Darrell Rebouche (Host): Welcome to Health on Point, presented by Willis Knighton Health, and This is the point where medicine meets real life. You know, we hear a lot about neurology and other disciplines of medicine that are close to neurology—neurosurgery, neurovascular neurosurgery. But our guest today is a renowned neurologist, Dr. Meghan Harris, at Willis-Knighton Paramount. Dr. Harris, thank you for being with us.

Meghan Harris, MD: Thank you so much for having me. Happy to be here.

Host: When we talk about neurology, talk about the kind of things you treat, migraines, Parkinson's, seizure disorders, tremors. There's just so much. Can you tell us a little, or frankly, a lot about what general neurology encompasses?

Meghan Harris, MD: Absolutely, Darrell. I think that it's a very important specialty and people don't always know what we do. It encompasses a variety of symptoms that we use our detective work to figure out what the diseases are. So, neurologic disease is very, very common. So, there was a study in 2021 in Lancet Neurology that reported one in three people, or actually affected by neurologic conditions worldwide. So, that's about 3 billion people in the world have some type of neurologic condition. And in America, the top three are going to be stroke, dementia, and migraines. So, they're becoming increasingly frequent, I think probably because of our increasing age in our population and some of our lifestyle risk factors, which as we all know, we can all deal a little bit better on those lifestyle risk factors, especially when it comes to diet and exercise in our country.

And so, with this increase in neurologic condition, the general neurologist is sort of the starting point where we see all of these things and are able to get the right diagnosis to determine treatment and what options that we have here. So, like we said before, and like what you said, we see things like multiple sclerosis and epilepsy, Parkinson's, tremors. And all of those actual conditions have these subspecialty clinics. And there's been this rise of these hypersubspecialty clinics, which is great.

So, subspecialists are wonderful and we do utilize our colleagues quite a bit, but it has to start someplace. And so, our general neurology clinics are where it starts. So, patients will have to come in with their symptoms. We'll have to try to sort it out and figure out what they have, and then decide on treatment plans and options.

Host: In North Louisiana, when you talk about neurology and you mentioned the name Meghan Harris, people go, "Ooh, Dr. Harris." It's just true because it is one of those things where we hope we don't need you. But if we do need you, we're so glad you're here. So, tell us about you and your partners and how your practice is structured and what everyone does.

Meghan Harris, MD: Absolutely. So like I said, we do have a general neurology clinic. So, this is sort of the hub of where people will come in with their numbness and tingling, a little weakness, a headache, memory loss, and we will go through the whole things in clinics such as a thorough history, a full exam, and then decide on what tests that patients might need. MRIs, blood testing, EEGs, nerve conduction tests, and we can do all this locally, which is great.

So even though we see everything, the unique part about our clinic is that I have two other partners. One of them had a fellowship in something called neurophysiology. So, he's sort of this expert in nerve conduction studies and EMGs. So when we have patients that need those kind of tests, we can utilize him for that. My other partner was sub-specialized in epilepsy, so she has specialty training in reading EEGs. So, it's wonderful because we do see everything, but everybody kind of has their own flavor with what their specialty is.

I myself am a multiple sclerosis-trained physician. And I am passionate about MS. If you talk to any of my patients, they know I really love to educate about MS. I like to educate patients. I like to educate other providers about MS, about some of the new treatments, about what we can do, how to gain your own power by having MS. We always tell patients, "You have MS. MS doesn't have you." And so, it's important that we all have sort of our own little specialties. So if, let's say one of my partners is seeing an MS patient, they can come to me, ask questions, sort of figure out some of the nuances that they may not be familiar with, and it really helps for overall better patient care because we can combine our expertise, but we also see all neurologic conditions in the clinic.

Host: Are there any emerging technologies or techniques or meds that are exciting you? I know you have a particular passion for MS, but you also mentioned Alzheimer's and some others. So, what's on the horizon? What's really getting you going giving people hope?

Meghan Harris, MD: So, I would say that in my time of being a neurologist, I have been blessed to be a neurologist in this point in time. So when I was in medical school, gosh, my friends thought I was nuts. They, like, just hated neurology And that sounds terrible. But it was a period of time where we could just diagnose patients, but we didn't have a lot of treatments, unfortunately. You kind of diagnosed people and said, you know, "I'm so sorry, you know, we treated some symptoms..." But that has changed substantially since I've been in practice. We now can make patients' lives better. And that is in a variety of conditions.

So for instance, migraines, huge portion of our practice. It's a very common ailment that people have, but migraine treatment has exploded. There are now treatment options that are very targeted to a particular area called CGRP. It is peripherally and centrally in the brain. And if you can target that area, you can reduce frequency and intensity of migraines. And there's a whole new sort of class of drugs that can target that. So, we have made an enormous difference in the lives of patients who have migraines. So, those drugs have been game-changers.

