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Avatar universal

I have a neuro appointment tomorrow 10/4/2007

If you have time can you please look over my timeline.  It needs lots of work.  I have been trying to put down in writing all that I have been feeling and it is very very long.  Too long and I need to shorten it.  Too long to post it here.  Here is a link to my journal space on an MS web community.  

http://*****************/component/option,com_mamblog/Itemid,47/task,show/action,user/id,101584/

Thanks

Yvette
10 Responses
147426 tn?1317269232
the link must have had an something in it that the MedHelp program deleted.  Why don't you post a portion of say..this years timeline here.  We can give you suggestions and you can adapt the suggestions to the other parts.

Have you read the "Timeline 101" thread?

Quix
Avatar universal
Part ONE

Symptoms over a thirteen year period can get unwieldy.  Especially if you don’t know if anything is connected.  I would appreciate input on how to streamline this information so I can present it to the neurologist tomorrow without overloading her with too much information.  I thought I would organize my list of symptoms by type, to show changes in function over a period of time.  I don’t have exact dates for a lot of things just general times and relative time versus events in my life.  

Sensory
1995- Mild pins and needles in hands and feet.  Evaluated in Navy x-ray and MRI of c-spine.  Have radiologist report

1998- Mild pins and needles in hands and feet and tip of tongue and lips  Evaluated by neurologist.  Have MRI films and neuro exam report to GP.  Don’t have radiologist report on MRI

Since 1998 the pins and needles come and go I have noticed when in motion or pressure applied the sensation is not noticed as much.  Tingling has increased in feet from toes to balls of feet to heel and tops of toes.  Left calf tingles sometimes from ankle to just above the knee on the rear of leg on the outside of leg and just to midcalf on the inside of leg.  In the last year 2007 noticed pins and needles and occasional numbness in vulva area when sitting that lasts for about an hour.  It doesn’t happen all time just some times but disturbing when it does.

Currently the pins and needles feeling on tongue has changed to tongue, lips left temple to chin, right eyebrow and right cheek. Also left side scalp back on the head in line with eyebrow

Currently the sensation of pins and needles in hands has changed to sharp pain in right pinky when tapped just right, general tingly feeling in whole hand.  My left hand has a general tingly feeling of the whole hand with a painful patch on pad of thumb.  Find it hard to point and click the mouse on the computer smoothly. It takes a try or two to fine tune hand motions to get mouse on hyperlink.  I don’t miss by much though.  I noticed on several occasions that hands actually tremble when trying to do tasks at the end of the day.  Husband could see the trembling.  Stopped the stimulant I was taking for attentional issues and fatigue incase that was causing the trembling but after five months of taking the drug I wasn’t sure that was the cause but had to rule it out because it was listed as a possible side effect.  I have been three days stimulant free but still noticing trembling on occasion.
Avatar universal
Part TWO

Mental state
Diagnosed clinical depression 1997 given Welbutrin 300 mg and Buspar  it helped with the depressed mood but still had days of low energy.  I continued treatment for three years when I became pregnant and stopped.  I lost the baby but still felt well emotionally and didn’t return to the antidepressant.  I became pregnant again 5 months later and felt great emotionally for 4 years.  A year after stopping breastfeeding I noticed a severe drop in energy.  (See note below about sleep apnea ) I didn’t think I was responding quickly enough to the treatment for sleep apnea, so I thought that perhaps some of the low energy was due to depression again.  I asked to be put back on Welbutrin and Buspar.  For three months everything was great and no problems I was sleeping fine, had energy was getting the house back into shape again.  Then I started feeling more tired and weak. I started having trouble finding words when trying to talk to friends.  I would either stop and find the word I was thinking of, or I would talk around it using similar words until I remembered the word I was thinking of.  I became more forgetful.  If it wasn’t written down I didn’t remember.  I started putting my schedule on outlook and set reminders for important dates several days in advance and everyday until the day in question.  It was then that I spoke to my son’s doctor who he sees for ADHD/Asperger’s Syndrome and who was monitoring my Welbutrin and Buspar.  She started me on some ADHD meds, Dexadrine, the same med that my son was currently taking.  I noticed improvement on focus and remembering appointments but word finding problems were still apparent.  I was feeling very stupid and I know that I am not because I have a BS in Chemistry with a B+ average.  Although, I think if I tried to go to school now, I don’t know how I would do grade wise today.

