Vegas

Got back from a 4 day R&R trip in Vegas with my gal pal, Megan Bates and her friend Jen. You know you 're in your mid 30's in Vegas when all you want to do is hang at the pool and are in bed by 11pm. Highlights of the trip, Bodies exhibit, Wheel of Fortune, outlets, lounge chairs and snacks poolside, cobalt PT Cruiser, Diet Dr Pepper and Lemonade Crystal Light.

Unpacking is always the pits!

I've been diagnosed - Brachial Neuritis

I'll be limited to my range of motion and have a jacked up shoulder blade for awhile. The dr said hopefully I'll have 80% of it restored after the 1st year. Umm those that know me know I'll try and make that happen before. Please, a year!?! More or less a virus attacked my central nervous system and paralized specific nerves. Who knew this could happen? Not me...
Brachial Neuritis:
Background
Brachial neuritis (BN) is a rare syndrome of unknown etiology affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. BN usually is characterized by the acute onset of excruciating unilateral shoulder pain, followed by flaccid paralysis of shoulder and parascapular muscles several days later. The syndrome can vary greatly in presentation and nerve involvement.
Pathophysiology
Brachial neuritis (BN) exists in an inherited and an idiopathic form. In the idiopathic version, the pathophysiology is unknown, but the condition is generally thought to be an immune system – mediated inflammatory reaction against nerve fibers of the brachial plexus. Axonopathy with subsequent Wallerian degeneration appears to predominate, but proximal conduction block has also been described in over 33% of cases in the series by Lo and Mills. The inherited form is autosomal dominant and has been linked to mutations in the SEPT9 gene on chromosome 17q. Septins are involved in the formation of the cytoskeleton and in cell division, but how these mutations result in BN is unknown.
Frequency
United States
The incidence of brachial neuritis is approximately 1-2 cases per 100,000 person-years.
International
In the United Kingdom, the incidence of brachial neuritis (BN) is approximately 3 per 100,000 person-years. BN has also been described in many countries around the world, although specific rates of incidence have not been reported.
Mortality/Morbidity
Brachial neuritis is not a fatal condition, although the phrenic nerve may be involved. The risk of significant residual disability in the involved limb after 2 years is approximately 10-20%.
Sex
Brachial neuritis occurs predominantly in males, with the male-to-female ratio for the condition ranging from 2:1 to 4:1.
Age
Brachial neuritis (BN) has been reported in individuals from age 3 months to 74 years; however, the condition's prevalence is highest in young to middle-aged adults. Onset in childhood should be considered suggestive of hereditary BN.
Clinical
History
The onset of pain in brachial neuritis (BN) is often abrupt and may follow recent illness, surgery, immunization, or even trauma (see Causes, below). Up to two thirds of cases begin during the nighttime.
The pain usually is localized to the right shoulder region, but it may be bilateral in 10-30% of cases.
The pain's intensity is very high (9+/10) and is maximal at onset.
Usually, the pain is described as sharp or throbbing in nature.
The pain usually is constant, but it is exacerbated by movements of the shoulder. Movements of the neck, coughing, and/or sneezing usually do not worsen the pain.
Intense pain can last from a few hours to several weeks and requires opiate analgesia.
Low-grade pain may persist for up to a year.
As the pain subsides, weakness becomes apparent.
In most cases of BN, this weakness manifests within about 2 weeks of onset.
Weakness is maximal at onset but can progress over 1 or more weeks.
A wide variety of muscles is affected, particularly those innervated by the upper trunk. The supraspinatus, infraspinatus, serratus anterior, and deltoid muscles are particularly susceptible, but many different single and multiple combinations of muscle involvement, including a pure distal form, have been reported.
The patient may notice considerable atrophy and wasting, as well as a deep aching in the affected muscles.
Numbness may occur, depending on the particular nerves affected, and usually is found in the nerve distribution corresponding to maximal muscle weakness. However, numbness is rarely a prominent complaint.
In 25-50% of patients, the medical history indicates a viral illness or vaccination that occurred days or weeks prior to the onset of symptoms. Some patients also may note recent trauma or severe exercise, surgery, infection, or immunization.
Physical
Due to the extreme pain involved, patients with brachial neuritis usually present acutely. Typically, the affected arm is supported by the uninvolved arm and is held in adduction and internal rotation.
Atrophy of the affected muscles becomes prominent after approximately 2 weeks.
Considerable muscle pain may be noted on palpation.
Passive and active attempts at shoulder and scapular movement result in a significant increase in pain. Movements of the neck are relatively pain free.
Muscle strength in affected muscles often is reduced severely (to 2 or less on the Medical Research Council [MRC] grading scale).
Reflexes may be reduced or absent, depending on which nerves are involved.
Sensory loss is not prominent but may be detectable (in particular, loss of axillary nerve sensation), depending on the specific nerves affected

