Nerve biopsy test: Is it done by a neurologist or rheumatologist?

Posted by maryflorida @maryflorida, Aug 4, 2020

What kind of doctor do I see for the nerve biopsy test? My PCP sent me to a rheumatologist for a diagnosis. She feels it is fibromyalgia but prior doctor in Wash. state said it is neuropathy. She won’t arrange for the biopsy. Which kind of doctor can finally give me a diagnosis or is she right? All she is offering is amitriptyline for pain. I do take norco too, but my PCP would like me to get off that. I need advice.

@sunnyflower

Hello. I typed a lot then it disappeared. Please tell me how to get to the beginning of the skin biopsy discussion. For years, even before I learned they are doing them I have wished I could have one! Thx so much! I am not proficient in getting around here. Blessings, Sunny

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@sunnyflower Hi there. 😊 Doesnt it drive you crazy when that happens!? I've managed to need to restart a post many times. Sunny, forgive me for not remembering but, can you remind me of your circumstance? I'm assuming you have neuropathy. If you've been told you have neuropathy based on clinical exam but have not had a confirming skin punch biopsy test, then you may approach with your neurologist. It seems some neurologists like to decide for the patient. I disagree. As a patient, you have every right to request a test to help dissect your neuropathy and bring you a more specific path forward on how to treat the type of neuropathy. Insurance may be a question regarding coverage. In my case, because I am on social security disability, my skin punch biopsy test helped prove my case and cause. Many folks who are diagnosed with fibromyalgia, actually have Small Fiber Neuropathy as proven by a skin punch biopsy. It helps for clarity. If your Dr does not oblige, I would move on and find a Dr who takes more pride and understanding in your health. Good luck! 🍀
Best wishes,
Rachel

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@sunnyflower

Hello. I typed a lot then it disappeared. Please tell me how to get to the beginning of the skin biopsy discussion. For years, even before I learned they are doing them I have wished I could have one! Thx so much! I am not proficient in getting around here. Blessings, Sunny

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Hi @sunnyflower nice to hear from you again! I remember you from a few months ago. Firstly, you ask about how to get to the beginning of the discussion. There is a handy button you can click on just above the first post that says "oldest to newest". That puts the very first post of the discussion right on the same page you are on. If you change it to "newest to oldest" it will change so the most recent post (the newest post) is right on the page you are on. It seems like that is what you are asking, forgive me if I have misunderstood. I hope you are well and hope you get your questions answered. Best to you, Hank

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@jesfactsmon

Hi @sunnyflower nice to hear from you again! I remember you from a few months ago. Firstly, you ask about how to get to the beginning of the discussion. There is a handy button you can click on just above the first post that says "oldest to newest". That puts the very first post of the discussion right on the same page you are on. If you change it to "newest to oldest" it will change so the most recent post (the newest post) is right on the page you are on. It seems like that is what you are asking, forgive me if I have misunderstood. I hope you are well and hope you get your questions answered. Best to you, Hank

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Hahaha…nice save here Hank. I see I totally missed the question at hand from @sunnyflower. Thanks for for the rescue!

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@jesfactsmon

Hi @sunnyflower nice to hear from you again! I remember you from a few months ago. Firstly, you ask about how to get to the beginning of the discussion. There is a handy button you can click on just above the first post that says "oldest to newest". That puts the very first post of the discussion right on the same page you are on. If you change it to "newest to oldest" it will change so the most recent post (the newest post) is right on the page you are on. It seems like that is what you are asking, forgive me if I have misunderstood. I hope you are well and hope you get your questions answered. Best to you, Hank

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Thx so much! How do I know which is the first post? Warm regards, Sunny

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@sunnyflower

Thx so much! How do I know which is the first post? Warm regards, Sunny

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When you set "oldest to newest" it will be the one at the top of the page you are on. Hope you are feeling not too badly these days @sunnyflower. I remember you had been in some terrible pain. How are you doing lately? Hank

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You, without doubt, need to consult the best Neurologist in the business. You will undergo many , many tests, including fMRI for multiple scans of your brain, a myriad of blood tests, 27 in my case, and of course skin puncture electric probes. The tests will prove exactly what your problem is. It is all painless? Book in asap for your own peace of mind. If it is Peripheral-neuropathy, that's ok, and not the end of the world, Good luck and go for IT!

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Barry, but what can be done for neuropathy plus fibromyalgia? My PCP said all that can be done is pain control.. ??

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@maryflorida

Barry, but what can be done for neuropathy plus fibromyalgia? My PCP said all that can be done is pain control.. ??

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@maryflorida Hi there, my wife was diagnosed with fibromyalgia around 1990. The neuropathy came in 2014. The way the fibro manifested was that when she overdid physically her muscles would become very painful. She would move around the house like a 95 year old person is what we always said. You know, like she could only move very slowly and stiffly and painfully. And that would last maybe a day if she stopped moving. So she learned to cool it on the overdoing. Not easy for her, she has always been a chronic overdoer. But through the years she has learned what the consequences are to overdoing.

As I said, she also has neuropathy, burning feet and sometimes calves from chemo. I would say currently about 70% or more of her pain is neuropathy and 30% is fibro, migraines and tinnitus. Actually the fibro seems like the least of her pain as long as, as I said before, she doesn't overdo physically. She has never taken pain killers, except marijuana occasionally. She is allergic to all OTC pain killers, i.e. no aspirin, advil, tylenol, etc. So my point is, she lives with the peripheral neuropathy pain, migraines and tinnitus. For the fibro she pretty much tries her best to "do" but not "overdo".

May I ask you, how does your fibro manifest and when? Can you describe how a flareup occurs in your case? How long do they last and how does the fibro pain compare to the PN pain?

Hank

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@jesfactsmon Hi Hank I'm Linda Lioness You didn't ask but I will tell you a flre from fibro last a day when I have one I ache all over my nerves are all on fire especially in my arms in particular ,neck and shoulder Nothing I do or take helps I just have to ride it out .

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@lioness

@jesfactsmon Hi Hank I'm Linda Lioness You didn't ask but I will tell you a flre from fibro last a day when I have one I ache all over my nerves are all on fire especially in my arms in particular ,neck and shoulder Nothing I do or take helps I just have to ride it out .

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Yep, Linda, that is my Linda as well. She will have dire pain in her entire body, like every muscle in her body. Not a burn but a deep soreness, like every muscle is bruised. So she describes being very stiff like the muscles have contracted and a deep deep soreness.

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@jesfactsmon

Yep, Linda, that is my Linda as well. She will have dire pain in her entire body, like every muscle in her body. Not a burn but a deep soreness, like every muscle is bruised. So she describes being very stiff like the muscles have contracted and a deep deep soreness.

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@jesfactsmon Yep that fibro but my neuropathy is the burning pain I have in arms legs today I have both so going to bed

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@jesfactsmon

When you set "oldest to newest" it will be the one at the top of the page you are on. Hope you are feeling not too badly these days @sunnyflower. I remember you had been in some terrible pain. How are you doing lately? Hank

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Hello. It must be my phone, but I don't see oldest to newest or anything to get me to the beginning of the biopsy discussion. I clicked on the 3 lines of options, and there were a lot, but not what I need. Ug. I am pretty ill. A lot of diseases and conditions, several are painful. My SFPN is heat to toe and has affected organs. Thx for asking. Sunnyflower

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