mrsD,

Thank you for such a comprehensive response full of useful information.

Yes, I post on the MS boards because in 2000 I was initially misdiagnosed with RRMS and them SPMS, undiagnosed for two years, suspected diagnosis of Hereditary Spastic Paraplegia. That remains unconfirmed because I will not spend the $7,000 for the genetic testing, nor do I trust the "system" as how it may reflect on my children and grandchildren.

All of my blood labs are well within normal limits with no deficiencies. My A1C is 5.6 and my average glucose levels hover around 98 to 105. My primary diagnoses include Cerebellar Degenerative Disease and Spinocerebellar Atrophy both with Ataxia.

PN is only one small part of my pain with muscles spasms, involuntary movement disorder, and neuralgia. I am currently using Neurontin, Topamax, Tramadol, Lortab, Requip and Klonopin. At this time the pain is progressive, as are the disease and symptoms, with an average pain level of 6.5 to 8.5 on a good day.

Throw in this mix the residual effects of a near fatal brain stem stroke and irregular sleep-wake rhythm disorder, with Ambien CR noneffective but for approximately 3 hours, and you have quite a medical, physiological mess.

I've done considerable research on supplements available in many different areas. Even with my PCP's review and willingness to try them, they have all met with little or no positive effect. As this disease has progressed, I've accepted the terminal prognosis with this referral to a pain management clinic my PCP's last resort to keep me as comfortable as possible and still function.

I apologize for being such a bummer. I come to these particular boards primarily because of my long history and the many similarities of my disease course to MS. Thus, as in your response, receive considerably reliable and applicable insights.

So, I pose my original question. What should I expect on my first initial appointment? What doctor's questions and type of physical evaluations are normally done?