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Hello, I Have Had Full Body Muscle Twitching For Nearly
Question: Hello, I have had full body muscle twitching for nearly 3 1/2 weeks. I fear ALS. I’ve tried to exercise and relax, but nothing seems to calm them. I literally have them from my face to feet. I do not have muscle weakness that I can tell in any location. Prior to last week, I had a valve that’s had twitching for over a year - it had been injured. Would ALS sudden onset with twtiching all over the body? I am extremely concerned and cannot see a neurologist sooner than 4/22.
Hello, I have had full body muscle twitching for nearly 3 1/2 weeks. I fear ALS. I’ve tried to exercise and relax, but nothing seems to calm them. I literally have them from my face to feet. I do not have muscle weakness that I can tell in any location. Prior to last week, I had a valve that’s had twitching for over a year - it had been injured. Would ALS sudden onset with twtiching all over the body? I am extremely concerned and cannot see a neurologist sooner than 4/22.
Brief Answer:
Not likely at all to be ALS by description
Detailed Answer:
Good afternoon and greetings once again kind sir.....
I'm sorry that your twitchings haven't really slowed down at all and that you feel that you're experiencing a protracted delay to getting in to see a neurologist.
I'm not certain I understand your reference to a VALVE that's been twitching for over a year which had been injured. I don't recall that part of your story from the 2 other consults I performed for you. But in answer to your questions:
1. Would ALS sudden onset with twitching all over the body.
>>>>Absolutely not. This is entirely outside the pathophysiological realm of how motor neuron disease (specifically to your concern of ALS) would present. In motor neuron disease, twitching is a manifestation of muscle fibers trying to make up for lost electrical support from DYING NERVE fibers. However, these dying nerve fibers correspond to a specific nerve that tracks back to a specific motor column in the spinal cord affected by the ALS process. Twitching is by its temporal nature seen once other symptoms have already manifest since the actual dying of nerves is a later process than when muscles become weak or atrophied. In order for twitching "all over the body" to occur and be related to dying of motor neurons in the spinal cord......the ENTIRE SPINAL CORD's supply of motor neurons (from the top to the bottom of where motor neurons originate) would have to be experiencing this atrophic phenomenon....and this is simply anatomically and pathophysiologically impossible. Furthermore to have the whole body go off spontaneously is not explainable by any anatomic means.
This sort of picture, however, IS quite explainable if the process under discussion were due to underlying METABOLIC disturbances, ENDOCRINOLOGICAL concerns, or disturbances of a psychological nature such as overall stress/anxiety, fatigue, and nervousness. These sentiments and emotions...along with the metabolic disorders mentioned could conceivably be manifest in a BODY or SYSTEM-WIDE manifestation of muscle twitchings that could in and of themselves beget more muscle twitchings to neighboring or more local muscle fibers until it was simply a DIFFUSE process.
However, these causes are all considered to be at least identifiable for the most part if not correctable in large part. You say that you've tried yourself to relax, however, this is a difficult proposition to do on one's own part. I would highly recommend soliciting the services of a trained professional who is well versed in describing and helping you implement techniques of deep breathing, muscle relaxation (eg. Alexander's Technique), along with other modalities not easily accomplished by oneself such as BIOFEEDBACK, massotherapy, yoga, and meditation. Make sense?
Finally, I don't know if this would help put you at more ease or not but Norwich, NY (where an uncle of mine resides....been up to his Lake cabin....beautiful country up there!) is about 6 hrs. by car from XXXXXXX If you are interested in making the moderate drive to XXXXXXX OH I would be happy to make time slots available to get you in much sooner than that time and with a little advance planning we could get you in to do all appropriate testing such as labs and electrical to make the diagnosis of what is more likely than not BFS (Benign Fasciculation Syndrome).
If something like that may be of interest to you then, feel free to contact us at PARMA NEUROLOGY at 440.842.3816 and the office will be happy to give you the details on how we would need to set things up so that everything can be done either on the same day or over the course of 2 days at the most.
As always, your critical comments are greatly appreciated since a famous person once said, "Feedback is a Blessing!" If you have additional comments or questions then, I await your response or you are at your XXXXXXX to contact our office for other information regarding getting you set up to be seen if you'd like.
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get you back on the path of feeling well soon.
This query required 24 minutes of professional time to research, assimilate, and respond in complete form.
Not likely at all to be ALS by description
Detailed Answer:
Good afternoon and greetings once again kind sir.....
I'm sorry that your twitchings haven't really slowed down at all and that you feel that you're experiencing a protracted delay to getting in to see a neurologist.
I'm not certain I understand your reference to a VALVE that's been twitching for over a year which had been injured. I don't recall that part of your story from the 2 other consults I performed for you. But in answer to your questions:
1. Would ALS sudden onset with twitching all over the body.
>>>>Absolutely not. This is entirely outside the pathophysiological realm of how motor neuron disease (specifically to your concern of ALS) would present. In motor neuron disease, twitching is a manifestation of muscle fibers trying to make up for lost electrical support from DYING NERVE fibers. However, these dying nerve fibers correspond to a specific nerve that tracks back to a specific motor column in the spinal cord affected by the ALS process. Twitching is by its temporal nature seen once other symptoms have already manifest since the actual dying of nerves is a later process than when muscles become weak or atrophied. In order for twitching "all over the body" to occur and be related to dying of motor neurons in the spinal cord......the ENTIRE SPINAL CORD's supply of motor neurons (from the top to the bottom of where motor neurons originate) would have to be experiencing this atrophic phenomenon....and this is simply anatomically and pathophysiologically impossible. Furthermore to have the whole body go off spontaneously is not explainable by any anatomic means.
This sort of picture, however, IS quite explainable if the process under discussion were due to underlying METABOLIC disturbances, ENDOCRINOLOGICAL concerns, or disturbances of a psychological nature such as overall stress/anxiety, fatigue, and nervousness. These sentiments and emotions...along with the metabolic disorders mentioned could conceivably be manifest in a BODY or SYSTEM-WIDE manifestation of muscle twitchings that could in and of themselves beget more muscle twitchings to neighboring or more local muscle fibers until it was simply a DIFFUSE process.
