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Just Disclosure I Am A Nurse. For About A Year

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Posted on Fri, 23 Oct 2020
Question: just disclosure i am a nurse. For about a year now i have been chasing symptoms that started as palpatations, then right upper quadrant pain, then weight loss, then random abdominal issues, then pelvic lower mid abdominal numbness when sitting, to tired legs when going up the stairs. --- all for a year and a half now---- I have had ct of the abd and pelvis, renal ct, chest ct, liver ultrasound, scrotal ultrasound, ultrasound of arterial legs. Small bowel follow through. For a long time i thought this was a cardiovascular issue i wore a halter monitor, and had a echocardiogram. I have had every and i mean every lab study done, even ones i paid for myself, thyroid, cbc cmp, liver, even tumor markers, seratonin, chromogranin a, a lot lot more... everything comes back normal. My cardiologist says the leg issues are neuropathy. I think---the abdominal numbness is neuropathy. I know---that the weight loss and upper abdominal pain was due to a bile salt deficiency because i had pain daily for a year and 30 pound weight loss, and after starting a bile salt supplement it went away day 1....and i gained all weight loss back in 2 months abdominal pain gone, weight loss, gone, now the only issues are pelvic numbness, weak legs, and sometimes, tingling and numbness in my right upper abdomen that travels in a straight line down on the right side of my stomach. Like down my ascending colon? when this happens i have numbness on my right inner thigh. My main issue right now...i guess is neuropathy. My question is this. I had an mri done of my pelvis and lumbar spine. The lumbar MRI showed borderline neuroforaminal narrowing at l3l4 and l4l5. So...is this all a back problem? if not...then what is it. I have attached pictures and my MRI. if you look at the pictures of my legs, you will see that i have lost the hair, on the outer thigh on each leg in the same place. How could neuropathy target each leg...in the same spot...and only that spot? I have also lost the hair on my buttocs..i know that is related but i dont know how. when i sleep on my right side..i seem to have palpatations worse, when i lay on my left side i feel bloating worse. i dont know if that is relalted to anything but it feels like it is. i know this is all a lot of info..haha but here are my questions.

1..Is it neuropathy? or is it cardiovascular and causing a neuropathy
2..If its neuropathy, why is it targeting only specific parts of each leg? but the same parts??? how does that work?
3..If its neuropathy, how does that target your right upper abdomen?
4..Could this be a back problem.
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Follow up: Dr. Ishu Bishnoi (0 minute later)
just disclosure i am a nurse. For about a year now i have been chasing symptoms that started as palpatations, then right upper quadrant pain, then weight loss, then random abdominal issues, then pelvic lower mid abdominal numbness when sitting, to tired legs when going up the stairs. --- all for a year and a half now---- I have had ct of the abd and pelvis, renal ct, chest ct, liver ultrasound, scrotal ultrasound, ultrasound of arterial legs. Small bowel follow through. For a long time i thought this was a cardiovascular issue i wore a halter monitor, and had a echocardiogram. I have had every and i mean every lab study done, even ones i paid for myself, thyroid, cbc cmp, liver, even tumor markers, seratonin, chromogranin a, a lot lot more... everything comes back normal. My cardiologist says the leg issues are neuropathy. I think---the abdominal numbness is neuropathy. I know---that the weight loss and upper abdominal pain was due to a bile salt deficiency because i had pain daily for a year and 30 pound weight loss, and after starting a bile salt supplement it went away day 1....and i gained all weight loss back in 2 months abdominal pain gone, weight loss, gone, now the only issues are pelvic numbness, weak legs, and sometimes, tingling and numbness in my right upper abdomen that travels in a straight line down on the right side of my stomach. Like down my ascending colon? when this happens i have numbness on my right inner thigh. My main issue right now...i guess is neuropathy. My question is this. I had an mri done of my pelvis and lumbar spine. The lumbar MRI showed borderline neuroforaminal narrowing at l3l4 and l4l5. So...is this all a back problem? if not...then what is it. I have attached pictures and my MRI. if you look at the pictures of my legs, you will see that i have lost the hair, on the outer thigh on each leg in the same place. How could neuropathy target each leg...in the same spot...and only that spot? I have also lost the hair on my buttocs..i know that is related but i dont know how. when i sleep on my right side..i seem to have palpatations worse, when i lay on my left side i feel bloating worse. i dont know if that is relalted to anything but it feels like it is. i know this is all a lot of info..haha but here are my questions.

