[00:00:00] Pete: This is Neurology Now, the podcast that explores the fascinating and complex world of neurology. Join us as we explore the human brain and beyond with expert guests who share their knowledge and insights. 

[00:00:11] Pete Waggoner, Host: We are pleased to bring in Dr. Jessica Pier. She is from the Minneapolis Clinic of Neurology out of the Edina office. 

[00:00:18] Jessica Piché – MS Specialist (Edina): Yes, 

[00:00:18] Pete Waggoner, Host: Thanks for joining us here today. 

[00:00:19] Jessica Piché – MS Specialist (Edina): Nice to be here. 

[00:00:20] Pete Waggoner, Host: Thank you. Can you tell us a little bit about your specialty and the location with Edina

[00:00:26] Jessica Piché – MS Specialist (Edina): yeah, so I’m one of five clinic sites and Golden Valley is the main one, but Edina is where I’m located five days a week. And so at that site I have my main office and I’m able to see. Patients of any neurological injury, but I primarily specialize in multiple SC sclerosis.

[00:00:43] Jessica Piché – MS Specialist (Edina): So I am able to get patients what they need at that clinic site. They’re able to get infusions there, MRIs, EEGs, EMGs. We have great nursing staff. We have physical medicine physical therapy, occupational therapy. So really it’s all. That I could ever want at a clinic [00:01:00] site. 

[00:01:00] Pete Waggoner, Host: Tell me about your journey to neurology.

[00:01:03] Pete Waggoner, Host: Did you think that’s I’m going there, or how did you get down that path? 

[00:01:07] Jessica Piché – MS Specialist (Edina): Great question. So I had a grandmother with multiple sclerosis. So I got to see the disease since I was little and went to all the MS. Society bike one fifties that they had in South Dakota and got to hear multiple MS patients give their stories and caregivers give their stories.

[00:01:22] Jessica Piché – MS Specialist (Edina): And so I was really exposed to that from a young age and through some research opportunity, I was able to shadow a neurologist. Boston. I just fell in love with the exam, with the complexity of everything. And at that time, the world of MS was exploding with new medications and it just seemed like a really exciting place to be for a neurology subspecialty.

[00:01:43] Jessica Piché – MS Specialist (Edina): And so that is what really interested me to specifically get into ms. 

[00:01:48] Pete Waggoner, Host: Were you feeling pre. Explosion. So obviously your grandmother was, you saw most of that probably. If not all before then. What were the things that really stood out to you [00:02:00] in terms of outcomes that are like, whoa, this is different?

[00:02:03] Jessica Piché – MS Specialist (Edina): My grandmother. Unfortunately, most of my life, I knew her in a wheelchair. Yeah. And so what I’m seeing nowadays is the bli. Way that we can keep people out of that, getting them on, very effective medications earlier on and helping reduce their disability down the road.

[00:02:17] Pete Waggoner, Host: Does it continue to evolve in your eyes? It 

[00:02:19] Jessica Piché – MS Specialist (Edina): continue? Yep. So I mean, they’re doing research trials into ways that we can help the non-active, secondary progressive patients who aren’t really having active disease but continue to decline.

[00:02:29] Jessica Piché – MS Specialist (Edina): They’re looking into. Ways that we can even maybe consider remyelination. And I mean, there’s treatments that continue to be investigated. That, things have slowed down, but I think the bigger guns are coming up in the future. Another 

[00:02:41] Pete Waggoner, Host: one, basically, 

[00:02:41] Jessica Piché – MS Specialist (Edina): yeah, lots of research is still pouring into MS Night.

[00:02:44] Jessica Piché – MS Specialist (Edina): That’s wonderful. I’m very excited for the future. I keep telling my patients, I’m like. You’re at the best time to have MS for now stay, but 20 years down the road, we’re gonna have huge changes in treatments for MS too. Is there, just as we’ve had in the last 20 years, 

[00:02:57] Pete Waggoner, Host: is that, that’s great. So it doesn’t stop now.

[00:02:59] Jessica Piché – MS Specialist (Edina): Yeah. 

