Talking to Your Doctor Discussion Guide



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My Responses to the Discussion Guide In the past two weeks: 1. How much has MS limited your ability to walk? 2. How much has MS limited your ability to run? 3. How much has MS limited your ability to climb up and down stairs? 4. How much has MS made standing when doing things more difficult? 5. How much has MS limited your balance when standing or walking? 6. How much has MS limited how far you are able to walk? 7. How much has MS increased the effort needed for you to walk? 8. How much has MS made it necessary for you to use support when walking indoors (e.g., holding on to furniture, using a stick, etc.)? Adapted from the 2000 Neurological Outcomes Measures Unit

My Responses to the Discussion Guide In the past two weeks: 9. How much has MS made it necessary for you to use support when walking outdoors (e.g., using a stick, a frame, etc.)? 10. How much has MS slowed down your walking? 11. How much has MS affected how smoothly you walk? 12. How much has MS made you concentrate on your walking? Adapted from the 2000 Neurological Outcomes Measures Unit

Questions to Ask My Healthcare Provider How might AMPYRA (dalfampridine) Extended Release Tablets, 10 mg, help? Can you explain how it works? How long do you think I'll need to take AMPYRA before I see results? Is AMPYRA safe to take with the other medications I am taking? What are possible side effects of AMPYRA? What should I do if I experience any side effects while taking AMPYRA?

Questions to Ask My Healthcare Provider How will I know if AMPYRA is working for me? Can I get help paying for AMPYRA? How is AMPYRA taken? Can I take AMPYRA if I am taking compounded 4-aminopyridine (fampridine, 4-AP)? Notes: