DOCTORS
Everyone knows what a doctor is?
But in dealing with DMD you'll get to know several different types.
Almost all doctors practicing today have completed at least four years of college, then four years of medical school, then a one-year internship, and then a residency in a specialty area. Some doctors then take even more training, usually known as a fellowship, to further specialize.
Doctors have academic degrees (a doctorate in medicine, or M.D.) and are then licensed to practice medicine by their states after passing an exam.
Neurologists
Most MDA clinics are directed by neurologists, doctors who have completed a residency in neurology, or sometimes a general medicine residency and then a fellowship in neurology or neuromuscular disease. Neurologists specialize in the treatment of diseases of the brain, spinal cord, nerves and muscles. Strictly speaking, a muscle specialist should be called a myologist, since myology is the medical term for the study of muscles. However, as of now, there is no such medical specialty, and muscle diseases are generally classified with nerve diseases.
Neurologists are oriented toward understanding the biology of a disease and finding therapies to treat it, most often through the use of drugs.
Physiatrists
A few MDA clinics are directed or co-directed by physiatrists (not to be confused with psychiatrists). Physiatrists have done a residency in physiatry, also known as physical medicine and rehabilitation in many institutions.
Specialists in physical medicine emphasize helping a person adapt to a disorder through physical, supportive measures, such as bracing, ventilation aids or surgery to prevent deformity.
Orthopedists
Orthopedists have done residencies in surgery with an emphasis in orthopedics, the study of structural disorders of the muscles, bones, joints and associated tissues. Orthopedics is a surgical specialty, and orthopedists are more oriented toward surgical or mechanical correction of problems associated with muscle disease than are neurologists. A few MDA clinic directors are orthopedists, but usually orthopedists are called in by neurologists to consult on a surgical problem (for example, if spine-straightening surgery is being considered for a boy with DMD).
Cardiologists
Cardiologists specialize in disorders of the heart. They usually have completed a residencies in general medicine and then fellowships in cardiology. Since the heart is involved in almost all cases of DMD, you will almost certainly see a cardiologist at some point.
Pulmonologists
Pulmonologists specialize in disorders related to the lungs and breathing. Some of the muscles involved in breathing, particularly the diaphragm and the muscles between the ribs, are eventually affected in DMD, so you'll probably see a pulmonologist at your medical center as your son's disorder progresses.
A pulmonologist's training usually is a residency in general medicine and then further training, such as a fellowship, in respiratory medicine.
Pediatricians
Although your child has been diagnosed with a serious disorder, he still has much in common with any other growing boy. He still needs immunizations, monitoring of his overall growth and development, and treatment for routine illnesses and injuries. DMD is no protection against ear infections, cuts and scrapes, or food poisoning, so it's important to have a general doctor you can go to for this type of problem. These days, such doctors are often called primary care physicians. Specialists provide secondary (second level) or tertiary (third level) care, because you generally get to them after being referred by the primary care doctor.
A pediatrician is a doctor who has completed a residency in pediatrics and specializes in the overall health of children. Modern pediatrics programs emphasize the importance of promoting the child's growth and development, even when severe illness is present.
Family Practitioners
A family practitioner has completed a residency in family practice. His emphasis is even broader than that of the pediatrician, since it encompasses the whole family and all stages of growth and development.
Adolescent Medicine Specialists
Adolescent medicine is a new specialty. Doctors in this field have completed residencies, usually in pediatrics, and have then taken additional training that focuses on the health-care needs of teen-agers across a broad range of diagnoses. They generally focus on the needs of the whole child and his family.
It's best not to assume that neurologists or pulmonologists will have a growth and development emphasis. Their focus is usually (not always) on the condition being treated rather than on the "whole" child and his family. You'll probably want to maintain contact with a pediatrician, adolescent medicine specialist or family practitioner, and he or she should remain in close communication with the neurologist or other specialists you're seeing for the child's muscular dystrophy.
Psychiatrists
Psychiatrists are medical doctors who have completed residencies in psychiatry. Psychiatrists focus on diagnosing and treating mental disorders the same way other kinds of doctors diagnose and treat disorders with more readily identifiable physical causes; that is, psychiatrists use standard diagnostic techniques and then prescribe drugs or other therapies.
These days, psychiatrists usually treat the more serious forms of mental illness, while other mental health professionals are more likely to help people cope with specific problems of living, such as having a severe illness in the family.
Depending on state regulations, you may need a psychiatrist's signature to obtain a prescription for medications, such as antidepressants, to treat mental disorders
