Chapter 1: the neuroradiologist
This Tuesday afternoon was the vascular myelogram (a CT scan of the nervous system) ordered by the physiatrist, Dr. Deviren.
Before the event, we met at some length with the neuroradiologist, Dr. Donna Hoghoughi (hoe-GOO-gee). (Are there no doctors named Smith and Jones in this place?) She said the most extraordinary thing. She said that she had reviewed Marina’s CT scan done last November, before the surgeries, and while she knew nothing of the current complaint, based on what she saw in the scan, she predicted a strong likelihood of severe left leg pain.
In other words, Marina had some condition in the sciatic nerve, good old L-5, a narrowing at one point, that showed a predisposition to exactly the current condition. Dr. Hoghoughi politely said that it almost certainly would not have been noticed last November, because there were no symptoms; no reason to look at that part of the CT scan.
Chapter 2: the electrophysiologist
Faithful readers will recall that Dr. Null (filling in for Dr. Misakian) referred Marina to Dr. Charles Skomer, for an electrical test of nerve function, for which the preliminary diagnosis was a problem with L-5. Dr. Skomer, meet Dr. Hoghoughi. Marina returns to Dr. Skomer tomorrow for the detailed report.
So it may all be starting to come together. Dr. Hoghoughi has agreed to fax her report to Dr. Skomer, and of course it will go to Dr. Deverin as well. And Dr. Skomer’s report will go to Dr. Deverin as well. And everything will also go to Dr. Misakian and Dr. Hu. And then all these good people will, we all hope and trust, figure out what to do next.
Incidentally, the myelogram was no fun at all. A long and extremely painful procedure, Marina reports. Just positioning the needle in the spine to introduce the colored fluid was a 20-minute process, one millimeter at a time, guided by continuous ‘live’ Xrays to monitor where the needle was going. Marina will be pretty much out of commission for two or three days, mostly confined to bed, recovering from this, but for the trip to Dr. Skomer.
I'm sorry Berton Roueche is no longer around. I think he would have enjoyed this medical mystery.
Posted by John Bear
at 11:51 PM PST
Updated: Tuesday, 15 March 2005 11:53 PM PST