Making Sense

[DrKurrPhDMBA]

I have been having issues for sometime where I experience electrical sensations in my arms and legs and they fall asleep pretty much whenever I sit or lay down.  I get muscle spasm and my vision has been getting blurry, maybe age, but also have a feeling like wearing a visor or something that sort of makes the filed of vision less.  I am constantly fatigued, but my testosterone level is only at 59.7, I had a bone density scan and it shows osteopenia.  I take oxycodone, Nucynta, and morphine for the pain and yet I still get all of these feeling.  I do not have bladder problems, but do have issues with some of the other areas down there.  I saw a urologist and he said that maybe I need to see an endocrinologist, but have not been referred, but I did see the neurologist and the scan stated the following:

MRI BRAIN With and Without Contrast

INDICATION: numbness

TECHNIQUE: Multisequence, multiplanar imaging of the brain was performed before
and after intravenous administration of 20 cc Multihance contrast.

COMPARISON: None

FINDINGS:

There is no evidence of intracranial hemorrhage or abnormal extra-axial fluid.
The ventricular system is normal in size and configuration for patient's age.
Basal cisterns are patent. Major vascular flow voids are maintained.

There is no evidence of restricted diffusion to suggest acute ischemia. No
abnormal enhancement is seen following administration of gadolinium.
demonstrates maintained gray-white matter differentiation>].

unremarkable>].

Impression:

No acute, traumatic, demyelinating or neoplastic intracranial process
identified.

During the visit he asked me if there were any issues with balance or coordination and I said no there was not, but when he had me walk heel to toe I was unable to do so (good thing he was not a cop giving me a drunk driving test).  I have also been finding that I am much weaker than normal, but it is hard to really measure.  I am 44 and not sure if this has anything to do with anything.  I did notice symptoms of having odd muscle twitching and electrical sensations quite sometime ago, nearly 10-12 years.  I use to get, and still do, this feeling of having a not in my neck that I cannot get loose.  I find myself having to try to extend my neck to no avail.  I do have degenerative disc disease and my lower back is shot, I have herniations throughout the mid back and also have issue in the neck.  There has been 7 MRI's, 1 bone density scan, 1 nuclear scan, and 1 CT scan in the past 9 months.  There also has been 6 rounds of injections in the back and 1 in the neck, all useless.  

Does it appear that these are the cause of the experiences I am having?  The other findings that were reported were:

BONE MINERAL DENSITY

HISTORY: Osteopenia

COMPARISON: None

Utilizing a dual energy x-ray absorptiometry technique, bone mineral density
over the mid lumbar spine and femoral neck was measured.

BMD as determining the from AP spine L1-L4 is 1.04 g/sq cm with a T score of
-1.5. This patient is considered osteopenic according to WHO guidelines .
Fracture risk is moderate.

BMD as determining from femur neck is 0.92 g/sq cm with a T score of -1.2.
Fracture risk is moderate.

BMD as determining from femur Troch left is 0.71 g/sq cm with a T score of -2.0.
Fracture risk is high.

World Health Organization (WHO) criteria for post menopausal, Caucasian Women:
Normal: T-score at or above -1 SD
Osteopenia: T-score between -1and -2.5 SD
Osteoporosis: T-score at or below -2.5 SD

Impression:

Osteopenia, treatment is advised if there are other risk factors.

Another one stated:

Bone marrow: Heterogeneous lesion is seen in the proximal tibia . the area measures about 3 to 4 cm. There is also bone marrow edema in medial femoral condyle.There is a heterogeneous geographic appearing lesion in the proximal tibia.

Neurologist diagnosis thus far: PARASTHESIA IN LEFT LEG & ARMS

Labs:

Alkaline Phosphatase 50 - 136 unit/L 46 unit/L                    Low
RBC 4.50 - 5.90 mL/mcL 4.37 mL/mcL                                         Low
Testosterone Total-Male 59.7 ng/dL                                Low
MID Cells 2 - 10 % 14 %                                                         High
GOT/AST (Asparate Aminotransferase) 15 - 37 unit/L 14 unit/L Low   diff month
GPT/ALT (Alanine Aminotransferase) 30 - 65 unit/L 25 unit/L         Low
ANION GAP 10 - 20 mmol/L 21 mmol/L                                 High
GOT/AST (Asparate Aminotransferase) 14 - 50 unit/L 11 unit/L Low   diff month
GOT/AST (Asparate Aminotransferase) 14 - 50 unit/L 8 unit/L Low  diff month
GOT/AST (Asparate Aminotransferase) 14 - 50 unit/L 10 unit/L Low 2 weeks after previous listing
NEUTROPHILS 33 - 69 % 70 %                                                 High  

It is a lot of information and probably nothing to do with MS, but there are some other things I know I am missing as far as the experiences I am having.  I guess I would like to know if there is

[Guitar_grrrl]

I, too, would be interested to know about a T and C spine MRI.  I could mean finding the difference between spinal lesions, and foramenal narrowing/pinching, facet narrowing, etc. that are related to musculoskeletal issues.