Eye
1993 prescribed glasses by Navy Optometrist. I had a baby Oct 1993 and during next appointment after that I no longer needed glasses.

2007 several months ago I woke up with an extremely painful left eye, very wet feeling, reddened white part of eye, extreme light sensitivity causing even more pain, painful to move eye back and forth or up and down and blurry vision.  Over the first day the pain lessened to more tolerable levels better and the blurriness lessened. The next day pain was mostly gone except still tender to move eye.  Redness faded on the third day.  Since then I have noticed larger halos around lights.  Driving at night is more difficult because of blinding by headlights from up coming cars. Parts of my field of vision seem more blurry but I can’t pin point exactly where or how.
Avatar universal
Part Three

Ear
2007 over one month period I had a feeling of electric shock deep inside my left ear it would zap me once or twice and then go away completely until the next time later that day or a couple of days later.  It only occurred that one month I haven’t had that happen again.

Pain and other strange stuff
1994 severe back pain while in Navy determined to be back spasms.  Lasted three days while back would seize up and any movement would be unbearable then pass.

1993, 1995, 2002 left wrist tendonitis 3 months after birth of babies lasted a couple of months then went away.

1997 severe back pain again.  Worse couldn’t straighten back walked hunched over.  Went to doctor given muscle relaxers.  Didn’t work. Just waited it out pain lasted one week. During that time I had periods of soreness punctuated with periods of  screaming pain with any movement.

2001 mild back pain stiffness went to see chiropractor.  Found out had signs of deteriation on spine at lumbar back and a straight neck no curve.  Saw Chiropractor for two years of adjustments.  Noticed improvement in headaches and backpain

2002 to 2004 knee pain evaluated xrays showed no arthritis. Pain while climbing stairs and upon sitting. Worse after being inactive for awhile like in the evenings after watching tv climbing stairs to go to bed.

2003 stomach pain and heartburn that couldn’t be controlled by tums any more.  Referred to Gastro doctor upper endoscopy  findings: GERD prescribed previcid.

2005 several episodes of mid gastic pain at umbilical area.  Several hours of pain while I would stay in bed and then pass.

Early 2005 went to doctor due to room spinning for 10 days.  I was told it was vertigo, not very bad, probably caused by a virus irritating the auditory nerve.  It stuck around for another 4 days and then went away.  About a month later I had another smaller episode of vertigo that last about 4 to 7 days.  I did not go to the doctor that time since it wasn’t as bad as last time and they didn’t do anything then anyway.

2006 one morning after my morning pee I had extreme stabbing pain in my perineum I went back to bed doubled up in a fetal position for 30 minutes without any let up then I called my GYN and made an appointment with him at noon that same day.  I went back to bed to wait out the pain.  No change for three hours then the pain stopped.  I went to my appointment with my GYN.  Thoughts were possibly passing kidney stone but didn’t quite sound right.  Possibly a rupturing cyst.  Had ultrasound finding small amount of free fluid and one 2.5 cm complex cyst.  Followed up with another ultrasound 6 months later no change in cyst.  Had pelvic MRI no cyst found.  Findings hemoragic functional cyst giving complex appreance.  No pain in that area again

2005-2006

Early spring 2005 I noticed that I was haning trouble keeping my balance on occasion.  Bending over or turning I would wobble a bit. Nothing major but it happened occasionally through the summer.  I didn’t think much of it. Then in winter of 2006 I fell down the last three steps of my basement stairs and twisted my ankle.  I iced it and kept off of it for two days.  A month later I made a small misstep going up the stairs at a school function and fell on the top step twisting more severely that same ankle.  I went to the ER, who xrayed and braced my ankle, then to the orthopedic who said keep the brace on and crutches for a month.  When that time period was over I was given some exercises to strengthen my ankle.  One of them was stand on one foot and close eyes for 30 secs.  I failed it every time.  I would fall over immediately.  It wasn’t just my bad ankle but I would fall using my good one too.   That was when I thought I might have a balance problem.  But still I didn’t go to the doctor.  At that time I was having severe fatique and as part of an evaluation I was recommended to get a sleep study.  I had totally forgot to mention the balance problems at that time.  Sleep study came back as mild obstructive sleep apnea and significant upper respiratory resistance syndrome.  I was prescribed a cpap machine.  I was thinking of mentioning my balance problems to the ENT doctor I had to see before I could get my cpap machine.  I totally forgot to mention it. I received the cpap in January of 2007.  I used it every night.  My balance problems went away and I thought problem solved it was just caused by chronic sleep deprivation.  It was after July when I had problems again with wobbling when turning around corners bumping the walls a bit in halls on occasion and failing the sobriety walk I would give myself in my kitchen.  Thinking back I had several weeks of back to back fever blisters and early July our a/c went out and it was 90 degrees in our house for a week until we could buy a new one.

