Tuesday, August 13, 2013

How much nerve damage?

My neurologist came to get me from the waiting room herself.  As we walked back to the examining room, she asked how I was doing.  "A little worse,"  I had to say.  She nodded and I realized she was watching me walk.  I knew my walk had deteriorated in the few weeks since I saw her last.  Well, that was why I was here.

We reached her office/exam room.  She pointed to a gown on the exam table and gave the usual instructions.  I took off my outer clothing, then put the gown on over my underwear. Stuck my head out the door and told the empty hall, I was ready.

As I waited, I contemplated what I was facing: a nerve conduction study (NCS) and an electromyogram (EMG) to determine how well the nerves to my legs were working.  (clicking on the highlighted words will take you to a description of both procedures)  My legs had become unbearably painful after I walked only a short distance.  After eliminating circulation problems as the cause, the doctors had settled on neurogenic cludication as the diagnosis.  The MRI of my lower back had been quite bad.  Thirty years of arthritis had taken its toll.  My vertebrae no longer had the bone formations that kept them aligned.  In addition, bone spurs sprouted randomly, discs bulged, or no longer existed.  At one point my nerves were compressed so tightly that they were not visible.on the computer screen.  As bad as this looked, my neurologist wanted data to show the amount of damage to my nerves. 

My neurologist appeared at the door.with a smile and we began.  Most of the tests were pain free.  There were strange sensations but no pain.  Some of the needle insertions did hurt for an instant , but even that was not bad.  Flexing and relaxing muscles on command was a little problematic, but I did it.  I did feel uncomfortable when I needed to keep one leg raised off the exam table for one measurement. It has been a long time since I did leg raises of any kind.  A few needle insertions in my back, more measurements and the tests were done.

I sat up with my legs dangling over the side of the exam table.  My neurologist looked me squarely in the eye and said "there is moderate damage but it should be correctable."  She paused.  "You cannot wait, I can see deterioration since our last exam."  I nodded.

"As we agreed, I will refer you to a neurosurgeon."

I nodded again..  After thirty years of ignoring doctors recommendations for back surgery to relieve back pain, I had reached a condition I could not ignore.  I had to be able to walk.

There was a little paperwork to be completed, then I was told all my test results would be sent to the neurosurgeon.  Her office would contact me.

Now, I wait.

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