The second thing I would say, you know, multiple sclerosis, which is what I truly love. But the first FDA-approved treatment for MS was actually in 1993, which to me, that wasn't that long ago. I mean, to a lot of people, that was a really long time ago, but it wasn't that long ago. And the treatments then were just kind of, "Eh, okay." They weren't great. At least they were something. But at this point in our medicine technology and what we've learned, we have more than 23 FDA-approved medications for multiple sclerosis, all with better efficacy and better safety and tolerability factors than we had when we first started. We see less disability in patients, less relapses, less hospitalizations. Again, a wonderful time to be an MS specialist.

And then, the third biggest one I would say in terms of changes has been Alzheimer's. In terms of our referral pattern, I would say we probably have more referrals for memory loss and dementia more than anything. Right now, there's about 7 million Americans who are living with Alzheimer's disease. And that number's going to double by the time it hits 2050. So, huge problem. And we had to get better with things, right? Because it's just an enormous issue.

So with those particular patients, you know, we've had something called a PET amyloid test that has been approved for a while, but only until about two years ago has it been approved by insurance to pay for it. So, we had some things that we could do to see if patients had Alzheimer's, but nobody could afford to get it done. Those tests are very expensive. So, we had this PET scan. But now, our newest technology is down to a blood test. There's actually a blood test that can determine if patients have Alzheimer's. Now, it has to be in the right clinical context. The patients do have to have some type of memory loss plus this blood test. And we want to rule out other causes of memory loss, obviously, but this blood test will allow patients to determine if they may be candidates for some newer drugs. Right now, we have two FDA-approved drugs, both infusions that can actually take amyloid out of the brain, therefore decreasing the progression of some of this awful disease.

And so, I think that's been a really new, wonderful technology that we have been able to harness. We're able to do that blood testing here. We're able to do the infusions here on the right patient. Not everybody's a candidate. But those I would think would be the most exciting things that have come out recently.

Host: This is Health on Point presented by Willis Knighton Health. Our guest is Meghan Harris. Dr. Meghan Harris, of course, a neurologist in North Louisiana, in Shreveport specifically. You know, you talk about Alzheimer's and some of these other diseases. And I think a lot of patients do their own research And that can have its benefits, but it can also be a huge problem sometimes. What is, in your view, the most misrepresented or misperceived ailment that patients and families come in and talk to you about, the stuff you've read on the internet just isn't right?

Meghan Harris, MD: Well, first I want to say that I am definitely not opposed to people doing their own research. So, I have always been a proponent for some alternative medicine that can complement our current medicine. I think those approaches can be very helpful for people. And I do not discourage people from doing research. I just ask that they bring it to me so we can talk about it.

And I think people do this because they're afraid. Especially neurologic symptoms, right? They can be frightening. So, let's say all of a sudden you have some numbness and tingling and you have no idea what it is. Well, if you just pop it into the internet, numbness and tingling comes out with all kind of things. So, what patients need to know is that the things that are popping up on the internet are not the most common things. And that those rare instances that they are getting potentially some worst-case scenario diagnoses are generally not the rule. So if you pop into numbness and tingling, sometimes it'll pop up with multiple sclerosis and ALS. And I feel that those are the patients that come in very terrified. And oftentimes, it's not anything major, and we can get a handle on some of these things. They do deserve a proper workup. And I do think it's important that we validate those concerns in people. Because a lot of times, people just kind of blow them off. They, you know, have these symptoms and they've looked it up. But now in their head, this anxiety can sort of fuel things. And that can make the symptoms worse.

So if we just step back as providers, validate, yes, this is very concerning, yes, they did their own research, that's not a terrible thing. But we want to give them the knowledge that we have, the scientific evidence that we have to put it in perspective and in the right way. So, I would tell people, you can do your own research. Just remember where that research is coming from, where's the source of that information.

Now, with AI, which can be amazing, I'm not saying that it's not, but you will attract sources from everything across the internet, so blogs and what people say, and it's not always scientific data that's coming to your fingertips for you to read and have knowledge about. So, I encourage people that if they do have concerns and questions, to please share it with me, and most of my patients do. They'll show me like Facebook things often and say, "Hey, I found this on my feed. It popped up." And so, we can talk about it and say why it may not be a good idea. We certainly don't want you to do anything dangerous or why it doesn't have the evidence to back it up. And sometimes, you know, their research can prove to be actually quite beneficial. So, we're not discouraging it. We just want to talk about it with them to give them the proper answers that they need.

Host: In the modern world and, as podcasters, we're grateful for it. People have an intimate relationship with their devices and with technology, spend a lot of time staring at a computer, staring at your phone, staring at your tablet. So, is excessive screen time, does that become a neurology issue? If so, how? And how do people guard against that?

