Tuesday, February 26, 2013

My Foot Stopped Working: Neurology Wants to See You



I’m getting better at going to the hospital. I’d rather get better-period, but I’m taking pride in handling how these investigations work. On Friday I saw the Nurse Practitioner at my hospital’s Neurology department. You’d think waiting a month and a half would yield a doctor, but she was very friendly and thorough. She jabbed my feet with pointy sticks, banged on my knees with metal rods and tried to knock me over several times to figure out how much proprioception I still have.

Good news: I have some. Proprioception is the wonderful sense of balance and spatial reasoning. The notion that we only have five senses is a crock.

I need to be electrocuted again?
The sign of my improvement at managing healthcaregivers (perhaps the second-ever three-word portmanteau, after “plainclothesman”) came as she tried to dust me off to blood work. After we got the results, we could schedule a follow-up.

I opened a portfolio and produced the bloodwork from January, when the neuropathy was already going on, complete with disease tests and liver function. She found nothing suspicious in the data and said she’d have to sign me up for a Nerve Conduction Study, where they run electrical current through your nerves to see which are active. Shock tests. They usually took a while to get, but we really needed to know…

I opened my portfolio and handed over the results of the Nerve Conduction Study from January. Ba’am.

Bringing print-outs of records saved me at least two months of waiting between tests, but I still needed an EMG, because for all the data doctors have taken on me, the Nurse Practitioner couldn’t figure out a proper cause. In her experience neuropathy usually results from alcoholism, diabetes or age, none of which apply to me. The “age” one made us both laugh. I believe the only time I’m ever called young anymore is when someone is talking about the health problems I’ve already developed.

Because of two particular nerve groups that appear damaged, her best hypothesis was Tarsal Tunnel Syndrome. It’s like Carpal Tunnel, except focusing on the tibial nerve in your foot. Well, not your foot. Both of my feet.

That it’s in both feet is what baffled her, because such neuropathy and motor control loss is seldom symmetrical without a spinal issue. This sort of malfunction typically hits one foot and might hint at something. It’s something we’ll review after my EMG. She spent a proper half hour fielding my questions, getting down to some crazy theories about non-manifested diabetes and shoe sizes. At the worst, I couldn’t have asked for someone to be more indulgent of my curiosity.

This was also the first hospital visit on the case where someone said it might be all in my head. It was a joke, but it was said.

15 comments:

  1. I really, really hope they figure this out -- I don't like it when it's endless tests and no conclusions. Where's House when you need him?

    I know I mentioned this before, but damn if to my non-medical self this doesn't sound like a chiropractic issue.

    As for "it's all in your head" -- I hate it when people say that. If it's manifesting physically, even if there IS a psychosomatic component it left the exclusive domain of your head some time ago. I've been told my chronic sinus problems are hypochondria -- and that's after the CAT scan found stuff.

    Get well!

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    1. I'm not dismissing the possibility of chiropractics. The x-ray certainly made it seem like it wasn't a spinal issue, yet the neurologist went right to the backbone.

      I do have a little nervousness about chiropractors, though, since every visit I've had made whatever I suffered from worse. My system is so sensitive that such things go wrong easily. It's still not something to dismiss.

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  2. That phrase is so dismissive, as a joke or otherwise. Anyway, I'm with Katherine, hope they can be more helpful soon.

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    1. It can be a very harmful joke. She apologized for it immediately, though I couldn't read whether she was covering up an honest question.

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  3. See, it's occasions like this that validate the acquisition of the Paperwork Management merit badge. That's a skill that so many people dismiss as administrivial, but when applied correctly, the ability to keep records organized and produce them on demand is invaluable.

    Good luck, John.

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    1. It's a bit of a survival skill in bureaucracies! Or in hospitals, it turns out. I felt a little like Hermes Conrad.

      My manwich!

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  4. Aaargh. Sorry I have been largely absent from the blogosphere for a while. I had hoped that you were either better (wish number one) or that the medicos had found a reason for your problems. I really, really hope that you get answers SOON.

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    1. You've had very good reasons for being away. No apologies necessary. And thanks for the well-wishes - I'm certainly working on answers!

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  5. So is Tarsal Tunnel also a repetitive stress injury? I can't imagine it would be in your case, having not been able to walk for long stretches of your life. :-( As for Katherine's suggestion, chiro-crackers are like any other profession, some are better than others. The better ones will take your sensitivities into account and adjust how they adjust you.

    Nice job with producing the test results! You know, someone ought to invent a way to keep data where others can access it if needed, at a distance if necessary. Call it, oh, maybe a "networked database"? It could help a lot with health care stuff, you know?

    I've found that NPs are often doctors in all but name. They usually know what they're talking about, and can take more time to discuss things than an "official" MD. Let's hope the EMG, whatever that is, will zero in on a diagnosis!

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    1. Tarsal Tunnel, like Carpal Tunnel, can be a repetitive stress injury. It'd be funny if the intense exercise I've done for the last five years has caused that nerve damage. But there are other possible causes for injury to the nerve tunnel. That will take more tests to determine, though.

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  6. I've always had good luck with NP's and I'm glad she took the time to indulge your curiousity, even if she did jokingly insult you. Although I can't help wondering if drinking might actually help your situation. It could be one of those reverse cures. At the very least it would make you buzzed enough not to care about the pain. That's a win-win in my book.

    All joking (and insulting) aside. Medical tests can be a real bitch of a guessing game. I hope they find some real answers for you soon.

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  7. Sounds like you went in well prepared, and good you did. You have to be your own strongest advocate in today's world of medicine. I wish you all the best, John.
    ~jon

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  8. Good luck in your search for answers. I'll be thinking of you along the way. In the meantime, do you think acupuncture or acupressure might help?

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    1. They've never helped in the past, and my budget is fairly tight. What insurance won't cover is a tough question. If the numbness keeps expanding, though, I'll have to look into it.

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  9. Even as a joke, that is quite offensive. I have heard that too, when I went to the doctor with intense nerve pain. Made me want to jump over the table and pinch his shoulder so hard that he would feel the same kind of pain LOL. Eventually he realized it wasn't and he sent me to a physical rehabilitation clinic where I did exercises in really warm water until the nerve decided it would no longer be stuck somewhere :)

    The moral of this tale is: keep standing up for yourself, keep fighting and keep yourself from smacking a medical professional over the head when they tell you it's all in the head. It's not. So there!

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