[JasonDamag]

#30304

Hello, I hope your able to make sense of my brain fogged writing…

It may have all started in 2005 after years of working on a loading dock for Dillards.
I had cramps and numbness in my hands and feet and low back pain so a full spine MRI was ordered in December 2005:

c4-c5: No Spinal Stenosis is seen with a patent left neural foramen with minimal to moderate right neural foramen narrowing.

c5-c6: Degenerative changes causing moderate right neural foramina narrowing.

c7-T1 : there is minimal to moderate bilateral neural foramina narrowing.

There is disc desiccation and minimal disc space narrowing at
T7-T8 and T8-T9 with minimal Sponylosis/disc bulge at T7-T8 with minimal degenerative changes noted.

Very small Thoracic Syrinx at the T9-T10 level with very small central vertical linear area of increaded T2 signal. Conus Medullaris Demonstrates normal Signal intensity.

Lumbar Spine is in anatomic alignment. Vertebral body heights are maintained with normal bone marrow signal intensity. there is disc desication at the L5-S1 level. Conus Medullaris Demonstrates normal signal intensity.

L2-L3 There is minimal Spondylosis, with triangular configuration of the spinal canal without neural foramina narrowing.

L3-L4: There is triangular configuration of the spinal canal with patent neural foramina.

L4-L5: There are some posterior element and hypertrophic changes with minimal spondylosis with triangular configuration of the spinal canal without neural foramina narrowing.

L5-S1 There is Spondylosis/disc bulge with a patent right neural foramen. There is minimal to moderate left neural foramen narrowing with Spondylosis left posterolaterally.

The right S2 nerve root demonstrates a small lesion of increased T2 and T1 Signal consistent with a Tarlov Cyst.

I was rehabilitated for the lumbar disc bulge and Vocationally Rehabed to be a CDL driver. Over the next years i drive Truck and operated heavy equipment for a year or two until i could no longer sit for more than an hour due to pain and numbness in my low back and feet. I took a simpler job working at a community thrift store. I would have to move furniture and appliances and alot of repeat movements and repeated heavy lifting/throwing overheard…Over those 6 years my feet started getting numb and would cramp alot.
By May of 2018 I was having cramps in my left hand while I would be working, So i decided to go to a doctor because I thought it might be carpal tunnel or something.

I started to see Doctor Joshua Campbell in May 2018 as my primary. He dosent know how to read an MRI. But decided to order a neck mri then because my symptoms had progressed to constant burning pain in my left arm. That mri came back normal..?? how??
I suspect that the Radiologists only do a thorough Job for those who are with Private insurance, Workers Comp or self Paying. I am on Colorado Medicaid. So I feel that they are not as thorough for da$tardly rea$on$. By June 20th 2018 I was unable to return to work as was given a Family Medical leave..my workplace Management completely abandoned me.

Then I was sent to a Neurologist Dr. Dean. He ordered a Brain Mri and Thoracic Mri. The brain came back normal..

The Thoracic:
DIAGNOSIS: EXAMINATION: MRI THORACIC SPINE WO/W CONTRAST

INDICATION: Disease of spinal cord (CMS-HCC).

COMPARISON: None.

TECHNIQUE: Multiplanar, multiecho imaging of the thoracic spine with
and without contrast.

IMPRESSION:
1. No evidence to suggest a demyelinating process involving the
thoracic spine.
2. At T7-8 there is a tiny central disc protrusion causing mild
ventral cord deformity.

COMMENT: Marrow signal is normal. There is a tiny central disc
protrusion at T7-8 causing mild ventral thecal sac deformity. There is
a thin syrinx versus prominence of the central canal extending from T9
through T11. There is no abnormal cord enhancement. The prevertebral
soft tissues are normal. The mediastinum is normal.

Electronically signed by: Anthony Bullard, MD on 7/30/2018 11:31 AM
MDT.

Signing Radiologist: ANTHONY BULLARD^20180730113127

Then I was sent to Neurosurgeon Dr. Maurin
and He Said that i did not have Chiari Malformation
and that none of my widespread symptoms were questions for him.
Dr. Campbell then tried to say it was Depression and anxiety causing my symptoms.
I was referred to Colorado Injury and Pain Specialist..
Dr McCoy, told me upon meeting me told me that the Neck mri in May of 2018 could not be normal based on my pathology reported in the 2005 MRI.
So she ordered 4 sessions of PT and then a new Neck mri:
on oct 30 2018:

DIAGNOSIS: EXAMINATION: MRI CERVICAL SPINE WO CONTRAST

REASON FOR EXAM: Cervicalgia

TECHNIQUE: Multi-sequence, multi-planar MRI imaging was performed of
the cervical spine.

COMPARISON: 5/24/2018.

FINDINGS: The alignment of the cervical spine is anatomic. The spinal
cord is normal in caliber and demonstrates normal signal.

C1-2: Normal.

C2-3: Normal.

C3-4: Normal.

C4-5: Mild uncovertebral joint hypertrophy without foraminal narrowing
or central stenosis.

C5-6: Normal.

C6-7: Normal.

C7-T1: Normal

No pathologic marrow signal. No adenopathy or mass. Tiny 4 to 5 mm
diameter cyst noted in the right lobe of the thyroid gland. Normal
flow-void seen in the vertebral arteries.

IMPRESSION: Minimal spondylitic change. No frank disc herniation or
central stenosis or foraminal narrowing..

Electronically signed by: Roy Erb, MD on 10/30/2018 5:26 PM MDT.