However, these causes are all considered to be at least identifiable for the most part if not correctable in large part. You say that you've tried yourself to relax, however, this is a difficult proposition to do on one's own part. I would highly recommend soliciting the services of a trained professional who is well versed in describing and helping you implement techniques of deep breathing, muscle relaxation (eg. Alexander's Technique), along with other modalities not easily accomplished by oneself such as BIOFEEDBACK, massotherapy, yoga, and meditation. Make sense?
Finally, I don't know if this would help put you at more ease or not but Norwich, NY (where an uncle of mine resides....been up to his Lake cabin....beautiful country up there!) is about 6 hrs. by car from XXXXXXX If you are interested in making the moderate drive to XXXXXXX OH I would be happy to make time slots available to get you in much sooner than that time and with a little advance planning we could get you in to do all appropriate testing such as labs and electrical to make the diagnosis of what is more likely than not BFS (Benign Fasciculation Syndrome).
If something like that may be of interest to you then, feel free to contact us at PARMA NEUROLOGY at 440.842.3816 and the office will be happy to give you the details on how we would need to set things up so that everything can be done either on the same day or over the course of 2 days at the most.
As always, your critical comments are greatly appreciated since a famous person once said, "Feedback is a Blessing!" If you have additional comments or questions then, I await your response or you are at your XXXXXXX to contact our office for other information regarding getting you set up to be seen if you'd like.
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get you back on the path of feeling well soon.
This query required 24 minutes of professional time to research, assimilate, and respond in complete form.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Not likely at all to be ALS by description
Detailed Answer:
Good afternoon and greetings once again kind sir.....
I'm sorry that your twitchings haven't really slowed down at all and that you feel that you're experiencing a protracted delay to getting in to see a neurologist.
I'm not certain I understand your reference to a VALVE that's been twitching for over a year which had been injured. I don't recall that part of your story from the 2 other consults I performed for you. But in answer to your questions:
1. Would ALS sudden onset with twitching all over the body.
>>>>Absolutely not. This is entirely outside the pathophysiological realm of how motor neuron disease (specifically to your concern of ALS) would present. In motor neuron disease, twitching is a manifestation of muscle fibers trying to make up for lost electrical support from DYING NERVE fibers. However, these dying nerve fibers correspond to a specific nerve that tracks back to a specific motor column in the spinal cord affected by the ALS process. Twitching is by its temporal nature seen once other symptoms have already manifest since the actual dying of nerves is a later process than when muscles become weak or atrophied. In order for twitching "all over the body" to occur and be related to dying of motor neurons in the spinal cord......the ENTIRE SPINAL CORD's supply of motor neurons (from the top to the bottom of where motor neurons originate) would have to be experiencing this atrophic phenomenon....and this is simply anatomically and pathophysiologically impossible. Furthermore to have the whole body go off spontaneously is not explainable by any anatomic means.
This sort of picture, however, IS quite explainable if the process under discussion were due to underlying METABOLIC disturbances, ENDOCRINOLOGICAL concerns, or disturbances of a psychological nature such as overall stress/anxiety, fatigue, and nervousness. These sentiments and emotions...along with the metabolic disorders mentioned could conceivably be manifest in a BODY or SYSTEM-WIDE manifestation of muscle twitchings that could in and of themselves beget more muscle twitchings to neighboring or more local muscle fibers until it was simply a DIFFUSE process.
However, these causes are all considered to be at least identifiable for the most part if not correctable in large part. You say that you've tried yourself to relax, however, this is a difficult proposition to do on one's own part. I would highly recommend soliciting the services of a trained professional who is well versed in describing and helping you implement techniques of deep breathing, muscle relaxation (eg. Alexander's Technique), along with other modalities not easily accomplished by oneself such as BIOFEEDBACK, massotherapy, yoga, and meditation. Make sense?
Finally, I don't know if this would help put you at more ease or not but Norwich, NY (where an uncle of mine resides....been up to his Lake cabin....beautiful country up there!) is about 6 hrs. by car from XXXXXXX If you are interested in making the moderate drive to XXXXXXX OH I would be happy to make time slots available to get you in much sooner than that time and with a little advance planning we could get you in to do all appropriate testing such as labs and electrical to make the diagnosis of what is more likely than not BFS (Benign Fasciculation Syndrome).
If something like that may be of interest to you then, feel free to contact us at PARMA NEUROLOGY at 440.842.3816 and the office will be happy to give you the details on how we would need to set things up so that everything can be done either on the same day or over the course of 2 days at the most.
As always, your critical comments are greatly appreciated since a famous person once said, "Feedback is a Blessing!" If you have additional comments or questions then, I await your response or you are at your XXXXXXX to contact our office for other information regarding getting you set up to be seen if you'd like.
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get you back on the path of feeling well soon.
This query required 24 minutes of professional time to research, assimilate, and respond in complete form.
Not likely at all to be ALS by description
Detailed Answer:
Good afternoon and greetings once again kind sir.....
I'm sorry that your twitchings haven't really slowed down at all and that you feel that you're experiencing a protracted delay to getting in to see a neurologist.
I'm not certain I understand your reference to a VALVE that's been twitching for over a year which had been injured. I don't recall that part of your story from the 2 other consults I performed for you. But in answer to your questions:
1. Would ALS sudden onset with twitching all over the body.
>>>>Absolutely not. This is entirely outside the pathophysiological realm of how motor neuron disease (specifically to your concern of ALS) would present. In motor neuron disease, twitching is a manifestation of muscle fibers trying to make up for lost electrical support from DYING NERVE fibers. However, these dying nerve fibers correspond to a specific nerve that tracks back to a specific motor column in the spinal cord affected by the ALS process. Twitching is by its temporal nature seen once other symptoms have already manifest since the actual dying of nerves is a later process than when muscles become weak or atrophied. In order for twitching "all over the body" to occur and be related to dying of motor neurons in the spinal cord......the ENTIRE SPINAL CORD's supply of motor neurons (from the top to the bottom of where motor neurons originate) would have to be experiencing this atrophic phenomenon....and this is simply anatomically and pathophysiologically impossible. Furthermore to have the whole body go off spontaneously is not explainable by any anatomic means.
