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Neurologist Appointment

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Posted 7/2/2009 4:00 PM (GMT -6)
Good Evening Everyone,

I hope all of you are doing well. I have a neurologist appointment Monday morning and was kind of wondering what to expect? What information should I be ready to supply? I filled out all the paperwork they asked me to, but still have to get the x-rays transferred from my PCP.

My pain is still with me in full force, but my mental state is a little better, as I have stopped taking the orphenadrine that my PCP prescribed as a muscle relaxant, which did not help the pain at all but made me confused and agitated. The anti-inflammatories I take barely help with the pain. I am hoping this appointment goes well and takes me a step closer to having a diagnosis or some idea of where this pain is coming from.

Oh, and does anyone keep a "Pain Journal" ?

Logan
Posted 7/2/2009 4:43 PM (GMT -6)

Hi Logan,

Great to hear of the appt with the neuro on Monday. I suggest you make a list of questions to ask the dr.  That way on the way home from the appt you won't be going oh, I wish ai had asked that question. In addition make a list of your current meds and how well they are working, along with a list of meds in the past and how they affected your pain.

Yes, many people do in fact make a pain journal. Its one of those things some drs will look at them and read them, then on the other hand you may get a dr that will not take the time to look at it. Its a mixed bag so to speak. I think they are a very good idea, it gives a good picture of what your day is like.

Nascially it will be like any other ppt with a new dr. You will have a physical exam, checking reflexes and looking in your eyes with a light and such. You will be asked questions about when the pain started and so on.

I really don't much else to tell you other than be honest with the dr about your symptomd and how you are feeling. Good luck on Monday and let us know how it goes. Be sure to have all of your x-ray films and written reports with you at the time of the appt.

Posted 7/2/2009 4:46 PM (GMT -6)

Welcome,

I have been going to neurologists for years.  Your initial appointment will involve a complete neurological exam.  The doctor will be checking your gait, arm swing when you walk, muscle strength (pushing & pulling) in your arms and legs.  They will also check how your eyes track. They will feel how your joints move -whether rigidity or stiffness is present.   You will be asked to do some repetitive movements - stretch your arms out - close your eyes - touch your left and the right fingers to your nose.  They will have you do finger tapping - where you tap you thumb and index fingers together as quickly as possible.  You will be asked to walk one foot in front of the next in a line.  The neurologist will also stand behind you while you are standing up and pull you backward - to see how well you recover your balance.  Then they will probably use a tuning fork and touch it to different areas to see if you can feel the vibrations.  Your reflexes will be checked.  Sometimes they do a light pin prick to the bottom of your feet to assess what sensations you can feel.  The physical exam and your medical history will determine if additional tests are needed.  An EMG might be ordered to test muscle conductivity.  CAT scans or MRI's are used  to look at soft tissue.  EEG's are used to determine if seizure activity is present.  Sometime sleep studies are ordered is restless legs syndrome, sleep apnea or insomnia is a problem.  There are several different types of neurologists.  General - do everything.  Others special in stroke, movement disorders, cognitive problems and epilepsy.  A pain journal would be very helpful.  They will also be interest in family history.  Also bring a list any medications that you might have taken for a long time. Some meds have odd s/e that can last long after you stop taking them.  Also document any head injuries you might have had during your lifetime, as well as exposure to toxins and industrial chemicals.  They will throw in a brief mini mental - a few questions to make sure you do not have memory problems.

Good luck with your appointment,  Let us know how it turns out.  Let me know if I can answer any other questions for you. 

That's about it.


Posted 7/2/2009 6:41 PM (GMT -6)
Hi!

I can't add anything technical to this question...but Stella is awesome! Just want you to know I'm thinking of you and pray for good results and answers on Monday. Keep us posted!

Chutz
Posted 7/2/2009 8:25 PM (GMT -6)
Hello Logan,
Stella Marie pretty much said it all, your first appointment is basic diagnostics, until the
neurologist gets back the MRI"s, It's not to scary, I see mine yearly as I have an
enlarge pituitary gland (pea size tumor) and ocular migraines..I'll keep my fingers
crossed for you and prayers...the only thing that bothered me
was my neurologist wanted an exact date when my headaches started and for me
I just couldn't remember, as I've had headaches for a very long time now, it was just getting and finding
a doctor to believe me....
Anyways try not to let it worry you...
Prayers and hugz....
((((((((((((((((((((((((((((((((((((((((((Logan)))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))))
Posted 7/3/2009 12:33 AM (GMT -6)
I started going to a neuro doctor several years ago, who was 'suppose' to the best neuro doctor around, she was suppose to be specialized in neuro disorders and pain, but she does NOT do pain period, so why she has it under her name everywhere is beyond me, she finally removed it this last year as I guess too many people where expect pain releif from her when she doesnt provide that. When I first saw her, she was very cold, didnt really do anything physical (I was seeing her for my migraines)and asked just very few questions, she then ordered that weird thing where they have you sit on a recliner with thousand things stuck to your head and they flash lights on each side in weird patterns. Now I only see her every 6 months to just follow up with meds, she prescribes me imitrex and lyrica, and I asked her for ibprofen 800mg and she acted like I was asking for some narcotic, she wanted to give me the lowest dose, but the pharmacy finally convinced her to give me the 800mg ones. I know several people that have gone to her that wernt too happy with her. But of course I cant switch doctors cause it's impossible to find any doctor within town that takes my insurance and I already see a doctor out of town and I hate driving long distances. So i just learn to live with it, but luckly my migraines have almost disappeared with the meds I'm on now so it's no big deal now.

