Question: can you access my dashbord with a neurologist named dr spaho year 2017
I want a review on onset possibly from tr 1978 to the mri on dashboard of 1991

please give me an answer

Gary Cackowski-0254
65 e cloverdale ave
Pine hill nj 08021


Date 07/09/2022
Hello again Dr. Erion Spaho

My main question is I am getting your opinion also as I did with Professor Dr XXXXXXX Bash a neuroradiologist who has read you report, and of course made his own review. He has also read everything else.
Thankyou for you reply, I went back in my medical dashboard, and did a copy of the previous statements exactly as before information dated Sunday, XXXXXXX 11, 2017. Also the exact, very exact JPG immages pics of the MRI year 1991. That you have reviewed.
Thankyou for your view on c-2 and c-3, # immage-1, then next finding and view of c-5 and c-6- # immage-6
And a complete view of the separate 9 different images of 10 images.
My research of a Spinal Nerve Function chart from millerchiropracticclinic/spinal-nerve-chart/ shows the following, and as so it may be more than noted:
{ NERVE ROOT Innervation only }
c-2 and c-3 states 1.eyes, 2.Lacrimal Gland 3.Parotid Gland, 4.Scalp, c-3 = Base of skull, 5.Neck Muscles..
c-5 and c-6 states Neck muscles,..Shoulders…Elbows…Arms..And “wrist”/
1978 than you for the intermitting pain which we agree non-vascular inter cranial disorder of my multiple sclerosis mid brain.
Year 1977 started pain with wrist there were about 6 more treatments with wrist pain thru 1979, they could not clearly understand why. It is documented, they thought slept on it, strain, from working on it. Today they deny that it may have been connected with my multiple sclerosis.
They never realized it even today they never looked at the MRI, which shows c-5 and c-6 lesions from multiple sclerosis of 1991, but most importantly the lesions I felt in my body and arms and wrist were there way before that and I felt pain in 1977, 1978, and 1979. Its documented.
Not Documented but in the year 1985 working as an electrician, my upper back, neck, and both arms were having severe pain, and weakness, also very important both hands were cramping and closing by them selves without me doing it, very painfull.
I really need your 2nd opinion with the MRI showing Lesions of multiple Sclerosis.
NOW, I ask as your opinion of 1977 to 1991 in review of all, and even According to the Professor Dr XXXXXXX Bash has Stated These Lesions are far less than 7 years before year 1986. It, the m.s. lesions clearly took time to manifest and took its natural course that M.S. takes in the years say 1978 to oct, 20 1986.
Personally I am not qualified to diagnose, but I am extremely sure these M.S. lesions began somewhere around 1978.
I am fighting for my medication and my benefits. Please Help.

Please give your 2nd medical opinion of both, I put them in order for you.


And many thanks to Dr. XXXXXXX Panwar of also H.C.M.

Dr. XXXXXXX Panwar
Dr. XXXXXXX Panwar
Neurologist
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m.s.
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copaxone
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questionis to

dr. XXXXXXX panwar,

can you give me additional in the term of or description of the pathophysiology, or a medical science rational description of the underlying cause that was most likely was the cause of the description of the intermitting pain which we agree non-vascular inter cranial disorder of my multiple sclerosis, I shall enclose previous decisions.

how does it connect to it with a rational of medical science........
Asked by Me , Fri, 19 Feb 2016
Doctor's reply to your question above...
Brief Answer:
Intermittent pains are common with MS.

Detailed Answer:
Hi Gary,
Thanks for being here on HCM again.
I am Dr XXXXXXX Panwar,here with you,once more.

Of course,I agree that intermittent paroxysmal pains are common in Multiple sclerosis,which may last for short duration(even seconds)as in your case.

If MRI picture was suggestive of Multiple sclerosis,which is obviously a non-vascular intracranial disorder,I would rather say that these short duration intermittent pains are a part of disease process.

