Search results forcatastrophe


Have you heard the term catastrophic health expenditure or CHE before? You should have as many MSers and their families are exposed to catastrophic health expenditure.  CHE occurs when the spending on health exceeds a pre-defined percentage of a person’s or household’s capacity to pay. CHE has a massive impact on MSers’ lives and usually discourages them from using healthcare services and often...

Off-label methotrexate

Prior to interferon-beta being licensed, I used to manage several patients under Prof. W. Ian McDonald who were insistent on being on treated with some form of DMT. The rationale was better to be on something rather than nothing. At the time there was some evidence that methotrexate was effective in MS and as it was relatively safe, so Prof. McDonald acquiesced. In retrospect, I have no idea if...


If you live in London you may have had your life interrupted over the last two weeks by the Extinction Rebellion protests. This is a serious environmental movement that wants us to act now to save the planet from environmental catastrophe. As part of the protest, my daughters have been giving me a hard time about my carbon footprint. They want to know if I am offsetting my air miles, which I do...

ClinicSpeak: swallowing problems in MS

If you have swallowing problems tell your neurologist or nurse. #ClinicSpeak #MSBlog #MSResearch “More bad news for those of you who want their reading material to filtered and passed through rose-tinted glasses. The meta-analysis below (combination of studies) shows that more than a third of MSers have swallowing difficulties or dysphagia. I must admit this figure was much higher than I...



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