough reply. I really appreciate it.

I want to take my symptoms in written so that I don't forget them, since the 'tip of the tongue' feeling is pretty common for me, but I did that before about three or four years ago when I went in feeling depressed the first time (about a year after the mental fogging began), and they didn't take me seriously and implied I was faking or exaggerating and had just written symptoms 'from the internet or something', since "if it was really that bad then you wouldn't have to write them down". They said that I had no emotion to my words (I was suffering pretty heavily from a kind of hollow apathetic/anhedonic feeling almost constantly, which is not very uncommon with depression) and that I don't sound sad enough to be depressed (I wasn't sad, because of the aforementioned apathy, but I wasn't happy either, or anything really except hollow). In the end, she spurned me off to another doctor who, after less than two minutes in the room, gave me the advice (this is completely word for word, by the way) 'There's nothing wrong with you. Just do more exercise. Take up running or something.' (I didn't have a particularly sedentary lifestyle; I worked 40 hours a week as a shop assistant and was on my feet for most of that). This experience was the one that essentially made me very reluctant to go and see doctors for anything, and I've only been to see a GP once since then when the depression became almost impossible to work around, which is the one that I mentioned in my original post. The experience was OK, but I didn't bring the symptoms in with me and the brain fog was horrendous, so I could only describe how I felt as 'low' (rather than hollow or anhedonic or pained emotionally) and I could only barely talk about how my head felt (I said my brain felt slow, but couldn't recall the phrase 'brain fog' or 'tip of the tongue' (ironically)), and so with the only information to go on that 'I felt low and my brain felt slow', she gave me some starting anti-depressants and instructed me to call a separate part of the NHS to arrange therapy, but when I called them the fact that I couldn't tell them with any certainty whether or not I would be free on a date three or four weeks later (uni work load fluctuates horribly, and it quite often ) they got annoyed and told me "This doesn't work unless you're able to commit to it regularly. Call back when you are more commited to your mental health.", and so I didn't go to therapy in the end, and between that and the exam period consuming all my time, I didn't go back to the GP for a follow-up either. In the end, I found armodafinil helped and so I have been using that.

So essentially, as it stands, I fear going in there with a bit of paper and not being taken seriously; and equally I fear going in there, not being able to recall all of the symptoms off the top of my head, and then again - either because of my seeming 'hesitancy' (slowed thinking) or because I am unable to recall or express the symptoms properly - not be taken seriously. I am worried that I will end up failing my university course if I have 'non-urgent medical commitments' (which apparently includes everything short of illnesses that would prevent you from attending or completing work, and doesn't cover appointments for things like blood tests, etc., even if they are somewhat frequent or can only be arranged during times when 'essential sessions' are running), and similarly I am worried about getting worse if I put my education over my health. I might be able to speak to a university counsellor about the situation if it happens, but there is no guarantee that it will work and if it falls through after the fact then I could end up failing by default.

Also, how would I go about requesting a copy of the test results? Is it OK to just ask, and if they ask why then how do I respond?

Thanks again.

Leyton wrote: - I took a list of symptoms I was experiencing in with me before to a previous appointment (not for this), and was not taken seriously because of it. However, I doubt I will be able to recall all the problems on the spot from memory (brain fog et al); I only managed to make the original post because I had access to a list of symptoms that I could use to reference which ones I had experienced/am experiencing.

- How would I go about requesting a copy of the test results? Is it OK to just ask, and if they ask why then how do I respond?

You are in the UK; I am in the US where customs and policies are probably different from yours.

Every time I see my doctors I take a list of symptoms to discuss, and I even take a written list of questions to ask (Memory often fails me.). I can simply compose my thoughts and questions more easily in the quiet of my home.

If questioned about my habit of bringing along papers and notes, I would simply answer that I do it for the sake of being accurate and making effective use of the doctor's time (not wishing to waste his time trying to recall the details).

It is not unusual today for patients in the US to request copies of all test results. We know that it is not enough simply to hear that the results are "normal." There is often a big difference between "low normal" and "optimal" – it is best to have the actual numbers. In general, I believe the feeling here is that the patient (or his insurance) has paid for the test, and the results belong to the patient.

There may well be a different policy in the UK. In your shoes, I would certainly ask the doctor for a copy of my test results. If he asks for a reason, I would simply say that I prefer to keep a medical file of my own at home. Then, I might be insolent enough to ask why he would not be willing to give me copies of my own test results. (I understand that you are 22 years old and may feel insecure and threatened by the doctor's position; being much older, I am long over that insecurity – my philosophy in asking for copies is "What do I have to lose?" The worst answer I might hear may be "No." On the other hand, I may obtain the copies!

Be polite and respectful, but remember that the doctor has no job without you, the patient.