That is how I felt leaving the neurologist today. I went in certain the nerve biopsy - he corrected me as it is a "skin biopsy"- would be ordered and I would have more certainty on my condition.

When I brought it up, he told me of course I have large and small fiber damage. Right, my day to day life informs me of that, the EMG/NCS of the former, but what is the extent of the latter.

He uses the biopsy on patients who don't present any other clinical symptoms or via EMG/NCS. Since I do every other way to the moon he sees no point. As he said "Ho, ho,ho" and pushed my forehead with his boot, I unfortunately didn't stop my way down the slide until I was at the grocery store.

Over coffee I used the patient portal to kindly request the biopsy again as I want hard numbers as a marker in time. Not to be a downer, but I don't feel likely for improvement and even if I were, let's take a picture!

So we are doing it next appointment. I will not shoot my eye out and it is past Christmas so the Bumpuses dogs will not be getting our turkey.

A nerve/skin biopsy, my great award.

If you have not viewed A Christmas Story, I apologize for this post.

Jon

I totally agree with your decision. Having that report can also help if you have to file for SSDI.

I needed to know for ME even though all my other tests were negative.

Debi

YEs go get it. its the gold standard right now for diagnosis.

I wasn't really sure if your scheduling the biopsy appt and saying "we're doing it" meant your doctor said yes to it or you're going to be insistent. So, if that doesn't work how bout you "make him an offer he can't refuse" by bringing a red rider bb gun to your next appointment -JK!
OR
As Debi mentioned use SSDI as a reason.

I know you care about having a base to compare. I would too. I just don't know if your doctor does. This could be projection caused by my past few experiences with doctors.-

*Strike the last paragraph because I now know your doctor is on board! YAY!!

They got back to me and said yes, he can do it next appoinment. If that is not soon enough then call the office and he will do it sooner. Honestly, I can wait. I have done so much to alter my course I don't see 3 1/2 more month being a big deal.

I have now dealt with 4 neurologists on this journey. The first guy was early on. My symptoms were so mild then looking back I think, "I'll take that!". His practice was a larger group and he specialized in something else. He did a lower back mri, I tried amitriptyline under his care, but we agreed I should look for someone specializing in neuropathy if it got worse.

One of the others was so dismissive it was insulting to a level I am not sure I have other life experiences to compare.

The other referred me to my current one for my EMG/NCS. I ended up staying with my current guy. While I don't agree with everything, I agree he knows more in general and I know me better.

So yes, biopsy will happen despite us "knowing" SFN is an issue come early 2016 we will have some sort of hard numbers.

And I didn't shoot my eye out.

Jon

With density numbers you may at a latter date have a way to determine whether healing is happening using concrete comparisons. Tell him that if this doesn't happen that something will "snap" and curses will be like a blue flame from your mouth offending all the sailors that ever were and that blows will rain down upon his head to where he is sure he is experiencing the end of the world. Ken in Texas.