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73 year old female, Started experiencing numbness on right…

73 year old female ...

73 year old female

Doctor's Assistant: What are your symptoms? Have you used any medication for this?

Started experiencing numbness on right side of chin in November 2017.

Doctor's Assistant: Have you seen a doctor about the numbness?

Yes the numbness started to spread to the right cheek into the temple area and then spread to left side of face. Having extremely difficulty eating because the food falls from her mouth. Eating soft foods only and Ensure. Recently she has started to cough and choke on food because she can't feel it going down her throat. Her speech is slurred her voice is getting weaker and more high pitched. She has seen here dentist, an endodontist, a periodontist, her PCP, an emergency room doctor, an ENT and 2 neurologists and no one knows whats causing this. She had a CT scan and an MRI of the brain and the neck. Her PCP thought it was Bell's Palsy and treated with an anti viral for 2 weeks and prednisone for a month which did nothing. The first neurologist didn't know what it was so said she would treat the symptoms and gave her gabapentin which just made her nauseous and not want to eat, she lost 22 lbs. Medical history is she has been healthy most of her life. She had Bell's Palsy in her 20's and five years ago she had stage 3 rectal cancer and had a colostomy (which could not be reversed), chemotherapy and radiation. She has been cancer free since that time.

Doctor's Assistant: Anything else in her medical history you think the doctor should know?

She had a hysterectomy in 2001 due to a vaginal hernia but other than that like I said she had always been very healthy until she was diagnosed with the cancer. We are extremely frustrated because this has been steadily getting worse since November and we are not getting any answers

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Answered in 14 minutes by:
6/12/2018
Connie Pennington
Category: Medical
Satisfied Customers: 686
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified

Hi, this is Dr. Pennington.

You know this is a tough one, and she has had a really good work up that I cannot fault.

They really have done everything to try to find and treat the issue.

One thing that comes to mind, and it's a long shot, is environmental toxins.

What I mean, is anything in skin care products, soap, shampoo, etc, They are full of chemicals.

Something that would touch her face. After chemo, the body just can't detox these things.

Can you think of anything she uses. Time to go organic for sure.

How about a C-PAP machine? Many are allergic to the plastic.

Just a thought

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Customer reply replied 2 months ago
She does not use a C-Pap machine. She has not used any new products on her face. This started with a small numb spot on the right side of her chin in November. It has gradually spread to her entire face. She has feeling on the skin of her face the numbness all seems to be inside. She had an MRI of the brain and the doctors felt it was unremarkable except for a small hemangioma on the outside of the right side of the brain which they did not feel was responsible for the symptoms. It resembles a stroke but the doctors said they saw no sign of that on the MRI. They did say they saw some indication on the MRI that she had TIA but could not determine when that might have occurred. This has had a dramatic effect on her life, where she used to be very active and social, she now hardly leaves the house. Any other thoughts on this?

I do not mean new products, I mean any products with chemicals. Like sodium lauryl sulfate, etc.

A TIA, by definition would resolve, as it is transient. They do not show up on MRI's. It is a clinical diagnosis not a finding. It is determined by history. She could have lacunar infarcts, which if in the brainstem, would cause all of her symptoms. The only treatment is anti-coagulation to try to prevent if form happening again. You can think of it as a tiny stroke, with horrendous effects. It happens. I am so sorry, I know this is not what you want to hear.

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Customer reply replied 2 months ago
We are just looking for an answer. I am concerned about this new problem of her having difficulty swallowing because she doesn't feel the food or fluids. The last neurologist sent her for a blood test or scleroderma I believe she was thinking it could be an atypical manifestation. We don't have those results yet. I thank you for your help, I think I'm going to put a call in to her neurologist and update her on this new problem.
Customer reply replied 2 months ago
One last question. Is there a scan or something that would tell us if she had lacunar infarcts?

The lacunar infarcts would show up on the MRI. You are right to work with the neurologist, and honestly you have done everything you can. These most difficult issues are most likely in the brain stem. Physical therapy is all that can be done, and preventative measures to keep it from happening again. I am so sorry. If an MRI does not show the infarcts, then nothing will, but I suspect that is what they were talking about.

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Is there anything else I can help you with.

Please rate this question if you can, as we work for stars, and I will receive credit for assisting you.

I am sorry your mother is not doing well. It is stressful, take care of yourself.

Connie Pennington
Category: Medical
Satisfied Customers: 686
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified
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