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Avatar universal

New here trying to figure out why I don't meet the dx criteria...any opinons?

I have been having sx for three years. It started with pain, numbness and tingling in my feet and lasted for about six weeks. I was sx free for about a year, then the feet problems came back, but this time it spread up to my hips. That attack lasted for about eight weeks. But, I haven't been completely symptom free since then. I have had many other smaller attacks affecting different areas of my body since this all started.

Here are my positive tests so far...MRI showing four hyperintensities two near the lateral ventricles, and two in the deep white matter (I'm not sure how big these areas are, maybe that's holding the dx up?). ENG showing Central Nervous System dsyfunction. Urodynamics Studies showing retention and slow flow rate. Urologist always marks neurogenic bladder on my check out sheet. Neuropsych test results showing problems similar to those seen MS...slow processing, memory problems, etc.

I've had one episode of bed wetting, and following that I had incontinence (although not complete) for a few weeks. I've had four or five episodes of bowel incontinence (a few I was given no warning). I've also had what one doctor thought was L'hermmete's sign...I get a buzzing, tingling sensation when I move my neck a certain way (this has come and gone over the years). I am very heat sensitive, and I'll get numbness and tingling when I'm exposed to the heat in any form.

I have balance problems and failed the modified Rhomberg's test. I also have had nystagmus. I also had one attack, which lasted about seven weeks, where my eye lid would just close on its own. That was very strange and scary especially because it happened a lot when I was driving.

OK, so I've been through more than my fair share of neuros. Each one would do a very brief exam, maybe order and MRI, then send me on my way. Very few have wanted to follow me long term. I am worse though and feel like I need to try once again to get help. It's been nearly a year since I've seen a neuro. I don't know how much longer I can function like this. The fatigue just hits like a ton of bricks, usually early in the afternoon. I have pain, tingling, weakness in my arms and legs.

I am lucky enough to have found a good Internist. He says he does feel like I have MS, but I might not meet the strict criteria. He has referred me to an MS specialist.

It is my understanding that in order to be diagnosed you have to have two separate attacks that affect two different areas in the CNS. Do these attacks have to be documented by the doctors? About the only thing that shows up on my neuro exams (besides the Pos Rhomberg's) is reduced sensation with the pinprick test.  

Do my positive tests account for something? Or do all of these tests just mean I have many problems that are unrelated?

I'm sorry for the rambling. I realize none of you here can dx me. I just want some opinions. I'm trying to decide if I want to see another neuro, or try and wait until I get worse.

Has anyone else been through the wringer when trying to get dx'd?

Thanks in advance.

18 Responses
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Avatar universal
Thanks again to all of you who have been so welcoming. Sorry it's taken me so long to get back here. I am almost done with my Medical Office Assistant program through Voc Rehab. I'm hoping I'll be able to get a part time job. I have so much pain by the middle of the afternoon (and exhaustion) that I'm unsure if I'll be able to hold down even a part time job.

T-lynn, Oh my! It sounds like the docs put you through the wringer. I'm sorry. I can really relate to what you went through. If you don't mind me asking, what was it specifically that finally clinched your dx? What did your tests show at the time?  Was it  
just having another docs opinion? I'm glad you are on treatment now. Thanks for your reply.

Jenn, I do think docs could learn a lot by reading these forums. I think so many of them are clueless as to what we go through. Have any of you read the new book How Doctors Think? (I think that's what it's called. LOL!) I just finished it, and it had some good info.

Donna, I'm starting to work on a time line, but I have to admit that I'm concerned about getting a doctor to look at it. I think it is a great idea though, and if anything it is helping me to clarify things in my mind (I've been going through this for so long). I'm wondering if it might be a good idea to send the timeline in before the visit with all of the other records? Or would it just get lost?

Sorry for the ramblings again.

Thanks again!!
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Avatar universal
Please excuse typos...fingers are not cooperating.
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Avatar universal
The funny thing is it is hard enough to get some doctors to read our own time lines/symptoms...it would be an extrodinary doctor (like Quix) who would actually read our ramblings!!!

I agree though, it would be an eye opener for many drs. to see what patients actually think and feel.  

And, my appologies to the many doctors who do listen and help their patients.  Our hats are off to all of you and may we all be under thier care!

Donna (Wanna)
  
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Avatar universal
I agree wholeheartedly!

Jenn
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Avatar universal
It would be interesting to know if any neuro's or other specialist do take a look at these forums.it definatlety would give them an insight on how patient perceive the misdiagnosing.I honestly think if Drs read what patients wrote it might improve the quality of care DRs give there patients
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Avatar universal
You know, I have actually suggested to my rheumatologist before to look at this forum (in a nice way ofcourse).  I told him how much it was helping me, and the great information I was getting.  I don't know if he ever did.  I would be interested to find out!

Jenn
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Avatar universal
You definately have had your share of CRACKER JACK NEURO'S.

You have just joined the ranks of many here.

