|
Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Painful MessForum: Neurology Forum
| ||||
Re: Painful MessPosted by ccf neuro M.D. on May 25, 1997 at 22:14:10: In Reply to: Re: Painful Mess posted by GAIL on May 19, 1997 at 21:30:16: : : My husband is 38 years old and having alot of painful : problems. In 1988, he had extreme pain in his chest. : He couldn't even lift a hammer. The doctors had no : answers for him. So he learned to live with the pain : and it is not as extreme, but there. He progressively : has had other problems occur, such as hot/cold feeling : in his right thigh, shooting pains to the groin area, : and most recently extreme pain in the hands.
: feeling in his hands. The first one proved to show : carpal tunnel syndrome with the start of neuropathy. : But when this test was done he came out of the test not : being able to move this thumbs in both hands and in so : much pain he could hardly drive. By the way no explana- : tion can or will be given for this. Since then his hands : have been in the most intense pain he can hardly work. : He also had another EMG done by UofM in Ann Arbor and : they also told him CTS and found 4 different pinpoints : of nerve abnormalities. He has had blood test to rule : out lymes disease, B-12 deficiencies, syphillis, and : everything else under the sun. He has had an MRI of : the lower back and the upper back. The lower showed no : problems, except a spur on the disk. The upper showed : no problems whatsoever. : Due to the extreme pain he has been suffering, he finally : forced himself to come to terms with CTS and had surgery. : He has been off for 3 months and the pain has not changed. : He has been doing things with his hands, but trying not : to overdue it. He can't sit still. : Most recently, he has had a third EMG by a neuorologist : himself. He told him he had CTS. His number from the : first test were 4.6 and the numbers this time were 4.1. : Some improvement, not much. After this EMG as all the : others his hands and arms are in so much pain he can : hardly stand it. : For the most part whatever is happening to him it is : progressively getting worse. He feels he will never : be able to return to his job as a service technician. : Also, at one point they told him he fibromyalgia. But : our family doctor felt that it was a wastebasket diagnosis : and sent him to specialist. : If you can shed any light on this very confusing case or : need more information, I would really appreciate it. : It is a tremendous weight on our shoulders as we have : 5 children and the normal duties of a family.
WITH DIABETES. HIS BLOOD SUGAR LEVEL WAS 190 NON- FASTING. DOCTORS FELT THIS WAS TOO LOW TO CAUSE ANY PROBLEMS. THE OTHER THING I FORGOT WAS THE FACT THAT WHEN HE WORKS ALL DAY THE CONSTANT MOTION AND EXCERCISE HELPS SOME, BUT WHEN HE STOPS MOVING, EVEN TO SIT DOWN FOR DINNER, HE JUST FREEZES AND CAN HARDLY MOVE TO GET UP AND DO ANYTHING. HE IS ABSOLUTELY MISERABLE AND HAS TO FORCE HIMSELF TO MOVE. HE FEELS HE HAS TO KEEP MOVING 24 HOURS OF THE DAY TO AVOID FREEZING UP. = Gail, diabetes can cause many different types of neuropathies. Otherwise unexplained carpal tunnel syndrome is on rare occasions the first clue to someone having diabetes. On rare occasions, neuropathy can PRECEDE the clinical diagnosis of diabetes and/or be disproprtionately severe to the degree of apparent diabetes. A fasting blood sugar of 190 is certainly well above the normal limit of 110-120, depending on your local lab's range of normal values. Control of diabetes has been shown to be helpful to persons with daibetes in a recent alrge trial called the DCCT (Diabetes Complication and Control Trial). There is a simple blood test called a hemoglobin A1C test that will show how severe or mild your husband's diabetes (if indeed he even has it) has been over the past few months. All this having been said, it also sounds as if your husband is suffering from a serious chronic pain problem far above and beyond any degree of underlying neurological or other disease that might also be present, and that from your description of things it sounds like there is a MAJOR psychiatric or psychological component to your husband's complaints that needs to be addressed FAST. No surgery, test, or medical label will fix this part of things. By the way, the lack of major improvement in your husband's symptoms is not surprising, since diabetes related carpal tunnel syndrome (or apparent carpal tunnel syndrome) does not usually respond well electrically or clinically to such surgeries, and psychiatric pain syndromes will usually worsen after such surgeries, since they provide additonal minor physical stimuli which are greatly magnified into grossly disproportionate degrees of pain by the affected indiviual's mind. At any rate, I would suggest the hemoglobin A1c test, controlling the diabetes , and seeing a PAIN MANAGEMENT PROGRAM PSYCHIATRIST ASAP!!! Otherwise your husband will pain his life away, perceiving and reporting every penny's worth of pain as a dollar's worth, never getting on with his life. I hope this information is helpful to you and that your husband is willing to get the help he needs.
|
| |||