heel to shin test

[LATW]

is this test suppose to be done while sitting or standing. Also, what does it mean when a person can get pull one foot onto of the knee on one side but not the other?

I can get my left foot on top of my right knee but have to pull my right knee ontop of my left knee.

Also, I can lift my right heel and run it along my left shin, with a lot of effort while I am sitting.

While standing I can NOT run my right heel along my left shin.
But  while standing I can run my left heel along my right shin ...it that clear as mud?!

I know, I have been doing too much reading! Two weeks to go until I see the MS specialist and I am wondering if she will even do any of these types of tests.

I am also wondering if I should take any notes from my previous, tunnel vision type, neurologist who refuses to think out side of the box. Or just take the test results and films so I do not infect my new doctors thoughts with my old doctors short sidedness.  

L

[T-lynn]

I have 4 children,21,18,16 and 12.

The youngest 2 are still at home.When I first started having symptoms,I got every excuse from neuro's stress from the kids,depresion,symptoms from previous back surgeries.

Its finding the right Dr with the knowledge and without an attitude.

It took me 2 years for a Dx.

Left me with impaired legs,but there's nothing to say that the disease modifying meds would of prevented it.

All hang in there,theres good neuro's out there.Sometimes it takes time for this disease to rear its ugly side to get a DX.

[Rachelinpain]

just wanted to add since I saw you guys talking about it that I have 6 kids, and dealing with not having a diagnosis...I have a 7 year old daughter, 4 yo and 3 yo sons, a 2.5 yo daughter and 17 month old twins (boy and a girl), most of them have 1 problem or another (3 of them are adopted from the foster care system) my oldest has ADHD and PTSD, I think my 4 yo has autism, my 3 yo is just very wild, 2.5 yo has failure to thrive with unknown cause (going through the hoops with her for a diagnosis as well) and my youngest son just got his first serious injury and now has a cast on most of his left arm...I think he has EDS, a genetic connective tissue disorder that my doctor thinks I have, which is going to be an ongoing struggle with him.  

Just want to say I can sympathize with you guys and I get so tired of people telling me wow if I had that many kids I guess I would be tired too...people do not understand that it is not about the kids, most of us have done just fine with "all the kids" until we find ourselves suddenly ill and then it miraculously it is caused by the number of children we have...personally I think there are some people who just can handle having lots of kids (and dealing with all the things that come along with them like special needs, etc.) and there are some that can not.  I think people who make comment like that just say it because they can never imagine themselves taking care of lots of children as a healthy person, more less dealing with a large family and an illness...they just do not understand.  For some people having one child is stressful so they see having more than that to multiply the stress and fatigue they feel.  I think everyone just has a different level that they can handle.  For my husband an dI we have not found that level yet...it has been hard with me being ill, fortunately he stays at home right now (he is an author) and is basically doing everything that I can not...no matter what happens i want to get back to being able to handle the household on my own, I just can t seem to figure out how to get there yet...the fatigue, weakness, dizziness, parathesia, etc. just make everything so much harder.  I just hope I find some answers soon so I can start getting back to my normal life.  I would really love to have more children and am very afraid I may not have the chance.

Rachel

[LATW]

Hello,
My appointment is on Sept 11th. Sounds like you are a very busy mom too! I love my kids but some days I just want to find a spot on the beach and SIT and watch the waves and not have to get up!

All boys! Wow! That would be a loud house hold!  We have 7 children total. Four girls and three boys. Five of them are adopted ages 1-10. Our biological childern are girls and both adults now. The oldest  is expecting her first baby in January! Which we are all very excited about! Our oldest boy is only 10 so I have not gone through the teen years with a boy yet. We have two daughters with Downs 10 years old and 4 years old. And two sons with Downs 9 years old and almost 2.  

Good thing we can not know what the future is going to bring our way. If I had known I would be facing this sort of health problem at 44 years old I would have thought twice about taking on special needs children. I don't regret it but do wonder what the future will bring.

I do have a time line made up. I hope the new doctor is willing to sit and listen and not be offended because I actually have notes. My PCP is sending a note that supports my timeline. I didn't want to go and say I had trigeminal neuralgia or other things without him supporting it.  

Fatigue is still a huge problem for me. I understand about the insurance issue. That is huge. My husband just went through major foot surgery in July. He will be off work for at least 3 months, maybe 4. This insurance we have saved us from the poor house! But, it is scary to think about the future. My plan was to go to work when my little kids are bigger, but if I have a health condition like MS will that even be possible? Who knows. I just want to know why I feel so out of sorts.