Well that is my long story.  If anyone managed to slog though it they deserve a medal.  I need a lot of help distilling this into something that will help the neuro but won’t mislead him thinking I am looking for any specific diagnosis.  I only want him to know that I have had strange things happen to me over many years that can be explained away by doctors when taken individually but perhaps mean more when they look at the whole picture.

Yvette

147426 tn?1317269232
What time zone are you in?  My first thoughts are do not give the neuro three timelines.  That's three separate histories he has to mentally combine.  Put all the symptoms where they belong - year or month.  Leave out all the non-neuro stuff.  Cut out gynecology stuff.  Mention arthritis as briefly as possible.  Quix
147426 tn?1317269232
I'll start, but I have to leave for a family reunion dinner in about 30 minutes.  I'll be home about 8pm PST.  Note that I am cutting out the little words like pronouns.  This is just an outline.  If he is interested he will ask you to flesh out the details.

1995- Mild pins and needles in hands and feet.  (state general results of Xrays)

1997 to Present - Mental state
Diagnosed clinical depression 1997 given Welbutrin 300 mg and Buspar  it helped with the depressed mood but still had days of low energy.  I continued treatment for three years when I became pregnant and stopped.  I lost the baby but still felt well emotionally and didn’t return to the antidepressant.  I became pregnant again 5 months later and felt great emotionally for 4 years.  A year after stopping breastfeeding I noticed a severe drop in energy.  (See note below about sleep apnea ) I didn’t think I was responding quickly enough to the treatment for sleep apnea, so I thought that perhaps some of the low energy was due to depression again.  I asked to be put back on Welbutrin and Buspar.  For three months everything was great and no problems I was sleeping fine, had energy was getting the house back into shape again.  Then I started feeling more tired and weak. I started having trouble finding words when trying to talk to friends.  I would either stop and find the word I was thinking of, or I would talk around it using similar words until I remembered the word I was thinking of.  I became more forgetful.  If it wasn’t written down I didn’t remember.  I started putting my schedule on outlook and set reminders for important dates several days in advance and everyday until the day in question.  It was then that I spoke to my son’s doctor who he sees for ADHD/Asperger’s Syndrome and who was monitoring my Welbutrin and Buspar.  She started me on some ADHD meds, Dexadrine, the same med that my son was currently taking.  I noticed improvement on focus and remembering appointments but word finding problems were still apparent.  I was feeling very stupid and I know that I am not because I have a BS in Chemistry with a B+ average.  Although, I think if I tried to go to school now, I don’t know how I would do grade wise today.
******************************
Yvette, need some dates/years when the meds changes happened.  especially when the Dexedrine was started.  Are you still on Wellbutrin and Buspar?  
**************************

1998- Mild pins and needles in hands and feet and tip of tongue and lips  Evaluated by neurologist.  (State general results)

Since 1998 the pins and needles come and go I have noticed when in motion or pressure applied the sensation is not noticed as much.  Tingling has increased in feet from toes to balls of feet to heel and tops of toes.  Left calf tingles sometimes from ankle to just above the knee on the rear of leg on the outside of leg and just to midcalf on the inside of leg.

2005 - Early in year had episode of vertigo, seen in ER, diagnosed with viral inner ear infection.  Lasted 2 weeks.  Recurred a few weeks later.  Thereafter noticed frequent problems with balance, especially with bending over or turning.

Winter 2006 - During PT for sprained ankle discovered inability to stand on either foot with eyes closed without falling.  Also extremely fatigued.  Sleep study revealed Mild Obstrctive Sleep Apnea and was prescribed CPAP.  Fatigue and balance problems improved, but have returned despite the ongoing use of CPAP.

2007 (bold type)

SENSORY -

Pins and needles sensations continue in feet, left calf to thigh.  Occasional numbness, tngling in perineum.  Hands tingly, occs'l jabs of severe pain R pinky.