It took me 14 DRs of the 14 were 4 neuro's..The first neuro was a nasty DR with a chip on his shoulder.Neuro no# 2  was a pathological lier,of my DRs I was treating with when I seen him all had different notes from him(GP,Neurosurgeon and electromuscular)none of them coorelated with each other.Neuro no# 3 I truely liked,but enjoyed argueing with the results from specialist that he referred me to.I couldn't deal with that.

After neuro no#3 I was ready to give up until I got a letter from neuro no#4's assistant stating that he had replaced neuro no#1 and that he would like to go over test results and would I give this neuro a chance.After an hour and a half consult and office exam and reveiw of test results I was dx'd with MS before I left his office.December 2006.

I have been on rebif for 5 months and have had 2 attacks since March.

Finding a compentant neuro who is in it for the long hall is half the battle,seeing an MS specialist is benificial.

My thoughts on MS symptoms are if it walks like a duck,quacks like a duck,its a darn duck!!!!

Ever since many neuro's went to the McDonald criteria score vs the posier many patients are getting kick to the curb without answers.

I wish neuro's would read these forums to get an actual patients veiw on how we are treated and how we veiw their bedside manners.And the frustration many go through undiagnosed.

The sooner the treatment , there's the possibility that they can slow the progression down.I am left disabled and wear leg braces do to the lack of treatment and DX.The neuro community just honks me off!!!!

Keep fighting for a DX,don't give up until you get one.
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Avatar universal
All the answering posts were everything I would say.  I am new to this whole idea of MS and haven't had any tests as of yet, but my heart goes out to you.

This is a fantastic forum with many caring people, you will be glad you found it, I know I am. The support you find here is second to none.

Best of Luck to you
Doni
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Avatar universal
Not much to add to the above, but welcome and maybe by being here you can get some direction as well as support.  

Best Wishes...

Wanna
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Avatar universal
Kristin,

Thanks for your kind words. I do think it is good that we can all help each other here.

Don't let what I've been through discourage you. I truly believe there is a reason for what I'm going through (unfortunately, I could tell you more, but, for now, I wont). I've grown a lot spiritually, and emotionally (not physically though, LOL!).

I hope I can somehow help others who are going through a similar thing, not just here, but in other ways too.

I hope that you have at least found someone who is willing to follow you long term. It's been my experience that that's half the battle.

Good luck!
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228463 tn?1216761521
Welcome to the forum and I was appalled when I read your posts above.  I cannot believe you have been treated so badly by a group of people who have made their life's objective to "help people"!!!!!

I have not been dx'd yet and have alot fewer clinical signs that point in the direction of MS and reading about your struggle has made me feel a bit hopeless.  I know though that with the support of this forum and my family and friends I can and will get to the bottom of what is going on, MS or not.

Please know we are all behind you here and are pushing you forward to fight for a dx and a route for treatment.  Take care and work on your Timeline!
Kristin
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Avatar universal
Thank you everyone!! I cannot tell you how much I appreciate your warm welcome.  I think I'm going to like this place. I've been a member of another MS board for several years, but it is too fast paced for me at this point, and I seemed to get lost in the shuffle over there.

The format here is a bit different, but I'm sure I'll figure it out soon. Rather than reply to everyone individually, I thought I'd try to answer everyone at once. I know it is important to start early treatment, and honestly I do not want to wait any longer. It's just that gearing up for a new doctor thing I hate going through the emotional roller coaster. Grrrrr!!

One thing I wanted to mention is that I did see a very well known neurologist last fall. We (DH and I) actually heard him speak here in our home town, and felt he would really try and get to the bottom of things. From what I've read about him on line, and what he spoke about at the seminar we went to, he advocated early dx and treatment. He mentioned how not everyone meets the dx criteria 100%, etc. I felt so hopeful.

Anyway, we traveled over six hours to see him. Half way there, we get this call that he is going to be out of town for the day (someone in his office screwed up), could we possibly come another day? Uh, no. That should have been a sign. They called back and said he'd agreed to fly back in town early to see me. Because of that, I think I was rushed in and out.

So, he probably spent 15 minutes with me. Said if he'd seen me two years ago he probably would have started me on treatment, but since my MRI's had remained stable over two years, MS wasn't as likely. Then he started talking about the Mayo Clinic study (which I understand most MS neuros don't agree with), and about how they'd discovered they had probably been overtreating MS. He asked me what it would do for me to get a dx? Uh, well, I could get started on treatment. Needless to say, we were totally blown away. I knew going in I might not get a dx, but it was not at all what I expected. He did want me to have the neuropsych testing redone (the first round I had done had shown problems), and the urodynamic testing done. After I did all of that, he wanted to see me back. But, I'm unable to travel that far now. Another thing that was so frustrating about that visit is that when I got my records from him he had notations about elements in the exam he hadn't even performed!!!

I did have an LP done three years ago. It was negative. I know that it could be positive now. But, honestly, I feel as if I have enough evidence without it. I had such a horrible headache afterwards, so I'm not eager to go through it again if I don't have to.
I had the Evoked tests done about two years ago. The technicians were very inexperienced, and I have to wonder about the validity of the tests. It did show a slight delay in one eye, but the neuro that read them felt it was insignificant. I've also had nerve conduction tests, and EMG's, all have been negative. Spinal MRI's were negative as well.