This sort of picture, however, IS quite explainable if the process under discussion were due to underlying METABOLIC disturbances, ENDOCRINOLOGICAL concerns, or disturbances of a psychological nature such as overall stress/anxiety, fatigue, and nervousness. These sentiments and emotions...along with the metabolic disorders mentioned could conceivably be manifest in a BODY or SYSTEM-WIDE manifestation of muscle twitchings that could in and of themselves beget more muscle twitchings to neighboring or more local muscle fibers until it was simply a DIFFUSE process.
However, these causes are all considered to be at least identifiable for the most part if not correctable in large part. You say that you've tried yourself to relax, however, this is a difficult proposition to do on one's own part. I would highly recommend soliciting the services of a trained professional who is well versed in describing and helping you implement techniques of deep breathing, muscle relaxation (eg. Alexander's Technique), along with other modalities not easily accomplished by oneself such as BIOFEEDBACK, massotherapy, yoga, and meditation. Make sense?
Finally, I don't know if this would help put you at more ease or not but Norwich, NY (where an uncle of mine resides....been up to his Lake cabin....beautiful country up there!) is about 6 hrs. by car from XXXXXXX If you are interested in making the moderate drive to XXXXXXX OH I would be happy to make time slots available to get you in much sooner than that time and with a little advance planning we could get you in to do all appropriate testing such as labs and electrical to make the diagnosis of what is more likely than not BFS (Benign Fasciculation Syndrome).
If something like that may be of interest to you then, feel free to contact us at PARMA NEUROLOGY at 440.842.3816 and the office will be happy to give you the details on how we would need to set things up so that everything can be done either on the same day or over the course of 2 days at the most.
As always, your critical comments are greatly appreciated since a famous person once said, "Feedback is a Blessing!" If you have additional comments or questions then, I await your response or you are at your XXXXXXX to contact our office for other information regarding getting you set up to be seen if you'd like.
You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors in order to help get you back on the path of feeling well soon.
This query required 24 minutes of professional time to research, assimilate, and respond in complete form.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You are a blessing Dr. Saghafi! It is unexplainable the amount of emotional direst this has caused my wife and I. I will try a few more days to let your information set in and if things do not improve for me, I will see you in Cleveland! I live in CT, so a flight will work for me. Maybe a drive would cool me down too..... I’ve been very, very concerned of als and other diseases. Just recently, I viewed my friend (former mother in-law) pass from a rare form of one. I’m sure that has caused a spike in my fears. But hearing that “sudden onset” is not in the medical picture gives me a sense of relief. I will contact your office by Monday if I do not improve.
I meant to say “calve” not valve in my post. I had muscle twitching in my calve for years prior. I had sustained an injury dating back to 2015. Both calves twitch when heavily used, but I have never experienced weakness. They have always been tight since the injuries and seem to feel tighter if I’m dehydrated. I hope your office accepts Cigna. I will call to find out shortly! Thank you so much!
I meant to say “calve” not valve in my post. I had muscle twitching in my calve for years prior. I had sustained an injury dating back to 2015. Both calves twitch when heavily used, but I have never experienced weakness. They have always been tight since the injuries and seem to feel tighter if I’m dehydrated. I hope your office accepts Cigna. I will call to find out shortly! Thank you so much!
You are a blessing Dr. Saghafi! It is unexplainable the amount of emotional direst this has caused my wife and I. I will try a few more days to let your information set in and if things do not improve for me, I will see you in Cleveland! I live in CT, so a flight will work for me. Maybe a drive would cool me down too..... I’ve been very, very concerned of als and other diseases. Just recently, I viewed my friend (former mother in-law) pass from a rare form of one. I’m sure that has caused a spike in my fears. But hearing that “sudden onset” is not in the medical picture gives me a sense of relief. I will contact your office by Monday if I do not improve.
I meant to say “calve” not valve in my post. I had muscle twitching in my calve for years prior. I had sustained an injury dating back to 2015. Both calves twitch when heavily used, but I have never experienced weakness. They have always been tight since the injuries and seem to feel tighter if I’m dehydrated. I hope your office accepts Cigna. I will call to find out shortly! Thank you so much!
I meant to say “calve” not valve in my post. I had muscle twitching in my calve for years prior. I had sustained an injury dating back to 2015. Both calves twitch when heavily used, but I have never experienced weakness. They have always been tight since the injuries and seem to feel tighter if I’m dehydrated. I hope your office accepts Cigna. I will call to find out shortly! Thank you so much!
Brief Answer:
Understandably disturbed and distressed
Detailed Answer:
Thank you for your kind words once again and I hope you can additional solace from the fact that the description of your muscle twitches being so generalized without any background of muscle weakness or atrophy if anything, points AWAY from motor neuron disease (MND).
It was ironic that today I was having a discussion with a patient in the office on the naming of XXXXXXX cities and what I told him was the name of XXXXXXX was virtually unique in the United States compared to other major metropolitan cities (such as CLEVELAND) which exist in multiple parts of the country. Actually, XXXXXXX is found in the states of Wisconsin and Illinois. Norwich, on the other hand, I simply assumed was in New York (where my uncle lives) but I had never heard of it outside of NY until you told me that you were in CT! LOL! In fact, curiosity caused me to look things up a bit more...and as I had suspected, Norwich, CT was settled well BEFORE Norwich, NY (1659 vs. 1788)....and so being so much further would make a drive somewhat daunting to be sure!
Thank you for the clarification of the CALVES since twitching valves were clearly something that I was very much looking for an explanation on...especially the INJURY part of it that resulted in the VALVE twitching away! For a moment, I thought perhaps, I was in communication with a CYBORG! HA!
And so your calves) were injured all the way back to 2015....and having been twitching ever since? Understood....and you can refer back to my previous comments in this thread where I mention that local twitching due to some type of metabolic or NON-neuromuscular phenomenon can BEGET other muscles locally and then, eventually regionally to start twitching due to ephaptic phenomenon (overflow electricity triggering nearby muscles to twitch which under some circumstances (with anxiety/stress being perhaps a primer) can result in generalized twitching. You've probably witnessing people who start yawning in a group....before you know it....everyone in the group starts yawning....same thing can happen with BENIGN fasciculations. In ALS fasics are only known to occur and be sustained on the basis of denervated muscle fibers that have no inhibitory controls left upon them anymore.
Again, it was a pleasure to speak earlier today and perhaps we can continue this conversation a bit later as you make a decision whether you'd like to travel to XXXXXXX for further workup or just hang tight out there in Norwich. Your consideration toward providing some positive critique on my answers is always most appreciated.