Left hand has a general tingly feeling of the whole hand with a painful patch on pad of thumb

Face, and scalp - tingling patches in different areas

Difficulty with fine motor/ computer mouse - overshoot and undershoot wioth 2 or 3 tries to click on screen

Hands tremble visibly (to husband) when fatigued, especially at end of day.  Improved when stopped stimulant med, but still occurs.  Fatigue worsened off stimulant med.

Spring - I woke up with an extremely painful left eye, very wet feeling, reddened white part of eye, extreme light sensitivity causing even more pain, painful to move eye back and forth or up and down and blurry vision.  Over the first day the pain lessened to more tolerable levels better and the blurriness lessened. The next day pain was mostly gone except still tender to move eye.  Redness faded on the third day.  Since then  (to present?) I have noticed larger halos around lights.  Driving at night is more difficult because of blinding by headlights from up coming cars. Parts of my field of vision seem more blurry but I can’t pin point exactly where or how.

Electric-like "Zaps" in left ear (what season or month???) Over one month period I had a feeling of electric shock deep inside my left ear it would zap me once or twice and then go away completely until the next time later that day or a couple of days later.  It only occurred that one month I - resolved

Obstructive Sleep Apnea - CPAP begun 01/07.  Improvement of fatigue and balance problems

July2007 - Balance problems, difficulty walking a straight course and making turns (missing doorways).  Walked "like a drunk"

Problems with the heat - A/C went out, Balance issues worse, fatigue worse, back to back fever blisters.  A/C repaired, but fatigue and balance problems still continue, just not as bad.

***************************

Yvette - almost all of the "part III" should be omitted, except what I included above. The various pain things in your back can be summed up as recurring back pain treated with exercise, stretching and manipulation.  The gyne stuff, the GERD, the abdominal pain don't belong.  They ARE part of your medical history, but do not add to understanding your neuro stuff.

The long paragraph on the depression needs to be paired down.  Had depression treated successfully with XXX.  When became fatigued asked to be restarted.  Diagnosed with ADD.  BTW that is weird.  ADD does not just start in adulthood.  Your cognitive and attentional problems were either the sleep apnea or from something like the cognitive problems of MS ( whcih you can't say.  I'm just commenting. )  MSers often benefit from stimulants.

Also you need a statement about what has changed in the recent past (over the last year) that has impacted your life, robbed you of being able to do things you used to be able to do.  Describe the change, if there has been one.  And I will find the Timeline thread and bump it up.

These changes are a suggestion only.  Put back in things you really want to say, but remember.  If the text is too dense (too wordy) to skim he may ignore it entirely.

Quix
Avatar universal
Thanks very much for taking time to make comments.  I was putting everything that I could think of just to get my thoughts clear.  I know that a lot needs to go.  My appointment is tomrrow at 10 am EST.  Even with all that I wrote there is still a lot that I forgot to add.  Lol  there goes my swiss cheese brain again.

I will make the changes you reccommended and try to cut a lot of the verbage.  I had to post this before I could really edit it because I had to go to my son's school this evening.
Avatar universal
Quix I did some editing.  I probably need more though.  What do you think?  I'll check back tomorrow morning.  I have to go to bed now.  Thanks again for all of your help.

Yvette

1995- Mild pins and needles in hands and feet.  
Oct 1995 X-ray cervical spine series: impressions mild disc space narrowing C5-C6  
Dec 1995 standard MRI of cervical spine using disk/cord protocol Minimal bilateral uncovertebral joint disease at C4-5 and C5-6. which does not result in appreciable neural foraminal or central canal stenoisis.


1998- Mild pins and needles in hands and feet and tip of tongue and lips  Evaluated by neurologist.  (State general results)

Since 1998 the pins and needles come and go I have noticed when in motion or pressure applied the sensation is not noticed as much.  Tingling has increased in feet from toes to balls of feet to heel and tops of toes.  Left calf tingles sometimes from ankle to just above the knee on the rear of leg on the outside of leg and just to midcalf on the inside of leg.

2005 - Early in year had episode of vertigo, seen by GP, diagnosed with viral inner ear infection.  Lasted 2 weeks.  Recurred a few weeks later.  Thereafter noticed frequent problems with balance, especially with bending over or turning.

Winter 2006 - During PT for sprained ankle discovered inability to stand on either foot with eyes closed without falling.  Also extremely fatigued.  Sleep study revealed Mild Obstrctive Sleep Apnea and was prescribed CPAP.  Fatigue and balance problems improved, but have returned despite the ongoing use of CPAP.