1..Is it neuropathy? or is it cardiovascular and causing a neuropathy
2..If its neuropathy, why is it targeting only specific parts of each leg? but the same parts??? how does that work?
3..If its neuropathy, how does that target your right upper abdomen?
4..Could this be a back problem.
doctor
Answered by Dr. Ishu Bishnoi (32 minutes later)
Brief Answer:
Interpretation of reports and images

Detailed Answer:
Hello, thanks for asking from HCM.


After going through your reports, it can be said that your heart, peripheral vascular system, abdomen and chest are normal. The palpitations, weight loss, abdominal pain, backache could be due to hyperthyroidism. However it has been ruled out.
Excessive caffeine intake can also cause similar type of symptoms. Please let me know how much is your daily coffee/tea intake?

Coming to your questions,

1. Neuropathy can cause hair loss, legs pain. Bilateral symmetrical peripheral neuropathy, which involves autonomic system, can cause such kind of symptoms. Cardiovascular system is unlikely as your ECHO, CT abdomen are normal. Your leg colour is okay. There are no pale skin, varicosities.

2. Specific leg area could be targeted because of specific nerve or nerve root involvement. In your case 'peroneal nerve' involvement can cause lateral part of leg involvement.

3. The pain in right upper abdomen is altogether different symptom. It could be gastritis, gastroenteritis or mild colitis. Even involvement of right lower chest muscles can cause pain right upper abdomen.

4. As per MRI report, your disc bulge and foraminal stenosis are minimal. The back problem could be due to muscle and bone pain. It can be dealt with physiotherapy, hot fomentation, rest, pain killer gel and tablets use.

Please let me know if you have any doubts. Thank you


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ishu Bishnoi (0 minute later)
Brief Answer:
Interpretation of reports and images

Detailed Answer:
Hello, thanks for asking from HCM.


After going through your reports, it can be said that your heart, peripheral vascular system, abdomen and chest are normal. The palpitations, weight loss, abdominal pain, backache could be due to hyperthyroidism. However it has been ruled out.
Excessive caffeine intake can also cause similar type of symptoms. Please let me know how much is your daily coffee/tea intake?

Coming to your questions,

1. Neuropathy can cause hair loss, legs pain. Bilateral symmetrical peripheral neuropathy, which involves autonomic system, can cause such kind of symptoms. Cardiovascular system is unlikely as your ECHO, CT abdomen are normal. Your leg colour is okay. There are no pale skin, varicosities.

2. Specific leg area could be targeted because of specific nerve or nerve root involvement. In your case 'peroneal nerve' involvement can cause lateral part of leg involvement.

3. The pain in right upper abdomen is altogether different symptom. It could be gastritis, gastroenteritis or mild colitis. Even involvement of right lower chest muscles can cause pain right upper abdomen.

4. As per MRI report, your disc bulge and foraminal stenosis are minimal. The back problem could be due to muscle and bone pain. It can be dealt with physiotherapy, hot fomentation, rest, pain killer gel and tablets use.

Please let me know if you have any doubts. Thank you


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ishu Bishnoi (18 minutes later)
In reference to bilateral symetrical peripheral neuropathy of peroneal nerve or autonomic system, can you expand on this. As to what the cause could be or what the next step should be? What the cause could be or what steps should be taken?
default
Follow up: Dr. Ishu Bishnoi (0 minute later)
In reference to bilateral symetrical peripheral neuropathy of peroneal nerve or autonomic system, can you expand on this. As to what the cause could be or what the next step should be? What the cause could be or what steps should be taken?
doctor
Answered by Dr. Ishu Bishnoi (10 minutes later)
Brief Answer:
Peripheral neuropathy management

Detailed Answer:
Hello Jasoncl14, welcome back.