Hell of a week-long entry

What a week. It was a rough one and never want that one back. Time can keep it and turn to dust or sand or what ever it does with past time.
I had major allergies going on. I was in a place with some mold issues and being I'm allergic to it and have asthma, we'll just say that I was sicker than a dog.
I thank my lucky stars I wasn't in an environment like this. Holy cow how does that happen? YIKES!!


Of all weeks, Thursday I had 3 doctor appointments. The first was regarding my allergies, second, had my nerves tested for my shoulder, and the last was a MRI.


As some of you know I've had some issues with my shoulder. Apparently I've got some nerve damage. To learn more see pictures a few entries ago.


The testing of the nerves part one. The doctor had me lay down and sent electrical volts through me. He used a device just like this one in the picture. He did about 20 tests on one arm and about 30 on my other. I felt like I should have ran out of there since I knew something else was coming. Part 2...EMG.
I found the following on a medical website to describe what the EMG is all about. This is a test that involves needles.

What is an EMG test and why is it performed?
A test that measures muscle response to nervous stimulation (electrical activity within muscle fibers). EMG is most often used when people have symptoms of weakness, and examination shows impaired muscle strength. It can help to differentiate primary muscle conditions from muscle weakness caused by neurological disorders. EMG can be used to differentiate between true weakness and reduced use because of pain or lack of motivation.

How the test is performed?
A needle electrode is inserted through the skin into the muscle. The electrical activity detected by this electrode is displayed on an oscilloscope (and may be displayed audibly through a speaker). Because skeletal muscles are isolated and often large units, each electrode gives only an average picture of the activity of the selected muscle. Several electrodes may need to be placed at various locations to obtain an accurate study. After placement of the electrode(s), you may be asked to contract the muscle (for example, by bending the arm). The presence, size, and shape of the wave form produced on the oscilloscope (the action potential) provide information about the ability of the muscle to respond to nervous stimulation. Each muscle fiber that contracts will produce an action potential, and the size of the muscle fiber affects the rate (how frequently an action potential occurs) and size (amplitude) of the action potential(s).
How the test feels
There may be some discomfort with insertion of the electrodes (similar to an intramuscular injection). Afterward, the examined muscle may feel tender or bruised for a few days.
Risks
Bleeding and Infection at the electrode sites (minimal risk)

There is no other way to describe it other than I felt like I was being tortured. I would have told him anything he wanted to know! He kept telling me, wow you're a bleeder. Umm yea that happens to people when you shove needles in the muscles and then tell me to flex. I probably got stuck about 15 times. A few were in the arm, shoulder, back and also the neck. The only ones that didn't hurt were the ones that I couldn't flex because the nerves are paralyzed - scapula muscle. The needles in my neck put me over the edge. I had tears running down my face and felt like screaming.

He said okay we got to get you out of here and over to get your MRI. I immediately went to the building across the way for my MRI. Yes I'm claustrophobic, how are you to be shoved in this tube and not panic? I went to my happy place. While I was there, at my happy place, I felt like I was being bombed! MRIs are LOUD. I felt like they had a machine gun on an amp being shot right in front of me. Seriously we're in the 21st century and we don't have anything less nerve racking? The tech said, you need to make sure that you don't move because if you do we'll have to start all over. Oh hell no. I will be still as long as you need me to be. By the end of the 15 min I felt a cough coming on, mind you I'm sick during all this. Good thing I didn't sneeze.
Now I'm not sharing this for a pity party but just so you get an idea of what my week was like. HATED IT!