need some advice

[Udaysk]

I am a 25y old male, Asian. I was dx'd with urinary retention about a year back and need to cath 4 times a day to empty my bladder. After about 6 months noticed sensory changes in sexual function, then two months later faced constipation. I have recently started to feel my left leg toes fan out whenever I lift up my feet + tremor in the shin/tibial muscle, can still heel walk though. Both my arms and legs are hyper reflexive 2+ symmetrically. Sometimes I get mild spasms in both my hands (simultaneously), pain behind both eyes on and off without any visual disturbances. I have no cognitive and gait problems.

I have undergone plain T1 and T2W FLAIR MRI of brain and spine at 1.5T multiple times and 3T plain sagittal screening of spine once with no detectable lesions. Had nerve conduction test done for PNS, CSF checked for various common pathogens/STD -all negative. My neurologist says that I don't show any clinical signs of MS as I don't have any upper motor problems and suggests that I undergo neuromodulation/LDDM to correct urine retention and protect kidneys.

I plan to approach a different neuro again. Would Gd contrast make a diff. at 3T for MS lesion visibility? Is it possible to have gross neurological deficts due to MS/infections without showing any lesions on MRI?

[Margaretx]

Oh, for Pete's sake.  My post clearly states that it is a response to Hilton's stupid "materialistic world" post.  Were you imagining some sort of time travel on one of our parts so that my later post could have actually inspired his original one?

And I am amused by your implication that my use of the word "duh" so discombobulated you that you became unable to process simple English.  Hope you had a fainting couch or smelling salts at the ready.

[Quixotic1]

You go, girls!  As a medical professional I agree there is one persistently here on the boards who has posted many, many inconsistencies in the four months I've been reading.  He also trumpets far too loudly of his own magnificent atruism and passionate desire to help others, yet jumps down the throat of anyone who challenges him or seemingly breaks "a rule."   But, you're right.  He's entertaining in a "nail-down-the-chalkboard" sort of way.  I do fear, though, that he has given some bad info and advice.  To all who read these boards - take the postings in the thread at your own risk.  Google what they say, see if it really sounds viable, then search further.  People who post in his manner often have an agenda, be it personal (adulation) or ideological.  Who knows?

BTW - The CC Responding Neurologist here offers some amazingly lucid thoughts and recommendations.  I look for new responses daily and am learning a lot.

The retired neurologist is also helpful.  Part of the problem in interpreting his responses is the older terminology he often uses.  Even if he's wrong he offers some interesting points.

[BobbHilton]

Hi,
   I'm not sure if you are still follwing this thread, or you will be able to see my post, but these are few of the recent publications which you could visit any main medical library to get them and learn more about your case

  1-Curr Neurol Neurosci Rep. 2006 Jan;6(1):Page 57-64
Talks about Immune-mediated autonomic neuropathies published by Neurological Institute of New York, 710 West 168th Street, Unit 55, New York, NY 10032, USA
  
    2-Arch Neurol. 2004 Jan;61(1) pages 44-8
Published by the Department of Neurology, Mayo Foundation, Guggenheim 811, 200 First Street SW, Rochester, MN 55905, USA

   3- N Engl J Med. 2000 Sep 21;343(12)  Page 847-55
Talks about autoantibodies to ganglionic acetylcholine receptors (Cholinergic) in autoimmune autonomic neuropathies.published by Department of Neurology, Mayo Clinic, Rochester, Minn 55905, USA.

   God bless
   Bob

[Annie62]

Happy Easter to you, too, Jenny (and to everyone else who celebrates it). Thanks for the input.  I couldn't find any reference to priest but I found where he claimed to be a "good Catholic man" or something like that (nothing wrong in that, of course).

Margaret,

The 'materialistic world" posting on the other forum by BobbHilton clearly was a reference to exactly that-your (and perhaps others') questioning/incredulity  that any doctor would choose to donate his time for free when he could be out making money.  Why is that so hard for you to believe that a doctor (especially a retired one who has more free time) would choose to do this??  

Also, as I said, I am not in the medical field-just a very well-read layperson-but I do not see that he has handed out any bad advice or incorrect diagnoses, and I have read all his postings.  Some of what he says I am not familiar with, but everything that I have heard of/read up on in the medical literature (and it is considerable in the past 10 years since I've had the internet/seeking a dx) is consistent with what he says.  That is why I think he is legitimate.  There is just no way he could know all that he knows otherwise.  And I do not see him handing out diagnoses or advice cavalierly at all, but rather offering suggestions regarding possible diagnoses, suggesting tests that might be done, explaining how the body works, etc.  There is already a disclaimer on this site--so he really doesn't need to make one.  

Quixotic,

Of course I think your comments about JCmcc are right on target.  I never believed he was a medical student (and actually I believed even less he was a neuropsychologist considering his flighty online behavior), but I do know there are some people who seek his "advice/opinion," thinking he is some kind of medical professional, asking him to respond or e-mail them--so I agree that could be consequential if he gives them incorrect information.  It's just hard to believe any one could be that naive (to seek his advice), but I guess it comes down to how familiar you are with a certain field/subject--and he is quasi-educated-which probably makes it worse.  

It appears that you think BobbHilton is legitimate from what you wrote--but you didn't really say one way or the other.  You don't have to answer if you don't want to, but since you are a physician, do you believe BobbHilton is a retired neurologist?  I'm just curious.  I know what I think, but I would like to know what you think since your impression would be more based on facts/your knowledge of medicine.  Thanks.

[Margaretx]

What in the world are you talking about?  You wrote the following:

Margaret,

The 'materialistic world" posting on the other forum by BobbHilton clearly was a reference to exactly that-your (and perhaps others') questioning/incredulity that any doctor would choose to donate his time for free when he could be out making money. Why is that so hard for you to believe that a doctor (especially a retired one who has more free time) would choose to do this?? (end quote)

I have never, ever, ever said a word about a doctor "donating his time for free when he could be out making money."  Did you read my previous post?  I pointed out that that's a straw man--one that both you and Hilton keep repeating.  My issue with Hilton has absolutely nothing to do with some perceived belief that doctors won't donate their time to help people (in fact, I know many docs who do just that).  

Hilton made it up and you're running with it and it's beginning to tick me off.

[Margaretx]

Thanks for your posts.  I completely understand what Hilton was saying re "materialistic world."  My "duh" comment referred to the fact that no one here has questioned why a doctor would want to give his time to this group rather than make money.  He's set up a rather weak straw man and not bothered to adddress the true issues--his bad advice, incorrect "diagnoses," unprofessional behavior and, if your explanation is correct, language skills that are so bad he doesn't know the difference between urology and his purported speciality--neurology.  Just to be clear, the chief reason I think Hilton is not a physician is that doctors' ethical codes (and insurance companies) don't allow them to offer diagnoses or medical advice to people they don't actually examine.  That's why every time you see a reply from an actual physician here, it's filled with all kinds of caveats and "this is not medical advice" language.  IMO, no one truly trained as a physician would be as wreckless with his opinions as Hilton.  My best guess is that he's a foreign medical student.