Waiting on diagnosis.

One other thing done today, was I contacted the DVLA via their web chat, to start the process of medical questionnaire regards fitness to drive, as advised to do by my neurologist. While I do feel safe to drive, going by the DVLA website any “chronic neurological disorder” is declarable.

So even if it is FND I eventually get diagnosed with, and not MS, this would still come under the “Chronic Neurological Disorder”

I certainly do think once I get the all clear (via medical license from DVLA), I’ll probably switch to an automatic transmission car.

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Small update.

I now have an appointment to see Prof Jon Stone, at the Royal Infirmary Edinburgh Neurology department at the end of February. His speciality is Functional Neurological Disorder, so it’s likely that is what I’m going to end up getting diagnosed with.

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His speciality is FND. If you do have FND then he’ll recognise it - his method is a diagnosis based on positive id, positive clinical features, rather than exclusion, and he seems quite rigorous on that, judging by his recent videos. If you don’t have FND then he should also be able to determine that, even if he can’t put a name to what it is. Hope it is a useful consultation.

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Just going to add, that if it is FND, or if part of it is FND then you are at the right place as his unit seems to be really proactive in terms of rehab, physio, and other treatments to help restore normal functioning.

Thank you, yes, I’m quite pleased to be seeing him, as he is proactive in trying to arrange physio etc. However I am not in the NHS Lothian area, (NHS Fife instead), so that may be an issue for getting any neurophysio.

However I do hope he still agrees to further testing, especially since my previous neurologist suggested that it could actually be something degenerative. Although I’m not sure I can really cope with another 12 months of waiting for appointments for more tests, then months of waiting for results. It’ll be 19 months at the end of this month…

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I know what you mean about all the waiting. It will be 36 months for me, in a months time. I’m now waiting for repeat MRI brain and cervical scan, and a first time thoracic spine scan. What with Covid I dread to think how long the wait will be for those. Latest news of York Hospital is that it is pretty manic there - very long waits for everything, grossly overstretched. Just looked at the latest statistics and percentage waiting longer than 6 weeks for MRI in November was 40%, and 10% weren’t done within 13 weeks. My consultant will probably have retired before I get a follow up appointment. His job was advertised in December.

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Well, I saw Prof Jon Stone today, at the Royal Infirmary Edinburgh.

He doesn’t think it is “Functional Neurological Disorder” which I have, so instead is referring me back to my original neurologist, with the aim of getting lumbar puncture, nerve conduction tests, and genetic testing to rule out other things.

He is however, going to get a referral for me for “Neurophysiotherapy”, which even if it’s not a “Functional” disorder which I have, won’t do any harm, but should hopefully help with my symptoms.

He did comment though, how while the herniated discs in my neck may not be the entire cause from my problems, they may be contributing slightly. Whether anything will be done about them is another matter, because spinal surgery is pretty risky.

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Sounds like a very useful visit.

Well, it is good to have a pretty definite diagnosis of it not being FND, and from one of the experts - at least you now know where you stand on that, and are not given an incorrect label just to call it something and then dismiss you. And good that you are getting referred to neurophysiotherapy too - anything that can optimise or at least keep things from getting worse is a good thing. Maybe it will help with the herniated discs too.

Interesting that they are suggesting getting genetic testing. I presume you’ve not had a lumbar puncture in your earlier tests then?

Sounds as if you may be in a similiar category to me - probably a rare condition, without a name because it is too rare. Apparently approx 10% of neurological disease fits into this category (SWAN - syndrome without a name).

It is very hard to live with the uncertainty, though.

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Thanks Ziola, while I partially wished I had been given a diagnosis yesterday, and then be able to move on with my life, I’m actually happier that I didn’t get a tick box diagnosis of FND, especially when Prof Stone and Dr Zeidler thinks it may be something which isn’t a functional disorder.

As yet I have had no lumbar puncture, it was talked about in 2020 at the onset of my symptoms, but it was put off due to Covid.