Peripheral neuropathy must be confirmed first. It will be done by clinical examination and investigations. Clinical examination of both legs, which include

- Sensory examination - Examination of touch, pain, temperature, pressure and vibration senses of both legs.

- Motor examination - An expert will check your power of limbs, reflexes, tone and bulk.

After it, tests will be done

- Nerve conduction velocity of peroneal, femoral, tibial nerves. It will find out any damage to nerve.

- Blood sugar to rule out diabetes mellitus

- CSF study to rule out demyelinating disease

- Nerve biopsy to find out the cause after proving neuropathy

Causes of symmetrical neuropathy are

- Diabetes mellitus
- nutritional deficiency
- B12 deficiency
- Demyelinating disease
- medicine induced
- Unknown cause
- Hereditary causes

Please let me know if you any doubts.
Thanks
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ishu Bishnoi (0 minute later)
Brief Answer:
Peripheral neuropathy management

Detailed Answer:
Hello Jasoncl14, welcome back.


Peripheral neuropathy must be confirmed first. It will be done by clinical examination and investigations. Clinical examination of both legs, which include

- Sensory examination - Examination of touch, pain, temperature, pressure and vibration senses of both legs.

- Motor examination - An expert will check your power of limbs, reflexes, tone and bulk.

After it, tests will be done

- Nerve conduction velocity of peroneal, femoral, tibial nerves. It will find out any damage to nerve.

- Blood sugar to rule out diabetes mellitus

- CSF study to rule out demyelinating disease

- Nerve biopsy to find out the cause after proving neuropathy

Causes of symmetrical neuropathy are

- Diabetes mellitus
- nutritional deficiency
- B12 deficiency
- Demyelinating disease
- medicine induced
- Unknown cause
- Hereditary causes

Please let me know if you any doubts.
Thanks
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 901 Questions

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Just Disclosure I Am A Nurse. For About A Year

just disclosure i am a nurse. For about a year now i have been chasing symptoms that started as palpatations, then right upper quadrant pain, then weight loss, then random abdominal issues, then pelvic lower mid abdominal numbness when sitting, to tired legs when going up the stairs. --- all for a year and a half now---- I have had ct of the abd and pelvis, renal ct, chest ct, liver ultrasound, scrotal ultrasound, ultrasound of arterial legs. Small bowel follow through. For a long time i thought this was a cardiovascular issue i wore a halter monitor, and had a echocardiogram. I have had every and i mean every lab study done, even ones i paid for myself, thyroid, cbc cmp, liver, even tumor markers, seratonin, chromogranin a, a lot lot more... everything comes back normal. My cardiologist says the leg issues are neuropathy. I think---the abdominal numbness is neuropathy. I know---that the weight loss and upper abdominal pain was due to a bile salt deficiency because i had pain daily for a year and 30 pound weight loss, and after starting a bile salt supplement it went away day 1....and i gained all weight loss back in 2 months abdominal pain gone, weight loss, gone, now the only issues are pelvic numbness, weak legs, and sometimes, tingling and numbness in my right upper abdomen that travels in a straight line down on the right side of my stomach. Like down my ascending colon? when this happens i have numbness on my right inner thigh. My main issue right now...i guess is neuropathy. My question is this. I had an mri done of my pelvis and lumbar spine. The lumbar MRI showed borderline neuroforaminal narrowing at l3l4 and l4l5. So...is this all a back problem? if not...then what is it. I have attached pictures and my MRI. if you look at the pictures of my legs, you will see that i have lost the hair, on the outer thigh on each leg in the same place. How could neuropathy target each leg...in the same spot...and only that spot? I have also lost the hair on my buttocs..i know that is related but i dont know how. when i sleep on my right side..i seem to have palpatations worse, when i lay on my left side i feel bloating worse. i dont know if that is relalted to anything but it feels like it is. i know this is all a lot of info..haha but here are my questions. 1..Is it neuropathy? or is it cardiovascular and causing a neuropathy 2..If its neuropathy, why is it targeting only specific parts of each leg? but the same parts??? how does that work? 3..If its neuropathy, how does that target your right upper abdomen? 4..Could this be a back problem.