Eight Questions with Andrew Godbey, M.D.

Dr. Andrew Godbey is a Board Certified Neurologist and the Medical Director of the ALS clinic at Saint Francis Medical Center in Cape Girardeau, MO.

Can you tell us a little about yourself?

I grew up in Baltimore, MD and basically moved to the Midwest while attending Washington University for my undergraduate education.  I left for a year and a half to get a Master’s of Science in Public Health at Tulane University.  I followed this degree with Medical School at St. Louis University, neurology residency at Washington University, and neuromuscular fellowship at Washington University.  I moved to Cape Girardeau in 2010.

Why did you decide to become a neurologist?

Neurology is a discipline where you try to determine where the problem is located, or localization.  I enjoy this thought process and the neurological examination.  Neurologists still perform a thorough examination and that is basic to treating patients.

How long have you been treating people with ALS?

I have been working with ALS patients since my neuromuscular fellowship training at Washington University in 2009.

How is ALS diagnosed?

It is diagnosed based on the neurological examination in conjunction with neurophysiology testing (electromyography and nerve conduction studies).  The evaluation also entails ruling out other diseases that can mimic ALS such as autoimmune disorders and structural disease (problems with the brain or spine) which requires imaging of the central nervous system.

How is the ALS clinic at Saint Francis Medical Center different from a typical clinic?

The clinic is designed to involve multiple disciplinary evaluation-respiratory therapy, physical therapy, speech therapy, ALS coordinator, and case coordinator as well as an evaluation by a neuromuscular specialist.  Patients are evaluated all in one area so they do not have to travel to multiple visits/sites to get the comprehensive evaluation.

What are some of the exciting developments in research in ALS?

Obviously the most important developments include new treatments.  The FDA just recently approved of Edaravone (RadicavaTM) for ALS.  Also, there have been exciting developments in regards to the understanding the pathology of ALS.  The discovery of the NEK-1 gene and its role in the development of ALS.  We need to understand how one develops ALS in order to develop effective therapies for treatment.

What are the most common misconceptions about ALS?

The misconception that ALS is caused by infections. There has been no evidence that if one gets an infection such as Lyme disease, someone is going to develop ALS.  Also, ALS only affects muscle strength and motor activity.  ALS has also been associated with mild cognitive impairment in about 20-30% of patients.

What is the most rewarding thing about working with people who have ALS?

The most rewarding experience is being able to help people maintain a high quality of life as long as possible.  In the clinic, patients receive help with not only medications but more importantly they are seen by multiple therapies, which can help improve their quality of life (i.e. more comfortable wheelchair, supplementing diet, etc.).  Also, it is rewarding to not only help the patient but help their caregivers with coping strategies and with discussing concerns and questions.

The ALS Association St. Louis Regional Chapter supports four patient centered, multidisciplinary, ALS-specific clinics which provide compassionate care in a supportive, family-oriented atmosphere.  Visits typically last more than two hours, with patients and family members remaining in one room, while specialists orbit around them, consulting about ways to manage all aspects of health to ensure better quality of life. This multidisciplinary care model brings together a team of health care professionals specially trained to address the needs of people living with ALS, allowing them to receive care from each discipline during a single visit.

Do you have a question for Dr. Godbey?  Or a topic that you would like to see us cover in an upcoming blog post?  Email us at alsastl@alsastl.org — we’d love to hear from you!  And, for more information on ALS and multidisciplinary care, visit alsa-stl.org.

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