Re: Update: ?TM or MS

Errol White (eamjwhite(AT)bigpond.com)
Sun, 24 Jan 1999 13:42:04 -0800

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Hello Christopher,
Sorry to hear of the relapse or second bout of this, one in my opinion is two to many.   I know how you feel after consulting with someone who seems disinterested and just brushes over the chart and then comes up with something totally stupid.   I had a similar experience with  specialist urologist, only I did not have to face a four hour drive in a blizzard thank goodness, but I really felt totally let down, in fact I think I could have told him more of my diagnosis problems than he seemed  to know.   I did notice that his watch was off his wrist and in a place where he seemed to look at  all the time, it may have had a money earnings meter on it.   Anyway Chris, hang in there, hope you are wrong about a third attack and also hope  it is not MS.   Hope to hear better news in the future.    We will be thinking of you.
Regards from Errol, Queensland Australia. 
-----Original Message-----
From: Christopher Leighton <chris.leighton(AT)sympatico.ca>
To: tmic-list(AT)eskimo.com <tmic-list(AT)eskimo.com>
Date: Saturday, 23 January, 1999 7:35 PM
Subject: Update: ?TM or MS

23/1/1999
 
Well, thought I might update my story from October 98.  I am guilty of not following the internet postings the past 4 months. My second flare abated slowly.  The spasticity and weakness in my left leg has improved but comes and goes so now I have a permanent limp.  Bladder frequency and mild incontinence are also appearing.  I have developed new problems with my vision including intermittent dimming of my sight from the right eye.  The color vision is also distorted from my right eye so at times, it is like wearing 3D glasses.  I have had bouts of stabbing eye pain, and occasional double vision.  I have now seen 7 neurologists from Windsor to Toronto, Ontario.  Also, throw in a rheumatologist, and neuro-ophthalmologist for good measure.  I have had all types of responses to my numerous, unusual problems from compassion and concern to the other end of the spectrum  One neurologist spent 5 minutes reading my chart while I was talking, spent about 1 minute examining me then suggested I had an anxiety disorder.  This, after driving 4 hours through a blizzard to see him.  Being a physician I felt like reporting him to the College of Physicians and Surgeons!  I am becoming more convinced that my problem is evolving into multiple sclerosis though, MRIs have not been abnormal thus far.  I am keen to start interferon therapy, however, without plaques to see, my neurologist is not keen to prescribe.  Unfortunately, as I write this I am once again having severe neck pain and suspect flare #3 is starting.
 
I am always taken aback by the responses I have had from co-workers, friends and families.  One friend emailed me recently and asked "how is the wheel chair ramp coming".  Is that supposed to be funny?  People at work try to be helpful... but when you are asked how are you feeling 30x time in a day it becomes taxing!  Unfortunately, working in a smaller city, it is harder to preserve my privacy.  People I hardly know suddenly feel entitled to know the details of my medical assessments -- I guess I should be grateful to see this perspective first hand.  I hope it will make me a better physician.  But for now, I have to struggle with adapting the workplace so I can be comfortable and continue to practice medicine.
 
The literature the past few months has been scant.  One Scandanavian study looked at EMG studies (shocks applied to muscle groups) with patients presenting with TM.  Patients with abnormal EMGs early on may have more long term disability.
 
I would be interested in knowing if anyone has been started on interferon or Copaxone without a firm diagnosis of MS (ie recurring transverse myelitis).
 
Sincerely,
 
C. Leighton MD