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Old 10-07-2008, 11:48 PM #8 (permalink)
planningguy
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planningguy
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Default You all are wonderful

Thank you all so much for the wonderful sentiments. I was going to write up the visit tomorrow, but when I saw Rose had started a good luck thread I had to answer.

The rheumatologist was a very pleasant and informative person. He carefully went through my file with me there and explained each note as he jotted something down. He said he felt the bloodwork pointed away from an autoimmune disorder (no rogue antibodies other than the pernicious anemia). He also said it was unlikely to be polymyositis due to my normal CK level.

After the clinical evaluation he said it was unlikely to be fibro as none of the areas he tested were really painful to the touch (I never really suspected that anyway as I've never really had much neuropathic pain, just soreness). He examined all of the major joints and said there wasn't any significant inflammation or pain.

In the end he, "If you had come to me first I would have suspected metabolic myopathy and sent you to a neuromuscular specialist." He agreed that the muscle biopsy was a reasonable next step, and that there might be some answers there. We talked a bit about where I was at, and he said that if he had to call it today he would leave it at "unclassified myalgia" from purely the differential diagnosis perspective, but he didn't really think a diagnosed was appropriate at this point.

We talked about fears of NMD and he and I both agreed that the EMG should provide some comfort in that regard, and the biopsy even more. So one day and a couple hundred dollars later, I have a concurrence that a muscle biopsy is as good idea, but only a handful of possibilities crossed off my list.

My only frustration (other than still being in limbo) is that the rheum, like the U of U specialist, shrugged his shoulders at the dysphagia. He recommended I see an ENT.

Positives of the trip: I had a nice lunch with my wife (Billings after all is one of the "big cities" in my region), listened to some good music, and joked about a business we saw named "Sagebrush Meats." To me that invokes thoughts of such delicacies as roast prarie dog and braised jackelope.

Again thank you for all the well wishes. You're part of what makes this forum such a great place.

Robert