A complex illness requires comprehensive care. Multiple sclerosis is an autoimmune illness affecting the central nervous system that brings with it a variety of symptoms. The physicians with the Comprehensive Multiple Sclerosis Program at the UF Health Neuroscience Institute offer a one-stop clinic for MS treatment to provide convenience for patients. The program not only offers evaluation, diagnosis and treatment options, but it also offers education, medication management and physical therapy.
“Our program is unique because we have two Doctors of Pharmacy that play a role in our patient care, and we have two physical therapists who have doctorate degrees with a subspecialty in neurology,” said Scott Silliman, MD, a neurologist who specializes in multiple sclerosis diagnosis and management at the UF Health Neuroscience Institute – Jacksonville.
MS is typically diagnosed when a patient has a focal neurological symptom such as optic neuritis, which is the reduction of vision in one eye and eye pain, along with numbness or weakness on one side of the body. To confirm an MS diagnosis, an MRI is conducted to look at specific features on the brain. The presence of lesions allows the physicians to better understand how long a patient has had MS.
“Most people have had the disease before that first attack occurs,” Silliman said. “I’ve seen a patient who presented with optic neuritis, and I counted 50 additional lesions in the brain. In many patients, the disease presents itself probably a decade before it declares itself.”
This can be overwhelming information for newly diagnosed patients, which is why providers work together to make diagnosis and treatment as seamless as possible. Education and patient experience also extremely important, which is why Program Coordinator Adam Chaifetz, DC, is also essential to the team.
“Dr. Chaifetz is a patient navigator,” Silliman said. “He guides patients through insurance crises, loss of coverage for medication or if medication is denied. We fight for them, and he ensures that every patient receives optimal care.”
The program is recognized by the National MS Society as a Center for Comprehensive MS Care as it offers a multidisciplinary model of care to address the complex needs of people with MS. One of the requirements to be recognized by the National MS Society is the facility must provide access to a full array of medical, psychosocial and rehabilitation services delivered where providers share common goals for patient outcomes. In accordance with the society’s criteria, the Comprehensive MS Program provides neurologic care, rehabilitation and mental health counseling.
In addition to specialized and comprehensive care, the neurology team works behind the scenes to provide patients with the newest, most effective treatments and often participates in research and clinical trials. One of the most recent treatments to be approved the by the Food and Drug Administration was Lemtrada — the first medication for relapsing MS that is administered in eight doses over two years.
“We were involved in that study before it was approved by the FDA,” Silliman said. “We were part of the U.S. trial that tested the efficacy of the infusion treatment. We’re still following two patients that received this drug therapy, who are both eight years out and have seen no activity since their last infusion about six years ago.”
This commitment to care resonates with patients. “It’s amazing how MS treatment research has evolved,” said Emily Hosier, a 36-year-old patient who had her first Lemtrada infusion in November 2016. “That’s another thing I’m proud of, is that my doctor is involved in the research. It’s such a great comfort knowing that we have very knowledgeable people to take care of us.”
Each MS patient is unique, and the Comprehensive MS Program’s integrative approach focuses on providing treatments and therapies geared specifically to each individual's needs. The providers are excellent advocates for their patients to ensure they receive the best care.
“We’re all caring here,” Silliman said. “Typically MS patients are undertreated, and we want to make sure they are appropriately cared for with things like medication, but also exercise. We also provide support to address the emotional aspects of the disease.”
For more information, visit UFHealthJax.org/neurology/multiple-sclerosis or call 904-244-0411.
Assistant Dean for Clinical Informatics; Interim Program Director; Clerkship Director
Medical Director, Comprehensive Stroke Program; Program Director, Vascular Neurology Fellowship