At least my vison is coming back. I can finally hold a focus for a while. Part of my central vision is still blurry. I have to go for a vision field test again next week. I think I would rather lose function of about any other part of my body than my eye. It has been a real struggle.  Has any doctor tried to blame your problems on the fact that you have more than 2 children to care for? I am constantly getting comments like, well, if I had 7 children to care for I'd be tired too. It really frustrates and humiliates me. I do get tired taking care of my kids, but what is going on now is totally different. I am not well.

L

[Momzilla]

I know exactly what you mean about 'wanting' that diagnosis.  It sort of attaches a certain macabre yearning.  But you just want some validation for what you're going through.  

I have five children, too!  All boys.  Ages 6-18, though.  I provide the health insurance for our family, and feel stuck in a job I have come to dislike.  I've just gone to half-days, due to fatigue.  I feel pressured now to hang on to my job.  What if I get a diagnosis, and my husband is able to provide insurance finally?  Can I get switch insurance policies?  Would I be refused?  Like you said, life can be complicated.

I just think your new doc will be on the ball and put all this together for you.  He'she has to be.  You've got too many signs.  Have you done a brief time line of your symptoms?  I know you have your records and your PCP sounds to be very supportive.  But it may really help to have an outline with you.  I brought one with me to my appointment with my Attentive Neuro, and it helped me to keep things in order in my head as we went through my history.  When's your appointment?

Keep us posted.  Feel well.  Wade through the complications!

Chris*

[LATW]

Oh, don't worry about not getting back to me right away. I totally understand! I am not that great about responding to things myself.

Yes, my youth pastor case is very severe. But it is sad to think of what could have been if the doctors he saw early on would have been more aggressive. He went through a coupld of surgeries before his MS dx because they thought he had a pinched nerve. I don't know all of the details but enough to know they waited way too long. His family has gone through some very difficult times.  

I feel really funny about going to the MS doctor. I sure don't want anyone to think I am digging for a MS dx. I felt such a sense of relief, for a moment, when this other neuro said she thought the two spots on my MRI were from high bp. But then I realized if they were from high bp that was not good either!! So, with the Optic Neuritis and trigeminal neuralgia it really puzzles me. What is the heck is going on.....

My pcp has talked to me about Fibromyalgia. But I don't meet all of the criteria for FMS. I honestly am not in that much pain. I rarely even take tylenol. I have a friend with FMS and she is in so much pain most of the time. I do have tightness in my lower back that is miserable at times, but no actual PAIN.

So, yes, that appointment is coming up. I am looking forward to it just to get it over with! I have most of my test results collected. I have to get my last 3 from my PCP. I cancled my appointment with the neuro that said the spots are due to high bp. I will pick up my MRI films to take with me. So, I think I have done all I can to this point.

If this MS doctor says there is nothing to worry about...then GREAT!!! A dx of MS will affect our live in a very negitive way....I think. I am not sure how I will get insurance when my husband retires. He is 8 years older than I am.  If I do have to start treatment I am wondering where the money will come from to cover it. I am not sure how much our insurance will cover. Then there are the side effects of the meds and the fact that I have 5 young children to care for......Lots of stuff to deal with. So, things will work out, I know, but life can sure be complicated at times!

L

[Momzilla]

I'm so sorry you're struggling with this.  I can understand  your stress about your minister and your own diagnosis.    I totally agree that early diagnosis is SO important.  And Quix makes such good sense that it just seems that -- Duh! -- you should be getting treatment already.  

I know you understand that your youth pastor is a very unusual case.  He obviously has a type of MS that's very progressive.  Rare.  That's so sad.  Still, early diagnosis and treatment are critical.  

Your appointment is coming up.  Hopefully your new doc will have the sense to put it all together for you.  Do you have a timeline?  

I apologize for not getting back to you right away.  That was so rude.  Take care!

Chris*

[LATW]

My appointment is Sept 11th. So it is coming up. I am struggling with this. It is such an emotional roller coaster. I am one that does NOT go to the doctor easily. I have to be very sick and even then I am not good about taking things like antibiotics or pain meds. I take my high bp meds FAITHFULLY because I am well aware of the risks, but other than that it really takes a herd of horses to get me to the doctor! I would rather suffer!

