Dear Hockey

"Good Neurologist" certainly does seem to be an oxymoron, and I have also had trouble finding rheumatologists who aren't jerks. ENT's, of all people, seem to be really curious. I always wondered why these doctors thought that MRI's would tell all where the brain is concerned. It's like trying to understand China from satellite photos.

I think that there is pressure from the insurance industry to declare someone "clear" if nothing appears on an MRI. I know about neuropsych evaluations, because my son had his Asperger's disorder diagnosed through such an exam. Back then, they cost $1500, and today they are anywhere from 5000 to 7500 dollars. So insurance companies insist that you first see a neurologist (and get "cleared" through the MRI) to prevent people from getting the neuropsych evaluation.

Right now, I'm in the middle of trying to get a neuropsych eval for my wife. I'm a clinician myself, and don't like what I'm seeing, and her friends are worried too. After that, I'll pursue my own eval.

I got myself a referral to an endocrinologist when I used Kaiser's neat little test result program to graph where my TSH had been over several tests. It spiked up and down and back, and bore no relation to the free T4 in my system. I take pills because my thyroid was removed in 1980. I also was making almost no testosterone, and was having horrible episodes of sweating. I also have PTSD from multiple truamas unrelated to concussions, and that can overstimulate the adrenal hormones. Tests revealed I was way overboard with Insulin-like growth factor; normal range is 87-225 and I was at 381. They MRI'd my pituitary and I meet with the MD tomorrow to see the results..... This is usually caused by a tumor on the pituitary.

I will visit the brain injury webpage, to see if I can get support locally in Germantown.
Thanks for your concern.

gershonb