Today I had the follow up with the neuro. There is some occlusion in the external carotid artery which isn't the carotid that they really worry about. But, the thinking (I guess) is that if there is narrowing there, there might be narrowing in the main carotid artery (and no, that is not the technical term...I believe it would be the internal carotid, but not sure). Since they can only see a couple of inches of that with the ultrasound, they have scheduled an MRA (Magnetic Resonance Angiography). That's tomorrow. He said typically occlusion of the external carotid has no symptoms, so he doesn't think it would explain the pain (more like discomfort) I get up my neck into my ears. The fun part was the nerve conduction tests. He did the one with just the shock and the one with the needle into the muscle to get to the deeper nerves. The needle one sounds horrible, but it was nothing...barely noticeable. However, I really didn't like the external one. Especially on my left arm where I have ulnar nerve entrapment. When they don't get a response to the initial shock, they up it. NOT FUN. Then he says, oh, yeah, there's definitely an issue with that nerve. I'm thinking that I could have told him that without him hurting me, but he seemed so excited to see it that I didn't want to ruin it for him. So, I have to get an x-ray of that elbow and then an ultrasound to determine why it's an issue. I told him it started with a pain flare that was in my left shoulder and neck, but he seems pretty determined that it's from use. So after the tests, I'll let him tell me it's from inflammation and I won't even say I told you so. The down part is that he didn't get any abnormal readings from my right arm and that's where I have all the muscle involvement. He commented on how my wrist looks funny (that muscle stays puffy all the time now) and that I have a fat deposit (or something like that) along the muscle on my upper arm which is indicative of connective tissue disease. He thinks I'm interesting because of my medical history. Told me he was discussing me with his colleagues and they had never heard of anyone my age having the kind of heart disease, yada, yada, yada. He said heart attack and stroke are common - or more common, or something - with connective tissue disease. I already knew that, but it was nice to hear a doctor say that. So far the only one who doesn't think I have a connective tissue disease is the rheumy. And I'm getting a second opinion. I really like this guy (the neuro). He's a real person...you know, not the God complex. It's obvious he really likes what he does. He was so excited doing the nerve tests. Was telling me all about when they were learning this, they learned on each other for a period of 6 months. He didn't enjoy it at all. Although, he did say it's not as bad as grabbing an electric fence. That was another story. Funny guy. Oh and the neuropsychologist report...besides all of the other handy info in it, it has one very interesting paragraph: "Ms. R has been treated with medication for depression for a number of years. Her current emotional status seems to be generally stable with treatment. She is future-oriented and did not report evidence of suicidal ideation or feelings of hopelessness. There was no evidence that her cognitive problems were related to her history of depression." So, the next time some doctor tries to blame my pain or cognitive issues or fatigue on my history of depression, I'm going to whip this out and tell them to kiss my big, fat hiney. By the way, the diagnosis from the neuropsychologist is mild cognitive disorder, not otherwise specified with amnestic features. I still have to schedule the second opinion appointment with a rheumy. I've been laying low since easy child's accident. Kinda hit my limit. But I am feeling recharged today with another knowledgeable person recognizing that something really IS going on.