So, having to go through all of this is very stressful for me. I will be glad when this appointment is done. I realize I may be put on meds. But I understand what MS can do. There is a person who has had a huge impact on my life who is living with MS. Well, barely living. He was my youth pastor when I was in high school. He married my husband and myself 25 years ago. He has a wonderful wife, four children, 3 grandchildren.  I have watched MS suck the life out of him because his doctor misdiagnosed him.
It has been a tragic nighmare. His wife is urging me to get in to this specialist. She said it only her husband had been treated properly from the start he would not be where he is today. Today he is TOTAL care. They don't even know if he recongnizes them any more.
I know this is the EXTREME case of MS. But I know this person. They live 5 miles from them. They were a part of my life now for about 30 years. It is very difficult. I also had an aunt with MS. She was not treated, but did not have the progressive type of MS this friend has. It is so important to get a correct dx.
I would be thrilled to hear it is NOT MS. But we know it was not a stroke. So, what a feeling of desparation this can bring on. I feel bad for everyone going through this, especially those who know something is not right but they are being patted on the head and sent on their way out the door.
That is how I felt about my doctor.
L

[Quixotic1]

Yes, it is nuts.  I think I've said before that you have sufficient data to clinch a diagnosis.  In the face of ON, TN, you funny leg and a new and an old lesion you should be on meds!  Whether to do an LP would be up to the new neuro, but unless they are hyposthesizing that you have had actual stokes causing these things, they have no business calling 2 lesions as being caused by something controlled HTN.  Sheeshh!!  When is your new neuro appointment.

BTW that was NOT anywhere near a thorough neuro exam.  A good one done at lightening speed by an expert take a minimum of 30 minutes, usually a good bit longer.  That's just for the exam, not the history, writing down the exam, or talking to you.

When IS the new appt?  Arrrggghhh.  Quix

[LATW]

Actually, about 5 years ago I started having eye pain in my right eye and head aches. Some numbness in the sole of my right foot. Had an MRI and all looked fine. But that was the first mention of MS. My doctor felt something was going on but nothing showed up.

So, I decided to go on and ignore it. About 2 years later I started with pain in my head an face that I thought was going to kill me!
The doctor said it was trigeminal neuralgia.  My mom and my sister both have an official dx of TN and both are on medication.

I made it through the first time with Vicoden. The second time I went in and the doctor gave me dilantin. However, I did not take it becaue I was afraid of the side effects. Made it though the second time with Vicoden. Vicoden does not kill the pain, only made me sleepy. I have had TN pain off and on since then but the pain has not been full blown.

So, here I am about 3 years later with Optic Neuritis. TN was raising its ugly head a bit again. But so far it has not been bad enough for heavy drugs. I have ON, major fatigue, and a funny leg.

So far I have had an MRI which showed ON and two spots in the white matter of my brain. One old and one new (radiologist says demyelenation, the neurologist says spots due to high bp because they are not in the right shape and not in the right spot) That is why my pcp is sending me to another neuro.

Have had a BAER (normal), SER (normal), VER (abnormal, but I do have ON). I have been treated for high bp for years. It has been well controlled. The neurologist did do some testing with her fingers but she held them up in the air and asked me if I could see them. I could see them. No finger to nose. I think she did have me follow her fingers with my eyes. She looked in my eyes with her light.

She did have me hold my hands straight in front of me and hold them. But not for a while. It was pretty quick. So, I don't know. I can say I am really tired of all of this now. It has been going on for about 4 months.

My eye is still a problem. I am still dealing with fatigue way beyond what is normal for me and my leg is crazy. At least the numbness and tingling problems seem to be gone for now. I was also getting a lot of muscle spasm or twitches. Crazy stuff!! I know,,,,I am 44 and getting older, but this is nuts.

L

[Momzilla]

I'm so sorry!  I forgot we had to go!  I'm back now!

Have you had any other testing done?  I had a neuro exam that took SO long that included a test for dysmetria like finger-to-nose, finger to doctor's finger;  eyes following doctor's finger, slowly, quickly, side-to-side/ up-down;  also, it seemed like he was testing my joints by having me relax and rolling my shoulders and elbows around; had me hold out my arms with my eyes closed and hold them there for a while (I won't tell you why they ask you to do that--he told me why after--  it's kind of telling, and I don't want to lead you if you have it done);  SO many things....

I think if, after you have some other tests that maybe show something, maybe your doc will have a reason to do more of this.  What are your symptoms?

