Neuro Report

[11bravo]

Well hello all, I'm back in the states for a couple weeks R&R. I thought I would report back on my neuro doc visit and my following EMG results, I'll try and keep a glass half full perspective.

I went to my neuro visit and did the normal physical tests, strength, measurements etc. after eying me over the doc thought another emg was in order, this is where I start getting a little clueless and maybe you all can help me. My initial thoughts are that I may be in some trouble but the doc doesnt want to be the end all in that decision.
During the emg I was only supposed to have my right arm tested, how ever after finding "chronic denervation" he thought he should test my back and leg also. Here is the rundown.

My arm showed as he called "abnormal muscle issues" and "chronic denervation" along with fasculations / twitches.
The leg apparently was not as bad and he only found the fascics.
I tried to get his opinion and he kept mentioning that I have "Chronic and not Acute" symtoms not that it couldnt change in the future.

So my questions are what is chronic denervation?
What is the difference between chronic and acute symptoms.

The doc is trying to get me a rush appt with the U of Penn in Philly to have a muscle disease doc ,not general neuro, test me.

Thoughts comments? As you can imagine I am feeling pretty low right now, what a way to spend 2 weeks home from the sandbox

Take it easy
11B

[Jules45]

11Bravo, first of all thanks so much for all your work defending our great country.

2nd, God Bless to you and your family through this difficult time.

I'm curious as to the specifics of your symptoms were that led you to go to the Neuro?

Thanks.

[ktmj]

Bravo, I second that we appreciate your service.

The difference between chronic and acute is that acute happens suddenly - less than a few weeks. Chronic means it has happened over some period of time. That period of time I cannot define.

Denervation does not mean ALS - it can be caused by many things and many of those treatable. Glad the neuro is rushing you to a specialist - hopefully will work out before you go back from the R&R.

Best wishes and God bless...

[11bravo]

Jules and KTMJ,

Thanks for the replies, and I really look at it as an honor and responsiblity serving our great nation, but on to business.

Jules, my syptoms started May 17 2008 with twitching and muscle cramping of my right arm and hand, from there in a few months I began having fascics in my arm and tremors leading to muscle atrophy and weakness in the fall of 2008.
KTMJ, I am definitly praying for the alternatives in this thing. Ive had and MRI of my c-spine with and without contrast hoping for a pinched nerve or something but no such luck.

Thanks again

11B

[brendapals]

11B-
Thank you so much for keeping our country safe-what a huge responsibility you have.

For your health- hopefully, you can enjoy your much deserved R&R-sounds like you have a dr that is willing to send you in the right direction.
Our prayers stay with you,
God bless,
-b

[ktmj]

Bravo, your symptoms could be related to CIDP or MMN - both are treatable. We obviously can't diagnose you - but I certainly hope they are treatable.

I've had some buddies deployed - there are incredible stories. I think it is difficult for most 1st world country citizens to understand what it must be like over there. I can't imagine having a serious medical condition with very little medical support. We ain't got it that bad, huh?

[Jules45]

Thanks Bravo. Where in your right hand and arm was the cramping?

[11bravo]

My pinky finger and the ring finger next to it would just kinda cramp up and turn in towards my wrist, I would kinda push against my palm to straighten things out again.

Those symtoms really only lasted a couple months and quickly progressed to tremors fascics and twitching.

Jules are you in the process of being DX?

KTMJ, CIDP and MMN my new great hopes hahaha!

Good Luck All

11B

[Jules45]

11B, in early December 08' I went to a Neurosurgeon with weakness and tingling and clumsiness,. He looked at me did a bunch of in room examinations, and a CAT Scan and said he didn't see anything wrong but referred me to a Neurologist with the quote "You're probably wasting your time and money".

Went to a Neurologist a couple of weeks later who did an extensive in room exam (Babinski, Hoffman, strength, all tests). I had lost about 7-10 lbs in 2 months. Thought I was overanxious about ALS and prescribed Cymbalta. Ordered full blood tests, MRI of brain, brain stem, upper spine and an EMG. All tests came back negative. EMG was done on legs and neck last week in December with the summary by the Neurologist who did the EMG (1 1/2 hours) their was no signs of ALS. While this was happening I started getting more cramping in my palms along the pinkie, and in my forearms occasionally as well as occasionally in my thighs. Was still very, very scared of ALS and my symptoms.

Saw same Neuro in early January 09'who did in room exams again and said I was fine. Also told me that he ran my tests by a Dr. friend of his at Stoneybrook NY, who sees alot of ALS patients. Stoneybrook Neuro reviewed my tests saying no, my Dallas Neuro didnt' miss anything and so no indication of ALS.

My GP ran some more blood tests on 1.21.09 checking for vitamin deficiency to cause cramping, I had low B-12 and Vitamin B. My CPK was 121 which is fine.

Early this week one of the Neurologist's in my Neuro's office called and said they got the remainder of the tests back from DECEMBER 18th!!! She didn't even know who my Neuro was but that my CPK and protein was slightly elevated and that my Neuro would probably be calling me to recommend "a full ALS workup". Naturally this sent me into a full on panic.

MY Neuro called me later in the day to say that he didn't think that my elevated CPK levels were too bad and that simply because I work out my cause a little higher CPK levels due to muscles being rebuilt and dead muscle fibers being flushed into the blood.

He also recommended an ALS specialist that I could go to that would give me piece of mind to ensure ME AS THE PATIENT that I don't have ALS. His quote was "I don't want you to go to this ALS specialist for me, I don't think you have it, but you may want to think about going to him for yourself and your piece of mind".

It's been a tough journey and with my cramps, now I'm just waiting for the weakness to show up somewhere in my body.

[GGKK]

ALL (without exception) exams were fine 1 month ago.

How could be something wrong?

All the best for you!

[planningguy]

11bravo,

Thank you for all that you do. Looks like my brother will be heading back overseas next month, so I really appreciate the time you are willing to spend away from friends and family.

Too bad you have to spend your R&R worrying about this, but I wish you the best of luck getting to the bottom of it.

Take care,

Robert

[rose]

Bravo, like so many that have already expressed it, thank you for serving! (I have a son in the military that has done two middle eastern tours, and I see and hear what the effect has been on him. He has recently been diagnosed by a military doc with PTSD)

Back to your emg, out of many on here, I am absolutely not the one to try to interpret test results, but I do know that ALS shows a definite pattern of acute as well as chronic denervation (and reinnervation) so, you should be encouraged that nothing acute was recorded during your test.

good luck, and keep your chin up!

[sdsyd]

11Bravo-

I am so glad you are back to the States safely. I am also glad you decided to look into this why you are home. I am sorry though that you are spending yout time home dealing with this. I don't know much about the military but could you get an extended medical leave while they sort this out?

Stay Brave and I echo all the others who have already THANKED you for serving our country!!!!!

Love,
Cindy

[11bravo]

well the saga continues.....

I am very fortunate to have an ASAP appt with a big wig Dr at U of Penn this afternoon. Of course my glass half full self would say jeez this must really be bad to have the rush appt.

I spoke with my general Neuro who setup the appt for me this morning. When he told me of the Dr who ran the EMG findings I asked well is that good or bad and he responded with a resounding BAD! Super!! haha

Anyway I'm greatful for all of the responses and I'll keep you posted as things progress with my appts.

Maybe I wont be going back to iraq after all

Of course I would go back 100 times if all of this would go away

Take Care

11B

[Jules45]

11B, best of luck and God Bless to you and your family...