Who's on Your MS Health Care Team?

Teamwork is important to succeed in many areas of life, whether it's completing a project at the office or tackling a list of chores at home. For people with multiple sclerosis, teamwork is crucial when managing the disease. "It's invaluable. These patients face a complex set of challenges that go well beyond what the neurologist does," says Dr. Barbara Green, a neurologist with Mercy Hospital in St. Louis.

The Many Challenges of MS

MS is an autoimmune disease that attacks the coating of the nerves and the nerve fibers themselves. While the damage occurs only in the spinal cord, brain and optic nerves, the consequences manifest throughout the body. Some nerves are no longer able to transmit messages as quickly -- or at all -- causing a long list of potential problems, such as issues with muscles and coordination, balance, walking, vision, bladder and bowel control, cognition and emotions.

MS patients are also prone to developing secondary conditions, such as high blood pressure, high cholesterol, depression, anxiety, chronic lung disease, arthritis and sleep disorders. Other autoimmune diseases are also common in MS, such as thyroid disease and psoriasis.

[See: How to Practice Yoga When You Have Arthritis or Another Chronic Condition.]

The Starting Lineup

Many health professionals play important roles in helping people manage MS. The core team members include:

-- The neurologist. A neurologist is a physician who specializes in treating the nervous system. This doctor is the expert who manages a patient's MS. "The neurologist has to make the MS diagnosis and assess disease progression and medications, and is primary in deciding what steps need to happen for symptom management," Green explains.

-- The MS nurse. Nurses in the neurologist's office are an important resource for MS patients. They educate patients about medications and potential drug complications, and how to self-inject certain medications. They answer questions every day about symptoms and MS difficulties patients may be experiencing.

-- The primary care physician. You need a good primary care doctor to treat other health conditions and manage preventive care. "I don't treat diabetes or hypertension or your skin infection," Green points out. "I'm not the one to manage other autoimmune diseases. Your primary care doctor will either take it on or refer you to the right specialist."

Other Important Players

People with MS often rely on many other health professionals beyond the core team members. These other experts may include:

-- A urologist or gynecologist (for women) to treat sexual dysfunction or bladder disorders.

-- An ophthalmologist (eye doctor) with expertise in dealing with MS. "People with MS may get visual loss or eye movement abnormalities, causing double vision," Green says.

-- A gastroenterologist to treat bowel problems, like constipation.

-- Specialty nurses who administer medications that must be infused intravenously. "These medications can take an hour or many hours, and patients may need to be kept under observation," Green explains.

-- A sleep specialist to identify and treat sleep disorders, like sleep apnea, which is common with MS.

-- A psychologist or psychiatrist to address depression, anxiety or bipolar disorder.

-- A physical therapist to help MS patients with problems related to muscles, balance or walking.

-- An occupational therapist to help MS patients with everyday tasks such as grooming, bathing, eating, working or playing.

-- Exercise instructors who are experienced in working with MS patients and understand the challenges of the disease.

-- A neuropsychologist to test for problems with cognitive function and offer strategies to improve memory or cope with cognition issues.

-- A speech pathologist to treat problems speaking or swallowing.

[See: Which Practitioner Do I See, and When?]

Choosing Your Team

For any member of your MS team, make sure the professional has knowledge and experience in treating people with MS. "Don't go to a place just because it's convenient. They may not know how to treat you if they don't have MS sophistication," Green says. She recommends that people in smaller towns go to the nearest hospital that treats stroke, a neurological issue, to see if there's anyone who might deal with MS.

As you assemble the team, take the time to find out if your health care providers are communicating and coordinating your care. "Having a team that communicates with each other makes it a little easier on the patient. You can't tackle all of your issues all at once, and the team can break them down in terms of which are most important and actionable," says Dr. Robert Bermel, director of the Mellen Center for Multiple Sclerosis at Cleveland Clinic and an assistant professor of neurology at Cleveland Clinic Lerner College of Medicine.

One-Stop Shopping

Finding health professionals on your own and checking to see if they're coordinating care can feel overwhelming. So both Green and Bermel recommend visiting a comprehensive MS care center that specializes in treating MS and has all of the experts you need within one health care system. "It really works better in an environment where physicians know each other, communicate with electronic medical records and can read each other's notes," Bermel says.

Several nonprofit groups can point you to one of these centers, such as the National MS Society or the U.S. Department of Veterans Affairs.

[See: 10 Lessons From Empowered Patients.]

No matter where you go for treatment, Green suggests that you look for experts who listen to you, hear your concerns and work with you on your goal of better health. "You need people who are willing to take the time to deal with your issues," Green says. "They've got to be willing to take on chronic care."

Heidi Godman is a freelance health reporter for U.S. News. Her work has appeared in dozens of online and print publications, including the Harvard Health Letter (where she serves as executive editor), the Chicago Tribune, Baltimore Sun, Orlando Sentinel and Cleveland Clinic Heart Advisor. Heidi also spent more than 20 years as a TV news anchor and health reporter. She's interviewed surgeons in operating rooms, scientists in laboratories and patients in all phases of treatment. Heidi has earned numerous awards for outstanding health reporting and was the first TV broadcaster in the nation to be named a journalism fellow of the American Academy of Neurology. Email Heidi at health@heidigodman.com.