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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I had surgery for left side kidney stone and severe kidney

Resolved Question:

I had surgery for left side kidney stone and severe kidney infection in January 2012. They inserted a stent, sent me home for 10 days, then I went back in to have lithotripsy. While the stent was in, after 3 days, I had an evening where I had episodes where I lost 70-80% of the feeling on right side of my body. I was admitted to the hospital's neurology dept., they did an MRI to check for stroke, but negative results - no vascular problems. The episodes caused feeling in left arm, left leg, left side to go away, then after the episodes there was moderate pain in left side & shoulder. My left wrist rotated on its own during these episodes. The neurologist was unable to rule out they may be seizures.
After the lithotripsy, I had a follow-up with neurologist and urologist, neither was able to tell me anything about the episodes - a mystery. I had massage therapy, which helped with the pain - my left side and especially shoulder had moderate pain. Two therapists that I saw recommended it might be a disorder of the fascia. I also saw PT for 2 months, and did stretching exercises (I still do them). These cause little/no change.
Now, 13 months later, I still have fatigue in the left shoulder and pressure in the left side just between rib cage & pelvic girdle - no pain. If I lift my left arm, it feels as if someone is pressing down. So although I have full range of motion and full strength, my arm becomes fatigued after just a few seconds. My doctor is baffled, I am scheduling yet another follow-up with the neurologist, but no one seems to have a clue what this is or how it could have coincided with the surgery and infection.
Male, 53 years, non-smoke, non-drink, hypertension and obesity.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

neuromd2012 :

Hello

neuromd2012 :

welcome to Just Answer

neuromd2012 :

are you there?

Customer:

Hi there!

neuromd2012 :

hello

Customer:

My doctor says this is an interesting problem.

neuromd2012 :

yes

neuromd2012 :

so by surgery, you mean the ureteral stent?

neuromd2012 :

or something else?

Customer:

Yes. 1st the stent was inserted, and then the lithotripsy which was outpatient, 2 days apart.

neuromd2012 :

ok

neuromd2012 :

well how bad was the infection?

neuromd2012 :

did you have diffuse muscle pain?

Customer:

3 days after the stent was inserted, I had about 20 of the episodes over a 6 hour period, each lasting from 1 to 15 minutes

Customer:

The infection was bad

Customer:

They said I was just about in sepsis.

neuromd2012 :

I see

neuromd2012 :

so I am wondering if you could have a neuromuscular disease causing this fatigue problem

neuromd2012 :

myasthenia gravis

Customer:

I don't know about diffuse muscle pain. The main symptoms of the infection were fever, shortness of breath & flu-like.

neuromd2012 :

ok

neuromd2012 :

if you try to lift your arm

neuromd2012 :

and someone pushes it down

neuromd2012 :

and you lift it

neuromd2012 :

over and over

neuromd2012 :

does it become easier for the person to push it down after a few attempts

Customer:

I did that test this morning, but not over & over. I have full strength in the arm.

Customer:

I can try it now with my office mate - hang on.

neuromd2012 :

good

Customer:

OK we did it 5 or 6 times. It got easier to push my arm down because my arm got tired.

neuromd2012 :

ok

neuromd2012 :

well you need a neurologist to examen your for MG

neuromd2012 :

you do some blood work

neuromd2012 :

anti-acetylcholine antibody tests

neuromd2012 :

and you do an EMG examination

neuromd2012 :

to look if you have changes in your muscles from MG

Customer:

Hmmm.

neuromd2012 :

it can be hard to diagnose, and it is certainly the type of problem that mimics

neuromd2012 :

conditions, but no one can put their finger on it

Customer:

It affects 2 spots, my midriff and my arm

neuromd2012 :

it can be like that

neuromd2012 :

there is an association between MS and MG

neuromd2012 :

too

neuromd2012 :

but your MS evaluation was negative with that normal MRI scan

Customer:

Other than that, no symptoms. I did have occasional sharp pain in the arm when I urinated

Customer:

The MRI scan was head, not arm.

neuromd2012 :

right

neuromd2012 :

yes

neuromd2012 :

the MRI of the brain to exclude MS (multiple sclerosis)

Customer:

They were looking for stroke, I'm not certain they considered MS

neuromd2012 :

rught

neuromd2012 :

right

neuromd2012 :

but the MRI scan would show changes from MS

neuromd2012 :

if you had hemibody weakness from MS

Customer:

Ah, gotcha.

neuromd2012 :

or from stroke

neuromd2012 :

so it could be your transient weakness was MG and not MS

Customer:

So, these could have started with those weird episodes in Jan 2012?

neuromd2012 :

let me get you some information on MG

neuromd2012 :

yes

neuromd2012 :

and they can be episodic

Customer:

That might help.

neuromd2012 :

you are fine and then you have weakness, out of nowhere

neuromd2012 :

hang on

Customer:

Hmm, the episodes weren't weakness, it was like an OOB experience, like the left side of my body did not exist.

neuromd2012 :

http://emedicine.medscape.com/article/1171206-overview

neuromd2012 :

oh

neuromd2012 :

so that is why they were thinking stroke

neuromd2012 :

did you see that page I sent on MG?

Customer:

Yeah. I did see the page.

neuromd2012 :

one of the things in this problem is visual symptoms

neuromd2012 :

have you had any double vision?

neuromd2012 :

transient

Customer:

No vision problems at all.

neuromd2012 :

ok

neuromd2012 :

well that makes it less likely but does not exclude the possibility

neuromd2012 :

you can also get excessive salivation and slurred speech

Customer:

Also - I am still wondering because this was like a sudden series of "attacks," then this lingering debilitation.

Customer:

No slrred speech, no excess salivation, even last January.

neuromd2012 :

ok

Customer:

Hmm, I will ask the neurologist about this disorder, but it doesn't fit more than 50-60%. It is possib;le, though.

neuromd2012 :

right

neuromd2012 :

this is a very weird disease

neuromd2012 :

it is often missed

neuromd2012 :

but the blood checks can find it easily

neuromd2012 :

and it does happen as an allergic response to sepsis

Customer:

I will ask, thank you. I see the neurologist next week, the same one I saw last year.

neuromd2012 :

but you have a difficult problem

neuromd2012 :

sound good,

neuromd2012 :

let me know ok?

neuromd2012 :

Dr Frank T

Customer:

It is not too debilitating. I used to be able to lift over 150 lbs, now it is like 50-70

Customer:

How can I contact you?

neuromd2012 :

that really sounds like a neuromuscular disorder

neuromd2012 :

come back here, and look up this chat with your ID

neuromd2012 :

or start a new one and ask for neuromd2012

neuromd2012 :

ok?

Customer:

Hmmm, I am not a member, I signed on for a 1-time

neuromd2012 :

Dr Frank T

neuromd2012 :

does that matter?

Customer:

It would cost me another $28

neuromd2012 :

I don't think so

Customer:

: - (

neuromd2012 :

I don't think so, you just come back to your original posting

neuromd2012 :

and ask me a question ok?

neuromd2012 :

but please rate my service if you can , as that is how I get compensated

Customer:

OK, I will try to contact you after the appointment. And I'll give you a good review.

Customer:

My name is Tracy

neuromd2012 :

Dr Frank T

neuromd2012 :

come back and let me know Tracy

Customer:

Thank you for the information - I just didn't want to go in blind.

neuromd2012 :

sure

Customer:

Signing off.

neuromd2012 :

tell him you have fatiguability

neuromd2012 :

bye

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7201
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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Dr. Frank
Dr. Frank
Neurologist
7201 Satisfied Customers
Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.