1997 to Present - Mental state

1997 Diagnosed clinical depression 1997 given Welbutrin 300 mg and Buspar  it helped with the depressed mood but still had days of low energy.  

Jan 2001 Stopped Welbutrin and Buspar due to pregnancy no evidence of depressed mood for 5 years

Nov – Dec 2007 I started noticing memory problems.  If it wasn’t written down I didn’t remember.  I started putting my schedule on outlook and set reminders for important dates several days in advance and everyday until the day in question.  And still I would get distracted and forget appointments.

end of Feb 2007 Restarted Welbutrin and Buspar on request. 200mg Welbutrin and 25 mg Buspar divided into three doses

Beginning of April 2007 started Dexadrine for ADD symptoms and fatigue.

End of June  beginning July 2007 started to have significant word recall problems in conversations continued through Sep 2007


Sep 25 2007 stopped taking Dexadrine and reduced buspar to 15 mg a day in two divided doeses continued Wellbutrin 200 mg once a day to evaluate if med side effect was causing hand tremmor


2007

Obstructive Sleep Apnea - CPAP begun 01/07.  Improvement of fatigue and balance problems

Mar or Apr 2007- I woke up with an extremely painful left eye, very wet feeling, reddened white part of eye, extreme light sensitivity causing even more pain, painful to move eye back and forth or up and down and blurry vision.  Over the first day the pain lessened to more tolerable levels better and the blurriness lessened. The next day pain was mostly gone except still tender to move eye.  Redness faded on the third day.  From that day to present, I have noticed larger halos around lights.  Driving at night is more difficult because of blinding by headlights from up coming cars. Parts of my field of vision seem more blurry on occasion but I can’t pin point exactly where or how.

Spring 2006 Electric-like "Zaps" in left ear for a period of one month with varying frequency occurring as many as four times a day to as few as once every couple of days.  

July2007 - Balance problems, difficulty walking a straight course and making turns (missing doorways).  Walked "like a drunk"

Problems with the heat - A/C went out, Balance issues worse, fatigue worse, back to back fever blisters.  A/C repaired, but fatigue and balance problems still continue, just not as bad.


SENSORY -

Pins and needles sensations continue in feet, left calf to thigh.  Occasional numbness, tngling in perineum.  Hands tingly, occs'l jabs of severe pain R pinky.

Left hand has a general tingly feeling of the whole hand with a painful patch on pad of thumb

Face, and scalp - tingling patches in different areas

Difficulty with fine motor/ computer mouse - overshoot and undershoot wioth 2 or 3 tries to click on screen

Hands tremble visibly (to husband) when fatigued, especially at end of day.  Improved when stopped stimulant med, but still occurs.  Fatigue worsened off stimulant med.

Not enough strength in hands and shoulders both arms to break up two lbs ground beef in pan while cooking.  Had to change hands frequently and brace upper arms to torso to finish preparing dinner. Have to take extra care when using paring knife recently because of uncertain grip strength and needing to apply more energy to obtain similar cutting results compared to in the past and fear of knife slipping due to failure to properly grade muscle movement

Muscle twitching at various locations left eye lid, right shoulder, right forearm, right inside thigh never lasts long 30 seconds to two minutes.

Currently tripping or kicking things on the floor that I think that I have safely passed. Stumbling over uneven ground outside
147426 tn?1317269232
BINGO!!! Skims beautifully!  Good job.  Format a little with dates in bold maybe.  Use one additional color to highlight major things.  This reads so much more easily.  How do you feel about it?

Quix
Avatar universal
I am unsure how to present it.  Should I just hand it to him  just fyi?  Should I refer to it myself?  I started this to get things in order what came first etc.  I am still not certain exactly of dates.  I wish the GP had let me refer to my medical record like I wanted.  But she blew off my resqest to get a copy of my record to help me make a timeline as unnecessary.  I don't want to come across as trying too hard.  kwim?  That is why I got the referal to the same neuro practice I went to last time.  I thought that if I asked for a new one that I was looking for a particular dx.  I just want answers.  I talked about what has been going on with my psychiatrist and she agreed that a neuro work up was needed and that the depression and medication for depression can't be causing all of my strange symptoms.

I do have more formating in my document in Word, it just didn't translate here.  I will put the dates in bold.   I don't have color unfortunately but I can make it more noticable.

Thanks again.

Time to go back to bed.

Yvette
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