Leg Atrophy!

[jensequitur]

Well, I looked in the mirror today, and noticed my right leg is thinner than my left.  This is odd.  I know my right leg hasn't been working right since my flare, but I didn't realize it was atrophing... atrophying... however you say it!  Should I be worried?

I'm exercising regularly, so it's not lack of exercise.

[Super_sally888]

Hi Jen,

I wanted to jump in h ere.  Don't be fatalistic gal.  With MS there is a really big component which is use it or lose it!

Quix is right if you have really lost the innervation (nerve muscle connection) then it cannot recover.  However some people - quadriplegics etc. still use electric stimulation to make the muslce contract and build it up a little.  

However, remember that MS is a disease that has flares and remissions.  There can be partial or complete recovery even some time after the initial damage.  So get in and find a good pt and definitely don't give up on the excercise.

The atropy may also just be due to the fact that you are using the muscles differently, and will improve with working out and attention.

Lots of things can change with this disease!  Giving up is not an option!

Sally

[jensequitur]

Yeah, he's a little fatalistic, and unfortunately it rubs off on me!  I feel fortunate to have gotten a diagnosis from him, considering how many people have fought that battle and lost.

Since I've noticed the atrophy, I've tried to do spot exercises to isolate that leg...  Doing calf lifts while holding on to the wall, that sort of thing.  But you say the atrophy can't be reversed?  Dang it...  

I guess I need to bite the bullet and ask for another neurologist.  How in the world do you phrase that without sounding horrible?  

[Quixotic1]

Yes, you should be worried.  If the leg has truly atophied, then you have lost that function.  Atrophy cannot be reversed.  Your hope, as I said above, is to find what muscles or muscle groups in that leg still has a signal to it and can be strengthened.

Quix

[Quixotic1]

OMG - He's more than weird!!!  He's defective!  Clearly his attitude toward MS is futilistic.  Also, he clearly doesn't understand how MS does its damage.  Why bother to do anything, it'll just get worse.  Sheeeesh!  I wonder how aggressive he'll be (do you have a diagnosis?) with your other symptoms.

Okay.  MS attacks "spots" here and there.  It may affect just some fibers or bundles of a large muscle group.  So the muscle feels weak.  BUT, not all the muscles are affected.  YES, you want PT to find out what will respond to exercise and work to strengthen those muscles.!!!  Your nuero is assuming that if something is weak then it can't be helped.  This is WAY to simplistic.  It is true that if the signal to a muscle is gone, exercise won't bring it back.  But, often there are auxillary muscles that can help you do the same thing.  Those need work.

My fantastic neurological PT was able to analyze my gait and make all sorts of suggestions that made it sooooo much easier to walk.  ALL the MS literature puts rehab and PT high on the list of priorities for treating MS.  My MS Neuro made the referral to PT before he made the diagnosis!!

You are losing precious time with this neuro's attitude.

I am going to have to write some kind of book or article and call it, "Lies My Neurologist Told Me."

Quix

I think you need to get yourself a new neuro and have someone get you a PT referral.  You may need to demand it from him.  

[jensequitur]

I am right handed and right legged, so when I started having right side weakness, it was a real problem!  I could handle everything except writing with my left.

I've definitely changed my gait to adjust for my right leg not working - and it looks like I'm going to have to change it back.  Since I noticed it looking so skinny and weird in the past couple of days, I've been trying to use it more.  I work out regularly - I guess I can find an exercise to do that will isolate that muscle as well.

I don't actually have a good neuro... I have a neuro!  He's a little weird - I've asked about PT before, but he told me there was no point.  (!)  It's hard to be your own advocate.

[Quixotic1]

Hi, are you right handed and right legged?  The less dominant leg will usually be slightly smaller and it's not something we usually notice.  My right calf was always nearly an inch larger than my left (non-dominant) calf.  The dominant leg is the one you naturally use to kick the ball, start up the stairs, brake the rolling log that's about to crush you, etc.

That said, if the leg isn't "working right" you may have changed your gait to compensate.  This can cause some atrophy.  

You might want to get a referral to Physical Therapy and get a very good assessement of your muscle strength and gait.

About whether you should be worried.  If you can exercise with it normally and it's functioning normally (I suspect not) then I would get measurements and focus on that area in the exercises.  If there has been a change in how you use the leg, then I would get it fully checked out.  

So you have a good neuro who follows you?  If so, let him know.  If not, then have your regular doctor make the referral to PT and get some hard measurements.

Quix