Cheers!
This query required 58 minutes of professional time to research, assimilate, and respond in complete form.
Understandably disturbed and distressed
Detailed Answer:
Thank you for your kind words once again and I hope you can additional solace from the fact that the description of your muscle twitches being so generalized without any background of muscle weakness or atrophy if anything, points AWAY from motor neuron disease (MND).
It was ironic that today I was having a discussion with a patient in the office on the naming of XXXXXXX cities and what I told him was the name of XXXXXXX was virtually unique in the United States compared to other major metropolitan cities (such as CLEVELAND) which exist in multiple parts of the country. Actually, XXXXXXX is found in the states of Wisconsin and Illinois. Norwich, on the other hand, I simply assumed was in New York (where my uncle lives) but I had never heard of it outside of NY until you told me that you were in CT! LOL! In fact, curiosity caused me to look things up a bit more...and as I had suspected, Norwich, CT was settled well BEFORE Norwich, NY (1659 vs. 1788)....and so being so much further would make a drive somewhat daunting to be sure!
Thank you for the clarification of the CALVES since twitching valves were clearly something that I was very much looking for an explanation on...especially the INJURY part of it that resulted in the VALVE twitching away! For a moment, I thought perhaps, I was in communication with a CYBORG! HA!
And so your calves) were injured all the way back to 2015....and having been twitching ever since? Understood....and you can refer back to my previous comments in this thread where I mention that local twitching due to some type of metabolic or NON-neuromuscular phenomenon can BEGET other muscles locally and then, eventually regionally to start twitching due to ephaptic phenomenon (overflow electricity triggering nearby muscles to twitch which under some circumstances (with anxiety/stress being perhaps a primer) can result in generalized twitching. You've probably witnessing people who start yawning in a group....before you know it....everyone in the group starts yawning....same thing can happen with BENIGN fasciculations. In ALS fasics are only known to occur and be sustained on the basis of denervated muscle fibers that have no inhibitory controls left upon them anymore.
Again, it was a pleasure to speak earlier today and perhaps we can continue this conversation a bit later as you make a decision whether you'd like to travel to XXXXXXX for further workup or just hang tight out there in Norwich. Your consideration toward providing some positive critique on my answers is always most appreciated.
Cheers!
This query required 58 minutes of professional time to research, assimilate, and respond in complete form.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Understandably disturbed and distressed
Detailed Answer:
Thank you for your kind words once again and I hope you can additional solace from the fact that the description of your muscle twitches being so generalized without any background of muscle weakness or atrophy if anything, points AWAY from motor neuron disease (MND).
It was ironic that today I was having a discussion with a patient in the office on the naming of XXXXXXX cities and what I told him was the name of XXXXXXX was virtually unique in the United States compared to other major metropolitan cities (such as CLEVELAND) which exist in multiple parts of the country. Actually, XXXXXXX is found in the states of Wisconsin and Illinois. Norwich, on the other hand, I simply assumed was in New York (where my uncle lives) but I had never heard of it outside of NY until you told me that you were in CT! LOL! In fact, curiosity caused me to look things up a bit more...and as I had suspected, Norwich, CT was settled well BEFORE Norwich, NY (1659 vs. 1788)....and so being so much further would make a drive somewhat daunting to be sure!
Thank you for the clarification of the CALVES since twitching valves were clearly something that I was very much looking for an explanation on...especially the INJURY part of it that resulted in the VALVE twitching away! For a moment, I thought perhaps, I was in communication with a CYBORG! HA!
And so your calves) were injured all the way back to 2015....and having been twitching ever since? Understood....and you can refer back to my previous comments in this thread where I mention that local twitching due to some type of metabolic or NON-neuromuscular phenomenon can BEGET other muscles locally and then, eventually regionally to start twitching due to ephaptic phenomenon (overflow electricity triggering nearby muscles to twitch which under some circumstances (with anxiety/stress being perhaps a primer) can result in generalized twitching. You've probably witnessing people who start yawning in a group....before you know it....everyone in the group starts yawning....same thing can happen with BENIGN fasciculations. In ALS fasics are only known to occur and be sustained on the basis of denervated muscle fibers that have no inhibitory controls left upon them anymore.
Again, it was a pleasure to speak earlier today and perhaps we can continue this conversation a bit later as you make a decision whether you'd like to travel to XXXXXXX for further workup or just hang tight out there in Norwich. Your consideration toward providing some positive critique on my answers is always most appreciated.
Cheers!
This query required 58 minutes of professional time to research, assimilate, and respond in complete form.
Understandably disturbed and distressed
Detailed Answer:
Thank you for your kind words once again and I hope you can additional solace from the fact that the description of your muscle twitches being so generalized without any background of muscle weakness or atrophy if anything, points AWAY from motor neuron disease (MND).
It was ironic that today I was having a discussion with a patient in the office on the naming of XXXXXXX cities and what I told him was the name of XXXXXXX was virtually unique in the United States compared to other major metropolitan cities (such as CLEVELAND) which exist in multiple parts of the country. Actually, XXXXXXX is found in the states of Wisconsin and Illinois. Norwich, on the other hand, I simply assumed was in New York (where my uncle lives) but I had never heard of it outside of NY until you told me that you were in CT! LOL! In fact, curiosity caused me to look things up a bit more...and as I had suspected, Norwich, CT was settled well BEFORE Norwich, NY (1659 vs. 1788)....and so being so much further would make a drive somewhat daunting to be sure!
Thank you for the clarification of the CALVES since twitching valves were clearly something that I was very much looking for an explanation on...especially the INJURY part of it that resulted in the VALVE twitching away! For a moment, I thought perhaps, I was in communication with a CYBORG! HA!
And so your calves) were injured all the way back to 2015....and having been twitching ever since? Understood....and you can refer back to my previous comments in this thread where I mention that local twitching due to some type of metabolic or NON-neuromuscular phenomenon can BEGET other muscles locally and then, eventually regionally to start twitching due to ephaptic phenomenon (overflow electricity triggering nearby muscles to twitch which under some circumstances (with anxiety/stress being perhaps a primer) can result in generalized twitching. You've probably witnessing people who start yawning in a group....before you know it....everyone in the group starts yawning....same thing can happen with BENIGN fasciculations. In ALS fasics are only known to occur and be sustained on the basis of denervated muscle fibers that have no inhibitory controls left upon them anymore.
