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AKmom

Senior member
Joined
Jun 2, 2010
Messages
608
Reason
DX UMND/PLS
Diagnosis
11/2009
Country
US
State
Alaska
City
Wasilla
Ok I am back from the Mayo Clinic Florida. I am going to start at the beginning and hopefully make this an interesting story. First off, thank you to those who prayed and thought of me during this time and those who pm'ed and those who wrote on my page asking how I was doing. Your support ment alot to me and did help me through emotionally.

Our trip started out by going to Anchorage airport for our flight that was scheduled at 5:45pm to take off. When we went to check the luggage in, we were told that we were bumped from our flight and scheduled on a red eye, which in turn would make us miss the only flight out of Seattle to Orlando and we would then have a 8 hour layover and not get into Orlando till Sunday evening. Well obviousely this was not going to do. They did not notify us of these changes because the Alaska airlines computer system crashed that day, which was why everything was messed up! So with insistance of my hubby John, we got them to change our flight to one that was to leave already, but was two hours late. And with the help of the wheel chair attendent we managed to get to the plane just as it started to board those that need assistance. Perfect. We got out ahead of schedule for us.

In Seattle this plane we got off of, all the sudden became the flight we were to get back on for Florida. Perfect!

We got the rental car and drove to Jacksonville. We stayed at the Marriott Residence Inn in Baymeadows. Not the one at the hospital. This saved us $70 a day and we got all the benefits that the Mayo Marriott was claiming. Breakfast and dinner if we wanted, plus all the internet time was free. Very nice rooms with kitchens. The beds were not bad but too hard for me. But then I have yet to find a bed that is comfortable to me.

At the Mayo I talked to the doc they assigned me too. She was very young, must have been her late twenties early thirties. She was new to Mayo too. Not even listed as a doc there. She took a history and did neuro tests for weakness, which was obviously found. She then told me the tests she was going to order but wanted another neuro muscular doc to check me. The other doc came in and did some of the same basic strength tests and ordered some additional tests to the list.

So my tests were:
  • bloodwork
  • 24 hour urine collection (have no idea why)
  • EMG, NCS (nerve conduction study where they use the needles)
  • MRI of the brain and complete spine
  • Spinal tap
We told them we were scheduled to leave on Thursday. They had scheduled all these test and the final followup appointment to go until the next monday. With some days nothing happening! Its not that we would not have stayed longer if necessary but it would cost us an additional $500 plus hotel and car rental each additional day. But with prayer and John's persistance of diligently making phone calls with all the department heads...we were able to get all tests done plus have a consultation with the doc on the phone at the end. Although we were scheduled to actually see her, she called and said we could do it over the phone because I had a spinal tap earlier on in the day and she didn't want me to be up much.

So here is what she said. First she said that none of the tests show any evidence of why I have clinical weakness. She said that the MRI of my head showed some changes that would indicate one of the following:
  • Diabetes (which non of my test indicated I was diabetic)
  • hypertension (not a problem)
  • aging (she said I wasn't old enough to show this change)
  • Complex Migraines (this is what she has pegged the changes of the mri to. I did at one time have a chronic problem with migraines after a car accident, but they have been resolved for years now with magnesium complex, which she doesn't believe but she didn't argue when I pushed that it really did help.).

She said the MRI of the spine showed that I have mild arthritis in the facits of my low back, and that I have a bulging disc in the low back that is very mild and not impending on my cord. She also said there were two bulging discs in my neck but again they were not serious enough to be of concern. Non of these results are the cause of my problem according to her. The good news was that the stroke I had back in 04 no longer shows on the mri. So apparently it has healed. I wasn't aware that a small stroke damage on an mri could go away but praising God it has!

She said the EMG and nerve conduction test are fine. Although I must note that when they were doing my right foot (they only checked my right side btw) they had to keep redoing the shock one because at 10 they would get the first signal but then it would show nothing on any other signal. This happened when the neuro doc did the emg here in Alaska back in 09. They finally decided it was because the muscle on that foot is in a permanent tight cramp which is causing the foot to turn in.

