I write this report to supplement diagnosis from my cervical spine fMRI on 03/21/2018. Please accept this information as from a scientific observer. I have 2 PhDs, in physics and psychology. Competent patient feedback should be as valuable as instrument readings.

SUMMATION 4/8/2018
My walking, as in stores, has become very limited, as to back pain. By the end of a day I have difficulty walking i the house, and usually walk bent over.
When not otherwise occupied in doing things (keyboarding, eating, holding a cup) I am obsessed with stimming, hand to hand, finger to finger, the feeling being quite unique and powerful. This doesn’t bother me, but it disturbs others.

My recent slippery hands and fingers  is a very practical handicap.

I am in need of COMPREHENSIVE evaluation and care, which I am concerned cannot be provided by Banner.

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My most disabling and most recent issue is back/hip pain when standing or walking. This pain greatly effects my mobility:

This is “true pain”, not extreme discomfort as for most of my other issues. I also experience pain in my elbows,in certain positions.

This pain usually increases during the day. The pain can be present early in the morning, but can be absent for many hours. The pain is usually a uniform band across my lower back; with occasional extension to one or both hips. It can get so intense as to force me to stop (when walking) or sit down (when standing).

My walking stability varies. I have yet to use canes or walkers, although I push  cart when shopping. I stagger, bump into things, tip but never fall; but seem more mobile than many other old farts I observe. However, I will be seeking both a walker with seats and a motorized scooter. There ARE times when I can’t walk 30 feet.

I see I reported issues of back pain in my long msg to you 07/17/2017.
I also see from my records I had X-rays of my back on 03/31/2015, because of severe back pain. I had forgotten this, as this pain has not bothered me until very recently. This 2015 pain my have resulted from my fall on 03/18/2015.

My records:

3/8/15 8a FELL down taking out garbage, few scrapes and bruises
3/17/15 12:06p right hip hurts to put dog bowls on floor
3/18/15 10:07a hips still hurt groin hurts probably a result of my fall
3/22/15 11:48a right lower back stiff and painful – also groin
3/22/15 12:43p BACK PAIN MOST SEVERE almost go to ER
3/23/15 10:12a pain and stiffness minimal elbows hurt now, hands shake
3/28/15 1:21p BACK MILD, AREA ON HEAD, BEHIND RIGHT EAR CONTINUES TO BE SENSITIVE – INCLUDE IN CONCERNS WITH PCP
3/31/15 10:19p XRAYS – lower right back & right side of head acting up,

This HOSPITAL Xray report of 2015 indicated many problems local to the areas of back and hip pain and probably not due to my cervical spine.

XR LUMBAR SPINE 2 OR 3 VW (XR LUMBAR SPINE 2 OR 3 VIEWS) – Final result (03/31/2015 1:30 PM MST)
XR LUMBAR SPINE 2 OR 3 VW (XR LUMBAR SPINE 2 OR 3 VIEWS) – Final result (03/31/2015 1:30 PM MST)

Impressions
Impression: 1. Moderate to severe degenerative changes of the lumbar spine with mild dextroscoliosis and grade 1 anterolisthesis of L4 on L5. 2. Mild to moderate osteoarthritis of the hips, worse on the left.
XR LUMBAR SPINE 2 OR 3 VW (XR LUMBAR SPINE 2 OR 3 VIEWS) – Final result (03/31/2015 1:30 PM MST)

Narrative
Result: History: 80-year-old male with low back pain. Comparison: Pelvis and left hip radiograph from 08/23/2011 Technique: Three views of the lumbar spine. AP view the pelvis. Findings: Lumbar spine: No acute osseous abnormality is seen. The vertebral body heights are maintained. There is moderate to severe multilevel degenerative disc disease of the lumbar spine, most prominent at L1-L2 and L5-S1. Moderate multilevel facet arthropathy is seen of the mid and lower lumbar spine. There is dextroscoliosis of the track lumbar spine with the apex at L3. There is 4 mm of anterolisthesis of L4 and L5. There is mild loss of the normal lumbar lordosis. The alignment is otherwise unremarkable. Multiple abdominal sutures and surgical clips are seen. Pelvis: No acute osseous or mallet he is seen on a single view. There are mild to moderate degenerative changes of the hips, worse on the left. Minimal degenerative disease in the pubic symphysis. The sacroiliac joints are maintained. The alignment is unremarkable.
XR PELVIS 1 OR 2 VIEWS – Final result (03/31/2015 1:30 PM MST)
XR PELVIS 1 OR 2 VIEWS – Final result (03/31/2015 1:30 PM MST)

 

Current Issues with my hands and arms:

I present this detail, not that these issues need to be treated. Rather, as possible info about my cervical spine and the possible effect it is having on my back and my mobility.

I frequently drop things and have difficulty picking up simple things. This I reported in 07/17/2018, but it has worsened.

My fingerprints and palm prints are gone, making grasping surprisingly slippery.  I need to find appropriate gloves.

