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

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.

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

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

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.

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.

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

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".

Glenn:

I DO NOT UNDERSTAND THIS. If the man is telling the doctors "it's my back, it's my back", and then he goes to MANY orthopedists for second and third opinions (one was even referred to by his neurologist). and all of them looked at the MRI and ultimately said "no, it's definitely not your back", then how come, now, all of a sudden, he's being told "hmm, it might just be your back".

His chiropractor neurologist has all along indicated "there is something going on with your back". No one agreed.

But now they are sending him for another MRI??

what the heck. He's been having the neuropathy for 18 years, and NOW, THEY ARE CONSIDERING THAT IT MIGHT BE HIS BACK ALL ALONG???

What the heck does a person need? A Dr. House in his life all the time?

This is quite frustrating. Are there NEWER MRI machines that will show something different, than the original x-rays, mri's???

Thanks for letting me yell!!!

mel

I think that many radiologists/neurologists/orthopedists--
 

--are generally quite conservative in attributin symptoms to spinal problems. In other words, unless there's a big honking abnormality, such as unequivocal spinal compression or osteophytic nerve root pressure, they're hesitant to attribute neural symptosm to something going on in the spine.

What also makes this difficult is that many people with big honking abnormalities may have minimal symptoms, and people without obvious abnormalities may have considerable symptoms.

And, radiologists are not all equal either--some are much better with CT's than MRI's, or with certian areas of the body compared to others. (It never hurts to get a second--or third--opinion of the films.)

There are now more powerful MRI machines than there were even in the recent past--higher magnetic Tesla ratings--as well as function MRI's; so getting a follow-up from previous results is essential.

just my opinion...
 

The new tests refer to MOTOR issues.

I think this then signals more serious consideration. Sensory doesn't motivate doctors as much.

MOTOR ISSUES.
So does this refer to his balance, walking, etc? Because she told him "well, your balance is improved since you have been doing the IVIG (I'm just re-wording her exact words). She then changed him from getting IVIG every 4 weeks to getting it every 5 weeks because as she put it, "you are doing fine and I see some improvement".

So the IVIG is helping his balance issues and not his pain between the toes (when he adjusts his positions), so I'm thinking they are sending him for yet another MRI because they now think "Hey, the IVIG is helping his balance but his PN might be related to something in his back so let's get him another MRI and hopefully this new one will let us see something that we might have missed in the last MRI."

Did I get this right?

Thanks much

Mel

here is your report...
 

You will have to get out the older report and see if motor involvement was moderate on that one too.
Balance is different I think. This impression is referencing a previous study, which showed something else.

God, I wish I had your brains and your knowledge of ALL THINGS MEDICAL.

But I don't..so I have to rely on all the wisdom of my fellow people on these boards.

Thanks sooooo much.

Oh, just FYI, I've been growing sprouts in my kitchen. For 7 days now. And I just bought some seeds from ebay (from a reputable seller). It's much cheaper to grow your own sprouts then to go and pay $3.99 for a pint of them.

Guess what's been happening to my sugar? It got WAY BETTER. This morning it was 106. Can't remember the last time it was 106 in the a.m. And in the afternoon it's 126 sometimes. All this happened after I began to put sprouts in my diet. Who knew??? lol

I just might be able to go off my insulin when the Accord program ends for me in April.

hi there

Just a comment on the new glasses - apparently even glasses that are the same prescription are slightly different, which surprised the heck out of me. I replaced a pair of glasses (same reason, broke my glasses) and the new pair just plain felt weird for a while. I was told by my optometrist that this is usual, even though the prescription was the same. I did adjust pretty quickly (within days) so it was not a long term problem.

hope this helps

raglet

Hi Raglet:

Since he put back his old glasses (it's the former prescription from two years ago), he has not had one bit of problem.
So now he says "what am I supposed to do, well, I can go on the computer with my OLD glasses, and I'll try and walk around and do a test with the new replacement glasses.

See, the new replacement glasses were to replace the ones that he dropped (and THOSE GLASSES WERE THE ONES WITH A SLIGHTLY NEW PRESCIPTION). but he never had a problem with those.

It was only when he got the replacement glasses and wore them on the first day, and he was sitting on the computer and looking down at the keyboard that this "spell" happened.

The optometrist who prescribed the new ones (2 months ago), told him "I'm going to change the prescription a bit because you go on the computer a great deal of the time". Now after Alan got the Newer glasses (with the slightly changed prescription), there was no problem, no difference, no nothing. So he drops the glasses, the company replaces them, and BINGO, he gets the "spell".

We want to go back to the optometrist and say "these glasses make him dizzy", but Alan feels "gee, I only got dizzy for one second, and I can't tell the optometrist this, he'll probably say "give them a week".

Alan wants to put on the replacement glasses and see what happens. He wants to see if he gets dizzy again. I say "who on earth wants to get dizzy again?"

It's no fun. Especially when you have a history of vertigo.

And the optometrist is not the most FRIENDLY guy if you get my drift.

Not sure what he should do in this case. So far, (with the old pair), he is just fine.

melody

Mite be the glasses....
 

often enough prescriptions for lenses are not filled out correctly.
If it were me? I'd take them to an independent optician/optomotrist and have the lenses checked against your prescription.
I NEVER get a prescription filled out any more that I don't have a copy of! I've found too many errors in tests, prescriptions and bloodwork that wasn't done correctly to not do so!
Get those lenses checked, please! Errors can cause all sorts of peculiar problems... - j

PS good thing that they are double checking Alan's back, best to be safer than sorrier.