[00:02:59] Pete Waggoner, Host: [00:03:00] Is there a typical age or genetics that you see where it’s more natural when it starts to come on in terms of symptoms or is it random? 

[00:03:10] Jessica Piché – MS Specialist (Edina): So more often, this is a young person’s disease, seeing patients getting multiple sclerosis somewhere in their mid to upper twenties to thirties.

[00:03:18] Jessica Piché – MS Specialist (Edina): Still, I’ve had some patients get diagnosed later in their sixties as well. So it’s not rare to get diag. It is rare, but it’s not something I haven’t seen get diagnosed later on in life. But there’s definitely a peak when it comes to when MS is more likely to be diagnosed. But that’s not to say that it doesn’t still occur.

[00:03:34] Jessica Piché – MS Specialist (Edina): And. Treatments are a little bit different when you get a little bit older at some point. The relapses do diminish in regards to your immune system just declining the autoimmune part declining, and your risk of relapse declining. So there is a natural course to the disease that we are aware of, but it’s still, it’s treating everyone differently.

[00:03:51] Jessica Piché – MS Specialist (Edina): Their MS is a snowflake, it’s a fingerprint. Everyone’s a little different. 

[00:03:55] Pete Waggoner, Host: Are you noticing a consistency in symptoms no matter age? 

[00:03:59] Jessica Piché – MS Specialist (Edina): Yeah, so [00:04:00] everyone’s different, but majority of the time it depends on lesions, lesion burden, how much they have involved with their brain or spinal cord,

[00:04:07] Jessica Piché – MS Specialist (Edina): but yeah, depending on the severity, if they’re pretty impacted by this, you do see a large range of urinary symptoms, spasms. Trouble with cognition. If it’s, someone who maybe has a malar disease, they might have things just like fatigue or something that’s not even something that they really register.

[00:04:23] Jessica Piché – MS Specialist (Edina): They might even be asymptomatic. So there’s a huge range in how people are. It varies on where the lesions are and how much they have. 

[00:04:29] Pete Waggoner, Host: Do you find it’s hard then for someone to maybe ignore things a little bit and put things off. Is it is it trickier, do you think, for someone to recognize that?

[00:04:40] Jessica Piché – MS Specialist (Edina): I definitely have had patients when they come in, they talk to me about their symptoms leading up to this and what they may have had in the past. I kind of screen ’em for everything that like, oh yeah, back in. Five years ago, there was this hand numbness that I had for a couple of days that kind of went away, and so there’s some little things that they might not have thought was a big deal, or, you know, perhaps this hiking [00:05:00] trip.

[00:05:00] Jessica Piché – MS Specialist (Edina): My foot was dragging more when I was tired and exhausted. It got better, so I didn’t think much of it, but it keeps happening. So people definitely do put things to bed if they don’t think it’s a huge deal, like losing function in a full limb or arm. So they, there can be instances where people do off, but in fact, that’s similar to my grandma.

[00:05:17] Jessica Piché – MS Specialist (Edina): She was hiking a party peak. Yeah. And was having a lot of leg weakness, but kept putting it off. So that’s her initial symptom was something she was just noticing on a hike. 

[00:05:25] Pete Waggoner, Host: The, it is crazy how it presents itself, isn’t it? And it’s a matter of being open and willing to listen.

[00:05:30] Pete Waggoner, Host: And I know some people get nervous about a consultation what would be something you would say to anybody that’s maybe a little bit.

[00:05:39] Pete Waggoner, Host: Cautious or not really wanting to do it, how would you ease their nurse? 

[00:05:43] Jessica Piché – MS Specialist (Edina): For one, neurologists don’t bite. We’re really right. We’re really normal people. Some are a little quirky, but we want to do what’s best for you. And so coming in, getting an initial consultation, even just figuring out what the next steps are, should hopefully be able to.

[00:05:57] Jessica Piché – MS Specialist (Edina): Put some patients’ mind at ease, their [00:06:00] caregivers’s minds at ease to say we have a plan and go forward from there. Establishing even it’s not something you wanna go forward with, like a treatment. Establishing with the neurologist for those times that you need help, where you have something new to talk about will be very important to have.

