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. 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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Hi, I always use my computer when I am on the Connect forum. However, I just brought it up on my phone. Firstly, ignore the 3 lines of options. Just below those 3 lines of options you will see the heading of this discussion, i.e. "Nerve biopsy test: Is it done by a neurologist or rheumatologist?" Under that you will see maryflorida's original question in a faint blue tint. Scroll down to just below that, to just above the first post, do you see where it says "oldest to newest?" Anyway, that is where I see it on the phone.

Oh, @sunnyflower I am so sorry for your suffering. I remember being mind boggled by some of your posts back in the spring, at just how bad your overall situation was (and still is it sounds). I do remember you kept God very close and that He is your rock. You can't do any better than that. This world is a mixed bag, great for some, less so for others, horrendous for many as well. Hold tight to your spirituality, it will get you through better, much better than anything. Please feel free to elaborate further about your present situation. Sometimes it helps to talk about what you are facing. All my best to you my dear, Hank

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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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@lioness @jesfactsmon My heart breaks as I read how much pain both of you Lindas are enduring. God in heaven. I also had a history of fibromyalgia, but about 15 years ago, it seemed to vanish. I was just starting an OCD med at the time, but I never really equated this med with helping fibromyalgia. It just seemed to vanish, and never came back. I used to say that I felt like I was run over by a truck. Just so sorry for what Hank's wife and you, Linda, are enduring. I am clueless what to even say……. Lori Renee

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@lorirenee1

@lioness @jesfactsmon My heart breaks as I read how much pain both of you Lindas are enduring. God in heaven. I also had a history of fibromyalgia, but about 15 years ago, it seemed to vanish. I was just starting an OCD med at the time, but I never really equated this med with helping fibromyalgia. It just seemed to vanish, and never came back. I used to say that I felt like I was run over by a truck. Just so sorry for what Hank's wife and you, Linda, are enduring. I am clueless what to even say……. Lori Renee

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Wow, are you ever lucky to have it vanish like that. I would say that is not typical. But I'm glad it went away. You had enough going on with your feet! How is your pain level in recent days? Still a significant reduction to what went before? I really pray for you to have a very good outcome with this drg thing. Love 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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Thank you Hank but how do I find the "first post"??? I receive many, many emails a day. I get so behind b/c of limited time I feel good enough to read them. Once I can find the "first post", I can then, find the most recent. Thanks, Sunnyflower

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Hank, I spoke too soon. I'm on my table now and it does show the first post. Yay!!!!!! Sunnyflower

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@johnbishop

Hello @maryflorida, Did your prior doctor who said it was neuropathy do any testing or did they just think it was neuropathy? Sometimes doctors are not in agreement and I can understand how you must feel since you are the one with the pain. Here are some articles on the topic that may help you in a discussion with your doctor.

Fibromyalgia as a Neuropathic Pain Disorder: The Link to Small Fiber Neuropathy: https://www.practicalpainmanagement.com/pain/myofascial/fibromyalgia-neuropathic-pain-disorder-link-small-fiber-neuropathy

Mayo Clnic News Network – Mayo Clinic Q and A: Understanding myofascial pain syndrome and fibromyalgia: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-myofascial-pain-syndrome-and-fibromyalgia/

Mayo Clinic Newsfeed – Understanding myofascial pain syndrome and fibromyalgia: https://connect.mayoclinic.org/page/adult-pain-medicine/newsfeed-post/health-answers-understanding-myofascial-pain-syndrome-and-fibromyalgia/

Have you considered getting a second opinion for your diagnosis?

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HI John, Thank you so much for all you do for all of us! You are a warm, vast resource and greatly appreciated! Many blessings for serving us, Sunnyflower

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PS: Where on the body are biopsies done? I am in so much pain I can't imagine even more!! I suspect it would be feet and/or lower legs? I know the Rheumatologists and Neurologists feel each other should manage neuropathy. I worked in health care over 20 years and have a zillion specialists, so I know this goes on between the two specialties. I have autoimmune Dz and Fibro as well as a myriad of other diseases and conditions, many of which are painful and 3, are rare. Warm regards, Sunnyflower

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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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Sorry if this is a repeat. I think I replied in a different post of yours? I'm finally using my table and have it all figured it out now. I can see all the options you tell me about here. Be well, Sunnyflower

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@rwinney

@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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Hi Rachel, thanks for your concern and the good info. Where on your body was the Bx, and can you tell me what the path report said? Thanks so much, Sunnyflower

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@sunnyflower

PS: Where on the body are biopsies done? I am in so much pain I can't imagine even more!! I suspect it would be feet and/or lower legs? I know the Rheumatologists and Neurologists feel each other should manage neuropathy. I worked in health care over 20 years and have a zillion specialists, so I know this goes on between the two specialties. I have autoimmune Dz and Fibro as well as a myriad of other diseases and conditions, many of which are painful and 3, are rare. Warm regards, Sunnyflower

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Hi @sunnyflower, if you don't mind my asking, and not wanting to pry, but could you tell me what the 3 rare conditions you suffer from are besides autoimmune, neuropathy and fibro? Just curious. You sure have a load of grief piled on you. My compassion vibes get really tweaked whenever I hear you speak about what you face on a daily basis. With love, Hank

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@sunnyflower

Hi Rachel, thanks for your concern and the good info. Where on your body was the Bx, and can you tell me what the path report said? Thanks so much, Sunnyflower

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Hi @sunnyflower! My biopsy was a tiny scoop of skin and tissue taken from the back of my left thigh and from the back of my right calf. I was numbed first with a small needle. Minimal bleeding, covered with bandage and out the door. I'd say 15 minutes total in the office. The spots were tender for a few days and scabbed over. I never received my path report but, will be obtaining it, this Friday when I meet with my neurologist. Hope this info helps you! Have a pleasant rest of your day.
Rachel

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@sunnyflower

HI John, Thank you so much for all you do for all of us! You are a warm, vast resource and greatly appreciated! Many blessings for serving us, Sunnyflower

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Hi @sunnyflower I am honored to be a part of Connect where we all help each other. Thank you also!

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