Question: Please deliver to Dr XXXXXXX Shehu

Dr Shehu
Every time I go to sleep, I wake up with tingling on a leg, foot,etc. This started with tingling in the arms, then weakness in arms. Now it's tingling in face, arms, legs, etc. Does this mean the body is healing. Or is it getting worse. I go to sleep but then awaken with tingling. It's like the sleep mode causes the tingling. Then when I awaken, the tingling stops.


Please do not give up on me at this time. You are the only Dr who has expressed concern and listened to me. Please assist me through the test today. Based on results I will accept your diagnosis and suggestions, including therapy

The pain doctor stated that he believes the problem is from the neck. He said the xray showing abutment of spinal cord at c 3-4 and c 5-6 suggest that the problem is in neck. He said all of ymptoms are indicative of neck problem snd that the pain described is consistent with neck. He has requested mri today.
He stated he does not believe this is nerve damage because the emg/nvc from XXXXXXX 2016 was normal and if it was peripheral neuropathy that emg would have reflected it since that leg is also involved. He said he will not do emg/ncv until after he sees mri of neck.
He prescribed a medrol dose pack and that I continue gabapetin and return after MRI on Wednesfay

I hope he will do the ncv if the mri is normal. otherwise i have found a company that will do the emg/ncv if i can get a doctor to write an order. I will ask the chiropracor to write order. I will have to pay out of pocket but at this point I would like to get this issue resolved. This company can do test on August 17 if pain specialist will not do the test as staed on Wednesday. So I will have to wait another week unless there is a cancellation. I take mri in an hour. I will have results tomorrow.

Hi
This is the email exchange where I requested the neurologist to schedule the emg/nvc


Hi Ms. XXXX,

I am glad to hear that you scheduled an appointment with th counselor, that is great. In terms of EMG/Nerve Conduction Study (NCS), there was no evidence on your physical exam during the clinic visit that would warrant that study. I would recommend that you continue with Physical Therapy as we had discussed and let us see how your symptoms respond. The EMG/NCS is a relatively invasive and painful study, which we would not recommend unless we suspected that the study would provide us additional information regarding your medical management. If, however, your symptoms become worse or new symptoms develop, we can re-evaluate you and if the examination reveals any findings that are new, or of concern, we can discuss any potential future testing (whether it is EMG/NCS, imaging studies, or any other potential studies that would be better suited).

Best,
KAVIT SHAH, MD


----- Message -----
From: XXXX,
Sent: 7/31/2016 12:43 PM EDT
To: Patient Medical Advice Request Mailing List
Subject: Non-Urgent Medical Question

Dr Kavit Shah
I truly appreciate the attention that you and Dr XXXXXXX gave me on Monday regarding my medical issues. I scheduled counseling as recommended and will visit with counselor on August 17. I explained to counselor that eliminating muscle weakness and nerve damage could assist me with dealing with psychosomatic conditions.
I sent an email to Dr XXXXXXX requesting that I be given an emg and nerve conduction study on my arms. If these tests show negative results, that will be one less stressor in my life and assist me with effectively treating the psychosomatic conditions.
Please call me tomorrow August 1 and let me know when tests can be administered this week. I am avaiable all week for tests.

I should have the cervical mri results this evening or first thing tomorrow and I will send to you immediately
Please bear with me. We are almost there. If the MRI is normal I should have the EMG/NVC on Wednesday

Hi
Did you get a chance to read the MRI.

Thank you. If this is your diagnosis I accept it as you have diligently attempted to help me. I thank you with all my heart that you upheld the hippocratic oath in treating my illness.
I am very dissappointed in the neuroligist who all stated this was psychosomatic when the symptoms are real.
I would like to have taken the emg/nvc to rule out neuropathy but if you are satisified that the neck is causing thesymptoms I respect and accept your diagnosis for treatment.
I wish you God Speed.
I will contact you after months of treatment, hopefully abe to smile and inform you that I am back to my normal self again having fun making a contribution to life and living.

One final question. Mt arms are still tingling. I assume they are only not hurting because of the gabapentin and the medrox doz pack. Will the tinging eventually subside after treatment with the pain mediciene doctor if in fact this is related to the herniated discs. i do onot meet with him until Friday. I will let him know that the arms are still tingling. I still am somewhat concerned that I should rule out the nerve damage with the emg/nvc but I am following your advice.

Sr Shehu
I visited wit the neurologist today. She stated she is about 99 % sure that I do not have peripheral neuropathy. But to eliminate this concern so I can get on with counseling she will do test of all limbs. She stated however if by chance I have it I will have to live with it as there is no cure I am now afraid as to whether I should take the test. This can be very disabling and crippling.
She reviewed the MRI on the cervical spine and stated the findings are consistent with a person my age and are not causing symptoms.
She stated if not PN, the symptoms will not go away until I get the treatment I need.
Please advice whether you would take test. I am afraid that I will not like results.
Ms. XXXX

is it possible that the test can show nerve irritation and not nerve damage. i will take test but i am very very afraid. if there is nerve damage rhere is no cure. right?