Dr. Roberto Alejandro Cruz moved to the Rio Grande Valley in the summer of 2020 and a few months later developed a vision for a comprehensive multiple sclerosis center at DHR Health.

Five years later, the DHR Health Neuroscience Institute in McAllen received an official designation that makes it the only center of its kind south of San Antonio. Cruz is the center director of a medical facility that earned a designation from the National Multiple Sclerosis Society. 

It signifies a facility with a state-of-the-art approach to diagnosing and treating patients with MS.

“It’s not the job of a single person,” Cruz said. “It’s a group of people — an institution — doing what’s best for patients.”

Team Effort

Cruz spoke about the comprehensive team of specialists that serve his patients living with MS. 

The team includes neurologists, a neuroimmunologist, an ophthalmologist, pharmacists, psychologists, and physical and occupational therapists, among many others. 

“My team coordinates services with other team members,” Cruz said. “We all have access to the same medical records so we can all be on the same page. Great communication is key.”

One of his patients is attorney Joe D. Garcia, who in 2005 began experiencing numbness in his face and head and tingling in his extremities. At the time, doctors thought he had suffered a stroke. 

Five years later, Garcia’s secretary told him he tended to walk diagonally rather than in a straight line. A Rio Grande Valley neurologist diagnosed him with MS, referring him to a specialist in Houston for a second opinion. The diagnosis was confirmed. Garcia would travel to San Antonio for specialized MS care.

When hearing about Cruz, who is board certified in neurology and a fellowship-trained multiple sclerosis specialist, Garcia made an appointment.

“It has been a big blessing,” he said of not missing work to travel out of area for health care. “Having someone who is not just well educated but who cares and is at all of the MS events truly shows it’s his passion.” 

Garcia also sees nurse practitioner Maggie Rodriguez. She is an MS patient herself and can understand the patients with firsthand knowledge, Garcia said.

Cruz said most of his patients are referred to him by their primary care physicians.

The Gold Standard

Early symptoms include numbness or tingling in the face or limbs, fatigue, balance and vision problems, and unexplained muscle weakness. The history of symptoms plays a significant role in the diagnosis of MS, but they are only the beginning.

“MRIs are still the gold standard,” Cruz said. “Sometimes that is enough, but other times we need to do a lumbar puncture or laboratory testing to aid in the diagnosis.

“It’s important to understand that people with uncontrolled hypertension can have a lesion that looks like MS,” he said. “Diabetes and migraines can also result in minor changes in the brain.”

A trained MS specialist using a combination of diagnostic testing and patient history can make the correct diagnosis. Cruz and his team currently treat approximately 600 patients at the DHR Health Neurology Institute, which is under the umbrella of the Neuroscience Institute.

Although MS was long considered “a disease of Caucasians,” more than 90 percent of his patients are Hispanic. They travel from Laredo, Corpus Christi, San Antonio, Mexico and places in between for diagnosis and treatment. The mean age of MS diagnosis, Cruz said, is in the 30s. 

Cruz said the goal is for patients to only need an appointment with him twice a year as part of long-term healthcare plan. Early diagnosis is essential. 

“Research shows if you are able to identify, diagnose and start high-efficacy, disease-modifying treatment in the first two years, the chances of having a significant disability are extremely low,” Cruz said.

‘More Research Needs To Be Done’

Innovation doesn’t stop with the Comprehensive MS Center designation. 

Dr. Cruz and his team are actively recruiting for clinical trials for new MS medications and other treatment options. 

“Never, in the history of the Valley, have we had the opportunity for MS patients to participate in research,” Cruz said. 

Residents in the DHR Health Internal Medicine Residency Program complete a rotation at the Neurology Institute for MS training. Dr. Cruz and his team gather and review data to publish their findings. They also attend national and international meetings to share what they are discovering.

“More research needs to be done on Hispanics,” he explained. “All of the work our team is doing here is with the hope of sharing all of it and closing the gaps in MS care.”