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Old 11-17-2008, 04:59 PM #1
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Default Alan just got the results of his latest EMG

Here is what the report said:

(thank god I'm a fast typist) lol

Reason for Referral: 61 year old man with a diagnosis of polyneuropathy. A prior electrodiagnostic study (12/06) found absence of bilateral sural and right median sensory responses with reduced right unar SNAP amplitude and mild-moderately reduced bilateral peroneal motor CAP amplitudes, severely reduced left tibial CMAP amplitude, and an absent right tibial response. There was no active dennervation on needle examination of the lower extremities. There was evidence of a moderate right median neuropathy at the wrist. The patient has been receiving treatment with IVIG and notes improvement. This electrodiagnostic study is performed to assess for interval change.

IMPRESSION:
There is electrodiagnostic evidence of a symmetric polyneuropathy affecting the legs and right arm. The sensory component is severely affected. There is moderate motor involvement in the legs. There is electrodiagnostic evidence of a bilaterial L5/S1 radiculopathy. There is electrodiagnostic evidence of a moderate right median neuropathy at the wrist. in comparison to the prior study, there is currently evidence of a bilateral lumbosacral radiculopathy. The peroneal motor CMAP amplitudes have improved.

?????????????????????????????????????what does all this mean?

Also (and here is where it gets VERY INTERESTING) They are sending him for yet another MRI. OF HIS BACK!!!

Alan has always had the opinion that his neuropathy in his toes is a result from something wrong with his back (and Dr. Theirl said he agreed and it was his glutes). That's why Alan used to go to the gym and felt much better after all the stretching etc. etc. (and when Dr. Theirl uses the G5 machine on his back, well Alan is a new person) but the foot ulcer prevented him from going to the gym.

So I asked him "but you had an MRI two years ago, and every time you mention your back, they pooh poohed you".

He responded: "that's exactly what I told the neurologist today, I told her "your back guy told me it was not my back". She then said: "Well, that was two years ago, let's get another MRI, and we'll take a closer look.

Any and all comments are welcome (I've got a roasting chicken in my oven that needs my attention...lol)

Thanks much

Melody
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Old 11-17-2008, 05:46 PM #2
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For another ailment I had a cat scan and after that they told me I need an ulrtasound and after that they told me I need an MRI all within a couple of weeks. Then they told me I need an invasive scan. I did not go for that.

My neurolgist asked me if I knew why all the scans were recommended. I said Money, and he agreed.
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Old 11-19-2008, 12:38 AM #3
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Hi Melody, didn't Alan's PN feel better after he seen a neuro/chiropractor a long while ago, or am i thinking of someone else ?

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Old 11-19-2008, 08:28 AM #4
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Quote:
Originally Posted by Brian View Post
Hi Melody, didn't Alan's PN feel better after he seen a neuro/chiropractor a long while ago, or am i thinking of someone else ?

Brian
Hi Brian:

You are absolutely correct. When Alan (before he began seing Dr. Theirl), he was on Fentanyl, vicodin, he was all out of shape and AFTER SEEING DR. THEIRL and getting adjustments, and G5 machine, well he was a different person. He was able to s l o w l y get off the Fentanyl. You can't just take a patch off and go about your business. His primary care doctor said "no problem, we'll wean you off".

So that's why Alan (and his chiro-neurologist) always thought that his PN (only between certain toes) was caused by SOMETHING RELATED TO HIS BACK.

but everybody said "no".

So we shall see.

Drives one nuts doesn't it??

Melody
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Old 11-19-2008, 06:41 PM #5
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Hi Mel--That sounds like Alan has problems from his back, plus maybe some small fiber neuropathy from something else--diabetes? I think it's great the docs are looking at his back again.
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Old 11-19-2008, 08:13 PM #6
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Hi Mel--That sounds like Alan has problems from his back, plus maybe some small fiber neuropathy from something else--diabetes? I think it's great the docs are looking at his back again.
Hi, how are you doing?????

No, Alan never had anything with diabetes. His blood sugar is always around 77 and he just got his blood tests results the other day.

BUT SOMETHING DID HAPPEN ABOUT ONE HOUR AGO.
Alan was at the computer (he is on constantly and he knows to look away from it from time to time). Anyway, I heard him go "oh, oh". and he comes into where I was watching tv and he goes "I just had a little Menieres attack".

I said "oh oh, come and lay down for a bit". He said it lasted one second. (He came home with new glasses today by the way).

I asked him to describe what happened and he said "It was not like the vertigo I had 2 years ago when the floor came up and the room spun around me". I said "so what happened?" and he said "It was like I was going to pass out, but I was fine in a second". (To me, this did not seem at all similar to when he had the Vertigo attack all those years ago). I asked him "exactly what were you doing when this feeling came on you?" and he said "I was looking down at the keyboard and it came over me"

Ever since he has had that vertigo attack (about 2 years ago), there is no salt in my house, but he does make popcorn every night and sprays some Ken's light honey mustard spray on it). But he has not had any dizzy stuff in two years.

Now let me tell you what happened earlier (because I have no idea if this could contribute to a person getting dizzy).

1. We know he got new glasses today.
2. He had gone to his primary care physician's office to pick up a prescription. They did not have it. They told him to come and pick it up, it was not there. He felt the girl was disrespectful to him and he lost it. He really lost it.
He comes home from the doctor's office all upset and I couldn't understand. I knew this had nothing to do with any prescription, so I said "what really happened?" and he said "the girl just yessed me to death, just like my son did".

I knew immediately that he was having some kind of THING over our son. It all must have hit him today. Last month our son wrote him a nasty email and was quite hostile. Alan was devastated. I have tried to help him get through this and I had no idea it was eating him up inside.