If your therapy is not responding,you may switch to alternative disease modifying therapy.We have several options out there for MS like interferons,BG-12,Fingolimod or Tysabri. You need to have a discussion with your treating specialist regarding this.

Hope this helps.If you have some further questions,I shall be glad to have you in follow-up.

Regards
Dr XXXXXXX Panwar,
MD,DM(Neurology)



Ask a Fresh Question »
Do you have neuro-radiologist that can read my mri of multiple sclerosis
Asked by Me , Sun, 11 Jun 2017
Doctor's reply to your question above...
Brief Answer:
You can select one by speciality and ask him directly.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Yes, this online medical consultation service has Neuroradiologists in the team too, but you need to select such Doctor by the list of specialities and ask him directly your question.

I see that you uploaded 10 pictures (screenshots) of the MRI.

In my opinion it is not complete such uploading and the Doctor could not understand completely your situation, I suggest you to save the DICOM file from the CD on your desktop and upload it to google drive, or Dropbox for example.

After that you can send the link of uploaded DICOM file to one of our Neuroradiologysts.

Hope you found the answer helpful.

Take care.
Replied by Dr. Dr. Erion Spaho , Mon, 12 Jun 2017
Disclaimer: The Expert advice is meant for exchange of medical information, using information and communication technology, in the interest of advancing the health of individuals and their communities. It SHOULD NOT be relied upon as a substitute for face-to-face medical consultation, as a complete physical assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
I was told to ask neurologist, ok, the cervical mri has many lesion of ms, 2 of the pictures are very clear to this situation. Can you Identify those 2 pictures. I had neurologist look at them, it was very clear to them. I ask you as a second opinion. I certainly can see them. I await your expert answer.

thankyou,
Gary Cackowski
Asked by Me , Mon, 12 Jun 2017
Doctor's reply to your question above...
Brief Answer:
There are hyperintense lesions at C2-C3, and at C5-C6.

Detailed Answer:
Welcome back.

It is true that there is a hyperintense lesion of the spinal cord at the levels C2-C3 (image 001) and one at the level C5-C6 (image 006).

Multiple sclerosis is one of the conditions that may be associated with such MRI findings, however, the diagnosis of MS is achieved by clinical examination, imaging studies findings ( brain and spinal cord MRI ) and/or spinal tap.

Hope this helps.

Kind regards.

Replied by Dr. Dr. Erion Spaho , Mon, 12 Jun 2017
Disclaimer: The Expert advice is meant for exchange of medical information, using information and communication technology, in the interest of advancing the health of individuals and their communities. It SHOULD NOT be relied upon as a substitute for face-to-face medical consultation, as a complete physical assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
Dr. Erion Spaho
Thankyou for your expert view and also on the c-5 and c-6. And also of the other information on clinical evaluation, and other procedures. I have no other further questions at this time. I accept your expert view.

Thankyou Much,

Gary Cackowski
Asked by Me , Mon, 12 Jun 2017
Doctor's reply to your question above...
Brief Answer:
You are welcome.

Detailed Answer:
Welcome back.

Glad I helped you.

In good health.
Replied by Dr. Dr. Erion Spaho , Tue, 13 Jun 2017
Disclaimer: The Expert advice is meant for exchange of medical information, using information and communication technology, in the interest of advancing the health of individuals and their communities. It SHOULD NOT be relied upon as a substitute for face-to-face medical consultation, as a complete physical assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
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Thankyou Dr. Erion Spaho, H.C.M has been very helpful in knowledge and assistance on all medical questions.
Other Questions By Me

Answered by Dr. Dr. Erion Spaho, 5 hours ago
can you access my dashbord with a neurologist named dr spaho year 2017 I want a review on onset possibly from tr 1978 to the mri on dashboard of 1991
Premium Question

Answered by Dr. XXXXXXX Panwar, Wed, 15 Feb 2017
To Dr XXXXXXX Panwar, I have to tell you that the term paroxysmal pains or and attacks in multiple sclerosis was extremly very helpful, and is consistant with all medical research and journals. I am contacting you again because I forgot something important in our review, this is the last view, We...
Premium Question