Signing Radiologist: ROY ERB^20181030172652

In November 2018 I went to see Dr James, the Director
of Colorado Injury and Pain..
He decided to not have me there as a patient
because i told him he has a bad attitude.
I was abandoned after being put on Lyrica, Diclofenac, and Xanaflex.

Dr. Campbell says yup your depressed and anxious…yeah right.
So..
I was in so much pain by November 17th
I decided to go to a chiropractor that was recommended by my Lady
whose friend was an employee of the Chiropractor, He thought he could help.
He did not review my imaging though and proceeded to do a move that felt like he was diving into my
skull like he had hit me in the back of the head and neck
really hard, that there is still a dent where he hit me.
I probably should have gone to the ER but
was unsure of their abilities based on my last experience there in October when I had a neck cramp while driving that would not go away so i went to the st marys the er injected me with cortisone below the skull. But yeah things got a lot worse as far as symptoms progressing every since I went to the Chiropractor.. anyhow…

Then in December I went to Community Hospital
To Western Colorado Spine clinic.
They Read the MRI of the spine from May, October, then decided to
refer me to another Neurologist,
In Jan 2019 I started going to Dr. Mcdaneld at St.Mary’s.
He did nerve conduction test Confirmed I had Carpal Tunnel but apparently that is not the main concern here and then a Nerve Biopsy was ordered and found Small Fiber Neuropathy…

A followup mri that was ordered my the Neurosurgeon was done March 19:

Examination: MRI thoracic spine without contrast

Reason for exam: Cord syrinx

IMPRESSION: Mildly prominent central canal within the lower thoracic
spine, much less evident than on prior study

TECHNIQUE: Multisequence, multi planar imaging obtained through the
thoracic spine without contrast

COMPARISON: Prior thoracic spine MRI dated July 2018

Comments: There is mild prominence of the central canal in the distal
spinal cord at the T9-T10 level. The prominence is much less evident
and extends over a smaller distance than on the prior exam. The spinal
cord above and below this level appears entirely normal. There is no
evidence of edema, mass or atrophy. The conus has a normal appearance
and terminates at the L1 level.

There is mild posterior disc obtrusion at the T7-T8 level which is
unchanged. Disc space heights are normal elsewhere. There is no spinal
or foraminal stenosis.

There is normal marrow signal and alignment of these thoracic
vertebral bodies.

Paraspinal tissues are normal.

Electronically signed by: Reed Bumgarner, MD on 3/19/2019 11:04 AM
MDT.

Signing Radiologist: JOHN BUMGARNER^20190319110426

Now I am supposed to have a lumbar Puncture done.
I am very hesitant because Dr McCoy had told me that
my Lumbar Spine was rather low and had major thickening of the filum terminale indicative of Tethered Cord.
Is it wise to have a Lumbar Puncture if you have a syrinx? they said that the syrinx looks like it is smaller than in July. the radiologist has apparently reviewed my latest mri and says it looks ok to do the puncture…I am not convinced.
What do you think?
I am more that happy to pay whatever price you need, I am only 37 and whatever is wrong has made it difficult to even walk around the house or do the things that need to be done daily for my 2 children..
I had to File for Disability and have been denied initially, now awaiting the Judge…
Yeah I am depressed, Its hard not to be when you feel like your on fire and every movement is extra fuel to that fire. I also have widespread fasciculations and cramping that make it difficult to relax, the pain in my neck dent is horrendous, Floaters in my left eye now…i honestly feel like I am dying.
any help you can suggest would be appreciated beyond expressions.

Thank You in advance.

Jason

[Donald Corenman, MD, DC]

#30310

I am unclear what your symptoms are that pushed you to get multiple scans.The MRIs don’t demonstrate severe focal problems so I am unclear of the source of your symptoms could be (whatever they are).

You have seen at least one good neurologist so I assume your workup was complete. Small fiber neuropathy is a disorder that can occur without a disease process associated (called idiopathic) and is probably genetically generated. Some if not all of your symptoms could be generated by this disorder.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[JasonDamag]

#30335

Sorry, Thank You for replying.
I kept having cramps in my left hand which led to constant burning pain in my left arm up to the back of my neck and in between my shoulder blades with loud popping in between my shoulders (now a Crunching sound). after about 3 weeks of that the Constant burning pain spread to my legs and into my feet. so the 1st neck MRi was ordered in May. By July the burning was also in my right hand and right side of my face and it became hard to walk very far and the pain in my neck kept getting worse. by October the second neck MRI was ordered because my symptoms progressed to widespread muscle atrophy and fasciculations.

lately there is a crunching sound every time I move my arms out in front of me and when lifting them overhead and even just lifting my shoulders. I can barely lift my left shoulder up all the way. Brisk reflexes and the Jerking at times is also getting worse.

There was also a concern that I had been over exposed to mercury from working with electronics/light bulbs etc.. for 6 years with no protective equipment or proper training / disposal methods… But my blood work came back normal on all blood work so far including the heavy metal panel. although It might not show up that long after exposure?
Maybe mercury would still show up in the CSF? I haven’t been in that environment in about a year.
or maybe I should skip the lumbar puncture because one doctor so far said the lumbar spine looks too low?
There is a follow up with Dr. on the 19th of this month to go over the LP.
Could the lumbar puncture be an unnecessary intrusion though? Shouldn’t they have a good look at the lumbar spine first?

Thanks again,

Jason

[Donald Corenman, MD, DC]

#30340

Faciculations, cramping and constant pain into both arms and legs could be a metabolic problem (caused by malabsorption syndrome, diet deficiency, infection, or toxicity). Since nothing has been diagnosed by some good physicians, the lumbar puncture makes some sense but I cannot advise whether this test is necessary.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

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