Thursday, March 17, 2011

What do you do as a Neurologist, exactly?

Usually patients show up knowing exactly why they're here to see me, but sometimes patients show up and are not sure exactly what they are supposed to get out of this visit, what exactly I do as a Neurologist. It is not uncommon for someone to ask what type of patients I see. We as Neurologists see a wide spectrum of illnesses, anything that can directly, or often indirectly, affect the brain or spinal cord (central nervous system) or the nerves after they exit the spinal cord and weave their way into every nook and cranny of your body (peripheral nervous system). You can imagine that this would encompass a wide variety of illnesses such as the headline-dominating illnesses like Strokes and Alzheimer's disease, Parkinson's and Epilepsy, Tumors and Multiple Sclerosis among many many others... not to mention all the exotic and mysterious multi-syllabic-named illnesses out there, and the very common complaints such as carpel tunnel syndrome, headaches, neuropathy in the feet.

From day-to-day, when I'm not seeing patients in the hospital, I'll see an average of 5 to 8 new outpatients a day, and the rest are follow up on our prior visits or studies such as MRIs/lumbar punctures/urine studies/blood work, sleep studies or electroencephalograms (EEGs) to explain the results which can often be very tedious because of the diagnoses we are considering. I spend an average of 45 minutes with each new patient currently (although current healthcare cuts may make us change to 30 minute visits in the future). So in a 5 day week, I currently see an average of 25 to 40 new patients and a whole bunch of follow ups.

I wanted to give you a touch of insight into what people complain of, so I took word-for-word, the chief complaints patients write on their "REASON FOR THIS VISIT" section of their form and list for you a whole week's worth of new patient subjective chief complaints. This is what I see as their complaint before I walk in to see what I can do to help address it:

43-----I feel off
76-----Trouble speaking
80-----Memory decline
36-----Neurocysticercosis and sleepy
50-----Excessive daytime fatigue and sleepiness
23-----Night fits
63-----Neck pain and hands numb
45-----I snore like the banshee
40-----Post traumatic hypersomnolence
29-----Cognitive problems, fatigue, joint pain, muscle pain, insomnia, anxiety
52-----Increasing weakness; cerebral palsy
33-----Multiple sclerosis?
60-----Difficulty sleeping
75-----Weakness in arms and legs
65-----Recent "mini stroke"
45-----Sudden loss of consciousness
60-----PTSD at night? Kicking a lot.
51-----My vision is "shaky"
45-----Worms feeling in my legs
37-----Head injury-weakness
37-----Discomfort in neck, left arm, left leg, getting worse
76-----right leg weakness
39-----Bell's palsy?
35-----Burning in my toes
56-----Severe restless legs- meds don't work on me
74-----Gait disturbance
71-----Memory poor
43-----Off balance, speech pattern
67-----Sensation changes in arms and legs
53-----Continued 1 month right-sided headache
74-----Passing out but aware of surroundings
26-----Severe headache, pregnant