However, I have to share my story about my latest visit with my Physiatrist on Friday, to encourage those who are having trouble getting diagnosed with anything to make an appointment with one. Mark Lavelle knows what I’m talking about (Hi Mark!).
I know the definition has been posted before, but these guys are Physical Medicine/Rehab doctors – neuro, muscular, skeletal, spinal doctors. They’re not just looking at the neurological signs of your complaint. And mine is amazing. He recognized my Dad’s Peripheral Nervous System (PNS) issues years ago and sent him for genetic testing – dx was HNPP. His investigation of my finger tremor 9 years ago resulted in EMG tests, brain MRIs, and a diagnosis of both MS and HNPP.
This month I’ve been having all kinds of both new & chronic pains, jerks, twitches & spasms in my right leg (the non-MS one), which actually keeps dropping my leg out from under me, so I went to him again. I’ll tell you, I don’t know why I shouldn’t just make my annual visits to him instead of my neuro.
Anyway, this is an example of a great diagnostician. He immediately pointed out that my left leg exhibits the obvious hyper reflexes of MS. We already knew that. But my right leg is almost the opposite; it’s way more complicated, and he suspects much of it will turn out to be the peripheral nerves from HNPP (Hereditary Neuropathy with liability to Pressure Palsies), even outside of my other complications.
Also, my knee was chipped in high school, and I’ve had that kneecap taped into place. And the pressure of the cast caused a varicose vein from hell. And I’ve had bursitis in my right hip. And the doc confirmed Piriformis Syndrome (or Piriformis Palsy) in my lower leg – a dx that a PT had given me a year ago. (This is my sciatic nerve (a peripheral nerve) getting “strangled” by my piriformis muscle – hence a “palsy”). None of this is from MS.
During the EMG tests of my right leg, he kept shaking his head and muttering that pretty much every signal/reflex shows up as abnormal. That’s me. So, he could go with the current multitude of diagnoses and tell me I’m hopeless, but no, he said it looks like I have a problem with my lower back as well (I hadn’t mentioned my back a single time). So, now he’s sending me for an MRI of my lower back next week, and also of my C-spine due to previous whiplash episodes (it hasn’t been filmed since 2003), and a leg x-ray. He’s trying to identify something that’s at least treatable.
So…like I always say, “It’s not always MS, it’s not always MS, it’s not always MS.” And, “Why don’t you try a Physiatrist?” And, “If MS disappeared from the earth overnight, I doubt that I’d even notice!”
Good health & good humor to all!
Below are links & info.
Piriformis Syndrome from Wikipedia:
Physiatrist info from the organization site:
"A physiatrist, or rehabilitation physician, is a medical doctor who has also completed residency training in the medical specialty of physical medicine and rehabilitation (PM&R). This physician is a nerve, muscle, bone and brain expert who diagnoses and treats injuries or illnesses that affect how you move. The physiatric approach to patient care looks at the whole person and not just one symptom or condition. Rehabilitation physicians do not perform surgery."
Some of the conditions physiatrists treat:
Traumatic Brain Injury – mild to severe
Hypoxic brain injury
Post operative brain injury (function)
Spinal Cord Injury
Post-operative SCI (function deficit)
Central Nervous System
Myopathy associated with disease or medication
Amyotrophic Lateral Sclerosis (ALS)
PNS (Peripheral Nervous System)
Isolated nerve injury/dysfunction
Peroneal Drop foot
Carpal tunnel syndrome
Cubital tunnel syndrome