Answered by Dr. XXXXXXX Panwar, Fri, 19 Feb 2016
questionis to dr. XXXXXXX panwar, can you give me additional in the term of or description of the pathophysiology, or a medical science rational description of the underlying cause that was most likely was the cause of the description of the intermitting pain which we agree non-vascular inter...
Premium Question

Answered by Dr. XXXXXXX Panwar, Thu, 28 XXXXXXX 2016
Our past question about multiple sclerosis, 3/20/2010. I have several pages from prior. I need to adget your opinion on something that was missing from before. I had complained of intermitting mid brain pain. In 1978 it started. Felt like if you pressed your small figure in the upper scalp for...
Premium Question
questionis to

dr. XXXXXXX panwar,

can you give me additional in the term of or description of the pathophysiology, or a medical science rational description of the underlying cause that was most likely was the cause of the description of the intermitting pain which we agree non-vascular inter cranial disorder of my multiple sclerosis, I shall enclose previous decisions.

how does it connect to it with a rational of medical science........
Asked by Me , Fri, 19 Feb 2016
Doctor's reply to your question above...
Brief Answer:
Intermittent pains are common with MS.

Detailed Answer:
Hi Gary,
Thanks for being here on HCM again.
I am Dr XXXXXXX Panwar,here with you,once more.

Of course,I agree that intermittent paroxysmal pains are common in Multiple sclerosis,which may last for short duration(even seconds)as in your case.

If MRI picture was suggestive of Multiple sclerosis,which is obviously a non-vascular intracranial disorder,I would rather say that these short duration intermittent pains are a part of disease process.

If your therapy is not responding,you may switch to alternative disease modifying therapy.We have several options out there for MS like interferons,BG-12,Fingolimod or Tysabri. You need to have a discussion with your treating specialist regarding this.

Hope this helps.If you have some further questions,I shall be glad to have you in follow-up.

Regards
Dr XXXXXXX Panwar,
MD,DM(Neurology)
Replied by Dr. XXXXXXX Panwar , Fri, 19 Feb 2016
Disclaimer: The Expert advice is meant for exchange of medical information, using information and communication technology, in the interest of advancing the health of individuals and their communities. It SHOULD NOT be relied upon as a substitute for face-to-face medical consultation, as a complete physical assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also.
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Rating:
again,thankyou Dr XXXXXXX panwar, the medical term certainlty inserts itself perfectly at this time. I am satisfied with your review.
Other Questions By Me

Answered by Dr. Dr. Erion Spaho, 6 hours ago
can you access my dashbord with a neurologist named dr spaho year 2017 I want a review on onset possibly from tr 1978 to the mri on dashboard of 1991
Premium Question

Answered by Dr. Erion Spaho, Tue, 13 Jun 2017
Do you have neuro-radiologist that can read my mri of multiple sclerosis
Premium Question

Answered by Dr. XXXXXXX Panwar, Wed, 15 Feb 2017
To Dr XXXXXXX Panwar, I have to tell you that the term paroxysmal pains or and attacks in multiple sclerosis was extremly very helpful, and is consistant with all medical research and journals. I am contacting you again because I forgot something important in our review, this is the last view, We...
Premium Question

Answered by Dr. XXXXXXX Panwar, Thu, 28 XXXXXXX 2016
Our past question about multiple sclerosis, 3/20/2010. I have several pages from prior. I need to adget your opinion on something that was missing from before. I had complained of intermitting mid brain pain. In 1978 it started. Felt like if you pressed your small figure in the upper scalp for...
Premium Question
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Thankyou, Gary Cackowski

Additional information to be considered as follows,
The same right arm wrist in question but has been denied, no MRI at the years 1977, 1978, 1979 was invented yet.
Date 11-26-1990 Neurologist DR XXXXXXX Terranova medical report states burning sensation and weakness of right arm and hand.

