Neurology –> Neuropathy –> New To Me

With all the medical messes at my house lately, I hadn’t expected yet another one.  You’ve been reading about the established ones and how they affect Chronic Kidney Disease.  Here’s the new one: neuropathy.

I can’t tell you how long it took for me to simply pronounce the word correctly. I knew neuro comes from the Latin for nerve and pathy, also from Latin, is a “word-forming element meaning feeling, suffering, emotion, disorder, disease.” (Thanks for the help on pathy goes to The Online Etymology Dictionary at: There was no connect in my brain until my family doctor sent me to a neurologist.

Why you ask?  I wondered aloud in her office why I was feeling such tingling in both of my hands and, sometimes, my feet.  I found no discernible pattern to the tingling, although I could tell it was stronger in the hands than the feet.sad

Next thing I knew, I had an appointment with Dr. Maninder S. Kahlon at his Arizona Neurological Institute, better known as ANI, all the way out in Sun City.  That’s a bit away, but I agreed to the drive because Dr. Zhao recommended him so highly.  That’s also why I agreed to a male doctor when I usually prefer females.

This turned out to be a good move.  Dr. Kahlon is not only a good neurologist, but charming.  Now while that’s not usually my criteria for choosing a doctor, it was very necessary in this case since it was deemed necessary to have EMGs on both my upper and lower extremities.

EMG means Electromyography. Big help, huh? Back to basics (Yes, I do know how often I use that phrase, but let’s face it: you can’t build a house without a foundation.). According to eMedicineHealth at, “… electromyography involves testing the electrical activity of muscles. “

Next question: why in heaven’s name would anyone want to do that? I suspected it might have to do with a trapped nerve since I’d had carpal tunnel surgery 27 years ago and remembered a little bit of the process for diagnosing it.carpal tunnel at answered that one for me: “When muscles are active, they produce an electrical current. This current is usually proportional to the level of the muscle activity.”    

So did that mean I had carpal tunnel again?  Oh, sorry, carpal tunnel is when the median (middle) nerve in your wrist is trapped by the ligament.  Ligament surgery was pretty painful.  I’m hoping things have improved in the last 27 years… just in case, you understand.

Back to why.  I found an answer I could live with on my old friend The Mayo Clinic’s website at

“EMG results are often necessary to help diagnose or rule out a number of conditions such as:

  • Muscle disorders, such as muscular dystrophy or polymyositis
  • Diseases affecting the connection between the nerve and the muscle, such as myasthenia gravis
  • Disorders of nerves outside the spinal cord (peripheral nerves), such as carpal tunnel syndrome or peripheral neuropathies
  • Disorders that affect the motor neurons in the brain or spinal cord, such as amyotrophic lateral sclerosis or polio
  • Disorders that affect the nerve root, such as a herniated disk in the spine”

I was floored.  I hadn’t remembered that both my family physician and Dr. Kahlon explained this.  I only concentrated on the possible carpal tunnel.  Come to think of it, it would have had to be something else in my feet.  Lesson learned; you need to keep reminding yourself to listen to your doctors’ explanations even if you think you know the information already.

Scuttlebutt had it that this was a very painful test, but Dr. Kahlon distracted me with a constant stream of chatter about CKD, neurology, families, and even Landmark while he worked on my lower extremities. By the next day, we’re weren’t chattering anymore but having serious discussions.  This distracted me so much that I was barely aware of what he was doing.

Thank you, Dr. Kahlon from a stoic coward, which means I bear with the pain, but I hate the thought of it. This time, pain wasn’t a problem.

Time to tell you what the good doctor actually did to me. I was asked not to use any lotions or creams the days of the tests.  When we were ready to start, Dr. Kahlon asked me to lay down for the lower extremities test and sit up on the examination table for the upper extremities test.

EMG needlesFrom my side, the tests were simple.  First, electrodes were applied to different parts of my legs or arms (depending on which were being tested that day). Once he had recorded the readings from the electrodes, he pierced my skin with needles.  I cannot say any of this hurt, but there was some discomfort.

Bear had the test years ago and had expected me to come home in extreme pain.  Instead, I went to meet a friend for coffee one day and to the Landmark Center the other.  It really didn’t hurt.

Dr. Kahlon gave me the results of both days’ tests as well as those of the blood test he’d ordered for TSH, B12, folate, and vitamin D.  Apparently, a deficit of any of these could cause the tingling I had. None of my readings for these elements were out of range.

What I really got a kick out of was watching him use Dragon Medical to write his notes.  That’s the doctors’ version of the same program I’ve been struggling with since Christmas!

So far, I don’t need anything.  He suggested a follow up visit.  I suggested ten years.  He didn’t laugh.  I suggested a year.  He still didn’t laugh and told me six months would do.  I guess being on the borderline of having carpal tunnel is more serious than I thought.

How does this impact CKD?  There is medication that can help, but I didn’t want to discuss it yet since it is eliminated via the kidneys. I’ve become pretty good at doing without medication these days.  More on that should it come to a point when it’s a necessity.

Book news!  I have just paid off the cost for printing the book.  I’m going to keep this little game up, though.  Now I want to recoup the cost for converting the book to digital form.  You know I’m still going to keep donating, no matter how much I recoup or not.  I am thankful to have the money to be able to do this.Book Cover

Until next week,

Keep living your life!