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So, speech therapy was...interesting.

May 13, 2010 - 5 comments
Tags:

speech therapy

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endoscopy

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upper GI endoscopy

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superior laryngeal nerve

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Acid reflux

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GERD

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MRI

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brain

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neurological symptoms



As I mentioned in my previous journal entry, I was scheduled to see a speech therapist (speech pathologist) as my next appointment in this seemingly never-ending quest to elucidate my health issues.

Well, I saw the speech therapist and one of the striking comments she made to me was pointing out that one side of my face was drooping--not extensively, but noticeably, and she said she probably wouldn't have noticed it if she wasn't looking for it. Upon palpitation, she noted that my pharynx felt very tight since I was obviously compensating for my nerve damage in my throat by over-using the muscles in that area. She also said that I have some swelling under the left, back side of my jaw...interestingly enough, she's the fourth person to mention this during the past two years. I actually asked my GP to look at this last summer after I heard two dentists mention that I had a swollen lymph node there, and she didn't even bother, stating that she'd only worry if the lymph node was the size of a golf ball. *sigh* Ridiculous doctors....In any event, the speech therapist said she wouldn't be able to teach me any massage techniques to loosen my tightened throat and neck muscles until I had this issue looked into and resolved.

She also noticed my tongue deviating to the right side, but said that for the extent of damage to my superior laryngeal nerve (which my ENT apparently made out to be significant when he drafted a letter to her), she was surprised I could speak as well as I did. She expected someone with my amount of damage to sound a lot worse, I suppose. After detailing my medical history to her and being examined, she went over some verbal sayings I'll need to practice in a very funny-sounding, annoying voice in order to give my vocal cords a break and train myself to produce sound using different muscles in my neck and less vibrations of my vocal cords. Fortunately, I have an appointment bright and early this Friday with my ENT. I haven't seen him in some time, so I'm interested to hear his plans for my continued treatment especially after hearing that my neurologist thinks ENTs are mainly responsible for treating nerve damage in the throat area. The last time I saw the ENT, he only wanted to double-check my acetylcholine-receptor antibody levels to see if I have myasthenia gravis. I finally had that bloodwork done a few weeks ago, so I'm not sure how it turned out. I guess I'll find out soon enough!

I also saw a gastrointestinal specialist at my ENT's request a few days ago about my acid reflux, which my ENT thinks is pretty bad but can't figure out why, and the GI doctor said he'd like to do an upper GI endoscopy (as my ENT wanted done), so I get to look forward to that in a few weeks. He was shocked I have so many symptoms but couldn't offer much help as he was only being asked to evaluate my acid reflux issue. I'm not sure what they're looking for, but my ENT said he wants to get a better picture of what's going on in my stomach. *groan* Sounds like a field day. The GI specialist I saw wasn't the one my ENT requested, but I wanted to get a move on this issue and the doctor he requested was booked until August. I didn't really feel like waiting around because by the time I actually got the endoscopy done, it'd be September, and then I wouldn't see the ENT until October, and it'd just be silly to wait that long.

Nevertheless, it's my neurological symptoms that I'm still most interested in understanding and (hopefully) resolving. Unfortunately, it looks like this isn't going to be smooth sailing. Sadly, I can't say I'm not used to it.

A random thought that's been on my mind since my neurologist ordered another MRI: I'm very interested in seeing the results of this next MRI, but I'm not sure if I should go to a different hospital for the scan than I normally go to since the same radiologist reads the results each time and my reports from my older MRIs are in the computer system. I've had two MRIs and the first one said "13mm pineal cyst" while the second one just mentioned that the cyst appeared stable (but they didn't bother measuring it!) and everything else appeared normal. My reasoning is that if I go somewhere where they don't have my prior scans/reports on record, I might be able to get a fresh perspective. Although this MRI was ordered for looking at my brain stem, so there's no way of knowing if a new radiologist would comment much on the cyst, anyway. Nevertheless, I don't want the regular radiologist to see my "clear" (in his mind, anyway) original MRIs and just assume, "Oh, this girl is back AGAIN for a completely different issue? She's fiiiiiiiiiiine", and not look closely at my MRI. Because once the radiologist reads the report, my neurologist just takes them at their word and doesn't bother looking at the MRI, himself, unless I insist for a particularly good reason.

Note to self: I'm back to taking the appropriate dose of Propranolol (120mg) each day, I've tried Fioricet somewhat successfully, and I should be getting the Pepcid medication sometime soon so I can get back to taking that every night before going to sleep.

Alright, that's all, folks! I need to get back to finishing a daunting 20-page, take-home midterm for a chronobioengineering class that's due at 9am. Wish me luck..... =/

Comments
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by 898_1, May 19, 2010
Julia I missed a bunch of your posts by being out and unable to type for some period of time due to the arm injury (rdial nerve damage), so Imay miss what had been going on
Best of luck!!

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by Jules77733, May 19, 2010
Thanks, 898! I wouldn't say that you missed too much...my doctors are all still confused and not sure what to do, but the biggest news was the discovery of 40% nerve damage to my right superior laryngeal nerve, which innervates my right vocal cord. I guess this is where the "trouble swallowing" originated, as well as my difficulty singing. My ENT and neurologist are currently investigating the source of this problem, but I guess I'm not very hopeful anything will come of it. I might be stuck feeling sick until the problem resolves itself!

Glad to see you've returned, though. =)

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by 898_1, May 21, 2010
Are you (or your doctors) making plans to repeat the thyroid ultrasound/uptake to see if there are any changes took place there since 2008?

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by Jules77733, May 21, 2010
I actually just asked my endocrinologist yesterday if she thought another ultrasound was necessary and she said "no" since I'm having an MRI done on my neck sometime soon to look at the nerve damage. She said if anything was wrong with my thyroid, it'll get noticed on the MRI. I don't know if I agree with her, though, since the radiologist won't be looking at my thyroid for a problem...so something could easily be overlooked!

It turns out that even on 50 mcg Levothyroxine, I'm still hypothyroid (slightly elevated, as always). She's increasing my medication to 75 mcg Levothyroxine and still refuses to look at any blood test other than TSH.

1204245_tn?1356904325
by 898_1, May 24, 2010
MRI image is diffferent then ultrasound imaging and even it can detect nodular abnormalities it is not easy to compare MRI image to ultrasound image; but MRI is better then nothing. As long as no nodule is felt in the thyroid area, the nerve disfunction may not be thyroid related.It is not uncommon for TSH to go UP after L-thyroxin is prescribed (at least I 've read about few cases); the thyroid should shrink in size after that


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