Again, it was a pleasure to speak earlier today and perhaps we can continue this conversation a bit later as you make a decision whether you'd like to travel to XXXXXXX for further workup or just hang tight out there in Norwich. Your consideration toward providing some positive critique on my answers is always most appreciated.
Cheers!
This query required 58 minutes of professional time to research, assimilate, and respond in complete form.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Saghafi,
I failed to mention something of importance. Two years ago, I presented with full body twitching also. I attributed them to statin use (side effect of muscle tension). It lasted for nearly a week, with intensity for three to four days. Head to toe twitching with numbness. That occurred in January of 2017. I had a acdf surgery done on my C3-C5 disc which relived the numbness, but did nothing for the pain. Fast forward to now, I had been taking a high potency red yeast rice dose supplemented with CoQ10. I have had severe neck pain and stiffness dating back nearly two months. Very tight. Since the recent twitching began, I stopped taking the supplements with the exception of magnesium. I have had high stress and a poor diet over the last three months. I had also presented with PAC’s in my heart for a few months (Oct- Dec). I had a total of 720 incidents over a day that was detected with the heart holter. Could a depletion of Coq10 cause these events with twitching and PAC’s? I have started taking 100mg of CoQ10 tonight to see. I still have intentions of seeing you in Ohio. I would like to see you sooner than later, so hopefully the electrical study can be done soon. Days are getting more difficult for me and I’m feeling physically uncomfortable under all this stress. Thank you and I hope you’ve had a great day!
I failed to mention something of importance. Two years ago, I presented with full body twitching also. I attributed them to statin use (side effect of muscle tension). It lasted for nearly a week, with intensity for three to four days. Head to toe twitching with numbness. That occurred in January of 2017. I had a acdf surgery done on my C3-C5 disc which relived the numbness, but did nothing for the pain. Fast forward to now, I had been taking a high potency red yeast rice dose supplemented with CoQ10. I have had severe neck pain and stiffness dating back nearly two months. Very tight. Since the recent twitching began, I stopped taking the supplements with the exception of magnesium. I have had high stress and a poor diet over the last three months. I had also presented with PAC’s in my heart for a few months (Oct- Dec). I had a total of 720 incidents over a day that was detected with the heart holter. Could a depletion of Coq10 cause these events with twitching and PAC’s? I have started taking 100mg of CoQ10 tonight to see. I still have intentions of seeing you in Ohio. I would like to see you sooner than later, so hopefully the electrical study can be done soon. Days are getting more difficult for me and I’m feeling physically uncomfortable under all this stress. Thank you and I hope you’ve had a great day!
Dr Saghafi,
I failed to mention something of importance. Two years ago, I presented with full body twitching also. I attributed them to statin use (side effect of muscle tension). It lasted for nearly a week, with intensity for three to four days. Head to toe twitching with numbness. That occurred in January of 2017. I had a acdf surgery done on my C3-C5 disc which relived the numbness, but did nothing for the pain. Fast forward to now, I had been taking a high potency red yeast rice dose supplemented with CoQ10. I have had severe neck pain and stiffness dating back nearly two months. Very tight. Since the recent twitching began, I stopped taking the supplements with the exception of magnesium. I have had high stress and a poor diet over the last three months. I had also presented with PAC’s in my heart for a few months (Oct- Dec). I had a total of 720 incidents over a day that was detected with the heart holter. Could a depletion of Coq10 cause these events with twitching and PAC’s? I have started taking 100mg of CoQ10 tonight to see. I still have intentions of seeing you in Ohio. I would like to see you sooner than later, so hopefully the electrical study can be done soon. Days are getting more difficult for me and I’m feeling physically uncomfortable under all this stress. Thank you and I hope you’ve had a great day!
I failed to mention something of importance. Two years ago, I presented with full body twitching also. I attributed them to statin use (side effect of muscle tension). It lasted for nearly a week, with intensity for three to four days. Head to toe twitching with numbness. That occurred in January of 2017. I had a acdf surgery done on my C3-C5 disc which relived the numbness, but did nothing for the pain. Fast forward to now, I had been taking a high potency red yeast rice dose supplemented with CoQ10. I have had severe neck pain and stiffness dating back nearly two months. Very tight. Since the recent twitching began, I stopped taking the supplements with the exception of magnesium. I have had high stress and a poor diet over the last three months. I had also presented with PAC’s in my heart for a few months (Oct- Dec). I had a total of 720 incidents over a day that was detected with the heart holter. Could a depletion of Coq10 cause these events with twitching and PAC’s? I have started taking 100mg of CoQ10 tonight to see. I still have intentions of seeing you in Ohio. I would like to see you sooner than later, so hopefully the electrical study can be done soon. Days are getting more difficult for me and I’m feeling physically uncomfortable under all this stress. Thank you and I hope you’ve had a great day!
Brief Answer:
I have no problem with you returning to your former CoQ10 regimen
Detailed Answer:
Good morning and thank you for those points of clarification which I was unaware before having to do with your surgery and other past history of fasciculations.
I've not heard of any type of fasciculatory activity as a consequence of not continuing CoQ10 supplements. It is almost unheard of for CoQ10 to actually be deficient in a person to any point where muscle activity should be affected in that regard. Having said that, I have no problem if you'd like to return to the CoQ10 regimen. I see no down side to that plan. If the twitching gets better then, we've just made our job that much easier...and maybe that of the electromyographer.
The office told me that you had decided in favor the EMG/NCV study to be done when coming to XXXXXXX Therefore, I will send a requisition to their attention so that you can call them at the beginning of next week and set up your appointment. My preference is that you meet with Dr. Bashar Katirji from University Hospitals. His secretary's name is BOBBI and she is just a peach. She was there when I was a resident in training back in the 20th century and he was one of my mentors. He is considered the electrical XXXXXXX of this area for this type of problem.
