Before we begin, this is a friendly reminder: Schedule your annual wellness checkups with your neurologist, dentist and primary care doctor. And don’t forget your mammogram and colonoscopy, if age appropriate. Our check-up guides for men and women will help you keep track of all the preventive care you need.
Research tells us that wellness in all forms – exercise, nutrition, sleep, stress and relationships – is critical to maintaining good health, preventing disease and reducing symptoms of existing conditions. Discussing your health and wellness status with your neurologist and primary care doctor at every appointment can help ensure you’re set up for success.
Wellness plays an integral role in neurologic conditions and the effectiveness of treatment. For example, multiple sclerosis patients with depression or anxiety may sleep or exercise less, which has a detrimental effect on the disease process and how they feel physically. “We focus so much on what the illness is but we need to focus on how they’re doing,” says OhioHealth neuroimmunologist Jacqueline Nicholas, MD. “When we focus on how to improve wellness, patients have less symptoms and deal with their conditions much better.”
A significant amount of research into multiple sclerosis, Parkinson’s disease and other neurologic conditions, has shown that doing several days of aerobic exercise each week can improve your physical function and cognition, and mental health. This improvement is attributed to increased serotonin levels.
So what do your doctors want to know about your wellness habits and lifestyle? We asked Dr. Nicholas, who helped us create a list of wellness information topics you and your care partner should be prepared to discuss at every appointment.
Mood and Mental Health
Mood disorders are common in people with neurologic disorders. If your mood is off, everything is off. Dr. Nicholas says it’s the topic that gets the least attention, but is the most important. “One of the things doctors are always asking about is your mood,” says Dr. Nicholas. “If someone tells me they’re feeling great, we’ll move on. But if they express they’re feeling ‘eh,’ we will dig a little deeper.”
Sometimes doctors may make a lifestyle or behavioral recommendation based on your mood, such as taking a walk each day, or going out with friends or family once more per week. But depending on the severity, your doctor may identify your challenges as a mood disorder, such as clinical depression or generalized anxiety disorder, and you may be presented options for medication or psychologic counseling. Ultimately, the goal is to help improve your mood.
Questions about mood and mental health to prepare for:
In addition to thinking through answers to these questions, be prepared to answer a questionnaire around mental health.
- How is your mood?
- Are you doing things you enjoy with your friends and family?
- What brings you joy?
- Do you feel your life has meaning?
Fatigue is the No.1 symptom of multiple sclerosis and is prevalent in many neurologic conditions. One way to combat sleep challenges is to have a routine. “Our bodies enjoy consistency, so it’s hard for our bodies to adjust to varying sleep schedules,” says Dr.Nicholas.
Another way to combat sleep challenges is to have good sleep hygiene, which includes reserving the bedroom for sleep and intimacy – not for work or entertainment, like watching the television.
Questions about sleep to prepare for:
- How would you describe your sleep?
- Do you have trouble falling asleep?
- Do you have trouble staying asleep?
- If you have trouble staying asleep, what’s waking you up?
- What is your bedtime routine?
- What is your sleep environment like?
- Bonus: Track your sleep for one week leading up to your appointment and share with your doctor for discussion.
At every appointment, your neurologist wants to know what you’re doing for exercise.
“Oftentimes, I’ll ask if someone is exercising, and they’ll say yes. But a family member will say, ‘Well, you’re just doing activity in your normal life.’ Although it’s very important to stay active doing laundry or going up and down the stairs, it’s not enough to maintain health. You have to do something extra to boost that aerobic activity.”
If you aren’t exercising or are looking for something more specialized to your condition, your doctor may refer you to exercise programs such as OhioHealth’s MS Wellness, Stroke and Acquired Brain Injury Wellness, or Delay the Disease. You could also explore neurologic rehabilitation or physical therapy as ways to safely begin exercising. There are also online resources for exercise, such as Wellthon in partnership with OhioHealth for Parkinson’s disease or The MS Gym for multiple sclerosis.
Questions about exercise to prepare for:
- Are you exercising?
- What are you doing for exercise?
- How often (days per week and minutes) are you exercising?
- How much does exercise decrease your energy afterwards?
- Bonus: Track your exercise (which exercise and for how many minutes) for two weeks leading up to your appointment and share with your doctor.
Dr. Nicholas says it’s helpful to know what patient’s diets are on a regular basis so if they have constant constipation, loose stools or low energy, she can identify the source. It’s also important to ensure you’re getting adequate nutrition. “If we don’t talk about your diet, we may miss key pieces of information that could be causing problems,” she says. “We’re lucky that in our neuroscience interdisciplinary clinics for MS, stroke prevention and movement disorders at OhioHealth Riverside Methodist Hospital, we have a dietician on site that can come into your appointment and discuss your diet.”
Questions about nutrition to prepare for:
- Overall, how is your diet?
- Are you eating fruits and vegetables?
- Are you eating meats? If so, are they lean meats?
- How are your meals prepared? Do you prepare them yourself, eat at a restaurant or eat fast food?
- Bonus: If you want an extra opinion, track your food diary for one week leading up to your appointment and share with your doctor.
Energy and Fatigue
Sometimes, as you work to treat one symptom you can cause another. If you’re experiencing severe fatigue or lack of energy, your doctor may look into a variety of potential causes. One cause could be the medications you’re taking to treat your neurologic symptoms, such as nerve pain, or to relax muscles. Your doctor may also check your vitamin levels for B12 deficiencies or thyroid problems. Then, there are lifestyle implications that can impact fatigue, such as when you’re going to sleep and when you’re waking up.
Questions about energy and fatigue to prepare for:
- How would you rate your energy levels throughout the day?
- Great – I can conquer the world!
- Okay – I get tired as the day progresses.
- Terrible – I’m always exhausted from the moment I get up to the moment I go to sleep.
- It varies day to day.
- Do you experience severe fatigue?
- Do you see any patterns in your fatigue?
Sexual health is a topic that more doctors should be asking their patients about, says Dr. Nicholas. It’s something both patients and physicians can be embarrassed to talk about, but it’s important because it closely connects to mood and quality of life.
When you bring up challenges, your doctor can help you determine what is causing sexual dysfunction, and whether it’s directly connected to your neurologic condition, such as your medications, or if it’s connected to your mood, societal beliefs or another tertiary factor. “We can help the patient find support through medication, devices or therapy, depending on the potential causes.”
Questions about sexual health to prepare for:
- Are you sexually active?
- If so, are you having any difficulties?
The next time you have a well visit with your neurologist or primary care doctor, download and complete our neuroscience wellness appointment guide to help you and your care partner prepare for your appointment.
And if you don’t already have a primary care doctor, you can find one at OhioHealth.com/FindADoctor.