[post edited to remove doctor's names]
Yesterday, we met with BR's new neurologist. With over 1400 MS patients, he is considered the local expert on MS treatment.
We liked him right away. He spent a good deal of time with us, getting to know BR's history and current symptoms. BR is his only patient experimenting with Rituxan, so if we do decide the treatment is working, we will likely need to travel to Dallas (or back to UCSF) for subsequent infusions. We'll see the neuro again in another month to assess the effectiveness.
Additionally, he referred us to a pain management specialist. BR's pain has been trending up with all the stresses of the move, and the oral medications are leaving him sleepy, dopey, and the lesser known dwarf, constipated. The first pain management doctor we called had a very insensitive intake team. They didn't seem very concerned with BR's quality of life.
So the neuro referred us to another pain doctor, and recommended that we consider an "Intrathecal Pump Implant" to supply pain medication directly to the spinal cord. Though it should be safe, it's a pretty big step. I'm wondering if BR's suppressed immune system from the Rituxan will keep him from having such a procedure.