Dr. Bailey, a neurologist who specializes in neuroimmunology, has been caring for patients with multiple sclerosis (MS) at the Mandell MS Center at Mount Sinai Rehabilitation Hospital in Hartford since 2016. Dr. Bailey explains that she was first drawn to work at the Mandell MS Center, which opened in 2008, because of its model of coordinated and comprehensive care. The Mandell MS Center also has locations at Saint Mary’s Hospital in Waterbury and Mercy Medical Center in Springfield, Massachusetts (all part of Trinity Health Of New England).
Multiple sclerosis is a disease of the central nervous system that results from the body’s immune system attacking the covering of nerves (myelin sheath). This damage to the myelin sheath is visible on magnetic resonance imaging (MRI) and it interrupts the electrical impulses which normally travel along the nerves from the brain to other parts of the body. This can cause a variety of symptoms such as fatigue, blurred vision, muscle weakness or spasms, numbness or tingling, and bladder or bowel dysfunction.
Because MS can present differently among individuals and because there is no laboratory test that can confirm a diagnosis of MS, it can be a difficult disease to diagnose. Often, patients will have seen multiple specialists to rule out other diseases before a diagnosis of MS is confirmed. At this time, there is no cure for MS, so it is considered a chronic disease. Historically, it has been a progressive and often debilitating disease. However, Dr. Bailey explains that with advances in medicine and a comprehensive approach to care, such as that practiced at The Mandell MS Center, the outlook for newly diagnosed patients is much different than for those diagnosed in the past.
Dr. Bailey explains that because MS can cause symptoms in so many different body systems, a care model where all those problems can be addressed for the patient makes the most sense. So in addition to a neurologist to treat the MS itself, the Mandell MS Center has additional staff and resources to help patients with the physical symptoms and other impacts of the disease— psychological, social, or financial, for instance. Dr. Bailey offers, “For a patient with bladder symptoms, we have a urologist and for a patient with muscle stiffness or spasticity, we have physiatrists.” There are also physical, occupational, and speech therapists available, and Dr. Bailey points out that the rehabilitation piece of care cannot be emphasized enough—when patients focus on these rehabilitative services in addition to medication, their outcomes are much better. Other important resources available at the center include social workers, mental health workers, and patient support groups.
In January of this year, Dr. Bailey became the Trinity Health Of New England’s Regional Medical Director for Rehabilitation and Multiple Sclerosis. In this new role, Dr. Bailey says she will continue seeing patients, but she is also tasked with the ongoing advancement of the Mandell MS Center. She hopes “to create it into the best it can be and fulfill the vision that Joyce and Andy Mandell had for it.” She explains that the Mandells were the principal benefactors of the original center. They wanted for patients and families dealing with MS to be able to come to one place and have all their needs met.
One of the advances that Dr. Bailey had been interested in incorporating into MS care was the use of telemedicine. She explains that because much of MS care relies heavily on the patient’s verbal history and report of symptoms, it actually lends itself to a telemedicine visit. While the COVID-19 pandemic presented many challenges to the Mandell MS Center, as it did for everyone, one good thing that emerged from it was the creation of an infrastructure to support telemedicine. Providers transitioned pretty quickly back to seeing patients in person but the center is now certainly able to accommodate a telemedicine visit for those who request it.
Besides providing excellent patient care, the Mandell MS Center’s mission includes research and teaching. The center has partnerships with both Oxford University in England and The Frank H. Netter MD School of Medicine at Quinnipiac University. In addition to her role at the Mandell MS Center, Dr. Bailey serves as the Director of Institute for Rehabilitation Medicine and Chair of Rehabilitation Medicine at Quinnipiac University. These multiple responsibilities keep her very busy but she says, “I love it all. Having these different roles keeps it fresh and exciting.”
A Personal Connection with MS
Dr. Bailey grew up in Glastonbury. She remembers always being interested in medicine, even as a little girl. Her father was diagnosed with multiple sclerosis when she was 5 years old, and she remembers accompanying him to see his neurologist, Dr. Timothy Vollmer, who practiced at Yale. So when she was considering career choices during high school, Dr. Vollmer graciously allowed her to shadow him. She remembers him treating her like a medical student, asking her questions and integrating her into his clinic. That experience cemented her desire to pursue medicine as a career.
Dr. Bailey attended Georgetown University in Washington, D.C., where she majored in math and minored in English. She spent college summers working in Dr. Vollmer’s office, which exposed her to more patient care and even research opportunities. She went on to pursue her medical degree at Yale School of Medicine.
When asked if she knew she wanted to go into neurology and specialize in multiple sclerosis because of her work with Dr. Vollmer, she replies “Actually, I tried very hard not to pick neurology because I didn’t want to choose it just because I had had that exposure.” But she notes, that with each different clinical rotation during medical school, she just didn’t get that sense of fulfillment and excitement that she felt doing neurology. So she did go on to complete a residency in neurology and a fellowship in neuroimmunology and multiple sclerosis at Yale-New Haven Hospital.
She and Dr. Vollmer are now colleagues, seeing each other at international meetings and discussing patient cases or thoughts on different medications. She believes her personal connection to multiple sclerosis has helped make her a better physician. She says, “I enjoy my job because I think that my personal background with MS from my dad really allows me to connect with patients and their stories on a different level and understand at least a piece of what they’re going through.” She emphasizes, “While it is my career and my job, I really enjoy what I do. I love working with my patients!”
New Approach to Multiple Sclerosis Treatment
Dr. Bailey explains that the biggest advance in the treatment of MS over the past decade has been the development of several high efficacy disease modifying therapies. Their approval by the Food and Drug Administration (FDA) has shifted the treatment approach for MS. Rather than waiting for patients to have relapses of the disease and then stepping up their therapy to a higher level, the current approach is to use one of these disease modifying therapies from the time of initial diagnosis to prevent relapses all together and to protect the patient’s current level of function. “The goal of therapy now is NO future relapses and NO new lesions on MRI!” she exclaims.
But Dr. Bailey thinks that one of the continuing challenges, even though there are these new effective therapies, is making sure that all patients have access to them. She finds that physicians who specialize in MS are more comfortable prescribing these medications, and therefore, more likely to utilize them for their patients. At the Mandell MS Center, an infusion center allows patients to receive these medicines and be monitored on site. Dr. Bailey would recommend that any patient diagnosed with MS see an MS specialist at least once early on to develop a treatment plan.
Margaret M. Burke, Pharm.D., BCPPS, is a freelance medical writer with more than 25 years of clinical pharmacy experience, including board certification as a pediatric pharmacotherapy specialist. She lives in Manchester.
Photopgrahy by Stan Godlewski. Stan is an editorial, corporate and healthcare photographer based in Connecticut and working primarily between Boston and New York City.