The neuropsych testing showed only a small element of depression, and the psychologist felt it was due to my health issues. After everything I told him, plus the testing he did he said he was quite surprised I wasn't on any treatment.  I only had one neuro suggest it was all in my head and this was after she had me do the hypervenalation tests. She asked me if I felt any tingling around my mouth, when I said yes she said I had anxiety and depression. She wouldn't listen to me when I tried to tell her that my sx were not at all like that. She sent a letter back to my PCP saying I needed to be on antidepressants.

I saw a neuromuscular disease neuro who was wonderful. He said he felt I did have MS, but that was not his area, so I couldn't see him again. The neuro who referred me to him, had refused to see me once he referred me. This was when I had my bowel accident. I called him, and his nurse said, he wouldn't treat me anymore. The was before I had even seen the Neuromuscular guy. Can you believe that!! Honestly, at this point I'd just be happy to have someone follow me long term.

I've never had any trouble with any other doctors. Most of my doctors I've been with for a long time. I'm not demanding (maybe I should be a little more demanding?), and I do what they tell me to do.

OK, I know I've rambled on way too long. But, I thought more info might help you help me more. I'm going to check out the time line. I tend to be wordy (can you tell? LOL), so I will need help with that.

Thanks again for all of your help!!! I'm going to try and send this off now. I hope I don't lose it.

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Avatar universal
Just wanted to say welcome, and I concur with what everyone else said!  I don't think I can tell you anything right now that they haven't already said.  I hope you will take advantage of this great support group we have going on here.  Let us know if you need anything!

Jenn
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Avatar universal
Welcome,

Get copies of all your medical records including mri's ,reports and so forth.

I'm glad you are seeing an MS specialist.

Research the McDonald criteria score for MS,most neuro's use this scale now.

I know I didn't typically fit the criteria,but I have a darn good MS neuro.

There are so many defective neuro's out there that are not well informed about MS or how to DX it.Thats why MS specialist are so important to see.

Writing out a time lime of symptoms and attacks will help you and the MS DR.
Helpful - 0
147426 tn?1317265632
See?  I didn't even get my post done before you got your first round of answers!  

Do go to the thread Called "Timeline 101" and see what we mean by a timeline.  I have to go right now, but I'll talk about it later if you need.

Quix
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199882 tn?1310184542
You should most definetely see a neuro.  Please don't wait until your worse.  One thing I have learned from Quix is that, if you have MS it's alot better to treat it early than to wait.  I would assume that would go for any auto-immune diseases.  Probably any disease.

Your symptoms and problems sound a whole lot like several people right here.  I'm sure you will get alot of knowledgable responses.  My job is to welcome you to a great place.  With outstanding people.

Best of luck,

Carol (OK)
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147426 tn?1317265632
Oh, my!  Welcome to the right place.  I read your post, and you made criteria for Dx long ago.  It has been our experience that many "regular" neuro's aren't create or deep enough thinkers to put together the diagnosis of MS unless you come in with it stamped on your forehead.  As I have said many times, "Welcome to the home of the Undiagnosed, the Misdiagnosed and the Diagnosed, But Pissed Off.

With a positive MRI (4 lesions - size doesn't matter), positive history (at least two attacks involving different parts of the body "dissemmination in both time and space), objective evidence of neurologic problems (brainstem - + Romberg  AND documented "neurogenic bladder) and some classic symptoms such as fatigue, documented cogitive problems, paresthesias-----------your neuro's have either been stupid or lazy.  While none of us can diagnose you online, you are in the right place.

At this point, I'm pleased that you're here.  We'll help you put together all your data.  Yes, your new Internist needs to refer you to a good MS Specialist.  Theses doc's have to be as good at nailing the diagnosis of MS down as there are at ruling it out.  We'll tell you how to put everything together and answer any questions you have and be friends.  I suspect that no one has seen the "whole picture."

Were your prior neuro's dismissive of you?  Suggested that you are imagining bad things or too worried about your health?   I find neuropsych testing often to be a great help in distinguishing anxiety or depression that is CAUSED BYserious illness versus anx/dep that is causing psychosomatic complaints.  What is unusual is your report og having neuropsych testing, but not other important neuro testing like a visual evoked response, a spinal tap...Have they done an MRI of your C-spine and T-spine?

Well, you will be deluged soon with people wanting to know more about why these symptoms, test results and findings have not resulted in a diagnosis.  Some will give you instructions on making a timeline - our best tool against being overlooked.  All will share their stories.

Welcome again.  I invite you to read some our posts.  There is one thread from several of us who have diagnoses called "What it took to get a diagnosis of MS".  It 's probably on the 2nd page.  We have many new people on the forum right now, from all over the world and we're answering a lot of questions right now.  So dive in and read and we will answer your #1 question.  

Has anyone else gone through **** to get a diagnosis?

Quix
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Avatar universal
It sound like MS to me. I would suggest you call the MS Society at 1-800-344-4867. Ask them for a Neurologist that specializes in MS. Keep us posted. Sorry I can't be of much help. Take care.
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