Ask the Neurologist: A Discussion with Dr. Wagner, Part 6

Q: What has been the most unique experience of your career?

Dr. Wagner: Being able to recognize neurological disorders and treating them in patients. Especially those cases where diagnosis has been difficult to confirm. I take pride in being able to utilize all my skills as well as observation to pinpoint the problem(s).

Q: What are some helpful hints for choosing a good neurologist?

Dr. Wagner: Make sure they are board certified in their specialty; they should have attended a reputable medical school and college. Steer clear of doctors who were educated out of the country. Doctors who had their training in third world countries should also be avoided. Training in these countries are allowed to bypass undergraduate school. In fact, they are able to go to medical school directly from high school!

Q: Here is a question from one of our readers that relates to dopamine therapy.

Is there a difference between taking 250 mg ISICOM (250 mg L-DOPA and 25 mg Carbidopa) qAM and ISICOM (100 mg L-DOPA and 25 mg Carbidopa) bid, it means, 1 hr. AC or 2-4 hrs. PC? What difference would you expect short-term and long-term?

Dr. Wagner: There is a difference in strength. The problem with a higher dose is that they are likely to develop dyskinesia. Similar to Huntington’s disease. This may include: grinding of the teeth,   protruding of tongue, and/or wild movement. It’s best to keep the dose small as long as possible. The first few years of the honeymoon period can provide complete relief. The fourth and fifth year the meds become less effective. Dosing needs to be increased. Rather than increase right away, I like to keep the dose low and add other low dose meds to it. Hope that helps!

This concludes our feature of “Ask the Neurologist” series. I hope you found this interview helpful and informative. I would like to extend my thanks to Dr. Martin Wagner for his enthusiastic involvement in this project along with Mindy Schwartz for photography. Comments? Please e-mail me.

Dr. Wagner is a board certified neurologist practicing at Summit Medical Center in Hermitage, Tennessee.  He attended two of the finest medical schools in the country: Baylor University in Texas, for his bachelor’s degree and University of Texas at Houston for his medical degree. He received honors in neurology and psychology.