Klarinet Archive - Posting 000134.txt from 2003/07

From: "Christy Erickson" <perickso@-----.net>
Subj: RE: [kl] Neurological damage - help!
Date: Fri, 4 Jul 2003 10:42:08 -0400

James, I have a friend who is a physician in the Nashville area, =
believe it
or not. I ran your questions by here and for what its worth, here is =
her
take on this:

"Nerve entrapment is a tough one.=A0 If it can be released as he has =
described
by removing the obstruction, usually the nerve will be okay unless there =
has
been permanent damage.=A0 Then you are left with residual sensory=A0 or =
motor
(strength) loss.=A0 It seems odd that he had three days of relief and =
then he
lost it again.=A0 Almost like a reaction to the surgery.=A0 Three days =
is kind
of a magic post op day.=A0 Allergies and inflammatory reactions are =
highest
around this time.=A0 But they usually resolve spontaneously.=A0 =
Unfortunately,
his did not.=A0 Another EMG might be warranted to determine if there is =
a
second place of impingement, perhaps at the elbow.=A0 And I disagree =
that it
doesn't respond to surgery as I have had a handful of patients have good
results after release at the elbow.=A0 Not picking on Neurosurgeons, but =
some
are better than others.=A0 I know some good ones in Nashville.=A0 The =
biggest
concern I have was in the earlier e-mail where this might be related to
diabetic neuropathy.=A0 As this one doesn't respond to surgery and is =
not
related to entrapment.=A0 It is best treated with either TCAs like low =
dose
Elavil or anti-convulsants like Neurontin.=A0 Just my spin on it."

If you wish, I can put you in touch with this lady.

Christy Erickson

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