Date 12-11-1991 Neurologist Dr XXXXXXX Terranova has a medical report of same right arm of numbness and
Paresthesias of right arm and hand.

Several additional Neurologist have noted Both Neurologist reports of 11-26-1990 and 12-11-1991 and the MRI images of 1991 you have viewed already image# 1 and image # 6 are chronic and persistent with multiple sclerosis.

Last question
Separate from wrist pain, which they said may be tendonitis from working on it.
now looking back on the MRI of c-2 and c-3,,,,and c-5 and c-6
Could the m.s. lesions in the spine have caused dizziness and not being able to walk as fast as normal
and also cause lower back, thoracic back pain, and cervical pain, may there have been m,s, lesions more
than what was seen on this only partial set of images, note these images are of cervical only, that is all I have.
I had a problem with thoracic muscle stiffness and pain in the years 1978, and to this day still have upper back
pain in the right side of thoracic area,

Hi, I have provided some attachments. Please review them.

Dr Erion Sapho,
When the Inner mid brain pains where happening in the same years,1978 and 1979, I have a co- worker that gave a statement also of same, for more than a year and a half. The wrist pains went on at the same time and more even undocumented items existed.
It is correct about other things can mimic M.S., I very firmly believe this was my M.S. I now know for sure working as and electrician 6 years later, the weakness in both arms and severe cramping was also my M.S. in my spine.
When the wrist problems were going on the treating personal did not have more than a couple of years of treating personal. I am sure he did his best but just did not know.
Sorry but nobody gave an MRI of brain till years later. As noted there is still plaques showing on reports and are consistent with M.S.
There is also multiple nodular and linear high signal intensities in the periventricular and deep white matter of the frontal and occipital lobes. Consistent with multiple sclerosis.
Dr. Spaho, I am in need of your expert medical opinion again, Thankyou.




FROM FAX NO 0000
ST FRANCIS HOSPITAL
7th XXXXXXX STREETS XXXXXXX DE 19805-0500
CACKOWSKI XXXXXXX
PHONE (609) 264-9292
DOB 08/12/1958
DATE OF SERVICE 05/24/2000
ATTENDING DR UNK
ORDERING DR Hooker Maryann M.D.
EXAMS: CERVICAL SPINE COMBINED 663044 (70553)
COPIES TO Hooker, Maryann MD
EXAM REASON: DEMYELINATING DISEASE FOR NINE YEARS
UNCONTROLLED MUSCLE SPASMS AND BURNING SENSATION IN ARMS AND LEG
** REPORT SIGNATURE ON FILE
READING DR Yoo, Jae-Hwi M,D.
ON FILE 05/25/2000 **
SIGNED BY Yoo,Jae-Hwi
REPORT OF Findings
DEPARTMENT OF
RADIOLOGY (302) 421-4300
MR# W0000 ACCT# W0000 RM/BED. UNK
………………………………………………………………………………………………..
REPORT OF Findings
Sagittal, axial ' T1-weighted images and axial T2 and FLAIR images were obtained.
-After intravenous injectIon of gadolinium, sagittal and axial T1- weighted images were obtained.
The Sagittal T2-weighted images show ill – defined focal high signs in the upper cervical spinal cord at the C-2 - 3 level, which is seen on the right side on pathology of the cervical spine is seen.