Once we get that requisition into the hands of UHC (University Hospitals of Cleveland) we will let you know and then, you can call them for an appointment. They require speaking directly with the patient since they will ask for insurance information and give you instructions for the day of the examination. We will make our appointment fit in to when they can see you. You may wish to check with your insurance company to see what their policy is regarding coming to XXXXXXX for this testing since many carriers will only approve OUT OF STATE TESTING for procedures if it's something for which no network providers are available in your area. I'm not saying that's the way your policy is written but just suggesting you call your carrier to let them know ahead of time what your intention is so that they can tell you what to expect in terms of reimbursements or coverages for the services.
I really only anticipate doing the EMG/NCV study and nothing else at this time unless examination reveals something that may look like something good to do (as I explained to you by phone). If your neck needs to be revised or looked at with MRI or labs need to be done, etc.....I'm sure you can get all that back home instead of here if the insurance company is going to say anything about these tests being doing out of state.
Vitamin and electrolyte levels that I am DEFINITELY interested in testing and then, RAISING to adequate or even SUPER-adequate levels are your B12, FOL ATE, VITAMIN D, Magnesium, and Calcium (both total and IONIZED portions).
This query required 72 minutes of professional time to research, assimilate, and respond in complete form.
Cheers! And I look forward to seeing you soon.
I have no problem with you returning to your former CoQ10 regimen
Detailed Answer:
Good morning and thank you for those points of clarification which I was unaware before having to do with your surgery and other past history of fasciculations.
I've not heard of any type of fasciculatory activity as a consequence of not continuing CoQ10 supplements. It is almost unheard of for CoQ10 to actually be deficient in a person to any point where muscle activity should be affected in that regard. Having said that, I have no problem if you'd like to return to the CoQ10 regimen. I see no down side to that plan. If the twitching gets better then, we've just made our job that much easier...and maybe that of the electromyographer.
The office told me that you had decided in favor the EMG/NCV study to be done when coming to XXXXXXX Therefore, I will send a requisition to their attention so that you can call them at the beginning of next week and set up your appointment. My preference is that you meet with Dr. Bashar Katirji from University Hospitals. His secretary's name is BOBBI and she is just a peach. She was there when I was a resident in training back in the 20th century and he was one of my mentors. He is considered the electrical XXXXXXX of this area for this type of problem.
Once we get that requisition into the hands of UHC (University Hospitals of Cleveland) we will let you know and then, you can call them for an appointment. They require speaking directly with the patient since they will ask for insurance information and give you instructions for the day of the examination. We will make our appointment fit in to when they can see you. You may wish to check with your insurance company to see what their policy is regarding coming to XXXXXXX for this testing since many carriers will only approve OUT OF STATE TESTING for procedures if it's something for which no network providers are available in your area. I'm not saying that's the way your policy is written but just suggesting you call your carrier to let them know ahead of time what your intention is so that they can tell you what to expect in terms of reimbursements or coverages for the services.
I really only anticipate doing the EMG/NCV study and nothing else at this time unless examination reveals something that may look like something good to do (as I explained to you by phone). If your neck needs to be revised or looked at with MRI or labs need to be done, etc.....I'm sure you can get all that back home instead of here if the insurance company is going to say anything about these tests being doing out of state.
Vitamin and electrolyte levels that I am DEFINITELY interested in testing and then, RAISING to adequate or even SUPER-adequate levels are your B12, FOL ATE, VITAMIN D, Magnesium, and Calcium (both total and IONIZED portions).
This query required 72 minutes of professional time to research, assimilate, and respond in complete form.
Cheers! And I look forward to seeing you soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I have no problem with you returning to your former CoQ10 regimen
Detailed Answer:
Good morning and thank you for those points of clarification which I was unaware before having to do with your surgery and other past history of fasciculations.
I've not heard of any type of fasciculatory activity as a consequence of not continuing CoQ10 supplements. It is almost unheard of for CoQ10 to actually be deficient in a person to any point where muscle activity should be affected in that regard. Having said that, I have no problem if you'd like to return to the CoQ10 regimen. I see no down side to that plan. If the twitching gets better then, we've just made our job that much easier...and maybe that of the electromyographer.
The office told me that you had decided in favor the EMG/NCV study to be done when coming to XXXXXXX Therefore, I will send a requisition to their attention so that you can call them at the beginning of next week and set up your appointment. My preference is that you meet with Dr. Bashar Katirji from University Hospitals. His secretary's name is BOBBI and she is just a peach. She was there when I was a resident in training back in the 20th century and he was one of my mentors. He is considered the electrical XXXXXXX of this area for this type of problem.
Once we get that requisition into the hands of UHC (University Hospitals of Cleveland) we will let you know and then, you can call them for an appointment. They require speaking directly with the patient since they will ask for insurance information and give you instructions for the day of the examination. We will make our appointment fit in to when they can see you. You may wish to check with your insurance company to see what their policy is regarding coming to XXXXXXX for this testing since many carriers will only approve OUT OF STATE TESTING for procedures if it's something for which no network providers are available in your area. I'm not saying that's the way your policy is written but just suggesting you call your carrier to let them know ahead of time what your intention is so that they can tell you what to expect in terms of reimbursements or coverages for the services.
I really only anticipate doing the EMG/NCV study and nothing else at this time unless examination reveals something that may look like something good to do (as I explained to you by phone). If your neck needs to be revised or looked at with MRI or labs need to be done, etc.....I'm sure you can get all that back home instead of here if the insurance company is going to say anything about these tests being doing out of state.
Vitamin and electrolyte levels that I am DEFINITELY interested in testing and then, RAISING to adequate or even SUPER-adequate levels are your B12, FOL ATE, VITAMIN D, Magnesium, and Calcium (both total and IONIZED portions).
This query required 72 minutes of professional time to research, assimilate, and respond in complete form.
Cheers! And I look forward to seeing you soon.
I have no problem with you returning to your former CoQ10 regimen
Detailed Answer:
Good morning and thank you for those points of clarification which I was unaware before having to do with your surgery and other past history of fasciculations.
I've not heard of any type of fasciculatory activity as a consequence of not continuing CoQ10 supplements. It is almost unheard of for CoQ10 to actually be deficient in a person to any point where muscle activity should be affected in that regard. Having said that, I have no problem if you'd like to return to the CoQ10 regimen. I see no down side to that plan. If the twitching gets better then, we've just made our job that much easier...and maybe that of the electromyographer.
