The MS community in the Rio Grande Valley is abuzz with the news of a new doctor in town.
Multiple sclerosis is an immune-mediated disease of the central nervous system, which includes the brain and spinal cord. It causes the immune system to attack the myelin, or protective sheath, around nerve fibers. This makes it difficult for the brain to properly communicate with the rest of the body. As nerves receive damage, lesions (scars) form within the central nervous system. The term MS refers to multiple scars.
Experiences Lead to the Valley
In late July, R. Alejandro Cruz, MD, moved to the Valley to work at DHR Health Neurology Institute, thus becoming the first and only fellowship-trained neuro-immunologist and MS specialist in the region.
Cruz earned his medical degree from Universidad Autónoma de Tamaulipas in Tampico, Mexico. He then completed a three-year neuro-ophthalmology clinical-research fellowship at the University of Houston’s College of Optometry under Rosa Tang, MD, MPH. Following was his neurology residency and internal-medicine internship at Louisiana State University Health Science Center in New Orleans.
In the fourth year of this residency, Cruz was named neurology chief resident. From there, Cruz headed to Austin to complete a second fellowship. This one was in neuroimmunology and multiple sclerosis at University of Texas at Austin under Elliott Frohman, MD, and Teresa Frohman, PA. Then this summer, Cruz moved to the Valley.
“My family is four hours away in Monterrey, and my wife’s family is in Monterrey and Houston,” Cruz said. “For us, it is important for our two children to know their Mexican/Latino culture. I wanted to be with my community and to treat them.”
Cruz added that being fluent in both English and Spanish is important for his patients in the RGV.
“This is long overdue,” said Hidalgo County Assistant District Attorney Joe Garcia, who received his diagnosis in April of 2010.
Garcia traveled to Houston for treatment with Flavia Nelson, MD, until she moved out of state, and he then travelled to San Antonio for treatment. Cruz moving to the area is welcome news, not only because his expertise in the field is crucial but also because of the impact it will have on the entire medical community.
“I definitely see the potential for Dr. Cruz to educate family doctors so they will recognize early warning signs of MS,” Garcia said.
Filling A Need
Lucia Rivera, president of the South Texas Multiple Sclerosis Council, says there is an undeniable need for this type of education. Her daughter, Lorena Pena, noticed distinct changes in her voice and speech seven years ago as she prepared to start her freshman year at Baylor University.
Pena spent two weeks in a Valley hospital with no diagnosis. A friend suggested Rivera take her daughter to Baylor Scott & White Medical Center in Temple, where a neurologist quickly diagnosed her with MS. Rivera started the local Council, determined to improve education, treatment and networking for people in the Valley living with MS.
“Now we don’t have to travel out of town to see an MS specialist,” Rivera said.
Trips to see a neurologist in Houston or San Antonio can be costly, she says. This is due to expenses such as gas, hotel and meal expenses.
Cruz is anxious to meet Valley residents living with MS. He wants to share his knowledge about what he calls “a wave” of new disease-modifying therapies (DMTs) and to build long-lasting relationships.
“MS typically affects young people in their 20s and 30s,” Cruz said. “That allows their neurologist to develop a relationship with them. You truly become a family. It’s like what doctors used to be a long time ago.”
As for the DMTs available for patients with MS, Cruz said, “It is a great time to be a neuro-immunologist. There is no reason for someone diagnosed with MS in 2020 to be in a wheelchair.”
Cruz, the Artist
“It is like an art to diagnosis,” he said. “You look at your patients’ MRIs and their bloodwork and you listen to them. You put their tests and their story together to create the correct diagnosis.”
Cruz envisions a comprehensive MS Center in the Valley in a few years, where he will train nurses in the field of MS. It’s where urologists, mental-health professionals, ophthalmologists, and therapists will work together to provide the optimum care for their patients.
Cruz began seeing patients in the Valley the first week of August. Jennifer Niittula was one of them. A former school nurse and field nurse for United Healthcare, Niittula went on long-term disability in late 2019, three years after a MS diagnosis.
For Niittula, blurry vision, weakness in her extremities and balance issues led to her diagnosis. Because of his fellowship at UT, Cruz is well-versed in managing his patients’ symptoms.
Like Garcia and Rivera, Niittula has traveled out of the Valley for treatment. She most recently went to Austin after a friend from high school, who also has MS, told her the Dell Medical School at UT-Austin is top-notch in MS treatment. It was there that Niittula met Cruz in December of 2019. She rejoiced when she heard about his move to the Valley.
After her first appointment at his new McAllen office, Niittula sent a text to her friend, who told her, “I’m glad you like Dr Cruz. We think he’s a special talent and he’s going to be a great addition to the medical community in the RGV.”
Niittula could not agree more.