-hellokitty
Posted 7/3/2009 12:51 AM (GMT -6)
Thanks a bunch for the responses! I have started making a list of semi-intelligent questions to ask. Thanks for that idea, straydog. Stella, you layed it out in great detail! Thank you so much for this - it makes me more comfortable knowing what will happen - I had a bit of anxiety over it for some reason.

Sorry to hear that your neurologist didn't help much with main management, hellokitty. It seems like the ultimate treatment was more or less successful, though, which are the results I hope for. I want someone who will find the root cause of this pain. Although... at this point I am starting to be slightly distressed over the pain that is constantly with me. I like to joke around a lot and am finding it somewhat harder to do that as of late.

Thanks for all your positive comments and wishes, it makes me feel better without any medications at all!~

Logan
Posted 7/3/2009 1:07 AM (GMT -6)
Well my neuro doctor didnt actually help with the migraine pain, it was the Cymbalta I got from my Suboxone doctor that help. I know most neuro doctors can help pin point pain if it's caused by neuro problems but they dont do pain management, thats really rare if they do. Actually my neuro doctor just got a partner that is a pain doctor but he only does procedures and doesnt prescribe pain meds on an on-going basis, but I really do want them to fix my lower back, but the doctors around that do procedures dont take medicaid. I know my neuro doctor offered to do tests on the nerves in my back to see if it my nerves where damaged but all she could do was the tests to prove it was damaged nerves and maybe offer some treatment but she wont prescribe me anything for pain, the most I ever got from her was ultram that was allowed to take one every 12 hours, but then I found out the ultram can cause withdrawals if taken when your dependant on other pain meds, so I didnt take them. And she gave me zanaflex but that made my heart beat so slow and I didnt like that feeling, but that was it for pain meds. I think the lyrica she is giving me mixed with the Cymbalta is helping the migraines (since it isnt helping the fibro and nerve pain). But the past month I havent taken the lyrica for some odd reason, I guess I jsut advoid meds like the plague lol. It's kinda sad that I get my pain releif from an addiction specilist even though I'm not an addict, but that's ok, I dont really care as long as I'm getting something great for my pain lol.

-hellokitty
Posted 7/3/2009 1:12 AM (GMT -6)
SpaceButler,
I haven't weighed in here, but you've already been given some great detailed advice, so let me just wish you the best for your initial appointment. My neurologist won't do pain management either, which I find very frustrating, since most of my pain is nerve pain.

But they can help you find some answers and order the right tests.

Good luck at the appointment!

PaLady
Posted 7/3/2009 1:13 AM (GMT -6)
Interesting, so it looks like I will be having to make several more appointments with yet more different doctors if I want to fully treat my problems. I hate dealing with this pain. I just hope the diagnosis is quick or apparent to my neurologist, so I can finally get diagnosed and start treating these problems in the most intelligent way. Wow those drugs like suboxone are powerful, I hear. I wouldn't even want to take something like that, but if it helped you hellokitty, then I am grateful. Thanks for chatting here so late in the evening :-)
Posted 7/3/2009 1:16 AM (GMT -6)
PAlady
Thanks for you wishes of good luck, I hope to get some answers for sure! So many doctors one must see, I did not expect this. I will hold off on going to a pain doctor until I know what is actually wrong with me, though, I think. I don't want to take a pain medication with huge side effects without it actually helping my body to get better!

Logan
Posted 7/3/2009 1:42 PM (GMT -6)
Logan,
Sure you want to get the most accurate diagnosis you can, and I hope it's something that can be corrected, or managed with things like PT or less potent medicaitons.

This is a learning process for all of us, for sure. I always figured my neurologist (who I've seen for 25 years for another condition) would just follow me, but doctors in my area are terrified of the local District Attorney and the DEA so what my neurologist said was that he "wasn't equipped" to manage my pain long term. I had chronic sleep deprivation for probably a good year because of the pain, until someone finally gave me a script for two vicodin a day, one of which was to be taken at night. I had to break the other one in half. Now of course I'm on tons of stuff due to failed back surgery. I've learned way more than I would ever wish anyone has to. So I wish you a quick and easiliy repaired diagnosis!

Let us know what happens.

PaLady
Posted 7/3/2009 8:29 PM (GMT -6)
Logan, With all the good information you have received, you could probably give yourself the exam. Just don't write you own perscriptions. Just kidding. I just want to encourage you as you continue on this journey. As you already know thare are very few easy answers. We get frustrated that our doctors can't touch us with a piece of equipment or give us that magical pill that makes it all better. One of the biggest dissapointments that I have had to deal with is the unexpected side effects of medications. You take the meds that in all honesty, we really don't want to take to deal with pain that we don't want, don't get the results we expected and then we suffer the side effects that make us wonder why we did it. That does not sound encouraging does it. Just remember what works for one of us might not work for another. We can all share our experiences but

we all respond differently. Also, each doctor is going to be different. That is one reason staying in touch on here is so important for most of us. We find encouragement, comfort and strength when we seem to be drained. We also find new ideas that might assist in making life a little better. Please let us know what the appointment was like and possible choices they give you. Have a great weekend.

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