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  • Kenneth Makus

Rationing of Tests

Hello all,

I am receiving questions as to the possible postponement of routine blood work. We do routine blood work in both our MS and epilepsy patients. In the epilepsy patients, the

routine blood work can likely be postponed, unless the you have started on an anti-epileptic recently or if you are having problems with toxicity on the medications, or perhaps seizures, but in those situations the blood work is not really routine anyway.


The situation in MS patients is more complex. If a patient has been on a drug for a long time with very stable blood work for perhaps a year or more, then more likely than not, delaying blood work by a month or two is not a big deal. However, with medications like Lemtrada, the situation is more complex, as regular monthly blood work is recommended. I am still trying to get some guidance on this issue from colleagues and the company. The problem with Lemtrada is that patients can develop difficulties without warning, so I would argue that Lemtrada blood work is not routine blood work.


We are told that some CT and MRI studies are being re-scheduled. This is obviously frustrating to someone who has been waiting for months. The most important advice is to keep in close communication with us. If you feel your situation is deteriorating, please communicate with us and if there are serious concerns, then the emergency is always an option. In this time of turmoil, patients with chronic issues should avoid the emergency room, but at the same time I was recently advised of a patient who waited for 48 hours to come to the emergency room with serious problems, which was also not good. The rule is that a change in the medical situation requires communication.


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