[00:06:14] Pete Waggoner, Host: Obviously you wanna see. Be seen sooner. And there’s a I think there’s a bit of an industry expectation that, ooh, this, the, everybody’s booked

[00:06:21] Pete Waggoner, Host: here, things are different, right? I mean, people can see you pretty quickly, correct? 

[00:06:25] Jessica Piché – MS Specialist (Edina): Yeah. I have had a lot of kind of blocks in my schedule that I’ve tried to implement and try to get, some people who are coming outta the hospital for their first MS relapse. I’m trying to see them a week afterwards to just, wow, go over everything, go over the labs, see how symptoms are improving, and just talk to them.

[00:06:41] Jessica Piché – MS Specialist (Edina): Okay, this is what happened. This is what this could be. We should go forward with these further tests and confirm, or this has been confirmed and we should go forward with other treatments going forward so I can get people in pretty quickly. And that’s, I think, been really helpful for people not to be out of an admission or hospital or urgent care problem to be able to be [00:07:00] seen and make sure they’re not.

[00:07:01] Jessica Piché – MS Specialist (Edina): Stressing for the next month or two that they have something going on and no one’s seen them for that. 

[00:07:06] Pete Waggoner, Host: And we’re not talking half a year here. No, 

[00:07:08] Jessica Piché – MS Specialist (Edina): I’ve seen people a day after, it’s amazing being discharged or a week after. So I try to do, keep my schedule open for those kind of ms new patients. I think that’s amazing.

[00:07:17] Pete Waggoner, Host: That’s really good. Your favorite part about this group at the Minneapolis Clinic of Neurology? What is it? 

[00:07:23] Jessica Piché – MS Specialist (Edina): I think it’s a. The clinic is everything you need is there. So I have patients who can be seen in my office and they get out and they can get scheduled for their MRI.

[00:07:32] Jessica Piché – MS Specialist (Edina): At the same site. They can get scheduled for an infusion at the same site. They can see my great physical therapist and occupational therapist at the same site. If they have any weakness or hand weakness that needs to be addressed. We have a great nursing staff and care team that can address issues, and I make it a point to try to address patient’s problem as much as I can.

[00:07:50] Jessica Piché – MS Specialist (Edina): So the fact that everything is just nicely boxed into one location and making it easier for patients to get to and get everything arranged in a quick manner, I think is [00:08:00] my favorite part. 

[00:08:00] Pete Waggoner, Host: Packaged beautifully. 

[00:08:02] Jessica Piché – MS Specialist (Edina): Yeah.

[00:08:02] Pete Waggoner, Host: And then in your career, you know, obviously when you’re going to school and you’re thinking, you know.

[00:08:06] Pete Waggoner, Host: I can’t wait to get going. I can’t wait to do this. What are some of the highlights of your profession that you’ve chosen that you’re most proud of? 

[00:08:14] Jessica Piché – MS Specialist (Edina): Oh, that’s a good question. It’s always nice to, you know, cinch a really hard diagnosis that’s been. Having patients, struggling with and not getting the answers to and helping them with that.

[00:08:23] Jessica Piché – MS Specialist (Edina): Being able to maybe even provide some new therapies that patients have benefits from is the highlight of my day when I have patients come in, they’re like, thank you Dr. Che. That really helped. And oh, you just made my day.

[00:08:34] Jessica Piché – MS Specialist (Edina): Just like record that. I’m gonna play it back when I have some hard days. So it’s nice to hear that. 

[00:08:39] Pete Waggoner, Host: That’s amazing. Thanks for joining us Dr. Pache. It’s been awesome.

[00:08:43] Jessica Piché – MS Specialist (Edina): Of course. Thank you for having me.

[00:08:45] Pete: thank you all for joining us for this episode of Neurology Now. We hope you found it informative and engaging. If you enjoyed this episode, please subscribe to our podcast to stay up to date and help us educate our community and beyond. We welcome your feedback, comments, and [00:09:00] suggestions for future topics. So please feel free to reach out to us through our website or social media channels. 

[00:09:06] Pete: That’s gonna do it for today’s program. I’m Pete Waggoner. So long everybody.