Please keep in touch, and let us know what's happening - and again, Welcome!

[ku111]

The best thing you can do is what you are doing.  Keep getting all your questions answered and looked at.  Don't let anything go.  It may be a few things wrong but atleast maybe they can be fixed or ruled out.  Maybe then things will be easier to weed through.  Make a list of your symptoms and carry it with you.  This might paint a picture for the dr.  I wish you the best and I hope you get answers soon.  Wishing you the best!

[supermum_ms]

ROFL!! sorry about that, well your kind of lucky that menapause is soooo not your problem too.

Cognitive issues are unfortunately part of MS, not a commonly known sx though. There are other numerous causes for mild cognitive issues, eg medications, anxiety, sleep apnea etc. etc. In MS executive function, word retreval, alternate word placement, and attention issues are the most common. LOL strange but true, for a while there I lost all nouns, just nouns which made conversation more a game of 'guess what i'm talking about' saga.

Not sure what to say about the heart attack comment, though you'd be slightly mental to just ignore it. My BL had all the test and was told his heart was perfect, 48hrs later he had a major heart attack, so nothing is fool proof but still i'd be doing some major life changes trying to stay on top of it.

I'm still thinking your backs the imediate major player, the nerve testing should shed more light on whats going on, hmmmm i'd usually tell you to treat your self with some chocolate but since your missing the necessary hormones to truely appreciate the indulgence, i'll recommend a visit to the hardware store lol how stereo typical is that. lol

Cheers...........JJ

[DrKurrPhDMBA]

Thank you for the kind words, I must add though that I hope I am not post or pre menopause because I am a guy, lol.  I do have to say that there is definitely issues of electrcial sensations and the numbnes etc, but I see your point about the snowballing.  I do not know if the fact I am getting more depressed, have a bad well, intimate life, and there are not really any issues with bladder or bowel except for trying to start or stop urinating.  I have only started working with the neurologist and have another visit, but not for a month because of his schedule.  I think at that time he is going to do some sort of test with needles and electricity, did I mention I hate needles?  Not to the point I faint or anything, but there is the simple association that when there needles are involved there is also the "here comes a slight poke".  There is some history in the family of MS as well as one uncle with bladder cancer and last year I lost an uncle to pancreatic cancer and the year before that another uncle to the same thing, all three are my mom's brothers.  

The urologist told me in a rather straight forward manner that I will have a massive heart attack within 4-5 years based on the history, lab results and current state of where things are at. He followed this by saying that he said this because the results at my age are statistically proven and he can show me the presentation he gives to other Doctors regarding this, yeah right, ok.  I did not say to him that I have to view those with a certain degree of bias understanding and that I know how these things are reported in research (I have quite a bit of experience recently in research because I defend my Phd in 14 months, God willing).

I also would like to know if it is just simply age or anything related to this inquiry, but I have a memory that is extremely good, but I am finding myself stopping in mid-sentence and having to ask what I was talking about.  I also am finding myself getting somewhat tongue tied, when I normally do not have a problem.  This gets bothersome especially when I am trying to lecture.  These are not related are they? I hope not.  I also will mention to the Doctor about the C and T test mentioned in the earlier post, or, is this something that is just digging?

Thanks again for the kind words and take care.

Best wishes to all
Dennis

[supermum_ms]

Hi and welcome,

Personally i think most of your sx are consistent with degenerative disc, osteo and probably the heavy pain meds, plus the continued pain ontop of it, its probably all snowballing the problem. Sorry but i'm not sure if your pre or post menapausal, but either can throw your hormonals levels out of whack and that could be adding to the issue too.

I'd think your back is the major issue, so i'd be focusing on that and probably seeing a pain clinic, to avoid drug dependancy and the dosage issues that commonly happen with long term usage. I'm thinking of your tomorrows and the importance of getting your back and your pain level at the best senario possible for you.

I hope things get better soon for you soon.............JJ    

[jenphilly]

Did your neuro call for a C and T spine MRI?   I also had a clean brain MRI which kinda threw everyone for a bit.  But when they did the C and T spine MRI, they found where all the lesions had setup home.

A spinal tap was the true clear deciding test....  

I also have the buzz especially in my left arm and hand, its kinda my new norm....  

Are you working with a neuro that has some MS experience?   Ask about the C and T MRI and his/her thoughts on the spinal tap.

The diagnosis rollercoaster is the worst part of things....  much of what you typed I can relate to, but doesn't mean anything really!   MS can mimic many things and vice versa...  You could even be dealing with something as easily treatable as lyme...  

I hope you have a wonderulful neuro that you can openly communicate with!

Best of luck and I hope it turns out its something much easier to fix then MS!

Jen