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.
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12:44 pm; 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.
6:17 PM 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.
Plan:
- Further studies to find the 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.
have you searched medical literature?
Where is my response to you? I wrote almost an entire page.
Geez, now I have to start over.
At best I have a herniated disc requiring surgery. Other possibilities include paraneoplastic syndrome, cancer, motor neuron nerve disease, autoimmune disease associated with labile blood pressure and MS.
Worrisome is the fact that since my fall I have not recovered. Also worrisome is the acute nature of yesterday’s symptoms, now I cannot dorsiflex and plantar flexion is diminished.
What has me most concerned is the quality of healthcare. Tufts was a nightmare and I think it had to do with the Indian doctor setting the tone for the ER. There was corruption, the ER was involved in a conspiracy that resulted in no administrators coming to my aide and being sent redacted medical records. Release form stamped and not signed.
Now I go to MGH where I never had a problem and I get yet another foreign doctor trying to dismiss me. He is also implying I have some motive.
This resident neurologist completely LIED to the attending who could care less. He only examined my right foot.
Both he and the resident wanted me to see a psychiatrist stat and wanted me on psychiatric medications. This is without getting the discharge from my admission one week earlier or talking with any of my doctors including my sleep specialist at MGH.
12:44pm 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 along a path that starts at dorsum of right great toe and includes the lateral portion of knee.
BP 140/95 P 76
I leave for my appointment. My oldest, Gary is taking me.
I am glad I started this journal. I feel empowered should anything happen.
The documentation (by medical providers) is alarming me because it is inaccurate, paints a picture not consistent with my clinical history. When the shit hits the fan the doctors note will show NO neurological issues, my life of tragedies and their diagnosis of hysteria. No one will question a MGH doctor’s competence.
The video allowed me vindication. Both together allow me to document on my end. A dead person cannot defend herself, I want to make it easier for my children.
Carleton, since my fall my symptoms have been downplayed.
Doctors are more concerned about malpractice and covering each other’s asses than listening to me.
My doctors in NH are far superior and more thorough than the two idiots at MGH or the corrupt and cruel Emergency department at Tufts Medical Center.
I am enraged at a system that keeps labeling me and I am having problems with mostly non-white male doctors. The attending was white. These doctors are dismissive and are harming me.
Finally, I am very worried when the tests are normal because doctors forget about the fatal diseases that present with negative imaging and labs. Some of those diseases include motor neuron diseases such as ALS.
Also paraneoplastic syndrome is a difficult to diagnose. If I have doctors continue to label me psyche, dismiss my history and physical findings–like the neurology resident and attending at Mass a General Hospital or the corrupt and cruel emergency department doctors at tufts medical center—I will be dead sooner than I think.
Dear Angy,
About your (right) foot :1)-STÒP thinking in psychiatric direction ! 2) (let) check you blood-sugar, not once, but let them exclude (potential) diabetes, but apart from DM, sugar is poison and can create all kind of “immitations” of misleading “fake-diagnoses” 3) I don’t think in neurological causes, but, of course (let) make X-rays of your lumbar spine to exclude pathology.(I don’t think there is) 3) I think in neuro-vasculair direction, in which sickle-cell-disease (AS /AC ?) should be excluded,( is not a tempory factor)Further lab-examination for hormones(meno-pause, thyroid-factors, electrolytes is done, I hope and the circulation(legs / feet)should be tested 4)STÒP smoking(if do) 5) Is there difference after a wam bath(minimal 15 minutes)?(not only shower) or worse complains at low weather-temperature ?
5) Be open to receive a HUGE package of love from your tropical boy-friend, who wishes you a wonderfull and painless X-mas, all kinds of goodness for the coming year, in which our meeting should be scedulled(Sorry to say, but I don’t come to Boston…)
Please keep me informed
Love you still,
Bart
Hi Bart,
How timely your comments and compliments. My blood sugar is good, so is my thyroid. I hope it is not any of those but my findings are neurological.
Deep down I think it is autoimmune / inflammatory process or some type of neuritis. I do not smoke and I do not drink daily or binge drink. My labs are usually normal. I am sure they did an ESR and CRP and other inflammatory markers and am assuming they were normal.
I guess I am trying to figure out why someone would label me psyche…what is the motive? It is important for me to figure that out. And you are right I should stop thinking about it. Still in bed…took my blood pressure still elevated.
Nice to know you still think me desirable. I feel like an invalid.
Bart, Happy Holiday!