Fingers and hands are weak for certain actions.

The grasp test, in medical exams, on a finger remains somewhat strong, but doesn’t represent weakness for other actions.

I have very strange feeling of my fingers, which have evolved since my “accident” on 10/01/2017 and my carpal tunnel surgery on 02/15/2018.

Prior to the Oct01 accident, I had adapted to my decade long issues with my elbows and my arthritic hands. Medical exams always focus on these because of your necessary query about pain – which I must answer honestly. I now realize that recent explorations about treatment or surgery for my elbows has distracted me (and my doctors) from more significant issues. However, these new issues are critical, and should be distinguished from my prior issues with my elbows. Noted: elbow pain did radiate into upper arms.

Since childhood I have “played with my hands”. I recently learned this is “stimming” (self stimulating), characteristic of autism spectrum behavior. One habit was picking skin off my finger tips and occasionally loosening a finger nail. A few years ago I had bloodied my fingers so much that I started using rubber finger tips (for secretaries using paper sheets) to keep me from “picking my fingers”. I soon became addicted to these rubber fingers, and used them constantly when stimming. This replaced all normal finger-to-finger play.

Also, the strength of my arms and hands has been decreasing, for decades; which I was adapting to.

What is happening SINCE OCT 2017 is qualitatively different that my symptoms and issues before !!!!!!!

The label “neuropathy” is inadequate to describe the changes in my experiencing my hands and things I touch and how I am able to use my hands and fingers.

The “accident”: I was parked in a left turn lane. The foot of the driver, in the car behind me, slipped from brake to gas and rammed into my cars’ back – destroying the rack for motorized chair. I remember no sense of being injured. However, it must have jarred my cervical spine.

From my records it took a few weeks after the “accident” before I began reporting new experiences with my hands and fingers. Primarily the FEELING INTENSITY has increased by “orders of magnitude”, forcing my conscious attention to my hands almost continuously. This had increased over time.

As the feeling in my fingers increased, I used the rubber fingers less and less, doing mostly finger-to-thumb touching. Also finger nail of one finger to top front of another finger or thumb. I danced with my fingers – oblivious to what others saw. The feeling I had of my fingers changed. They felt fatter and more “cushy”, like big, soft sponges. This activity was almost always within hand, not hand to hand – which later shifted.

It is hard to describe the new feeling sensations I am now having. My proprioceptive senses have always been weak, which I’ve attributed to the factors that deny me mental imagery in all sensory modalities, including proprioceptive mental imagery. I can’t sense the direction my feet are pointing without looking: making it impossible for me to ski. Before I became aware of autistic stimming, I rationalized my “finger picking” (and beard twirling) as my need to “prove” I was there. My new attraction to my fingers was unique, and beginning to attract conceptual attention to my feeling experientials.

Then I had my carpal tunnel surgery, recommended to reduce my upper arm pain – attributed to my elbows? This was done in spite of the fact that the nerve test showed my right arm worse whereas my symptoms were worse in my left arm. Also, this was a “low hanging fruit” surgery, before considering cervical spine issues. Today I wish I hadn’t had that surgery. The incisions in my hands are healing very slowly and are ugly and sensitive.

Over time, the “heaviness”, “dense”, “intense” feelings in my fingers progressed down my hand, wrists, lower arm, to my upper arm. I also think it as progressing up my legs; and my toes have long been “numb”.

I have totally abandoned my rubber finger tips. Except in bed, I seldom self stimulates within one hand; instead I stimulate hands with each other – usually finger tips to finger tips, often in a dance of movement. But, the behavior isn’t what is most significant; instead it is the change in tactical perception.

I have never before experienced the intensity of feelings I have in my finger tips even when touching nothing. What is most interesting, is that I no longer psychologically project my feelings to the textures of objects being touched. Now I FEEL MY FINGERS, not what I am touching! This makes my finger tips to finger tips dance so intense and addictive. It verges on the intensity of orgasm.

Also, the quality of feeling in my fingers has changed drasticaly. Before the surgery, my fingers felt fat and spongy. Today each finger reels like a narrow straw of stiff rubber, with very sharp tips. Te feeling of movement of fingers is far greater than what is visually observed.

All feeling in arms, hands and fingers ge significantly stronger during the day; being most intense when I go to bed to sleep. I usually takes me 1-3 hours to relax, not stim fingers, and find non painful positions for my arms. I wake frequently during the night with my entire arm/hand/finger systems “as a clay lump, with no differentiation of feelings. Turning over, I can move them and return to “normal” “weird” feelings. I can usually return to sleep quickly, fortunately.

The condition of my hands results in a lack of ability to perform many actions. Fortunately, I can still keyboard, but with many, many typos. I either press a key too lightly, not typing the symbol, or too strongly, getting repetitions. Frequently reversing letters or accidentally adding letters is more brain than hand.

I can adapt to most of this. I’m not sure I would risk spinal surgery in an attempt to return my hands and fingers to their earlier condition.