She said all blood work that has come back is fine and that she suspects the ones that were sent out were going to be fine too. She said the peliminary spinal tap was fine and she suspects the other tests of the fluid will be fine too when they come back.

She said she does NOT know why I have clinical weakness and stiffness. I asked her specifically if she thought it was PLS. She said no its not pls. I asked what ruled out the pls? She said that they did not find any changes on the emg or mri to indicate pls.

She said she could not give me any diagnosis (I did not type in the ALS before that word, this is done automatically by this site, irritates me but I am not going to keep editing these things out when I type in ALS diagnosis. ;)

Now, she did start to say that she thought it was my complex migraine disorder causing all this and I should go on a migraine medicine. I protested and reminded her that the symptoms of the weakness/falling started before the migraines started (which was after the car accident) and that the migraines have been delt with already. I only get a migraine about once every 3 or 4 months if that much!

So because I protested and reminded her of some of the symtoms in which she had a detailed history that I had typed out and given dates and everything, she then changed and said that it could be a rare form of dystonia, but it would have to be hereditary and found with a dna test. I told her that I had a dna test when I was pregnant the last time (due to a doc who insisted that it be done) and that test did not show any markers of anything wrong with the dna. She said that the rare form could be that I am the first in the family to get it. She suggested I take a med that is used for dystonia and if it works and improves things then it most likely is dystonia I am suffering from. I looked up dystonia after talking to her and it doesn't sound like my problem at all!

So she has not given me any ALS diagnosis. She wants me to go to physical therapy (physiologist doc). I feel she has ignored 3/4's of the things I have told her. The only reason I am not in a wheel chair is because of my relentless drive to stretch and exercise to keep things moving. The contractures I am getting is going to happen because of the constant spaticity. But being a soccer coach for 16 years and going to training on injuries and treatment of injuries, has taught me enough to keep me moving now. I am not sure I want to throw anymore money to a pt who will show me the same things I already know.

I asked if she thinks I am taking any meds I shouldn't be. She looked at the list and said that they all should be bennificial to me. I find this incredible that she was not willing to come up with a ALS diagnosis of anything. Am I wrong in stating the mri's and emg's cannot rule out pls? If anything they make the case for pls all the more don't they?

I even asked her if she thought it was a mental thing. She said no she didn't believe it was. She did ask me if I was under stress. I told her no, the only stress in my life is that I am loosing ability to live my life the way I choose to live it! That is the only thing I stress about and I have coping skills that have helped me to move on when I can but quite honestly, its frustrating to find another ability that I have lost. She didn't say anything to this.

So I am left with the same problems as before...only about $10,000 in the red now. This has been an ordeal and I should have gone with my first instinct of fighting for getting more experienced doc. I have lost respect for most medical professions when it comes to them trying to figure out what seems to be pretty clear to me. But for an institution that claims to be able to figure out medical puzzles, to roll over and play the "I don't know" game with me has really made me angry. I got sucked into another money and time wasting scheme!

As for the flight back, we sat on a plane in Orlando 3 hours before it finally took off (do to weather). That made us miss our connecting flight in Seattle, but we were able to get on a flight and had enough time to eat dinner in Seattle airport. So not so bad. We were only 5 hours later than originally planned for landing in Anchorage.

Congrates if you got through all this post!:p
 
oh joyce,i am so sorry you have come away none the wiser.
i would personally not have had this young doctor,would have insisted on someone with more experience.
in fact i did that on my first neuro appointment,after 5 min max exam and the same chat the an imbocile he announced i had m.e
i told him he was an idiot and he sheepishly left the room then came back and told me to wait outside,i then was seen by my long term neuro to come who found clinical weakness and other stuff.

no,pls does not show on a mri till late on if ever.............mri does not show grey matter lesions.
if it happened to show up all i found was that it shows an hour glass shape of tracts in spinal cord due to atrophy.
sometimes magnetic spectroscopy can show umn weakness but again unless a severe progressive case usually its late in the desease process.
only autopsy can give a definate diognosis of pls..........untill they can make a diognostic test machine or mri.
i sent a neuro who said pls showed on a mri copies of people who all had pls and clean mri's plus a letter from an american neuro who has pls patients and said it does not.

i did post a while back a list of neuro's in america who have pls patients.
will try to find it as if you have one near you it would be good to see them.

hang in there joyce,we are all in this together.
 