Meghan Harris, MD: Absolutely great question. Very common now. Most of the research is in small children and in adolescence, but that translates to adults, because these people grow up, right? So, there's lots of research that shows that excessive screen time can actually affect cognition. And cognition is the whole realm of our thinking, specifically the things that it affects is our attention, concentration, and our executive function. Our executive function is what it takes for us to make decisions so people that use too much screen time have more trouble making decisions later on or as adults and as adolescents, that's a really big deal, because we want our adolescents making good decisions. And being a teen doesn't always translate to that either.

So, the American Academy of Pediatrics has a very clear amount of time that kids should spend less than one hour a day for younger children, one to two hours a day for school-aged kids. And it's because it can affect their cognition as time goes on. And we're utilizing and we're relying so heavily on our devices that our brains just aren't able to think like it used to. It's okay to have a little boredom to just observe things, not to be totally immersed in something all the time. Our brains were meant to have some downtime. So, it's very important from kids even to adults to put that phone down. If I could take everybody's phone away before sleep, our sleep would be much better. Really, really important to do for our overall general health.

Host: We mentioned you're in demand, and that's because you and your partners and the people you associate with are really, really good at what they do. The level of neurology that is provided right here in this community is as good as anywhere else. Can you speak to that please?

Meghan Harris, MD: Absolutely. So, what we do here, we are trying to keep people in the area so they don't have to drive hours away for subspecialty treatments. Most of what we do can be done right here, including all the testing and the evaluations. And again, we do have to use subspecialists at times, and that's okay. They're very needed. But 90% of what we do, we can keep in-house, in-clinic without patients having to go to three or four different neurologists with different ailments, because that's how a lot of big subspecialty clinics are set up. You have to go to your MS doctor. But let's say you have neuropathy too, so then you go to the neuropathy doctor. And let's say you have a migraine too, then you go to the headache specialist. So, you're seeing three different subspecialty clinics who are all neurologists. It's a lot of time for patients. It's a lot of money for patients. So, we try to take care of it in your visit when you're here.

So if you have MS with neuropathic pain and migraine, we want to try to take care of all of it at once. So, I think that's a very big specialty that we have as general neurologists in our clinic. And we can do this here at home locally. It's important for people to know that.

Host: We were talking about relationship with technology and how it's always changing and growing. You mentioned the present, but you also very strongly mentioned the future. and I know. Those are future patients, which again, we'll say, we hope not. But if they need you, we are glad you're there. But there's also somebody coming along behind you. You're preparing the next generation too.

Meghan Harris, MD: Absolutely. So again, some of my biggest passion is in teaching. So, we still have medical students that rotate with us who are interested in neurology. And we would like more of them to be interested in neurology. But we also have residents. So, everybody in whatever specialty they see are going to see something neurologic. We want them to be able to identify that, decide if they can treat it, do they need to refer it to neurology. So, we get to train internal medicine doctors. We get to train psychiatry doctors, which is a huge link between psychiatry and neurology, because most of our neurologic conditions often have a psychological component and vice versa.

A lot of psychiatry patients have some neurologic symptoms as well. So, we're trying to train the next generation of doctors in a variety of specialties on neurologic conditions so they can recognize them, they can do proper workup and then decide do you need an actual neurology consult. So, education is key because, again, like we said, the rise of neurologic conditions is just getting more as people get older. So, we need people to identify things that we do and take care of it.

Host: So along those lines, what's your best advice for people to keep their brain healthy and to look out for their cognitive health?

Meghan Harris, MD: The overall health of a person is imperative and keeping their brain healthy. So, there are lots of studies out there published that clearly show that exercising regularly. And everybody is in their own way where they are where they can exercise. But if you can do it consistently, if you can do that four and five times a week, if it's walking, if it's aerobics, the best studies show that moderate exercise is best for our brains and doing it early.

So, it's really saddening when people come in with a diagnosis of Alzheimer's. They're older. And, you know, family wants to change all these things about their lives now. And although that's good, what we need to realize is we want to be proactive doing these things 20, 30 years ago was probably more beneficial.

So, staying physically active, having a good diet, things like a Mediterranean-style diet, less sugar in our diets. Those are things that have been proven to really help reducing vascular risk factors like hypertension, cholesterol, diabetes, all of those can help to improve brain health and prevent. And even simple things like getting your hearing checked. Hearing loss is an independent risk factor for dementia. If you don't hear it, you can't remember it, right? So, little things like that to keep in mind for overall health and cognition. Very important. Do it early because it makes a difference.

Host: I think I know what my next wellness appointment is going to be your advice. Thank you so much, Dr. Meghan Harris. It has been very enlightening, educational and, of course, delightful being with you today.

Meghan Harris, MD: Well, thank you for having me. Happy to be here.

Host: This is Health on Point presented by Willis Knighton Health. I'm Darrell Rebouche, and we'll see you next time.