The office told me that you had decided in favor the EMG/NCV study to be done when coming to XXXXXXX Therefore, I will send a requisition to their attention so that you can call them at the beginning of next week and set up your appointment. My preference is that you meet with Dr. Bashar Katirji from University Hospitals. His secretary's name is BOBBI and she is just a peach. She was there when I was a resident in training back in the 20th century and he was one of my mentors. He is considered the electrical XXXXXXX of this area for this type of problem.
Once we get that requisition into the hands of UHC (University Hospitals of Cleveland) we will let you know and then, you can call them for an appointment. They require speaking directly with the patient since they will ask for insurance information and give you instructions for the day of the examination. We will make our appointment fit in to when they can see you. You may wish to check with your insurance company to see what their policy is regarding coming to XXXXXXX for this testing since many carriers will only approve OUT OF STATE TESTING for procedures if it's something for which no network providers are available in your area. I'm not saying that's the way your policy is written but just suggesting you call your carrier to let them know ahead of time what your intention is so that they can tell you what to expect in terms of reimbursements or coverages for the services.
I really only anticipate doing the EMG/NCV study and nothing else at this time unless examination reveals something that may look like something good to do (as I explained to you by phone). If your neck needs to be revised or looked at with MRI or labs need to be done, etc.....I'm sure you can get all that back home instead of here if the insurance company is going to say anything about these tests being doing out of state.
Vitamin and electrolyte levels that I am DEFINITELY interested in testing and then, RAISING to adequate or even SUPER-adequate levels are your B12, FOL ATE, VITAMIN D, Magnesium, and Calcium (both total and IONIZED portions).
This query required 72 minutes of professional time to research, assimilate, and respond in complete form.
Cheers! And I look forward to seeing you soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello doctor. My insurance covers the emg exam in Ohio. That’s good news. I’m beyond nervous still. If they are unable to fit me in for the emg next week, would you recommend coming to see you for your portion of the test? You have been more than accommodating and I’m truely appreciative. I’ve just been through a mind blowing 4 weeks and to have someone with hands on experience examine me - will help me tremendously! You’ve explained everything wonderfully and I’ve read our thread numerous times, but my anxiety over the twtiching is mentally painful. The more I think the more “possible” symptoms present. I am exhausted. Your thought are appreciated.
Hello doctor. My insurance covers the emg exam in Ohio. That’s good news. I’m beyond nervous still. If they are unable to fit me in for the emg next week, would you recommend coming to see you for your portion of the test? You have been more than accommodating and I’m truely appreciative. I’ve just been through a mind blowing 4 weeks and to have someone with hands on experience examine me - will help me tremendously! You’ve explained everything wonderfully and I’ve read our thread numerous times, but my anxiety over the twtiching is mentally painful. The more I think the more “possible” symptoms present. I am exhausted. Your thought are appreciated.
Brief Answer:
It was always my plan to get you in next week no matter what
Detailed Answer:
Hello kind sir. As a variation of the 1956 Greyhound Bus Service's Mantra we state with great pride and encouragement:
GO PARMA NEUROLOGY AND LEAVE THE DIAGNOSIS TO US!
It was really my intention to get you in some time within the next 2 weeks with or without being able to schedule the electrical studies if for nothing else to do a good top to bottom neurological examination, get a good history about what happened to the calves back in 2015, and allow you to ask any questions you have. I would also give you my opinion on how your condition should be worked up to find an underlying cause. and print the necessary lab requisitions to do the metabolic portion of the testing that you can take back home with you and get done at your convenience. You can then, provide me the results for interpretation or alternatively, take the results to whomever you choose locally.
As we spoke on the telephone performing electrical studies is not necessary for the diagnosis of motor neuron disease.
However, I'm happy to again, to print up a requisition for you to have done at your leisure back home forwarding the results to me for interpretation or taking it to a local neurologist.
Again, I'm very appreciative for your reaching out on this network for additional guidance and I look forward to seeing you in the office. I will have them contact you tomorrow (Saturday) between 8a-3p to make an appointment for next week.
Cheers!
This query required 133 minutes of professional time to research, assimilate, and respond.
It was always my plan to get you in next week no matter what
Detailed Answer:
Hello kind sir. As a variation of the 1956 Greyhound Bus Service's Mantra we state with great pride and encouragement:
GO PARMA NEUROLOGY AND LEAVE THE DIAGNOSIS TO US!
It was really my intention to get you in some time within the next 2 weeks with or without being able to schedule the electrical studies if for nothing else to do a good top to bottom neurological examination, get a good history about what happened to the calves back in 2015, and allow you to ask any questions you have. I would also give you my opinion on how your condition should be worked up to find an underlying cause. and print the necessary lab requisitions to do the metabolic portion of the testing that you can take back home with you and get done at your convenience. You can then, provide me the results for interpretation or alternatively, take the results to whomever you choose locally.
As we spoke on the telephone performing electrical studies is not necessary for the diagnosis of motor neuron disease.
However, I'm happy to again, to print up a requisition for you to have done at your leisure back home forwarding the results to me for interpretation or taking it to a local neurologist.
Again, I'm very appreciative for your reaching out on this network for additional guidance and I look forward to seeing you in the office. I will have them contact you tomorrow (Saturday) between 8a-3p to make an appointment for next week.
Cheers!
This query required 133 minutes of professional time to research, assimilate, and respond.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
It was always my plan to get you in next week no matter what
Detailed Answer:
Hello kind sir. As a variation of the 1956 Greyhound Bus Service's Mantra we state with great pride and encouragement:
GO PARMA NEUROLOGY AND LEAVE THE DIAGNOSIS TO US!
It was really my intention to get you in some time within the next 2 weeks with or without being able to schedule the electrical studies if for nothing else to do a good top to bottom neurological examination, get a good history about what happened to the calves back in 2015, and allow you to ask any questions you have. I would also give you my opinion on how your condition should be worked up to find an underlying cause. and print the necessary lab requisitions to do the metabolic portion of the testing that you can take back home with you and get done at your convenience. You can then, provide me the results for interpretation or alternatively, take the results to whomever you choose locally.
As we spoke on the telephone performing electrical studies is not necessary for the diagnosis of motor neuron disease.
However, I'm happy to again, to print up a requisition for you to have done at your leisure back home forwarding the results to me for interpretation or taking it to a local neurologist.