Well all I can say, is Dam, and join the club. Actually, I think that your experience is so Deja vu to many people hanging out on this PLS forum, that it is becoming a diagnostic criteria, to go through all this. I would think that your neurologist probably was being overseen by another, behind the scenes. As Olly said, having UMN signs, with normal EMG and MRI is a definite indicator that PLS could be the problem. I wonder why they did not mention HSP?

I almost went to Mayo. I had an appointment, but decided that I would probably have the same experience as you. Had I not found an intelligent neurologist, then probably I would have spent the money and gone. It really comes down with having a dr brave enough to suggest the possibility of a very rare disease.
The good thing Joyce, is that you now know that you do not have ALS or UMN Dom ALS, and maybe deep down that is the answer you really need. It was for me. You have a UMN syndrome obviously, whatever it is. You may find it all helps you worry less and cope( as I know you already do).

Rest up if you can
Aly
 
This is ridiculous, EMG does not show PLS.. This is so wrong..Such a crock..
 
finally found the place where the info was but can not get to it to copy and paste,have adobe 9 but i keep getting error message saying i can not view because i need it ...........aaaahhhh.
so directions.......go to page 4 of this forum to thread "spf newsletter and web site",go to page 2 of that thread and then post 21.
its in tha autumn synapse 2010,if you can not get access to it becky maybe able to help as she is member of yahoo pls friends like i was.
she may have subscription and access to back dated issues or can ask linda one of the forum heads for the info.
will try and log on there and see if i can find it,if i can remember my user and password lol.
 
what gets me is that she was willing to guess that it could be a rare form of dystonia yet she was so quick to say it wasn't pls because the emg didn't pick up on it. PLS symtoms and progression fit my symptoms completely (which is the first diag. that has) yet I have considered all the other diags. that they have 'thought it might be' and when looking them up its like it just didn't fit completely and sometimes it was a real stretch. Some of the symptoms might match but then there is something in there that doesn't. And it seems that no two docs can agree on any of these diags. or they change their minds completely. Like they did with the RA thing.

What are they afraid of? I can sue a ton of docs already for incorrect diags. but I don't because I know that its called "practicing medicine". However, when it walks like a duck and quacks like a duck...just call it as it is and quit wasting my time. The only reason I need a diag. is because of insurance. The cost of equiptment is expensive and it would be nice to get what we already pay $20,000 a year for (yes that is what we pay before out of pocket and deductables are met).

Sorry to vent. The more I think about it the angrier I get. I have an appointment next Wed. to see my GP. I know he is on my side and hopefully he will have the guts to put the proper diag. on paper for me. Its not that I am wanting to have a disease, its just the fact that there is something wrong and its getting worse. No matter what I do to try and keep it from happening, its still progresses. So I know that the medical community do not have the answer for a cure, however its still a fact that its happening and we need to plan for the future and try to get the services needed payed for.
 
We're also so excited to have the listings of 50 clinics that treat PLS, HSP and both. Many of you had told us you didn't know where you could go. . . now you do, thanks to the SPF collaboration with NEALS.

found this in an old post but my adobe reader still wont let me access old autumn 10 synapse.

becky when you see this could you get access if you subscribe or ask linda jentner on pls friends,thankyou.
 
