Hi all.

What an interesting day. We went to see Dr. Goldfarb. She is a specialist in Peripheral Neuropathy. When we first got there, I had all films, copies of all of Alan's reports (MRI's, previous EMG's, reports from this doctor and that doctor, etc.) and most important, I had Liza Jane's charts which had been filled in and updated. I was curious as to how Dr. Goldfarb would react to me coming in and showing her the charts. I had never done this before.

Well, surprise, surprise. She was very happy. She told me "wow, you have certainly done your work and research haven't you. This is an excellent job"!!!

She loved the charts. She said "this is so thorough, it's great". (So kudos again to Liza Jane)

I was thrilled. I didn't want to hit her with the suggestion of tests that Alan should have yet. I wanted to hear her out first, (to get the feel of her as a doctor).

She couldn't have been more thorough or nice to Alan. She brought us over to a wall and showed us images of axonal and fibres, and myelin sheath. (and everything). Didn't really understand everything but I got the jist of it.
She looked at all the papers (all of Alan's records) and this is what she said:

"Okay, I will examine Alan today, I will schedule him for an EMG, which I will do myself (I'm thrilled about that). I want to go over each and every report and test that you have just given me. (About 80 pages or so).

Then, after Alan has the emg, I will decide which tests to do!!"

That's when I said "on Wednesday, Alan is scheduled for an arterial duplex and the doctor will run a test for vasculitis." She said "terrific". Alan then told her "Dr. Fred wants to work with you, he wants to know what tests I should get and he will order them"

Seemed like a perfect opportunity to show her the tests that Liza Jane suggested. I politely explained that I knew someone who has neuropathy and who has charts and suggestions of tests. Is it okay if I show these to her?" and I whipped out the Athena Tests and she said "oh, I know all about Athena, and here's my own Neuropathy Test Page Chart." Had the same tests on them.

So she does know her stuff. She then said to me "we have to see if Alan's insurance will cover the Athena tests because sometimes insurance doesn't cover them.". "We have to check into that" So I said "so you don't want to run any blood tests until he gest the Emg?" and she said "yes, that's how I do things here. I want to see his emg, I want to look over every report and all his films. I want to check for axonal and demyelinating neuropathy". I understood completely. ALAN GETS HIS EMG ON DECEMBER 13.

Then she took a complete family history. Everything about his father, his mother, his sister. Their health. everything. Then she started the examination.

Besides the tuning fork thing and the reflex thing, she checked his muscles, his strength, his balance, she did a complete neurological exam.

Then she went to his feet and did the "can you tell me if this toe is going forward or backward?, thing. She kept going hmm hmm.

Then she told him to take off his socks. ALAN DOES NOT LIKE TO TAKE OFF HIS SOCKS AND GO ON BARE FLOORS ANYWHERE!!!

She explains "Alan, I have to see how your feet are on the floor, I have to see you walk and do things". So he complied.

She watches him walk, (all good). She told him to hop on one foot (he couldn't), she told him to skip, (he couldn't) she told him to walk on his tippy toes, (good), she told him to walk on his heels (good). Then she told him to get down on one knee and get up all by himself without holding on to anything. He did absolutely fine she said (both knees). She said he is very strong and he did very well in that department. He told her he goes to the gym three days a week and she said "that's great".

Then we told her about Dr. Theirl and what he has done for Alan. That before Dr. Theirl he was on Fentanyl patch and after, Dr. Theirl, well, it was a whole new ball game but Alan still has PN between his toes.

Well, after the examination this is what she says "I know Dr. Elowitz, and I respect him" (She also mentioned the guy she trained under but my memory is not good today and I can't remember the guy's name). I understand that Dr. Elowitz doesn't think it's his back, but his PN might have a little to do with his back and a little to do with something else. We also have to check for auto-immune". We have a lot of work ahead of us." I then asked her if she thought it was small fiber and she said "yes, I believe it is".

She said if, after all tests are done, and if she is convinced that it might be attributed to his back, she'll send him to someone she knows but it might just be 50/50. For now, we have to start with the EMG. That's the most important thing.

Alan was very comfortable with her. She answered all of our questions. She made complete copies of everything and as we left she said "I have a lot of reading ahead of me tonight, I am going to familiarize myself with Alan's past, and present". She didn't BLOW US OFF, if you get my drift.

THEN!!! she said "Alan, I'm going to give you a free prescription for one week of Lyrica. The lowest dose. Take one in the morning and one at night."

So as of tomorrow morning, Alan will begin his Lyrica.

We were her last appointment and she said "I can take all my time with you".

So all in all, it was a good appointment. He was examined, he got his lyrica, and his emg is in December. They had nothing open sooner than that.

She held the films because she wants to take her time and look at them and read all reports.

I'd love to hear what you all think of his day!!

Melody