After diagnosis, do you continue to see your neurologist?

Posted by robindancer5678 @robindancer5678, Jul 14, 2023

I was just diagnosed in June 2023 with small fiber polyneuropathy. It developed suddenly in February 2023 with some tingling in my calf and foot and progressed rather quickly to tingling in all extremities and spasms in all extremities. And weirdly some breathing issues. So far we can’t figure out why. I am negative for any autoimmune diseases, medication toxicities or vitamin deficiencies. I am suspecting it may have been due to having COVID in 2021 (long hauler?) or have something to do with my body‘s reaction to vaccines and medications. I had ShinGrix vaccines in late 2022 followed by a Covid booster, followed by a Prolia injection. Anyway, my question is this. Will my neurologist continue to follow me? Or after I’m diagnosed, am I on my own since it is allegedly incurable? It took forever to get an appointment with a neurologist! Believe it or not, even though I am in Baltimore, with great medical institutions around me, there appear to be not enough neurologists.

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@julbpat

Yes, I agree that a knowledgeable NP is invaluable. I left my previous neurologist because he didn't have a nurse or NP to call on. He was the only source of information, and was very difficult to talk to. Now I'm in the same situation again - my current neurologist is a new doctor, and apparently doesn't get to use the NP in the office! Fortunately he is not overbooked yet, so I've been able to see him when I need to, and we communicate a lot by messages via the patient portal. He has even messaged me on the weekend, and on July 4th! I can't complain.

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My neurologist was more accessible pre diagnosis. Once she confirmed I had SFN via biopsy, I think interest was diminished. Although a specialist in SFN, she does she the full spectrum of neuromuscular disorders. And she basically told me I’m lucky compared to other disorders. So IDK 🤷‍♀️. I don’t think that she or my PCP has a whole lot of interest as to how this will affect the rest of my life 😭.

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I had a similar experience! Dr W, who ordered the skin biopsies, didn’t talk to me for 2 weeks after someone from the office called to give me the positive results. When he called, he seemed perplexed about my concerns. The next week, I drove to the office and handed the receptionist my list of questions for Dr W. I looked like a crazy person, crying and handing them this piece of paper. A few days later, the OFFICE MANAGER - not a nurse - called me with his answers. 1. There is no cure, but you won’t die from this …etc etc..
I knew this doctor/patient relationship would never work, and I started looking for someone who I felt comfortable with for the long term. I am fortunate to live in a larger city with lots of options. I’m aware not everyone has choices.

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@tprift

I do agree with you on this. But I think it is an excellent question to raise. I see my neurologist twice a year. She is a well known researcher and clinician in SFN. She is easy to talk to and monitors me mainly for changes and progression (usually I know way before her what has changed). But the medication, Low Dose Naltrexone, that I was most interested in, she wasn’t willing to prescribe. And there is no discussion about how to live with this or even how it affects my overall health and quality of life. Would love to have a NP or other support person to brainstorm ideas with.
She is always going to know the latest developments in the field, so I will stay under her care. But sometimes I wonder why.

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Sometimes I wonder why too. It’s difficult because you may have new (or unrelated) symptoms develop that you’re unsure how to treat, and talk to your PCP or GI or Cardiologist thinking it falls under their realm, but they say it’s “probably” your PN so you should see your Neurologist. So you’re thankful you have the standing Neurologist appointment, even though they may likely say they don’t think it’s your Neuropathy, see your GI again. A bit of a vicious cycle feeling like a ping pong ball, but once in awhile it might fall in the right court and there might be a remedy.

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My most helpful professional is a Patho physiologist who studied in Amsterdam. He has a private practice… Not connected to a hospital or clinic. He acknowledges PN is painful and frustrating. He did a very, very thorough exam on me and felt like the PN is related to poor posture and old back injuries. He didn’t have a cure or promise any miracles, but suggested exercises and positioning which have helped. Gave me the book. “ McKenzie method.,.. treat your back”. Other professionals just wanted to use meds then just kind of shrug when those don’t work. The most information I have gotten has been from him and from you people on Connect. Thanks for everybody’s input.
Bcool123

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I had the same question too so I asked my physician therapist and neurologist. They both pretty much said when you’ve got a new “something” that lasts for more than a few days and is severe enough that you cannot get it off your mind and it continues to bother you. We all know our bodies and we all have ongoing “normal” aches and pains both chronic and acute to a varying degree. I hope this helps provide some prospective?

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