Joyce. I was ranting and raving to my Hubby about the raw deal you had. Grumping about your Dr telling you that PLS would show on EMG. During my rave, I happened to say that your spasms are so bad that they have damaged your tendons in tha past. He walked past and said, sounds like Dystonia to me. Now I never mentioned they had mentioned Dystonia to you at Mayo........instead of us all going half off like I did, maybe it was not such a waste of time. He said PLS causes spasticity, but if the muscle spasms are that severe, then Dystonia would be more likely.

Just food for thought.
Aly
 
joyce,you vent all you want we are here to take it.
majority of pls'ers have been exactly where you are,we understand.
becky will be able to get the list for you from linda if she can not get access to synapse.
off now so you take care ((hugs))
 
University of Arkansas - Stacy Rudnicki Little Rock, AR 72205 501-686-5838
Barrow Neurological Institute - Shafeeq Ladha Phoenix, AZ 85013 602-406-6262
Phoenix Neurological Associates - David Saperstein Phoenix, AZ 85018 602-258-3354
Phoenix Neurological Associates - Todd Levine Phoenix, AZ 85018 602-258-3354
University of British Columbia - Hannah Briemberg Vancouver, BC, CAN V5Z 1M9 604-822-7929
University of California, Irvine - Tahseen Mozaffar Orange, CA 92868 714-456-2332
Univ. of California, Davis, Medical Center - Bjorn Oskarsson Sacramento, CA 95817 916-734-3588
Univ. of California, San Francisco - Catherine Lomen-Hoerth, MD, PhD San Francisco, CA 94143 415-353-2122
University of California, Fresno - Jeffrey Rosenfeld Fresno, CA 03721 559-264-9100
Hospital for Special Care - Jinsy Andrews New Britain, CT 06053 860-827-4924
Mayo Clinic, Florida - Kevin Boylan Jacksonville, FL 32224 904-953-6915
Emory - Michael Benatar Atlanta, GA 30322 404-778-3444
University of Iowa Hospitals and Clinics - Andrea Swenson Iowa City, IA 52242 319-356-4505
University of Chicago - Kourosh Rezania Chicago, IL 60637 773-702-9200
University of Chicago - Raymond P. Roos Chicago, IL 60637 773-702-5659
Beth Israel Deaconess Medical Center - Elizabeth Raynor Boston, MA 02215 617-667-8130
Brigham And Women’s Hospital - Anthony Amato Boston, MA 02215 617-732-8046
University of Massachusetts Medical Center - Johnny Salameh Worcester, MA 01655 508-334-9040
Massachusetts General Hospital - Nazem Atassi Boston, MA 02129 617-726-1728
Lahey Clinic - Jim Russell Burlington, MA 01805 781-744-7273
Baystate Medical Center - Carmel Armon Springield, MA 01199 413-794-1150
Johns Hopkins - Nicholas Maragakis Baltimore, MD 21287 410-614-9874
University of Michigan - Kirsten Gruis Ann Arbor, MI 48109 734-936-9020
Saint Mary’s Healthcare / Michigan State University - Deborah Gelinas Grand Rapids, MI 49503 616-493-9727
St. Louis University - Ghazala Hayat St. Louis, MO 63104 314-977-6086
Carolinas Medical Center - Benjamin Rix Brooks, MD Charlotte, NC 28203 704-355-2000
Wake Forest University School of Medicine - Michael Cartwright Winston-Salem, NC 27157 336-716-4344
Duke University - Richard Bedlack Durham, NC 27707 919-668-7600
Dartmouth-Hitchcock Medical Center - Elijah Stommel Lebanon, NH 03756 603-650-5104
Robert Wood Johnson Medical School - Jerry Belsh New Brunswick, NJ 08901 732-235-7733
University of Nevada School of Medicine - David L. Ginsburg, M.D. Las Vegas, NV 89102 702-671-5025
Upstate Neurology - James Wymer Albany, NY 12205 518-438-0922
Beth Israel Medical Center Albert Einstein College- NY - Stephen Scelsa New York, NY 10003 212-844-8490
Columbia University - MDA/ALS Center - Hiroshi Mitsumoto New York, NY 10032 212-305-1319
SUNY Upstate Medical University - Jeremy Shefner Syracuse, NY 13210 315-464-4243
Cleveland Clinic - Rebecca Kuenzler Cleveland, OH 44195 800-223-2273
Ohio State University - John T. Kissel, MD Columbus, OH 43210 614-293-4969
Ohio State University - Yasushi Kisanuki Columbus, OH 43210 614-293-4969
London Health Sciences Centre - Christen Shoesmith London, Ontario, CAN N6A 5A5 519-663-3597
University of Toronto - Lorne Zinman Toronto, Ontario, CAN M5S 1A1 416-480-4213
Oregon Health & Science University - Jau-Shin Lou Portland, OR 97239 503-494-7772
Penn State Hershey - Zachary Simmons Hershey, PA 17033 717-531-4191
University of Pittsburgh - Sasa Zivkovic Pittsburgh, PA 15213 412-692-4917
University of Pittsburgh - David Lacomis Pittsburgh, PA 15213 412-692-4917
Drexel University College of Medicine - Terry Heiman-Patterson Philadelphia, PA 19103 215-762-6915
Rhode Island Hospital, Brown University - George Sachs, MD, PhD Providence, RI 02903 401-444-8795
Texas Neurology - Daragh Heitzman, MD Dallas, TX 75214 212-827-3610
University of Texas Health Science Center, San Antonio - Carlayne Jackson San Antonio, TX 78229 210-450-9700
University of Virginia - Lawrence H. Phillips, II MD Charlottesville, VA 22908 434-924-0000
University of Vermont - Rup Tandan Burlington, VT 05405 802-847-4589
University of Washington - Michael Weiss Seattle, WA 98195 206-598-7688
Dean Health System - Oliver Ni Madison, WI 53719 608-252-8000
Medical College of Wisconsin - PE Barkhaus Milwaukee, WI 53226 414-805-5224
WVU School of Medicine - Laurie Gutman Morgantown, WV 26508 304-598-4800
 
