such a materialstic world

Its so hard for some people here to believe that somebody would give away his free hours to sit and type slowely hoping he may be able to help a person in need? I just came from the Patient to doctor forum and I read some horrible comments from some of the posters? I have no reason why?...Is it because I could risk saying that a SPECT study is more sensitive for post head trauma , but the inssurance will pay for just an MRI..and what is wrong to disagree with the CCF that small fibers nerves are mainly unmyelinated and ...I will stop here..we really live an a very materialistic world and I should be playing Golf all the time instead.

   Bob

[Jenny Wren]

I'm sorry for your upset.  I think that it was rude, I read through some of the comments over there.  I never took a second thought at doubting you, whether you are a med student, retired neuro, or a fly-by-night, you are very thorough, and seem very intelligent, you helped me in the past, and I'm sorry that people have to be so rude.  Yes, it sure is a materialistic world, isn't it.  Smile Bob, you will run into all kinds in a life time, I'm only 36, and have encountered quite a few already.  I am a very short tempered person, try to keep my cool, my grandfather always told me a still tonque makes a wise head, to bad he didn't follow his own advice, his tongue isn't still thats for sure, LOL.  Sounds and looks like there are a few tongue waggers here also.

[BobbHilton]

Hi Jenny,  
     Its my typing tone? but I'm not angree.....I feel sorry for those people...I guess the Hilton was not enough to show that there are people who could have so much  free time and  welling to make a use of it...though my friends never called me any thing more , but I think its the time to change it  to BobHiltonRolexBMW..LOL.....what do you think?

I read your questions about a swallowing difficulty, though you did not mention where exactly... in the throat..then yes its been reported a couple of years ago in MS if there was an MS lesion in the Medulla (the lower part of the brainstem) but I cant say how common (?%).. It would be unusual for a cervical disc , because as I mentioned  before swallowing is a job of > 50 muscles innervated by 6 cranial nerves!! and 2 cervical roots (2-3) even if affected (I meant C2-3) the main contribution is from the 6 CN

Happy Easter to you too
Bob

[Jenny Wren]

I think BobbHiltonRolexBMW sounds good.  Are you related to Paris?  My husband watches her program all the time.  I can swallow, it just seems that when I eat certain things, like bread, or something thick like that, it doesn't want to go down, it doesn't hurt or anything just seems like I can feel it still going down, but you what, its worse when I drink carbonated drinks with it.  As far as the medulla, brainstem, would the brainstem show up on the brain MRI also?  My disk problem is C-3-4.  Do you think that having another c-spine MRI is stupid, my last one in August 2006 was in an open MRI without contrast, do you think have the closed MRI with contrast would show anything better?  And lastly, does this sound like MS to you?  I was having the symptoms for 5 years before I got the brain MRI last spring, the symptoms are all the time, they don't wax and wane, do you think it would have showed up by now?  I also have never had numbness or any problem with heat (weather or baths), bowel/bladder normal, no weakness.  Should I have any other blood work done besides the ESR, ANA, EBV, CMV, TSH, FSH, lyme, IPEP/SPEP, anticardiophoslid,  I never had any metabolic profile done, just the ones mentioned above.  Thanks, BobbHiltonRolexBMW, your funny!!!   Jennifer

[LLWB]

I think you should add Saville Row Suits to the list! Please don't let some negative comments stop you from helping all of us who need you so much! I tried to post to the doctor/patient forum for a month, and could never get a chance to even ask a question, much less get a reply. I know many of us are sent from doctor to doctor to doctor, each one with a conflicting opinion. WE live in our bodies, and I believe we know our bodies best, and KNOW when there is really something wrong. I have been told it was all in my head, and I was taking up valuable time that could be spent with someone who "really" needed help. It's really very frustrating, when you look healthy, but are in constant daily pain. If there was a day I didn't hurt would be the miracle! Let's get angry together! But PLEASE don't wuit helping us. Have a Blessed Easter.

[BobbHilton]

LLWB,
    you are right I need a brand name from England too... BobHiltonRolexBMWSaville Row Suits  ...no more space left for my medical advice/comments!!.....from the first few years in North America (esp California I call it the state of the extrems...very/extremly  rich who are very generous too with doctors to the very poor ones) I felt that doctors hands are tied from being able to provide the best available test to every body, though some time the system/health budgets will lose much more by either reordering the the less accurate test, seeing the patients on more visits, the psycological effect and cost on the patient..ext its a bad circle ...I'm not sure I will be violating the rules here by going on this subject? so I will stop at this point
     About the EMG/NCS, I assume your EMGier knew your MRI result so he did more than a routine one? meaning sampling more muscles innervated by C6 where the major herniated disc is, as well as the central or areas of forminal stenosis ? ..because this EMG is benign compared to your MRI and a non surgical approache is still justified ..But I still dont find the myelopathy u posted niether on the MRI (cord sgnals?) or clinically...about the management of the pain..vicodine is an opoid analgesic plus acetaminophen..you will need an NSAID on board which gets secreted into the joints unless you had an ulcer?..have you ever tried the Glucosamine? physiotherapy...when ever you have time try to post what ever details you have esp the full report of the EMG to add the peaces together....because at this time , not only because of your job, but also the diabetes, and if a weight issue needs to be targeted better before any surgery even if just the X-Top (the new one)!!

