Information for Existing Patients

Consult with your family doctor if you experience:

• new symptoms that last more than 24 hours
• the recurrence of previous symptoms lasting more than 48 hours
• a worsening in present symptoms lasting more than 48 hours

Your family doctor can see if an infection is present. Bacterial infections (such as bladder or chest) and viral infections (such as flu and colds) can make MS symptoms temporarily worse. In most cases these symptoms settle down quickly. If the infection triggers a relapse, you may need further medical attention.

You can call the clinic and discuss your concerns and questions with staff. You may find that you have the need to call more frequently following your diagnosis. As you come to understand your disease, the need for frequent contact may decrease.

When you call, please leave your phone number(s) where you can be reached at specific times of the day. If the clinic secretary is away from her desk or on the phone, you can leave a phone mail message. On days when staff are seeing patients, they may not be available to speak with you. There might be some delay in the call back.

The clinic does not operate on weekends or holidays. The clinic also closes at Christmas and during the summer for one to two weeks. During these times our phone message will give you information on how long the clinic will be closed and advice on handling emergencies.

Services Available through the MS Clinic Team

The Neurologist and/or the Advanced Practice Nurse:

will see you at each clinic appointment.

• A neurological examination will be completed
• A history will be taken
• Any questions or concerns that you have about your condition will be addressed at this appointment
• It will help for you to write down your questions to bring to your appointment

The Clinic Coordinator/Social Worker:

is available to discuss:

• the current programs available to you through the clinic
• suggestions that you may have about how clinic services could be developed or changed to better meet your needs
• the emotional impact of this diagnosis for both patients and families
• living with chronic disease
• financial, career and employment issues

The Physiotherapist:

is available to assess your:

• movement
• strength
• stiffness
• pain
• fatigue
• balance
• walking

The physiotherapist may:

• prescribe exercises
• use hands on techniques
• use modalities such as heat or ultrasound
• recommend bracing or walking aids

The Occupational Therapist:

is available to discuss issues you may have with managing in everyday life. The occupational therapist gives information about:

• managing fatigue
• performing daily life tasks
• prescription of assistive devices
• home accessibility
• vocational issues

The Clinical Nutritionist:

can discuss any nutritional issues you have. Teaching is available on healthy diet and also specific clinical diets for any medical condition you have.

The Clinical Research Coordinator:

organizes and manages clinical trials and research projects in the MS Clinic. The neurologist or advanced practice nurse may suggest that you participate in a specific drug trial. The research coordinator will give you the information about the drug and discuss your commitment as a participant in the trial (for example: monthly travel to the clinic). Once you begin a trial, the research coordinator will maintain regular contact with you until the trial is completed.

Not all symptoms require treatment. Symptoms often settle down with extra rest. The decision to treat your MS is based on the degree of symptoms or disease activity and the effect on your ability to function.

For questions regarding a medication prescribed by your MS Specialist, please contact the appropriate physician's office.

The clinic neurologist may prescribe medication for you. Review and renewal of these prescriptions will be done during your clinic appointment. Your family doctor will receive information on each clinic visit and he/she should be able to provide you with most of your repeat prescriptions. If he/she is not comfortable with this, your pharmacy can request a renewal. Have your pharmacy fax a renewal request to 519-663-3744 at least two weeks before your prescription is needed.

Annual appointments are not routinely booked in the MS Clinic unless required by a treatment regime. If you need to be seen in the MS Clinic and have not received an appointment within one year of your last appointment, contact the MS Clinic office at 519-663-3697.

If you have not been seen in the clinic for over one year, we require that a referral, including an update of your medical history since last seen, be sent to us from your local practitioner. About one month prior to your scheduled appointment, you will receive a pre-clinic questionnaire with the date and time of your appointment at the top. Complete the questionnaire and return it to the clinic before your appointment.

Please ensure you list your family doctor’s name and telephone number in the space provided. The information on the questionnaire will help the team plan your visit and answer your questions. Additional appointments with team members (i.e.,, physiotherapy) may then be booked around your clinic appointment time. You will be notified in advance of additional appointments.

Occasionally, the request for additional services exceeds available therapies. When this occurs, local patients may be asked to come back on another day and long-distance patients can be referred to their local community services.

Please call the MS Clinic office at 519-663-3697 at least two weeks before your appointment to confirm this appointment. Failure to do so will result in the cancellation of your appointment.

• Complete and return the questionnaire sent with your appointment letter (remember to post this appointment on your calendar at home). Mark the most important topics that you want to discuss as well as the team members that you want to see (ie: the physiotherapist).
• Call to confirm your attendance at least two weeks prior to your appointment date. Confirmation of your attendance is mandatory. Failure to confirm your attendance will result in your appointment being cancelled.
• Bring a list of your current medications.
• Bring your eyeglasses.
• Arrange to have someone attend the appointment with you. It is helpful to have another person to hear the information you are receiving.
• Bring your Ontario Health Care card and LHSC blue card.
• If your personal information (address, last name, family physician, etc.) or if your Ontario Health Care card has been replaced since your last visit to the hospital, please arrive at least 30 - 45 minutes prior to your appointment to Patient Registration on the Main Floor to make the necessary changes.
• Please, give 48-hours notice for cancellations. This allows the clinic to provide the opportunity for another patient to use this time slot.

We would appreciate hearing from you as soon as possible if you need to cancel an appointment. When you receive your appointment and need to cancel, call the clinic number at 519-663-3697. If an unexpected situation arises and you are unable to attend your appointment please give us at least 24-hours notice. Advance notice of a cancellation will allow us to give the appointment time to someone else and to meet urgent requests for an appointment.

If you miss an appointment without informing us, we will not book another appointment for you until we hear from you. If you wish to be seen in the clinic, call 519-663-3697. There may be a wait for another appointment. If you miss two consecutive appointments, you will require another referral to the clinic from your family doctor. Make every effort to keep the appointment that is given to you. Cancel appointments as soon as possible.

Most requests for the completion of forms are for insurance or pension purposes. Your family doctor is able to provide the most comprehensive information on your entire health status. Therefore your family doctor can complete the majority of these forms because most of the questions are related to your health status. Forms that specifically require a specialist’s opinion and medical letters will be completed. There will be an administrative fee.

Research activities at the MS Clinic focus on the possible cause of MS as well as potential treatments. Areas of research include:

• Early diagnosis
• Prognosis and long-term outcome
• Clinical trials with new and experimental treatments
• Long term treatment
• Genetic Research

Research holds the key to the management and the cure of MS. You may be asked to volunteer for research projects. You may be asked to participate in the completion of surveys. Involvement in research is not a requirement of patients of the clinic. If you choose not to be involved, it will in no way affect the level of care you will receive through the clinic. Learn more about how to get involved in a research study.