Dan,
The first step that you might consider is trying to have a repeat MRI to further evaluate the findings in the white matter that were present on the MRI in January.
Then, you might consider a referral to a physician who is board-certified in Occupational & Environmental Medicine. There are also physicians who have fellowship training in neurotoxicology (neurology and toxicology).
~•~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
Thank you Dr. Parks for your time.
Our Vapor Recovery Unit was failing. The unit recycles the vapors from our truck loading rack. There are two tanks that cycle every fifteen minutes. There was a valve on one of the tanks that was not seating properly and when the other tank would pull in fresh air it would blow it out of the other tank with the bad valve. These tanks have carbon beds and they were saturated with gasoline. It's real hard to explain. The Unit is out side and there is a 3-4 foot containment wall around the unit. I was in the middle of the vapor cloud. The gas meter was going into alarm 100 feet away from the Vapor Recovery Unit. It was a vapor release. There was no wind that day. I have never been exposed like this before. I was working the grave yard shift and I could not see the vapor cloud and how thick it was until daylight.
The day I was exposed I had a really bad headache, my vision was blurry, I felt sick to my stomach, I was dry heaving, my whole body was real shaky, my heart was beating weird, I was confused, I felt drunk, light headed and my balance was off. My skin was oily to. I was wiped out and I just wanted to go home and go to bed.
The tremors started a couple days after the exposure. I have slight/moderate tremor all the time, but sometimes they get real bad. I have noticed lately that I have small twitches in my upper arm.
My symptoms seem to be staying the same. But on the other hand they are getting worse and I'm having new symptoms.
Sunday I was at my parents house just visiting. I was feeling ok that day. I was standing off and on and my legs started to get real weak and started shaking. I started to feel really sick like I was going to vomit and I was getting lightheaded. I started sweating real bad and I was having real bad chest pain in my left pectoral muscle. It lasted for probably 1 hour and then I was wiped out after that. I am wearing a King Of Hearts Monitor and I only recorded one when I was having the chest pain. I should have been recording it the whole time but I didn't. I usually have real bad pains below my left pectoral muscle that come and go. I was told that those pains were not from my heart. It takes me about a day to recover after I have an event like on Sunday. Those ones get kinda scary and they come out of know where for no reason.
I had the MRI in January and I have not had another one since. The MRI was 3 months after the exposure.
Dan,
As you may have found with reading and speaking with medical providers, n-hexane is known to cause peripheral neuropathy.
"The adverse neurological effects of hexane exposure are manifested as both sensory and motor dysfunctions. Initially, there is a symmetric sensory numbness of the hands and feet, with loss of pain, touch, and heat sensation. Motor weakness of the toes and fingers is often present; as the neuropathy becomes more severe, weakness of the muscles of the arms and legs may also be observed (Schaumburg, Spencer, and Thomas 1983/Ex. 1-228). There are no known conditions that predispose an individual to hexane neurotoxicity (Schaumburg, Spencer, and Thomas 1983/Ex. 1-228). The onset of neurological symptoms may not be evident for several months to a year after the beginning of exposure. Recovery may be complete, but severely exposed individuals often retain some degree of sensorimotor deficit." - http://www.cdc.gov/Niosh/pel88/110-54.html (accessed June 22, 2009)
Regarding your exposure 8 months ago, were you in a confined space? What was different about that day compared to other days (was there a spill?)?
What were your initial symptoms? When did the tremor began in relation to the exposure? Are your symptoms getting worse, better, or staying the same?
When was the MRI done in relationship to the exposure? Has there been a repeat MRI?
~•~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
I am 33 years old and 6'0". I was in good health and very very active. I weighed 225 pounds at the time of exposure but I was still very active. Now I weigh 270 lbs. I do smoke and have smoked about a pack a day for 18 years. I take Budeprion to quit smoking, Crestor for my cholesterol (which is good now), and Trazodone for sleep. I have been taking these for 3 years. Before this I have never had any medical conditions and my parents are in good health. I had never had problems with my breathing. I have not worked since 10/31/08.
I work for an Oil Company in the petroleum storage facility. We handle Gasoline, Diesel, Ethanol, Fuel Oil, and Additives. We ship and receive product by pipeline, marine, trucks, and rail cars. I take measurements, samples, and test the products. I climb the storage tanks all day everyday. These tanks are between 30-70 feet tall. I had never been exposed like I was on 10/12/08, the date of my injury. I have been with this company for 3 years. I worked for an inspection company for 5 years prior doing the same thing. I worked as land surveyor for 2 years. I worked for a construction company for 3 years where I built docks and gangways and some steel welding.
I do not have a diagnoses right now. The diagnoses for the first 5 months was Acute Chemical Bronchitis due to exposure to Chemical Vapors or Fumes. My doctor seems to think that it is in my head, which tells me he is out of ideas. I am seeing a Psychologist for PTSD from the exposure. My Psychologist says that my symptoms are not all in my head. I had an Independent Medical Examinations by a Toxicologist and a Neurologist. These were set up by Workman's Comp. The toxicologist said that gasoline vapors do not cause the symptoms I had at work when I was exposed or that I have now. Every doctor that I have seen since then completely disagrees with that. The neurologist said that I had a slight tremor in my right hand, which was not true. It was really bad that day. He did say in his report that he was concerned about the white spot in the deep white matter on the MRI. Nothing has been done to investigate that further. All of my blood tests have came back good. One problem with that is I did not go to the doctor until 3 days after the exposure. I should have been taken to the hospital that day and they would have found out how much of the chemicals were in my system. Since I live in the Northwest we get most of or Crude Oil from Alaska which has the highest Benzene in the nation. We have up to 6% Benzene in our Gasoline. The average N-Hexane is 3% in Gasoline. So it could be possible that I was exposed to twice as much Benzene as I was N-Hexane. I was exposed to 12,000 ppm. of N-Hexane for a total of 6 hours. I may have been exposed to 24,000 ppm. of Benzene for 6 hours. I can not say for sure because the gas meter did not give me a reading on Benzene. The meter only gave me readings on LEL, CO2, Oxygen, H2S, and N-Hexane. There are a lot of other chemicals in gasoline also such as Tolune, Xylene, Hexane, Cumene, Pentane, N-Heptane, 1,2,4-Trimethylbenzene, Ethanol, Tertiary Amyl Methyl Ether, Ethylbenzene, Cyclohexane and many others and they are all bad for you.
Thank you for your help.
Hi Dan,
Before I respond to your questions, I have a few questions for you.
1. How old are you?
2. Do you have any chronic medical conditions? or take any medications?
3. What type of work to you do and what types of jobs have you worked in the past?
4. What is the current diagnosis that your providers have provided to you?
~•~ Dr. Parks
This answer is not intended as and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
I was not wearing a respirator.