Jeniifer,
       I was told that my old pictures has Paris's eyes, nose  + the hieght, but the name I got it mainly by using the hotel esp during the medical meetings (paid for!!)..
      Whenever the swallowing is for a particular thing esp a solid ones and its not in the throat feelings then  its very less likely to be neurological.
     The MRI is meant for the brainstem area especially if its done 12hr after the onset  of a symptome.. you have had enough tests and your case does not sound like MS....Are you diabetic,lipids, weight issue? these should be taken care off before any clinical re evaluation!

     Blessed Easter to both of you
     Bob

[Jenny Wren]

I am not diabetic, cholesterol is great doc says, and I am 36 years old, 5'4" 127 lbs.  I was a very happy little camper until all this started 6 years ago.  Thanks Bob.

[BobbHilton]

Jennifer,
    Then you should one the very last people to see the surgeons knife...

AMO,
    you are right...golf is way overrated, I never liked it..Soccer is the best!! feel free asking..I hope I could help.

Meikman,
   you need to be seen by a neurologist for a bedside assessment and a possible referal..Please read my comment for  laurie106  on 4/1/2007



    Bob
    

[AMO]

dear Bobb,

i hope you will be able to look past the comments of just a couple posters aand if you seeee fit with your valuable time annd continue posting.
I knoww youur kindnezz and caring makes me ask my neuroo next visit more specifiiiic questions.

i have wanted too ask more but have not since you have been flooded here. I respect your expertiise and hopes you choosse to stick round here... golf is overrated anyways?? LOL LOL

hope your easter is wonderufl
amo

[meikman]

Sorry to horn in on your post.  I have a question about swallowing.  I have been having trouble on and off now.  It is like I don't have a problem swallowing but the food just doesn't go all the way down.  It will stop at the top of my throat and I have to be real careful not to breath as I will get chocked, which I do almost ever time this happens and once it was to the point that I was unable to breath on my own.  When the food stops I have to think about what is going on and try to swallow carefully as not to get chocked.  I know I might not be explaining this very well as it is hard to really say what I am feeling when I have trouble swallowing.  Any advice would be greatly appreticated.

[LLWB]

I don't rember any other important things about the EMG. Just that the neuro recommended  conservative approach for the Thoracic and Lumbar  spondylosis, but that the cervical area is more difficult. I may have confused the right wording.I meant radiating pain to the shoulders, arm, lower leg clear to foot. I think I should have said radiopathy, not melopathy. He  did recommend ANA, rheumatoid factor, and HLA-B27 tests.I tried DayPro  but had a reaction to it, so have gone back to ibuprophen, 2 every 4 hours. I tried shopping today, and made it one trip around Wal-Mart, then had to lean against things as my legs and back hurt so badly. My feet are always cold.I'm like a lot of others on this site, just want to fix it, whatever it takes. I am overweight, but do have my diabetes under control. After losing my husband last summer, I am so stressed out, one day I don't eat at all, then the next I eat all day.It's so hard to cook for one, too easy to just nuke junk food. Thank you so much for your responses. I am awaiting my neurosurgeon appointment. Do you think it would be appropriate to maybe have the X stop on the cervical disc, and try to treat the T & L areas conservativly? Bless you.

[BobbHilton]

Sorry to hear about your husband. Not from work only, but also from a personal experience, I know how a big gap in our life could be created by these events, but it

[BobbHilton]

Thanks for your nice words, but I believe that nothing happens without a reason....Im glad, during this weekend, I mad up my mind and gave my word to start, in few weeks,  a sort of a part time clinic work (so I could still sleep well)....I will do my best to make it as useful/helpful  as it is here.

   Bob    

[Quixotic1]

I've recently read many of your posts.  You are well-versed, insightful, helpful and appreciated AND KNOW WAY MORE THAN I ON MOST OF THESE TOPICS!  Stick around.  The disclaimers are already in place and need not be repeated "ad nauseum."  I wrote my answer on the Dr to Patient thread in haste and didn't mean at all to dismiss you.  I meant just the opposite, but stated it very poorly.  As for typos - well - I'm far younger than you and sometimes type the most ourtrageous things.  Keep on keeping on!  Quix

[bev62]

Bob, once again I want to thank you for all the help you have given me.  God has lead you to hurting people like us to try to answer our questions and give us advise on what my help us.  We can't thank you enough for taking out your time to do that.  So don't you worry about those cruel comments, we are very thankful and blessed to have you here helping us.  This world would be a much better place if there were more people with a giving heart like you have.