December 20 , 2013 4:00am
Last night did not feel well. My right leg feels heavy almost like deadweight. I am bumping into the wall, the chair, just about everything. My ability to plantar flex is diminished, my foot drop is about 99% complete.
I’m concerned my symptoms are definitely worse; started distal now moving proximal. I think my entire right leg is weak. The weakness is not uniform so I have good strength and movement in the proximal leg. However, my right foot and ankle are very weak and sensitive to touch; with strong pulses in my feet.
I wonder, what would be the thoughts of both the Mass General neurology resident and attending physician? Should I get the psych consult or start medications for hysteria as suggested by both? It is all in my mind…hmmm. Why the hell can’t I walk properly? Why am I bumping into the damn wall and stumbling?
I need to check my blood pressure. My BP is 177/113. I cannot dorsiflex my right foot. This is a worse, not the right direction….and progressing.
Of note my blood pressure is usually elevated when I don’t feel well or feel funny. I need to remember that.
12:44pm; Quick thoughts: could be medication related; re-started medication after diagnosis of hysteria. Med-related would mean reversible and that is good. I want this to be reversible.
My right foot is swollen, subtle and real. I have pain in my right calf, minimal tenderness; Hyperesthesia to touch along a path that starts at the right great toe and includes the portions of knee.
BP 140/95 P 76
I leave for my appointment. My oldest, Gary is taking me.
6:17PM Just got back from my appointment with the neurologist, went well. Had EMG and nerve conduction, both painful studies. Studies showed peripheral nerve damage localized to the peroneal nerve. Based on the above studies the damage to the nerve is somewhere between my back and my knee. There was no nerve activity in an area lateral to my knee and nerve conduction confirmed denervation of the muscles in my right foot and leg.
Lumbar MRI showed an annular tear at L5S1 with disc herniation but no compression of the nerve. The nerve conduction in the back muscles was also normal, making disc herniation unlikely cause of my symptoms. BUT if there was compression, it would explain my symptoms….still may???
Working Dx: Peripheral neuropathy or nerve damage of the peroneal nerve. Cause of neuropathy unknown, unlikely to be ALS or MS and no obvious malignancy.
- Further studies to find reason for peroneal nerve damage. (It is possible I injured it unknowingly.)
- Customized orthotics to prevent injury to foot;
- Hold on physical therapy until etiology becomes clear.