Confusing Symptoms

[chiang mai]

Before I engage more seriously with the medical profession here I thought I'd offer this up to see if any of it clicks with anyone:

 

Progressive numbness in the left big second and third toes, a slightly numb sensation on the bottom of both feet but left foot predominant, initial symptoms one year ago (a foot massage over the weekend brought this fact home to me).

(long standing, 25 years, prolapsed disc at S1. Periodic numbness in either thigh if sitting improperly, aka the movie theatres)

 

Less than six months, numbness in left hand finger tips, small finger and next to. Sporadic numbness in small finger tip right hand.

GP says B12 to start with hence on B12 supplements and Methycobal 1k/day.

 

Night time cramps left calf, occasional left thigh back.

 

Seriously stiff and at times painful neck, spinal degeneration (top and bottom) seen previously on MRI but hey, people get old!

 

All symptoms becoming more pronounced, A1C is good, plenty of exercise (DIY), maybe too much? Diet fine, all systems go, nada alcohol except the odd glass red wine.

 

Thoughts, apart from old age? I'm thinking maybe two separate problems, neck and hands vs toes/feet. Which medical speciality to pursue with, Ortho?

 

Thanks in advance

 

 

 

Edited August 3, 2016 by chiang mai

[MissAndry]

Diabetes would be the obvious first choice at your age. But they must have checked you for that?

Whatever it is, hope you get well soon.

[Sheryl]

The likely differential for what you describe would be spinal problems (neck and lower back) vs. some type of peripheral neuropathy, the latter more common in diabetics and alcoholics but there are less common neuropathies that can affect non-diabetiocs and non-alcoholics  as well.

 

Since you have a known history of spinal problems I would start with an ortho specializing in spinal problems. Should he find that the problem is not likely to be due to the spine then you would next need to see a neurologist specializing in peripheral neuropathies.

[chiang mai]

Thanks for that, it was what I expected you might say.

 

Next question is and I should know the answer but don't, any recommendations for an Ortho specialising in the spine?

Edited August 3, 2016 by chiang mai

[bkk6060]

I am 61 and have 3 herniated discs in my lower back and have several of the symptoms you are describing.  

I have just learned to live with it.  Young Thai girls seem to help keep me going.  

[chiang mai]

23 minutes ago, bkk6060 said:

I am 61 and have 3 herniated discs in my lower back and have several of the symptoms you are describing.  

I have just learned to live with it.  Young Thai girls seem to help keep me going.  

 

And I can live with it also, it's just that I like to confirm the cause before I take that step otherwise I could find myself living with something quite serious.

[Lowriesuzanne]

Don't self diagnose. Get an executive package from ram-1 or Bumrungrad-Bkk. What does "excellent" A1c mean? 4.5, 5, 5.5?

 

 

'

[chiang mai]

19 minutes ago, Lowriesuzanne said:

Don't self diagnose. Get an executive package from ram-1 or Bumrungrad-Bkk. What does "excellent" A1c mean? 4.5, 5, 5.5?

 

 

'

 

Your point is well taken but I don't self diagnose, however before I engage with the medical profession here I like to have some ideas about the symptoms and possible causes. I do this on the basis of some hard learned lessons with the medical profession in Thailand, some of whom are excellent but some of whom are far less so!

 

I have a full physical every year and have quarterly blood tests to check on the status of some legacy ailments, cholesterol, liver function etc, my most recent A1C, three months ago, was 5.2, it's due to be checked again this month as it happens.

[Lowriesuzanne]

Get blood tests for all vitamins and minerals. Diabetes "eats" magnesium, metformin destroys B-12. Excess peeing eliminates D-3. Always take multivitamins 12 hours apart. 2x day. Stop salting food and take potassium. Correct ratio is 5-1. Instead of instant whatever's, go to On-Ka-Jhu in CM and eat veggies. Take home a salad for later. Costco has a diabetes pack...vitamins for diabetics. Instead of yummy noodles, give the noodles to the dog and substitute diced zucchini. That means you take your kao soi  home and share with the puppy. Don't let the Thai see you.

[chiang mai]

4 minutes ago, Lowriesuzanne said:

Get blood tests for all vitamins and minerals. Diabetes "eats" magnesium, metformin destroys B-12. Excess peeing eliminates D-3. Always take multivitamins 12 hours apart. 2x day. Stop salting food and take potassium. Correct ratio is 5-1. Instead of instant whatever's, go to On-Ka-Jhu in CM and eat veggies. Take home a salad for later. Costco has a diabetes pack...vitamins for diabetics. Instead of yummy noodles, give the noodles to the dog and substitute diced zucchini. That means you take your kao soi  home and share with the puppy. Don't let the Thai see you.