Again, I'm very appreciative for your reaching out on this network for additional guidance and I look forward to seeing you in the office. I will have them contact you tomorrow (Saturday) between 8a-3p to make an appointment for next week.
Cheers!
This query required 133 minutes of professional time to research, assimilate, and respond.
It was always my plan to get you in next week no matter what
Detailed Answer:
Hello kind sir. As a variation of the 1956 Greyhound Bus Service's Mantra we state with great pride and encouragement:
GO PARMA NEUROLOGY AND LEAVE THE DIAGNOSIS TO US!
It was really my intention to get you in some time within the next 2 weeks with or without being able to schedule the electrical studies if for nothing else to do a good top to bottom neurological examination, get a good history about what happened to the calves back in 2015, and allow you to ask any questions you have. I would also give you my opinion on how your condition should be worked up to find an underlying cause. and print the necessary lab requisitions to do the metabolic portion of the testing that you can take back home with you and get done at your convenience. You can then, provide me the results for interpretation or alternatively, take the results to whomever you choose locally.
As we spoke on the telephone performing electrical studies is not necessary for the diagnosis of motor neuron disease.
However, I'm happy to again, to print up a requisition for you to have done at your leisure back home forwarding the results to me for interpretation or taking it to a local neurologist.
Again, I'm very appreciative for your reaching out on this network for additional guidance and I look forward to seeing you in the office. I will have them contact you tomorrow (Saturday) between 8a-3p to make an appointment for next week.
Cheers!
This query required 133 minutes of professional time to research, assimilate, and respond.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. Saghafi. I am set for our appointment tomorrow. I’m hoping to arrive before 9am. I will have my medical records and the latest bloodwork results available for the visit. Is there anything else I can bring aside from my worry?
Hello Dr. Saghafi. I am set for our appointment tomorrow. I’m hoping to arrive before 9am. I will have my medical records and the latest bloodwork results available for the visit. Is there anything else I can bring aside from my worry?
Brief Answer:
LOL! Negative....Bring as MUCH angst as you like!
Detailed Answer:
My job is to sop up all the angst, worry, and gurgly feelings in your stomach that you have. That's my job tomorrow morning. I believe I can handle that for you quite well. I will probably not be able to make it in much for 9a due to other rounds I have to make on the East side of Town but the office should open up at least around 8:30a so you're more than welcome to come in and relax.
Medical notes, lab tests, diagnostic studies from back in 2015 when your calves were injured, etc. XXXXXXX airport should be about a 35 min. ride from the office so my goal is to have back on the road for your return flight by 11am at the latest.
This is what Paty made me promise..... :)
Safe Travels. See you in the morning.
LOL! Negative....Bring as MUCH angst as you like!
Detailed Answer:
My job is to sop up all the angst, worry, and gurgly feelings in your stomach that you have. That's my job tomorrow morning. I believe I can handle that for you quite well. I will probably not be able to make it in much for 9a due to other rounds I have to make on the East side of Town but the office should open up at least around 8:30a so you're more than welcome to come in and relax.
Medical notes, lab tests, diagnostic studies from back in 2015 when your calves were injured, etc. XXXXXXX airport should be about a 35 min. ride from the office so my goal is to have back on the road for your return flight by 11am at the latest.
This is what Paty made me promise..... :)
Safe Travels. See you in the morning.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
LOL! Negative....Bring as MUCH angst as you like!
Detailed Answer:
My job is to sop up all the angst, worry, and gurgly feelings in your stomach that you have. That's my job tomorrow morning. I believe I can handle that for you quite well. I will probably not be able to make it in much for 9a due to other rounds I have to make on the East side of Town but the office should open up at least around 8:30a so you're more than welcome to come in and relax.
Medical notes, lab tests, diagnostic studies from back in 2015 when your calves were injured, etc. XXXXXXX airport should be about a 35 min. ride from the office so my goal is to have back on the road for your return flight by 11am at the latest.
This is what Paty made me promise..... :)
Safe Travels. See you in the morning.
LOL! Negative....Bring as MUCH angst as you like!
Detailed Answer:
My job is to sop up all the angst, worry, and gurgly feelings in your stomach that you have. That's my job tomorrow morning. I believe I can handle that for you quite well. I will probably not be able to make it in much for 9a due to other rounds I have to make on the East side of Town but the office should open up at least around 8:30a so you're more than welcome to come in and relax.
Medical notes, lab tests, diagnostic studies from back in 2015 when your calves were injured, etc. XXXXXXX airport should be about a 35 min. ride from the office so my goal is to have back on the road for your return flight by 11am at the latest.
This is what Paty made me promise..... :)
Safe Travels. See you in the morning.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. I missed check in due to a traffic accident. I can make it there late afternoon. Could you accommodate? I’m getting details now - looks like I can be there by 3PM. I’m changing the times now
Dr. I missed check in due to a traffic accident. I can make it there late afternoon. Could you accommodate? I’m getting details now - looks like I can be there by 3PM. I’m changing the times now
Dr. Could you call me right away - it’s an emergency! Thank you 860-705-9504
Dr. Could you call me right away - it’s an emergency! Thank you 860-705-9504
Brief Answer:
No worries. I heard traffic was beastly this morning for you. Sorry
Detailed Answer:
I'm told that I should circle back to the office at 5p today after the hospital. That's not a problem. I shall be there to meet you. Are you going to be staying in XXXXXXX tonight or do you have a flight to catch this evening?
No worries. I heard traffic was beastly this morning for you. Sorry
Detailed Answer:
I'm told that I should circle back to the office at 5p today after the hospital. That's not a problem. I shall be there to meet you. Are you going to be staying in XXXXXXX tonight or do you have a flight to catch this evening?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
No worries. I heard traffic was beastly this morning for you. Sorry
Detailed Answer:
I'm told that I should circle back to the office at 5p today after the hospital. That's not a problem. I shall be there to meet you. Are you going to be staying in XXXXXXX tonight or do you have a flight to catch this evening?
No worries. I heard traffic was beastly this morning for you. Sorry
Detailed Answer:
I'm told that I should circle back to the office at 5p today after the hospital. That's not a problem. I shall be there to meet you. Are you going to be staying in XXXXXXX tonight or do you have a flight to catch this evening?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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