So I got him to talk about his feelings. He was devastated over what our son has done and what he has become. My husband feels so troubled over this, he poured his heart out. I listened, then made him lie down and gave him a body massage and he went out like a light. When he woke up, we talked and I called his physician's office and explained what happened. they were most understanding. He has an appointment to see the doctor on Monday and we'll go over his emotional upset (don't have a better word for it). This hasn't happened since he was put on Zoloft.

So he felt better after getting his feelings out, and we had dinner. Then he goes on the computer, THEN HE GETS A ONE SECOND DIZZY SPELL.

So here's what I'm trying to ascertain. If the dizzy spell was from stress, or from his getting new glasses.

He feels that it's from the glasses, that this happened YEARS AGO and he said the feeling was exactly the same. (by the way, I immediately took away his glasses and put the old one's on. Same prescription. He had dropped a pair, and they were replaced. Today the replacement pair arrived and he feels it was the glasses.

So I'm trying to find out why a person can get dizzy for one second. I took his blood pressure. It was 107/73. So he's fine in that department.

He was in such a state earlier today over our son that he just fell right into a deep sleep after I massaged him.

I don't know what to think. Do any of you think it might be the new pair of glasses? Or can his episode of emotional stress, well could that have triggered a short dizzy spell later on in the day?

By way he has been fine ever since the one second spell and he said if I don't leave him alone, he'll go crazy. lol

I'm trying to get him off of the computer but he won't listen. Thankfully he's in he other room watching tv. He sits way across he room from the tv so at least that's good.

If anyone has any advice, it would be most welcome.

Lots of stress going on here.

Melody
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Old 11-20-2008, 12:04 AM #7
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I think it could be the glasses, they could be fitting just a bit differently even tho the rx is the same. And it may take a few days to get them settled in like the old ones.

Or he could be coming down with a sinus thing or allergies, I had some weird quick dizzy spells in sept that went away after using veramyst for a couple weeks.
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Old 11-20-2008, 02:35 AM #8
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Lightbulb changed prescription?

Was the prescription changed?

You know, one of the networks did an eyeglass experiment and found that a pretty high percentage of glasses are made WRONG.

I think it was ABC.
http://abcnews.go.com/GMA/Consumer/S...3820387&page=1

If Alan has astigmatism, and that is in the prescription and the
lens is not centered properly or ground properly, there will be a huge problem.

Also a change in the bifocal..can be rough. I wear trifocals now and when I had my close vision strengthened, it was very hard for me to walk for a while. I had to get 2 pairs of glasses, for the transistion. One pair with bifocal for work/driving, with middle distance on the bottom and my nearsighted far vision on the top. And a second pair for table/art/computer work.
Eventually I did get used to the full trifocal, but in the beginning with them I was a bit nauseous and tripped alot. We have alot of stairs here, and I could not afford a fall.

I'd take them back to have them remade.
You know once I had a pair made and when I put them on, they formed a light sphere just above my center vision. This was really strange. Everywhere I went a white ball was in my vision. The optical place tried to pooh pooh me and I was really adamant. They remade the lenses, and voila..the mystery white light was gone.
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Old 11-20-2008, 08:12 AM #9
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Thanks to all who responded.

This was the exact same prescription as the new glasses he received two months ago. He gets them from Davis vision. So two months ago, he went to the eye glass place, they examined him, and he got new glasses. Exactly one month later, he dropped the glasses, they broke and he found out he was entitled to a replacement pair.

These, he received yesterday. He thinks it's the glasses also. He seems fine since this little episode last night.

I really thought it was the stress attack (I DO NOT BELIEVE IN COINCIDENCES). It just seemed that after he got so upset, that later on in the day, he got dizzy.

But he also got the new glasses and I googled "new glasses and dizzy spells" and a whole bunch of similar stuff came up on the internet. Seems like this is VERY COMMON with people who just got new glasses and some people take 9 days to get used to them.

He did not have this happen 2 months ago when he got the new pair. He just put them on and every thing was fine. But maybe yesterday???

These are bi-focals (with the line). He always wears these.

He is perfectly fine with wearing bifocals. He is doing this for years. I see him putting up his head to see stuff, and bringing down his head to use the other part of the glasses.

I think the bottom part is for reading?? Not sure, I don't wear bi-focals.

He's sleeping now. I'm going out for a while.

Tonight is he neuropathy support group meeting in NYC.

I shall update you all of any new interests and discussions from this meeting. I'll start a new thread.

so here's to it being JUST HIS GLASSES. (I told him to bring the new ones back and tell the guy what happened).

Should he wear them some more to see what happens??

Melody
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Old 11-21-2008, 07:11 AM #10
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Default I have occassionally--

--had difficulty adjusting to a new eyeglass prescription, with a little feeling of disorentation/dizziness until my eyes adjusted to the new strenght and focal points of the lenses. Usually, this takes only a day or so to resolve.

As far as the other (EMG) discussion--given that I know Alan's neurology team well (LOL)--I had always suspected that Alan may have two different processes going on (and probably wrote about that at some point). It's entirely possible that he has some radicular compression going on in his lumboscaral spine that is being exacerbated by a further autoimmune process.

Neuropathy from two different processes is certainly possible--in fact the idea of the "double crush phenomenon" points to this, as nerves can be compromised by two different injured areas, or two different causes (i.e., ischemic damage from diabetes along with mechanical pressure from an osteophyte), and while neither alone may have resulted in significant symptoms, together they add up to more than the sum of their individual symptom "parts".
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