I think the genetic testing is just to cover all bases, especially since my great aunt (on my father’s side) did succumb to Motor Neurone disease.

I do think it’ll be a bit of a wait though for my next round of testing.

However since its looking likely that it isn’t FND, I’ve (politely) left a FND group on facebook which I had joined when all the symptoms kicked off.

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Bit of an update today I got a copy of the 5 page letter from the professor of neurology (Prof Stone) to my GP following last weeks appointment. Copy should have been sent to my previous Neurologist as well.

Basically Prof Stone (one of the top neurologists in Scotland) is unsure of my diagnosis, “Functional Gait Disorder” is a possible diagnosis, although my symptoms don’t really match that.

So Prof Stone wants me to get more tests done, to rule out the likes of Hereditary Spastic Paraplegia (HSP), Spinocerebellar Ataxia (CSA), as well as get tests to check spinal fluid to check for the likes of MS.

He also wants to check my GAD Antibodies?

Also, I’m also getting referred for specialist “Neuro-physiotherapy”, mainly to try to improve my mobility.

So no quick “tick box diagnosis” of Functional Neurological Disorder, but no real indications of what it is yet though.

Hopefully I’ll hear back from my previous Neurologist, Dr Zeidler, in due course.

Although I do wonder how long I’ll be waiting for my next round of tests and appointments…

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It is good to see a neurologist being that thorough. And a 5 page letter too!

I think there are a small number of neurological conditions associated with GAD antibodies. As you are having a lumbar puncture done it makes sense to check for those too.

Hope the wait for the neuro-pysiotherapy isn’t too long, to at least get something being tackled whilst waiting for further tests.

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A letter in the post today, with an appointment for outpatient physiotherapy assessment, at the Sir George Sharp Unit, Cameron Hospital, on the 11th of April. Fortunately on a Monday, which is my day off from work. This appointment will be to assess whether specialist neurophysiotherapy would be of benefit to me.

So not too long to wait, considering Prof Stone only decided to refer me when I saw him on the 28th of February.

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I’m afraid that you have the distinction of being an ‘interesting case’ - that most mixed of blessings…! Well, at least you’ve got the top people’s attention. I do hope that you get some clarity soon as to what ails.

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Anyway, following on from the Physio appointment, I’m now getting offered a form of “Neurophysiotherapy”, plus physio is going to chase next load of tests up with neurologist.

You’d think it’d be logical for the neurologist to agree to get me lumbar puncture & other relevant tests, then see me once he has the results.

No doubt I’ll need to wait until I see him next (in a few months time probably), then he’ll refer me for tests, then wait months for them…

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Things do move slowly but at least they are moving! Let us know how you find the neurophysiotherapy, and if it has any benefit.

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A couple of sessions in, and I can’t say I’ve noticed any real improvement. Next appointment with physio is on the 16th of May, and I’ll certainly ask if they have spoken with the neurologist to see how things are progressing…

Maybe it’s time to contact those local political councillors again…

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So I had to cancel today’s physio appointment due to having covid like symptoms last week (thankfully negative on LFT tests).

However I did phone my neurologist’s (DR Zeidler, NHS Fife) secretary today, to see where I am with regards to follow up appointment.

After the the secretary having a look through my notes, and phoning me back, it looks like I’ll get an appointment in two months or so (apparently Dr Zeidler has an enormous waiting list).

However there is nothing in my notes from Prof Stone requesting that I get a lumbar puncture / genetic testing. So no doubt I’ll need to wait until I see Dr Zeidler again, before he decides to possibly refer me for the waiting list for a lumbar puncture / genetic testing to rule stuff out… Surely the sensible thing would be to get these tests arranged, then see Dr Zeidler afterwards with results? Although to be fair, they could have done these tests way back in the mists of time when I was in hospital for a week in July 2020…

Apparently according to the neuro secretary I can go back to my GP if I feel I am getting worse. Except that my GP has pretty much washed their hands of me, since I am now under the care of a consultant…

I’m really not sure how much more of this I can take…

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Another update. I fired of an email to a local political councillor (Lib Dem) who helped escalate things last year (who I’m convinced helped me get my appointment with Dr Zeidler last November).

