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Timeline tutorial/requesting symptoms
Quix has requested that I help her with the Timeline 101 tutorial to be put on the Health pages. There is a tutorial post from Quix and I from last year, but I would like to make it more generic to reflect a factious patient.
Would any of you be willing to contribute a portion of your timelines so I can rewrite the tutorial to reflect a nonspecific patient?
Maybe you could just copy and paste your “favorite” section and post it here.
You'd think by now I'd be able to write a plethora of symptoms, but I do want the fact Timeline to make sense.
Thanks,
Wanna
Would any of you be willing to contribute a portion of your timelines so I can rewrite the tutorial to reflect a nonspecific patient?
Maybe you could just copy and paste your “favorite” section and post it here.
You'd think by now I'd be able to write a plethora of symptoms, but I do want the fact Timeline to make sense.
Thanks,
Wanna
Wobbly: Thank you. I get the red face thing also. It just happens and it is sooo weird!
Rena: Thank you. Maybe you could take your cane, stick it up your GP’s butt to go alongside the pole that is already up there, give him Lyrica, tell him to exercise, and then it will feel better. Nuf said?
Wanna
Rena: Thank you. Maybe you could take your cane, stick it up your GP’s butt to go alongside the pole that is already up there, give him Lyrica, tell him to exercise, and then it will feel better. Nuf said?
Wanna
You are welcome to take what you want from mine if it makes sense to you... Rena
Conclusion: The episode in March certainly sounds suggestive of a generalized nocturnal seizure and there appeared to be no obvious precipitating factors. The other episodes consisting of an olfactory hallucination could represent an aura and the one episode accompanied by confusion may have represented a complex partial seizure. Her EEG on March 19th was normal. In view of the fact that her symptoms raise the possibility of a focal temporal lobe seizure disorder, I feel she needs further investigation and a CT scan has been arranged.
June 1993 – Focal hypodensity in the Right lentiform Nucleus is identified and likely represents a Lacunar Infarct.
July 1993 – MRI- Multiple small lesions of high signal intensity are seen in the periventricular white matter. These lesions are highly suggestive of Multiple Sclerosis. (Report available)
Sept. 1993 – Visual Evoked Potential Conclusion – Abnormal visual evoked potentials with prolongation on the right side which would be in keeping with an optic nerve dysfunction on the right. (Report available)
March 1994 – Cerebrospinal fluid examination noted that both the albumin and absolute levels of IgG were markedly increased, an increased IgG index and daily rate of IgG synthesis at 45mg/day.
DIAGNOSIS: Multiple Sclerosis, Grand Mal Convulsion, Olfactory Sensations
October 2006: Symptoms include severe ice pick type pain in right temple with ptosis of left eye, treated by Dr. *. ***** with IV Solumedrol and weaning Prednisone with positive results until Feb. 2007.
February. 2007: Symptoms identical to October 2006, treated by Dr. *. ****** with IV Solumedrol and weaning Prednisone with positive results until approx. 1st of March 2007.
DIAGNOSIS: Paratrigeminal Neuralgia (Raeder’s Syndrome)
February 2007: Was seen by Dr. *. ******Ophthalmologist, had full vision exam, Dr. ****** stated, “Any vision difficulties Rena is having is due to the MS as there has been no change in Rena’s eyes in two years.”
July 2007: Symptoms include pain in legs and hands, severe muscle spasms in legs, neuropathic pain in legs.
September 2007: Symptoms include pain in legs and hand, pain in back due to Lumbar Strain diagnosed by doctor in ER, severe muscle spasms in legs which prompts Dr. ****** to order MRI of Spine and Pelvis to rule out possibility of spinal tumour. MRI normal (MRI on CD available).
November. 2007: Developed severe vertical double vision, CT Scan Normal, Blood test for Tegretol level – level result “high normal”. Speech became slurred and word retrieval became difficult. Began having paresthesia in legs.
MRI of Brain: There are a number of white matter hyperintensities. These are in typical distribution for the demyelination of multiple sclerosis. (CD available)
DIAGNOSIS: Multiple Sclerosis
November 2007: Developed severe pain in heels of feet equated to lightning bolts going through my feet...this pain has since travelled up the backs of my ankles and on occasion, into my large toes. Nothing has alleviated this pain to date.
December 2007: Swallowing issues which alleviated after the holidays. Breathing difficulties, difficulty expelling air. Quit smoking, 2 pack’s/day in July 2007.
January 2008: Had Barium Swallow: normal, visited ER due to breathing issues, given Prednisone X 5 days, Rx for Spireva and Advair. Lung Function Test: concern about right lung. Requested referral to Pulmonologist, reminded g.p. continually, no referral to date.
