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Nerve biopsy test: Is it done by a neurologist or rheumatologist?
Neuropathy | Last Active: Dec 10, 2021 | Replies (222)Comment receiving replies
@sunnyflower @lorirenee1 @rwinney I asked my neurologist to repeat tests that were done several years ago. He first did a nerve conduction. The original test showed near normal ranges for superficial pereneal sensory and motor, and for median sensory and motor, and radial sensory. The redo last month showed that all of the ranges tested were 50% reduced! He was not happy to see that. Neither was I. Then, 4 weeks ago he did skin punch biopsies in my foot, calf and thigh. He gave me the results on Tuesday, again not good. I don't know what the numbers refer to exactly, but the baseline tests were nearly normal 5 years ago. This is a nerve fiber density test. Normal for the foot is greater than 3.0, I'm 0.0. Normal for the calf is greater than 2.1, I'm 0.4. And normal for the thigh is greater than 6.0, I'm 0.1.
These numbers indicate sfn. No news there. But he also seemed to be saying that it indicates autonomic neuropathy, as well. In his notes he wrote that double vision, swallowing problems, bladder problems and GI function are being affected, if not totally caused, by AN. (At the end of each appointment he gives me a copy of the notes he wrote, detailing everything we talked about.)
I asked him to redo the tests, so I guess I shouldn't be upset by the results, but it's definitely taking a toll on my depression and anxiety levels. I talked with my therapist yesterday about my level of depression, and he pushed me to discuss it with my wife, which I haven't done yet.
I received a letter from my supplemental insurance that Medicare is asking for my doctor's authorization to determine if they will continue to cover my morphine sulfate contin that I've been taking for over 7 years. My understanding is that they don't think it's indicated for neuropathy pain. I don't know where it stands right now, but it's definitely in the mix of how I'm feeling mentally. I don't know how I'll deal with it if it's denied. I don't want to think what effect it will have on my pain if I have to stop taking it. The neurologist told me that he will include in his notes that morphine is keeping my pain at a level I can endure. The therapist said he would write a letter to my pcp. I need to write down what I want him to say, and text it to him. He's concerned about what happens when my depression worsens. I think it concerns him more than it does me.
Thanks for reading all the way through. I know my posts are almost always on the long side.
Jim
Replies to "@sunnyflower @lorirenee1 @rwinney I asked my neurologist to repeat tests that were done several years ago...."
@jimhd Hi Jim For you sir, I could write forever but, I'm forced to keep it short due to hand flares. I'm very sorry for the results that prove growing changes in your body. Now you can connect the dots and realize you may have new paths and hurdles but, ones you are fully prepared to tackle. I know this because I hear and have observed your strength, courage, perseverance and never quit attitude from afar. Your mental health may be challenged but, with your faith and loving family, that I hope you will include on your continued journey, I know in my heart that you will push, not give up and be the best version of you you can be. Best of luck my frriend. Many hugs of comfort are sent your way. We are all here for you. ❤
Rachel
Hi Jim @jimhd, I'm guessing you might already know this but you can file an appeal if Medicare denies the morphine sulfate contin that you've been taking for over 7 years to help with the pain. More info on Medicare.gov - https://www.medicare.gov/claims-appeals/how-do-i-file-an-appeal Hoping they will continue to cover the medication and not cause any additional pain for you.
Jim, so sorry for your struggles. Really. Sounds like you have the right PCP and Neurologist who will go to bat for you to get MC to cover your MSContin. Worst case scenario if MC still doesn't approve then you can appeal. You didn't have anything else to do anyway right? NOT!
This medication is well known for helping neuropathy pain. Geesh! The problem usually lies with doctors not wanting to prescribe it for patients who suffer with depression and /or anxiety. As you probably already know, one can have a depression induced anxiety.
There is a real opiophobia out there nowadays and many are given subtherapeautic care bc of it. Your test results validate your condition so that is a plus however I can see how discouraging and disconcerting that can be. I 'm sorry 😥
Hang on to all your records, letters, diagnostics, etc ,, and either make copies for new docs or if you give them to anyone, make sure you have them make copies for themselves and give yours back to you.
I will be thinking of and praying for you. May the peace of Christ which transcends all human understanding (Philippians 4:7) be yours, Sunnyflower
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@jimhd , Thank You for being on the long side. I learn a great deal from you as you share about your condition, your results and the challenges they bring. What helps me is to come up with options. These Options give you a potential alternative path, a solution to pursue when you hit a wall. Enlist the help of others, ie. letting your wife in on your struggles .. Stay the course. Keep the faith. Open up options. and know that you are good enough, tall enough, smart enough,wise enough, to face life each day. Continue to tend to your gardens and play your music and write us often. David