 

Much of that is already covered off: I eat at Onkajhu at least weekly, I don't take metformin, I take double B12, zero added salt, zero added sugar, salads, veggies, lean chicken, pork or fish only, spinach, broccoli, slightly green banana's, zero sweet drinks confectionery, I could be a poster boy for good diets! But thanks for the thoughts and your input on all of this, sage advice which is accurate and appreciated.

[Lowriesuzanne]

I like cashew chicken at BCC. Also, their tofu-pork soup. Seriously, assume you are vitamin depleted. Download dr. Bernstein's books. Ask Steve (webmaster) for advice... Dr berstein will give a consult for free.

[Sheryl]

4 hours ago, chiang mai said:

Thanks for that, it was what I expected you might say.

 

Next question is and I should know the answer but don't, any recommendations for an Ortho specialising in the spine?

 

http://www.med.cmu.ac.th/dept/ortho/en/doctors/8-staff/26-torphong-bunmaprasert,-m-d.html

 

I assume he can be accessed through Sripat (and I'm assuming you live in CM)

[chiang mai]

2 hours ago, Sheryl said:

 

http://www.med.cmu.ac.th/dept/ortho/en/doctors/8-staff/26-torphong-bunmaprasert,-m-d.html

 

I assume he can be accessed through Sripat (and I'm assuming you live in CM)

 

Thanks Sheryl, I'll see his name gets onto the pinned List of Medical Specialists in the CM forum.

[bkk6060]

12 hours ago, chiang mai said:

Thanks for that, it was what I expected you might say.

 

Next question is and I should know the answer but don't, any recommendations for an Ortho specialising in the spine?

 

9 hours ago, chiang mai said:

 

And I can live with it also, it's just that I like to confirm the cause before I take that step otherwise I could find myself living with something quite serious.

I understand.  Funny about what you say about the movies.  I actually consider myself in pretty good shape.  6-2, 200 pounds not fat.  But now after a movie when I stand up I cannot walk well for about 5 minutes.  Almost falling down from knee stiffness in both knees and a locking reaction.  A lot of it depends on your work history I think and the stress it may have put on your body.  But it sounds like you are actually in decent shape if you can exercise that is a good thing.  

[chiang mai]

7 minutes ago, bkk6060 said:

 

I understand.  Funny about what you say about the movies.  I actually consider myself in pretty good shape.  6-2, 200 pounds not fat.  But now after a movie when I stand up I cannot walk well for about 5 minutes.  Almost falling down from knee stiffness in both knees and a locking reaction.  A lot of it depends on your work history I think and the stress it may have put on your body.  But it sounds like you are actually in decent shape if you can exercise that is a good thing.  

 

My symptoms are somewhat different and it only ever happens in a movie theatre, seat angle and softness I suppose. But it's whilst sitting, my left or right thigh will go totally numb and only a shifting in the seat or crossing of the legs restores sensation, it's identical to the lack of sensation when a spinal block anaesthetic is introduced. Ah well, there goes my Lazyboy recliner!

[MissAndry]

21 minutes ago, bkk6060 said:

200 pounds not fat.  

 

200lb = 90Kg, around 10Kg overweight according to BMI.

Edited August 4, 2016 by MissAndry

[chiang mai]

Agreed, I'm 6ft 2in and 185., my BMI fits that combo. nicely. Having said that, BMI as a diagnostic or measuring tool has been trashed in recent times by the NHS, the ratio concept  doesn't fit all frames and builds.

[chubby]

fwiw, the S1 dermatome does NOT include the "big toe" only the little toe, the most lateral. 

you must mean L5/S1 disc ?

 

http://backpain-guide.com/Chapter_Fig_folders/Ch06_Path_Folder/4Radiculopathy.html

 

what do you mean by "spinal degeneration"? compression fracture or ?  seems like you may have cervical spinal stenosis but ......  what is your age

[chiang mai]

Very well spotted! Indeed, I intended L5/S1 which was significantly prolapsed in 1989, but following chiropractic treatment has not been painful or a concern since (until now perhaps).

 

I am 67, an MRI a couple of years ago showed discolouration on the film of the C-spine and the lower four vertebrae, the doctor at the time referred to it as spinal degeneration.