February 2008: Asked G.P. about possibility of pain problem is related to Fibromyalgia, G.P. referred me to Rheumatologist for June 2008. I have been using a cane since December 2007, given disability tag for vehicle for 6 month duration.
March 2008: Developed intermittent double vision again, G.P. states that she doesn’t know what could cause it, did no examination.
Currently on 900mg Tegretol/daily, 300mg Lyrica/daily, 10mg Oxycodone twice daily. Pain has not been alleviated at all. G.P. has decided that if “she can alleviate my pain I will be able to become more active and my mood will get better and the depression will lift.” The oxycodone has done nothing to help with the pain; it only makes me feel different about the pain. I have explained to the G.P. that I have managed to make through the side effects of the Lyrica in the hopes that the Lyrica will help but it hasn’t. I don’t know why I am still on the Lyrica.
Conclusion: The episode in March certainly sounds suggestive of a generalized nocturnal seizure and there appeared to be no obvious precipitating factors. The other episodes consisting of an olfactory hallucination could represent an aura and the one episode accompanied by confusion may have represented a complex partial seizure. Her EEG on March 19th was normal. In view of the fact that her symptoms raise the possibility of a focal temporal lobe seizure disorder, I feel she needs further investigation and a CT scan has been arranged.
June 1993 – Focal hypodensity in the Right lentiform Nucleus is identified and likely represents a Lacunar Infarct.
July 1993 – MRI- Multiple small lesions of high signal intensity are seen in the periventricular white matter. These lesions are highly suggestive of Multiple Sclerosis. (Report available)
Sept. 1993 – Visual Evoked Potential Conclusion – Abnormal visual evoked potentials with prolongation on the right side which would be in keeping with an optic nerve dysfunction on the right. (Report available)
March 1994 – Cerebrospinal fluid examination noted that both the albumin and absolute levels of IgG were markedly increased, an increased IgG index and daily rate of IgG synthesis at 45mg/day.
DIAGNOSIS: Multiple Sclerosis, Grand Mal Convulsion, Olfactory Sensations
October 2006: Symptoms include severe ice pick type pain in right temple with ptosis of left eye, treated by Dr. *. ***** with IV Solumedrol and weaning Prednisone with positive results until Feb. 2007.
February. 2007: Symptoms identical to October 2006, treated by Dr. *. ****** with IV Solumedrol and weaning Prednisone with positive results until approx. 1st of March 2007.
DIAGNOSIS: Paratrigeminal Neuralgia (Raeder’s Syndrome)
February 2007: Was seen by Dr. *. ******Ophthalmologist, had full vision exam, Dr. ****** stated, “Any vision difficulties Rena is having is due to the MS as there has been no change in Rena’s eyes in two years.”
July 2007: Symptoms include pain in legs and hands, severe muscle spasms in legs, neuropathic pain in legs.
September 2007: Symptoms include pain in legs and hand, pain in back due to Lumbar Strain diagnosed by doctor in ER, severe muscle spasms in legs which prompts Dr. ****** to order MRI of Spine and Pelvis to rule out possibility of spinal tumour. MRI normal (MRI on CD available).
November. 2007: Developed severe vertical double vision, CT Scan Normal, Blood test for Tegretol level – level result “high normal”. Speech became slurred and word retrieval became difficult. Began having paresthesia in legs.
MRI of Brain: There are a number of white matter hyperintensities. These are in typical distribution for the demyelination of multiple sclerosis. (CD available)
DIAGNOSIS: Multiple Sclerosis
November 2007: Developed severe pain in heels of feet equated to lightning bolts going through my feet...this pain has since travelled up the backs of my ankles and on occasion, into my large toes. Nothing has alleviated this pain to date.
December 2007: Swallowing issues which alleviated after the holidays. Breathing difficulties, difficulty expelling air. Quit smoking, 2 pack’s/day in July 2007.
January 2008: Had Barium Swallow: normal, visited ER due to breathing issues, given Prednisone X 5 days, Rx for Spireva and Advair. Lung Function Test: concern about right lung. Requested referral to Pulmonologist, reminded g.p. continually, no referral to date.
February 2008: Asked G.P. about possibility of pain problem is related to Fibromyalgia, G.P. referred me to Rheumatologist for June 2008. I have been using a cane since December 2007, given disability tag for vehicle for 6 month duration.
March 2008: Developed intermittent double vision again, G.P. states that she doesn’t know what could cause it, did no examination.
Currently on 900mg Tegretol/daily, 300mg Lyrica/daily, 10mg Oxycodone twice daily. Pain has not been alleviated at all. G.P. has decided that if “she can alleviate my pain I will be able to become more active and my mood will get better and the depression will lift.” The oxycodone has done nothing to help with the pain; it only makes me feel different about the pain. I have explained to the G.P. that I have managed to make through the side effects of the Lyrica in the hopes that the Lyrica will help but it hasn’t. I don’t know why I am still on the Lyrica.
