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How do doctors determine SFN is NOT ALS or MS?

Neuropathy | Last Active: Mar 19 8:36am | Replies (15)

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@domiha

@sb4ca THANK YOU! Reassuring words mean a lot! I've always been a glass half-empty type, so I tend to go to the worst-case scenario. I am not diabetic. A friend had seen the same podiatrist I was seeing for foot pain. The podiatrist told her she did not think the pain was coming from her foot, but from her back. She referred her for an EMG and it was found that she had nerve compression at L4/L5. She had a fusion, and that solved her foot problem. I saw the same podiatrist for an issue with a toe injury, and after my friend shared her story, I saw the podiatrist again and asked if she could do the skin biopsy and refer me for an EMG... because I had been waiting and waiting to get an appointment with a neurologist... with no luck. The podiatrist did the skin biopsy after I described my foot numbness and burning/tingling. She referred me for the EMG to see if I may still be having some nerve issues in my lower spine that were affecting my feet. I had a 4-level laminectomy L2 - S1 in Nov 2022. It was afterwards that I began to notice the numbness and tingling. All I can make out from the EMG report is that there is still some sort of ongoing issue with the nerves in my lumbar area... perhaps foramenal stenosis or spondylolisthesis. Perhaps, as you say, there is some radiculopathy. My spine surgeon has suggested that a fusion of L4/5/S1 may resolve the issues with my feet... but he is not a neurosurgeon, but an orthopedic spine surgeon and, of course, he can make no guarantee. I do FINALLY have an appointment with a neurophysiologist next week, and I'm hoping that since neurology is his foundation he may be able to guide me further. Though I was pleased the podiatrist agreed to do the skin biopsy and send me for the EMG, she could share with me the reports, but said I needed to see a neurologist for further answers to my questions. She did prescribe Metanx for me, which I took for four months. Two weeks ago my PCP did blood work and included a re-check of my B6 vitamin levels, which were in the normal range six months ago, but came back as too high. So I have now stopped taking the Metanx. I just really feel I need the guidance from neurology.... but it has been SO difficult to get in to see someone. I'm sorry.... I didn't mean to go on and on... enough whining. But I did SO appreciate you taking the time to reach out and offer some comforting words!! Thanks again! Best wishes! Mike

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Replies to "@sb4ca THANK YOU! Reassuring words mean a lot! I've always been a glass half-empty type, so..."

I'm glad I was able to give you some reassurance. I think when you are able to see a neurologist they will conduct the full scope of testing but surely your upcoming appointment will also provide a better understanding of the possibilities. Apparent the biopsy used for the diagnosis are from both the leg and the thigh. Is this what you had done?

Mike, I'm sure you've put yourself on a waiting list/calendar with a good neurology practice, but don't be afraid to check in and see if they've had cancellations. Here in Chicago I was told the soonest a Northwestern-associated neurologist could see me would be late July, so I made that appointment but put in a call to Rush. A cancellation happened to have just come in two days away, so I juggled everything at work and grabbed that appointment. I'm glad I did - the neurologist I saw was impressive and will be doing an EMG/nerve conduction test at Rush in early April.

Ordinarily I would also have had to wait until July to see a neurologist at Rush as well, it was a triumph of sheer dumb luck.

I know how hard it is to wait and worry - the sooner you can get that appointment on the books the closer you are to testing, a diagnosis, and a care plan. Sending you all my very best wishes for reassuring news for you.