Ask the Doc: Q & A with Edward Kasarskis, MD, PhD 

Dr. Kasarskis

Edward Kasarskis, MD, PhD is Director of the University of Kentucky ALS Multidisciplinary Clinic at Cardinal Hill Rehabilitation Hospital in Lexington, Kentucky, professor in the Department of Neurology at the University of Kentucky, and Chief of Neurology at the VA Medical Center in Lexington KY. 

Q: It's getting harder for me to get out and about and I'm wondering how many of my doctors I really need to keep seeing? Since I see my neurologist, do I also need to see my internist, pulmonologists, opthalmologist, dentist, and other specialists?

Dr. Kasarskis:  It’s very important to keep seeing your family physician or internist so that he or she can continue to assess and monitor your general health. You may need to have your blood pressure or your blood glucose (for diabetes) checked. You could get a bacterial infection and wonder if you need antibiotics. Your heartburn might return. Perhaps you’ve had a problem with anemia in the past and need your blood checked for that. In addition, your family physician can play a key role in helping you to access services in your community for managing your ALS.

Some people wonder whether particular treatments and tests are still important when they have ALS. For example, since statins provide primarily a long-term benefit, they may not be necessary for you. Mammograms may be less valuable to you if you have a rapidly progressive form of ALS. If you have questions about the importance of your prescriptions and screening tests, ask your primary care provider and neurologist about them.

If you develop a new symptom, or experience a flare-up of a long-standing problem, it would be wise to see your local doctor to get the problem handled.  Again, you will benefit from the partnership between your local physician and your ALS specialist.  And if you have an identified disorder other than ALS, be sure you continue to see the person who has been managing your care. Finally, your neurologist may recommend that you see a pulmonologist regularly to assess and manage your non-ALS respiratory issues (for example, asthma).

It’s also valuable to keep seeing your dentist. Be sure he or she is aware that you have ALS.  Your dentist should talk with your neurologist about certain issues such as: managing your secretions, identifying the best position you during your dental treatment and managing muscle spasticity that might impair opening your mouth, or delivering anesthesia if you need a dental procedure like a root canal or an extraction. Don’t assume that you can ignore your teeth and gums, because a dental infection can and will eventually affect your total health and comfort.

Each issue we feature a leading neurologist specializing in ALS responding to a question. If you would like to submit questions for a future Q & A, please send your questions to Amber Walters. Please understand that we won’t be able to address all questions and we won’t be able to respond to individuals personally.