With my permission, he is going to raise this with the NHS Fife Chief Executive.

Much as I feel guilty about using political councillors in this way, “shy bairns get nowt” as the saying goes…

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How frustrating that you got Covid-like symptoms and had to cancel the physio session. And yes, it makes sense for those tests to be done first before the consultation, but I’ve had exactly the same. I don’t understand it. It just adds on months to years of delay.

Oh, for a nice easy-to-diagnose condition! Preferably one that is treatable too!

Limbo is just such a horrible place to be, and the fact that the NHS is so overstretched with huge delay and lack of communication at every stage, it is simply soul destroying. Extra uncertainty which is completely unnecessary, on top of the uncertainty of no diagnosis. It just ramps up anxiety. Basically the NHS is failing many people, and adding to their ill-health, rather than treating it.

I tried to get something as simple as physiotherapy on the NHS for my deteriorating knees - muscle weakness and fatigue had put a load of extra strain on my aging knees. The physiotherapist just diagnosed by telephone, sent out a pamphlet of generic physio exercises for knees, with no structure or grading to them and not designed for people with neurological muscle weakness and fatiguability. (Even said repeat until you can’t do any more, then repeat again 3 times!) When the exercises made things worse, she wouldn’t help make a more personalised plan, and wouldn’t even see me face to face for over 3 months. I switched to another NHS physiotherapist, who just sent me off for x-rays, and again wasn’t interested in trying to select more appropriate exercises or exercise plan. I was paying to see an osteopath privately, who was fairly sure I had both osteoarthritis and torn menisci. Based on that knowledge I went online and eventually found a good structured exercise program. So simple - just has an exercise for each relevant muscle, so not overworking of some muscles or overloading the knee, and I now know exactly which muscles are problematic, and how quickly they fatigue, and can now gauge if the exercises are having a good or bad or any effect. And discovered which my weakest muscles are, (you’d have thought the physio would have wanted to ascertain that) and discovered that strength of them is essential for healthy knees, yet they weren’t included in the generic NHS knee exercises! Just hopeless.

Anyway the knee x-rays came back showing severe osteoarthritis. Had a 5 minute telephone consultation with the physiotherapist who basically said I could be referred to a surgeon (4 month wait for initial consultation) for total knee replacements (goodness knows what wait for that), or have some injections (which are known to be not effective, or actually degrade cartilage), or do nothing. I asked about knee braces (the type of OA I’ve got is amenable to knee braces - thank goodness for google!) and he was dismissive. I said I was going to continue with the exercises, and he just wasn’t interested. I’ve found out that knee braces can be prescribed on the NHS (I rang the company) so am going to tackle the GP at the practice who is also a trained osteopath to see if I can get those. I suspect that I’ll have to buy them myself, though. £600 for each knee.

Sorry for my rant! I do know where you are coming from, so can really empathise. How much bashing one’s head against a brick wall can we take before we give up … I’m actually about to walk away from any further neurology consulations. I’ve had enough. They haven’t even told me if there is going to be any follow up, or not. I’m just going to let it lie, and see if they ever bother to contact me again.

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Anyway, a letter from neurologist a couple of days ago, saying he agrees to do a lumbar puncture and genetic testing.

Letter said hee would prefer to see me first to go through the pros and cons of a lumbar puncture, however if I’m happy to go ahead , I can phone his secretary to arrange.

So I gave the secretary a phone, and that’s my now waiting on an appointment for a lumbar puncture as well as the genetic blood testing.

Hopefully not too long a wait, but at least I know I’m getting these tests done (which could have been done 2 years ago when I was in hospital for a week).

Of course, the lumbar puncture and genetic blood testing (HSP / SCA and GAD antibodies) may come back as inconclusive. However at least I’ll know that’s another diagnosis pathway completed then.

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