appointment note from new MS doc
 

Cranial nerrves 11-x11 were intact except for slight temporal pallor.

There was no Marcus Gunn pupil.

Motor did not show pronator drift, suboptimal effort for testing upper extremity strength was 4/5.

Legs were 3/5 in sitting position.

Patient had bilateral AFO.

There was no atrophy, fasciculation, or involuntary movement.

Muscle strentch reflexes were 2/4 in upper extremities, 3/4 in lower extremities.

There was no Hoffmas sign.

Plantars were extensor bilaterally. (Babinski's sign?? is that what he is saying I have?)

Crebellar did not show dymetria, in tention tremor.

alternationg movements were done slowly. ( I can't move quickly any more)

Romberg sign with eyes open was present, worsens with eye closed. (can't stand unassisted with eyes open for more than 15 seconds) stinks............

Patient coud not do toe or heel walking. (not even close)

Gait was slow, slightly wide based. (like I have a wet diaper...)

Sensory showed pin ***** was decreased on the entire right side including the face. (did not hurt on right side at all)

It was intact on the left side. (ouch!)

Vibration was dereased in the right side compared to the left.

There was no level on the trunk. (not sure what this means)

Pin ***** however on the right posterior aspect of the chest and abdomen was nearly normal to the left side.

Impression RRMS (which I already had that dx).

Wish they would put this in laymans terms!! This is the appointment notes from my new MS doctor. I have an MRI coming up here in September. My worst issue with now is my vision and walking.

Is this typical? good, bad, inbetween for RRMS???

Sounds pretty typical for MS....don't know what he was basing the RRMS, though. Ask the nurse to translate for you...LOL

That was not the whole letter of history. Do you think MS is the wrong dx? I have had ON twice, trigeminal nerualgia................

I am wondering if I hav eBabinski signs............

I had to look it up, I'm a little brain foggy today (insomnia sucks) but I think that you probably do have it. Follow the link and read what it says about "extensor".

http://en.wikipedia.org/wiki/Plantar_reflex

Wow, ok. I wish these doctor notes came with decoders! Or a medical dictionary!

It does look like I have it. Wish the doctor would have said something. I am going to ask!

I am sorry you have insomnia. I have the opposite. I CAN sleep and sleep and sleep........................:( Neither problem is good

LA

I took classes for Medical Transcription, and I got an A in Medical Terminology (havent finished the transcription classes tho...and everytime I want to go back, the MS acts up again) I still have my Medical Dictionary tho, and the internet is a good place to look things up if you know what to type into Google.

I got curious, so I went back and checked my medical records that I have from the year I was diagnosed. (scanned them onto a disc) and looked to see if I had a positive Babinski then. I was surprised that I didnt. I looked at the few records that I've collected since then, and one of my neurology records from last year says that I do now have a positive babinski.

I wonder if that goes away?

On the insomnia, I attempted to go to bed earlier than I have been last night. (330am) and didnt fall asleep till 430am. That sucked. Mostly because I had a migraine at the same time (which hasnt gone away yet! argh!)

I guess this is what I get for wanting my vision back and not doubled anymore. (I had IVSM last month for double vision) So, I guess it was an ok trade. I'm not walking into walls anymore.

I have experienced many of the symptoms/signs that you have mentioned. However, it varies from visit to visit. There are some symptoms/signs that are the same every time I go while others vary in severity. I always have Romberg's sign. Strength varies from 2/5 to 5/5. Reflexes vary as well. Sometimes I don't have any reflexes and other times they are hyperreflexic (usually when I am in a flare).

I have RRMS also. I think what the dr is saying is that you have RRMS and not SPMS or PPMS and the dx of RRMS remains the same.

As for the Babinski sign some times I have it and some times I don't and some times my toes don't even move at all.

"Plantars were extensor bilaterally. (Babinski's sign?? is that what he is saying I have?)" This is saying that you do have a positive Babinski sign in both feet.

An excellent online resource for terminology as well as many other MS related issues is http://www.mult-sclerosis.org/wholeglossary.html#S. The terms are put in layman's words. While you may be able to look many terms up, it still may not give you the answer that you need.

There are many health professionals that don't like to give results without discussing them and reviewing them with you 1st. It is understandable. I have seen many patients freak over findings that are actually "normal" because they don't understand the terminology and such. Just a suggestion, make notes/questions that you want to know about and bring it up at your next visit or give the dr a call. He/she will be better able to explain all the findings and how they relate to you and your MS.

In the meantime, know that you are doing just fine and that with RRMS this appointment note is only a snapshot in time. You can go in today and end up with a completely different report. Hang in there.:hug:

Thank you tkrik. Most everything in the report I knew. But the Babinski sign is something I did not know.

As silly as this sounds I have gone back and forth questioning my DX or the past 18 months.

Seeing I have bilateral Babinski just wraps it up for me. I am sure it is silly but it was just a mind game I was playing with myself.

Thank you for your response and help. Knowing that symptoms vary from one visit to the next helps a lot.

Because I tend to question myself a lot I would have been very confused if I have Babinski one appointment and not the next. :eek:

I can settle in for the long haul now and stop questioning. :)

LA:hug:

Settle in and enjoy the ride. LOL

You're doing fine. I too went through a period of questioning the dx. But everything matches and falls in to place. I have to remind myself of that every so often.