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Take me home...St Emilion  kay@diddakoi.com

Updated: 06/06/06

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Tuesday, 06 June, 2006

Brachial Neuritis. AKA, brachial plexitis, acute shoulder neuritis and Parsonage-Turner syndrome. Here are some of the highlights from the visit to the neurologist:

Brachial neuritis (BN) is a rare syndrome of unknown etiology affecting mainly the lower motor neurons of the brachial plexus and/or individual nerves or nerve branches. BN is usually characterized by the acute onset of excrutiating unilateral shoulder pain, followed by muscle paralysis of the shoulder and parascapular muscles several days later.

The incidence in the U.S. is approximately 1.64 cases per 100,000 person-years. A male predominance exists, with a male to female ration ranging from 2:1 to 4:1.

Onset of pain is often abrupt [yes!] and may follow recent illness, surgery, immunization or even trauma [no!]. Usually localized to the right shoulder region [no - it's the left]. Usually the pain is described as sharp or throbbing [you betcha!]. Intense pain can last a few hours to several weeks [!] and requires opiate analgesia [that would be Vicodin or Percoset, boys and girls].

As the pain subsides, weakness becomes apparent; maximal at outset but can progress over one or more weeks. A wide variety of muscles is affected, particularly in the upper trunk. The patent may notice considerable atrophy and wasting as well as a deep aching in the affected muscles.

Causes? Who knows? I'm not fitting the profile here. The only thing I could imagine was somehow doing something while bicycling on Sunday morning - but given that I've been riding regularly for 15 years, that seems a bit far reaching.

As the neurologist said, "The good news is that you're going to get better. The bad news is that it's going to take a while." Like up to TWO YEARS! Essentially, it's going to be physical therapy to maintain full range of motion in the arm and shoulder, with continuing "opiate" use as needed. Oh, and tomorrow I am going in for an EMG - Electromyography - wherein they stick needles in me and send electric shocks through the muscles. And I'm also going to have an MRI - all of this to rule out the other possible explanations for all this: cervical disc disease, polio and ALS.

[Given the alternatives, I think I'll let them stick me with needles.]

On a brighter note, there are some new residents at the Georgia Aquarium:

ATLANTA - The world's largest aquarium has added two of the world's largest fish.

Two female whale sharks Alice and Trixie went on display Sunday after arriving the night before at the Georgia Aquarium. They joined two male whale sharks, Ralph and Norton, in their 6 million-gallon tank. The four sharks are the only ones of their kind on display outside of Asia.

The females were flown more than 8,000 miles from Taipei, Taiwan. They received a police escort from Hartsfield-Jackson International Airport and were hoisted into the giant tank around midnight.

"They're in great shape," said Bernie Marcus, the Home Depot co-founder who bankrolled the aquarium almost single-handedly with a gift of more than $200 million. "They're very healthy, and we don't foresee any problems."

The two females are 11 and 14 feet long. They could grow to as long as 40 feet.

I saw my first - and hopefully not last - whale shark in Malpelo off the coast of Columbia. She was also a baby - only twenty feet long or so - swimming right below the dive boat. We all were able to get in and snorkel with her for a good twenty minutes or so.

A Room with a View



[Only 7,205 more needed for our wine cellar wall.]

Quote du jour:

"DIAGNOSIS, n. A physician's forecast of the disease by the patient's pulse and purse."

Ambrose Bierce (1842 - 1914) US journalist, short-story writer

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