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Robinetta

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I was under the notion that going in for a spinal tap would lead to a definitive Dx. After reading here awhile I'm afraid I may be laboring under a misconception.

I have small, symmetrical lesions on the outer cord at C2/3 per MRI (not reflected on EMG). Upper unilateral EMG has long since detected neuropathy @C6/7-which doesn't show on T-weight or Flare MRI.

I assigned the insane arm fatigue to Fibro and have believed to be Secondary Progression RRMS-early stage w cord presentation. This all began and initial EMG in summer 2010. I thought, at this point, stalled-out or slow progression in lesions.

I had no atrophy, but numbness and dropsies long since an issue in my hands. Things began to change 6 or 8 months ago. The fatigue became specific, localized and extreme.

Then came my hands. Both are fully "wasted" but my fingers have not yet curled at all. I couldn't find anyone else, "like me" but finally landed on the photos that were posted here in 2006. Yep. That.

Both hands have deteriorated rapidly and I've lost fine motor.

My fingers/hands kind of get "stuck" if I have my hand in one position for long. The joints lock up (jam I guess?) and I give it a shake to pop them back loose. It isn't painful-just like I need some oil.

Now I see that other areas are losing/have lost muscle and are either stark (gaunt) or sagging. (upper arms-biceps, lower abs, my face)

what was in my hands/forearms and feet (fatigue et al.) has moved solidly to shoulders and hips.

Am I really going to have to deal w these stupid doctors beyond collecting the disjointed scans and test results and going over GPs head after twice waiting 3 months to see the incorrect Neuro?

(Don't ask. He's bloody incompetent. He swears all of this is Fibro and hasn't seen my hands. Ortho Doc told me nothing except "This isn't something I can help you with. You should make an appt @the MS clinic."

It seems to be progressing daily. It's very rapid and widespread, in any event.

Are these hands and a spinal tap not enough? I don't relish the thought of hopping back on the merry-go-round of hit-or-miss doctors who refuse to admit, "I don't know." and each point the finger at the other.

I even have a Neuropsych who has reviewed the entire, combined litany of data and leaned hard on the GP and ortho surgeon-it's been a monumental exercise in futility.

It's pretty clear this isn't Fibro or MS, and I have been tested tip-to-stern by the Rheumy for all else. I don't make Vitamin D. My thyroid is a bit hypo. Nothing else.

Help...advice?

Oh! Btw, I'm Robin. I just turned 40. :wink:
 
I recommend calling your local ALS Association chapter and ask them what specific neurologist you should get a referral to go see. That should be someone knowledgeable in neuromuscular problems to sort out your various issues.

DC/MD/VA Chapter
Serving Maryland, Washington, DC and Virginia
7507 Standish Place
Rockville, MD 20855
Phone: 301-978-9855
 
Thanks, BrianD. :) I have been confounded and frustrated by the system to no end today. Healthcare is changing and medical care has suddenly all gone corporate. Or it seems so, after trying to wade through the mess these past 2 years or so.

The oxymoron, catch 22 is: I don't need a specialist referral (a referral to see a specialist) per my health Ins.

I can't find a neuro that will take a new patient who isn't being referred in by general neuro/neuro motor-who also requires a referral.

I've never waited more than a week or two for an appointment, anywhere, really. Not even for a -surprise!- random surgery, big or small. .Not until the past year and specifically an issue w UVA neuro. I live out yonder and can't ferret out another option. I don't think sitting here for 3 months, respectively, is the best idea ever.

Your help is much appreciated. It's exhausting and stressful mentally, never mind physically.
 
Check out aanem.org - American Association of Neuromuscular and Electrodiagnostic Medicine. Their site has a state by state listing of neuromuscular specialists and laborities that are accredited by them. At least you won't end up wasting your time going to a neurologist who doesn't specialize in EMGs or neuromuscular conditions.
 
Post went to moderation because I included a link to a website.

Check out the American Association of Neuromuscular and Electrodiagnostic Medicine website. They have a state by state listing of doctors and labs who are accredited by them. There are neurologists who do EMGs who are not as qualified as others.

My first EMG was done by a neurologist who I later found was not board certified or AANEM accredited. I ended up filing a complaint because of his shoddy work and was eventually refunded my money. But alot of time was wasted.
 
Is primary progressive MS a possibility that has been ruled out?
 
@Paul:

That's fantastic! Thank you much. Sincerely. I'll start checking off names and go over the list of candidates with Doc2 during my next session (next N.Psych appt.). He may well be able to open those doors. He surely has the gumption to ruffle the feathers of "professional protocol". I have a couple of top-notch guys who act as Central Command, I'll give it that much. Doc. 1 (MD., PhD) basically has a master file compiling the revolving-doctors scans, test results, legal crap and his own clinical documentation and Robinland record of events some 8 years past.

It started with 1.5 years, or more, of his diligent effort and ginormous brain to find the key to medicating me as a whole. I'm insanely hard to medicate. Something to do with GABA or a amino acid of the like parking in the receptor sites as an autoimmune defense. Small dose Cytomel. Idk. Nothing is any less than ridiculous with me.

@Tokahfan:

Ya, know.....the EMGs this summer and last were to compare to the initial one that marked the first progression. The big mystery of seeing/detecting separate areas of involvement via MRI as opposed to EMG was never reconciled. When I went in with this presentation in my hands he practically shoved me out of the shop and took his shingle in. It was off-kilter. Been seeing this guy since 2003.

The EMG was the measure of progression. It hasn't changed more than incrementally but is only done from palm to vert on the right arm. I have learned to measure out some control of symptoms w biofeedback, etc. The past year has been nearly free of flare ups. This hit in the absence of all that stuff. Initially that was what threw a red flag for me.

