the neuro is going to start with the standard tests....the bloodwork, likely more nerve conduction tests [if they did ONLY your feet something is inadequate in that] and a FULL MRI from head to pelvis to see if there is any spinal compression or the like. More bloodwork might be necessary after that, depending on the results of earlier tests... and then even more specialized tests as needed, depending on what those 'results' show. Having gone the 'full route' so to speak myself? It CAN be extensive and then some!
I've been there, done that! It seems to take forever once you get a neuro actually WORKING for you? It can take 2-4 months to get all the tests scheduled [maybe approved by your insurance to boot?] and THEN you have to WAIT for results another month or so.... It is agonizing to be in the limbo of not even being tested or waiting for the test results!
I actually REFUSED to have a sural nerve biopsy. Why? Because many insurances no longer cover it, and while skin biopsies aren't approved YET, they will be a standard procedure very soon. Also, all they show is that there is NERVE DEATH or life, and the extent of that. Conduction studies and other factors are much more important.....except-for those people who have a whole slew of 'inconclusives', yet are having progressive nerve deterioration as shown by conduction studies and other means. Also, lots of docs [younger ones in particular]want to get this 'procedure' on their resumes...No thank you. It IS an invasive procedure that can cause long-term additional pain and possibly infections. I declined because that doc was too eager [never saw again] and I'd more or less met the 9 out of 10 rule in terms of testing positive for my neuro issues and subsequent treatments..... It's your choice tho. You have to KNOW more about what these guys want to DO to/with YOU! Don't know about you, but I'm not a TOY to play with?
I'd do the sural biopsy ONLY, ONLY! as a very last resort. Not yet tho.
IF you aren't communicating well w/your rheumy? [And, it sounds like it's not happening]
Ask for and GET copies of your file [some things will be omitted...like doc's notes?] but all the test results and stuff you should be able to get. Just say 'HIPAA'! Health Insurance Portability & Accountability Act or something like that. They may charge you, but once you've the actual tests, you can start burning the web and learning far more than you ever wanted to know about what all is going on!
If you live in a metro type area, you should have a choice of specialists to either get second opinions from or referrals to... IF you like the neuro, simply ASK him! Not for just one name, tho...but for a couple. YOU must find a set of docs YOU feel comfortable with and to whom you can communicate well with [and ideally? Each other!]. Yeah, easier said than done, but...... YOU have to garner the strength to do it to preserve any quality of life.
And yes, RA and PN can be connected? But they can also be [sigh] independent of each other. Learn what all you can in the meantime, and it does 'overload' the brain at first? And that all will help YOU ask your docs the more concise questions to get better answers! For you some knowledge isn't empowering, you need a LOT of knowledge and then go for it!
Don't you just LOOOVE those 'pin' tests?????They mean so little to us, but so much to the docs! I've never gotten a handle on that one, not that it makes lots of difference.
Keep faith and go for it! Fight hard, and.....remember to be CONSISTENT, adding only as new things crop up.... But, consistency in what your problems ARE are key to getting docs to work with you. 's - j