Sorry about the formatting! They all treat PLS, some both PLS and HSP. Ironically, none treated HSP but not PLS... despite the fact HSP is less rare. Anyhow, the marking of which they did messed up the formatting.

I noted there is a Mayo clinic doc on there, and not the one you saw. Perhaps he could access your records, since you had the tests done there and give you a second look with his particular UMND experience? If he can look and still say dystonia, that could be more meaningful than the young pup you saw.
 
Joyce. I was ranting and raving to my Hubby about the raw deal you had. Grumping about your Dr telling you that PLS would show on EMG. During my rave, I happened to say that your spasms are so bad that they have damaged your tendons in tha past. He walked past and said, sounds like Dystonia to me. Now I never mentioned they had mentioned Dystonia to you at Mayo........instead of us all going half off like I did, maybe it was not such a waste of time. He said PLS causes spasticity, but if the muscle spasms are that severe, then Dystonia would be more likely.

Just food for thought.
Aly

I don't recall ever stating that my spasms have caused the tendons to snap. I do remember stating that my tendons seem to tear easily when I do simple everday things such as opening a jar or using my cane or one time long time ago when I was able to stand on my toes briefly then took a step backward. Needless to say I have not ruled out the dystonia thing..I will talk to my gp about it. But just from what I have read about it, the progression is totally different from what I have experienced.

also to be clear...she did not diag. as dystonia. She was just guessing and told me to take come kind of medicine that would be used in the treatment of dystonia, and if that worked then that is what I have. I find this to be an odd way of diag. someone.
 
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thanks for the info Caroline and Beky. I will try and see if the Mayo doc listed will look it over.
 
called the number for Boylan and it went to a Wendy something voicemail. So I left a message and asked for a call back. We shall see where that goes.
 
Oh ok. That makes sense. Then tendons tearing easily, will be caused by something else, or just a fluke.
 
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