He did say, before tossing me out on my bum, that this had nothing to do with structure or a change in what I have going on in the C spine.

I hadn't even considered PP. Good call. I'll start digging there, as well.

My gratitude to you both! I feel so much better just having some measure of control and even an inkling of a plan. It's hard to see the larger picture at all when you're left stumbling around with no sounding board. I appreciate you both putting your time, energy and thought into pointing out a sign post for me.

R
 
Oops..forgot I cannot yet pm, so @Toka:

I'm a zillionth generation "Richmonder". :) I moved to C.ville on Sept. 11, 01 and I did NOT want to. On any level. I had two toddlers to raise and "share" at that point. I miss home incredibly. I wanderin to see my best bud and go to the National/Penny Lane now and then.

River City. Sigh. I've mislaid those pesky ruby slippers. AGAIN. ;)

-R
 
Hi robin.
I could not even guess as to what is going on but clearly theres something really wrong.
With progressive ms I don't think you would have severe wasting of your hands.

The doctor really showed you the door when you mentioned your hands? Did he look?
Why did you see a neuropsych? Do they think your somotising?

I hope you find a neuro who listens and your able to get a diagnosis soon.
 
Thoroughly. Prior to the EMG. I re-saw him a couple hours after.

He did a big case study on me, eventually for int'l publication. I'm cirruiculum. I guess I was his "trick pony".

I've seen him every year since maybe 2003 and he never so much as let a nurse take my BP or give me an injection. He came down from his fat cat office or wherever and did my check-ups or follow ups behind a closed door, chatting with my husband and I and remembered every last detail of our lives.

I asked what the issue with my hands was called; what it was-what word to use for it; had he ever seen anything like it?,etc. He told me it wasn't structural or orthopedic and basically shrugged. He told me that I should go to one of the MS or neuro clinics and see what they might recommend or what department they could refer me to.

Then he said-for the first time ever-you don't need to schedule a follow up and good luck to you. I continued to ask, "Could this have something to do with Raynaud's, like in my feet? It feels almost the same as an attack of that."

He literally responded, "Well, what do you do to treat Raynaud's? I mean, don't go outside in the winter." (...Welcome to Corporate Medicine!)

*curtains*


Mind you, I have never even scheduled one appointment with him or with any of the other doctors I have seen, through him, for problems that weren't even hand-related. My shoulder, my neck. Even the surgeons. This Dr. just says, let me send you to my ______ guy. And *poof* we get a phone call.

I see Doc.2 to control flare ups by training my system to default to non reaction. Med.s have little effect, dosage doesn't factor in.

Some cra cra is going on w my hands. One then both. Then cra cra hand thing #2 and #3 made a debut. :shock: I started to panic a bit right there. It's happening too fast! I'm going in through the main emergency/acute care tomorrow morning. Progressing measurably by the hour?=I need a doctor. Now.

If they want to make it so difficult to be granted the priv of making a neuro appt. with a 2 month wait; I find it appropriate to use their ER as my PCP.


Somo....wha? Hmmm...that's a new onnnne....and Googling.

<3
R
 
Hi robin.
Theres a few choice words I could use to describe that doctor....unfortunately i'm a Christian and david the forum owner would not allow it lol.
Somotizing ...meaning its a physical illness brought on by psychological problems.
I know this clearly does not apply to you with visiable wasting and such but some neuro's like to pin the label on when they run out of answers.....to save face.
I only asked because you mentioned you were seeing a neuropsychologist.
 
Olly,

OOOOOHH...psychosomatic. I don't know if its possible to do that with most of this but I don't think it's been considered. My right fingers in the middle get pulled down when I curl my knuckles to a point. Left was fine. Then I remembered something I read here about putting your hands flat and if your knuckles are popping up...this was yesterday evening.

So I did that and the LEFT mid and ring knuckles were up off the table. My husband pressed on all of them and those two are like little springs.

So I pressed my middle fingertips (I read that here, too, but I don't know what it indicates...just stuck in my mind)and my pointer fingers come up the tiniest bit and buzz sort of. It's the weirdest thing I've seen in a long time. I see some weird things in my line. My left ring finger tip is not in line with the others. It is slightly forward.

Then an empty blister came up from the subcutaneous of my right palm. We are looking at my hands I mean, we were watching this happen. I pulled it off. Two small ones, actually, not one came up. So there was another one under it on the deeper level. Not red, nothing in it, just in the soft skin separated. Rob smacked my hand when I tried to pull that one up and it has kind of faded.

A couple of hours later I was playing with my left hand fingers, curling them to the point where they would catch and thunk! Pulled down. I had been using my left hand as a control simultaneously earlier so I know it wasn't the same but when I put both up to repeat the comparison ...thunk. Both hands.

I found the syndrome Dup something? The tendon thickening and pulling my hand into a claw eventually. I expected that along after the wasted hand but I haven't gotten that far in figuring out what the crud is going on.

The fatigue that was in my forearms, etc. this past month or so has moved completely out of those muscles as of today when I woke up. It's in my shoulders and my hips are worse. I can't walk far. I can't lift my arms even to eat if I'm sitting in the floor more than a couple of times.

Yay for iPads so that I can type...while laying on my side in bed with pillows stuffed up under me and "hugging" another. I'm going to the University of VA Med. Center main hospital ER now. I don't know how walking in there and sitting to wait is going to work out but I guess we'll be finding out.

I'll post the results of today's sojourn into medical care when there is some conclusion.

R
 
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