I'll put some of the one I'm trying to do now and you can let me know what you think OK...hope it's not too long...
1998 - Episode of Vertigo lasted appro 6 months, test - ENT - not ears, Neurologist - not Neurological. Tried Syrc medication, did not help. Vertigo felt like room moved back and forth, nauseated, at times vomited I was very tired afterwards. Head, ears felt full, and difficult to think
Red Face across nose, cheeks and brows - people asking if I’m blushing? Intermittent..comes and goes.
Heartburn - GERDS
Pain in knees and joints, wrists, knuckles, elbows, shoulders, ankles, feet, neck Swollen red knees and hands, fingers sore and difficult to hold cup, pen, book etc.
Double vision thought it was normal.
2004 - Difficult to walk with sore knees, had x-rays done in Kamloops Dr Brink and stated arthritic in both knees.
Rash on body - circular shape, size of a dime, red and turned dark after a few weeks. Itchy at times. Started on top of feet, neck, now all over my body including face and head.
Every few months it flares up again.
2005 - Vertigo episodes started again. Vertigo is a lot worse this time, Dr states Nystagmus and I’m no longer able to work
● Off balance walking, legs feel rubbery, heavy.
● circular body rash and Red face rash
● Fatigue - go shopping then I’m laying down for the next day or two
● Double/Blurry Vision, a lot of pain, light sensitive, flashing lights, - Dr states 20/20 vision except for reading
● Tracking movement, passenger in a car, watching TV can cause dizzy feelings
● headaches - dull, top of head.
● short term memory is bad, difficult to find right word
● Pain in Joints - stiff and swollen
● cold hands and feet - blue and white colour - I wear mitts in the home and use heat to help the pain in my hands.
● tingling/numbness on left leg, foot. Electric shock feeling in left foot - toes.
● Pain in left leg muscles, thigh and calf muscles will cramp up.
● numbness on right side of face
● Noise at back of neck - very loud, almost daily - Tinnitus?
● At times - shortness of breath - Lung function test Dr Cook - Reactive Airway Disease
● difficult swallowing, choking.
● feel like I have to use the bathroom and cant, or opposite and I’m too late.
Meds - Celebrex - 200mg, Tylenol 3 when needed, Pariot, Docusate Sodium, Clonazapam at bedtime, Salbutamol HFA.
1998 - Episode of Vertigo lasted appro 6 months, test - ENT - not ears, Neurologist - not Neurological. Tried Syrc medication, did not help. Vertigo felt like room moved back and forth, nauseated, at times vomited I was very tired afterwards. Head, ears felt full, and difficult to think
Red Face across nose, cheeks and brows - people asking if I’m blushing? Intermittent..comes and goes.
Heartburn - GERDS
Pain in knees and joints, wrists, knuckles, elbows, shoulders, ankles, feet, neck Swollen red knees and hands, fingers sore and difficult to hold cup, pen, book etc.
Double vision thought it was normal.
2004 - Difficult to walk with sore knees, had x-rays done in Kamloops Dr Brink and stated arthritic in both knees.
Rash on body - circular shape, size of a dime, red and turned dark after a few weeks. Itchy at times. Started on top of feet, neck, now all over my body including face and head.
Every few months it flares up again.
2005 - Vertigo episodes started again. Vertigo is a lot worse this time, Dr states Nystagmus and I’m no longer able to work
● Off balance walking, legs feel rubbery, heavy.
● circular body rash and Red face rash
● Fatigue - go shopping then I’m laying down for the next day or two
● Double/Blurry Vision, a lot of pain, light sensitive, flashing lights, - Dr states 20/20 vision except for reading
● Tracking movement, passenger in a car, watching TV can cause dizzy feelings
● headaches - dull, top of head.
● short term memory is bad, difficult to find right word
● Pain in Joints - stiff and swollen
● cold hands and feet - blue and white colour - I wear mitts in the home and use heat to help the pain in my hands.
● tingling/numbness on left leg, foot. Electric shock feeling in left foot - toes.
● Pain in left leg muscles, thigh and calf muscles will cramp up.
● numbness on right side of face
● Noise at back of neck - very loud, almost daily - Tinnitus?
● At times - shortness of breath - Lung function test Dr Cook - Reactive Airway Disease
● difficult swallowing, choking.
● feel like I have to use the bathroom and cant, or opposite and I’m too late.
Meds - Celebrex - 200mg, Tylenol 3 when needed, Pariot, Docusate Sodium, Clonazapam at bedtime, Salbutamol HFA.
I meant...but I do want the FACTITIOUS Timeline to make sense.
And I need a consensus...is it Time Line or Timeline??
Wanna
And I need a consensus...is it Time Line or Timeline??
Wanna
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