[LATW]

Well, She looked at my eyes, I have ON. Had me touch her fingers. Had me walk away from her and back to her about 6 steps. We were in a very small room. She tried to do the Babinski test through my sock with the end of her reflex hammer, but go no response. Checked my leg reflexes and had me resist her as she tried to push my leg down. My left leg is fine. My right leg is weak. I had quick reflex in my right leg and it was uncomfortable. My right ankle really did not respond to the reflex test. It didn't take much for her to push my right leg down because I could hardly raise it to start with.
So, I don't know. Is that a through nuero exam? We were in her office about 30 minutes total. That included the exam, checkout, and setting up a few tests.

[Momzilla]

I think this is just a small piece of the puzzle.  What was the rest of your exam like -- I forget?

[LATW]

OH so confusing! Well, what I do know for sure is the doctor I saw didn't do anything close to the way it seems things are suppose to be done.

L

[Momzilla]

I still peek in on you all.  I am on half days at work, so I am trying to find a way to prioritize, I suppose, is the best way to say it!  Mornings are good, but as the day goes on (10 a.m.)I get exhausted, so I nap when I need to, but I am getting really strong.  My toes are really back to normal.  My legs are much better, as well.  Weird.  I don't want to jinx myself.  I don't know what that means at all.  But I'm really eager to find out!  Thanks for asking.

You know I'm glad you're back!

Chris*

[Quixotic1]

As someone who had to work hard to develop the skill, I agree.  Also, Zilla, you said you were feeling better and a little stronger.  Your exam might be changing, too.  Is that true?  Are your legs a little stronger?  That would speak to one of the Relapsing Remitting processes like MS or CIDP, rather than some of the other,not-so-good upper/lower motor neuron diseases.

BTW - How are you feeling?  You are less around these days.  I hope it because you're better and actually getting things done.

Quix

[Momzilla]

That is so weird.  My Attentive neuro was haunched over staring at my legs like he SO wanted a straight line, but was expecting not.  Then seemed surprised at all the shaking.  I wonder why all the differing takes?  (Mine could be because I came straight from work in a dress that day?)

And I'll tell you what else--my internist tried to repeat the babinski in his office the other day with a very prickly device.  Couldn't do it.  Couldn't produce ANY hyper reflexes.  I know my neuro twisted his hammer a bit, like he was adjusting it.  But I was kicking like mad.  It's got to be skill developed over time, wouldn't you all agree?

Wondering in Detroit,

Zilla*

[Quixotic1]

huh...I was taught to do the heel down shin while the patient was lying down.  This requires less muscle strength and would more accurately measure the proper thing which is the ability to "know and move in a straight line."  Standing I can't lift my right leg that high and if I wobbled it would be because of muscle weakness.

Q

[LATW]

Hi,
thank you for your responces. I was sitting when this was done. Actually sitting on the exam table with my feet dangling. I struggled with my right foot but the doctor didn't say anything. I guess she was looking for really strong clues. Mine aren't so clear. She didn't take the time to really listen...oh well. That is why I am not going back to her and am off to see an MS specialist!

Ok, so it is best to only take the tests and not her notes. I am taking a letter from my PCP. He was not happy with the neuro I saw. I can get all of my records from him because I had the nueros office send everything to my PCP.

Right now I am just trying to keep up my hope that this new neuro will listen to me. At least show some interest that I am having a difficult time. Something is causing my problems....but what.  

L

[Momzilla]

I have always done this sitting.  Now granted, I was not able to stand well at the time. And I pretty much failed it in that I was supposed to smoothly slide my right heel down the length of my left shin, and vice versa.  Was not happening.  I could fairly smoothly run my left heel down my right shin, but not the other way around.  I could hard LIFT my right heel to get it up to my left knee, and when I tried to do anything remotely smoothly, it tremored fiercely.    I think it gave them a good idea about left/right side comparison and also perhaps strength.  Not sure.

Hope it helps!

Momzilla*

[moeck]

I'm taking only the copies of reports, they are objective findings.  The doctor's notes are subjective and if they reflected the doc's belief in your symptoms then you wouldn't need to find another doc.

[Nanners123]

"I am also wondering if I should take any notes from my previous, tunnel vision type, neurologist who refuses to think out side of the box. Or just take the test results and films so I do not infect my new doctors thoughts with my old doctors short sidedness." This is a great question!!

I am wondering the same thing as I am about to see my third Neuro.

N

[JonM]

I believe this is for motor coordination (Ataxia) check and balance.  When I did it I was standing up.
Jon