IMPRESSION: ILL-defined focal high signal in the right side upper cervical spinal cord at the C-2-3 level, probably due to clinically known demyelinating disease although not specific.
COPY MADE BY VARMC, ST. XXXXXXX FROM A RECORD IN VA'S POSSESSION
FPOM
ST FRANCIS HOSPITAL DEPARTMENT OF
7th XXXXXXX STREETS RADIOLOGY XXXXXXX DE 19805-0500 (302) 421-4300
CACKOWSKT XXXXXXX
PHONE (605) 264-9292
DOB 08/12/1958
MRI OF THE CERVICAL SPINE:
FR) NO 65E42959- Jun 2006 1: 46F11 Pb
RADIOLOGIC CONSULT
DATE OF Service 05/24/2000
REPORT OF Findings
Sagittal and axial Ti and T2-weighed images were obtained After intravenous
injection of gadolinium sagittal and axial Ti-weighted images were obtained
The sagittal T2-weighted images show ill-defined focal high signal in the upper
cervical spinal cord at the 02-3 level which is seen on the right side on
axial view No other abnormal al signal is seen in the spinal cord No other
pathology of the cervical spine is seen
IMPRESSION: Ill-defined focal high signal in the right side upper cervical
C-File year 2019
………………………………………………………………………………………………………………………………………………………………….
Detailed Report
MRI BRAIN WITH CONTRAST MATERIALS
Exam Date NOV 07 2003@07 41 Req Phys HOOKER MARYANN
(Case 597 COMPLETE) MRI BRAIN WITH CONTRAST MATERIALS(MRI Detailed) CPT 70552
Proc Modifiers OUTSIDE-MRI
Clinical History
MRI OF BRAIN WITH GADOLINIUM DONE ON 11/7/03 AT XXXXXXX MRI
CLINICAL HISTORY Patient with MS and worsening headache frequency and severity Also worsening lumbar radiculopathy to
the point of wanting to see the neurosurgeons
Report Status Verified Date Reported
Date Verified NOV 10 2003 Verifier Sig
Report from XXXXXXX VAMROC Station #460
*** WORK COPY ONLY *** Printed
Report XXXXXXX CACKOWSKI DOB 08/12/1958 11151 Examined 11/07/2003 #23413 MRI HEAD COMBINED The examination was
performed on 1 5 Tesla Superconducting Magnet Sagittal TI axial T2 FLAIR diffusion weight and echo planar T2* images
coronal gradient echo and T2 images and post contrast sagittal FLAIR and axial and coronal images of the entire brain with magnetization transfer and fat saturation were obtained The
fourth ventricle aqueduct pineal and pituitary region are
unremarkable Ventricles are not dilated There are multiple nodular or linear high signal intensities in the periventricular and deep white matter of the frontal and occipital region bilaterally The distribution pattern is consistent with multiple sclerosis Following Gadolinium injection no abnormal enhancing lesion is seen in the brain Cerebral cortical sulci
are mildly prominent There is no acute hemorrhagic product or
stroke
Impression
/////////////IMPRESSION Multiple nodular and linear high signal intensities
in the periventricular and deep white matter of the frontal and occipital lobes with no contrast enhancement The distribution pattern is consistent with multiple sclerosis//////////////
Primary Diagnostic Code ABNO: ITY ATTN NEEDED
Primary Interpreting Staff
MYUNG XXXXXXX Staff Physician Verified by transcriptionist for MYUNG XXXXXXX /DMR
DMR…………………………..c-file year 2019 pg 3305
………………………………………………………………………………………………………………………………………………………………….


e2
Jun18 2004
TITLE NEUROLOGY NOTE
DATE OF NOTE XXXXXXX 21 2004@12 37 23 ENTRY DATE XXXXXXX 21 2004@l2 37 23
AUTHOR HOOKER MARYANN EXP COSIGNER
URGENCY STATUS COMPLETED
Patien tis here for continuing care of MS and lumbar radiculopathy He
has put on weight since he moved in with his sister He is smoking
occasionally walking daily and exercising to help his back He is trying
to stay away from Excedrin He is learining how to ski Weight is 47#
over guidelines for height of 6feet
He is alert speech is clear language is appropriate facial movements
are full and symmetrical Motor strength is full No dysmetria/
incoordination
VITAL SIGNS
WEIGHT 227 lb [103 kg] (01/21/2004 12 16)
TEMP 98 [36 C] (01/21/2004 12 16)
BP 141/81 (01/21/2004 12 16)
PULSE 87 (01/21/2004 12 16)

Weight loss and continued activity as tolerated encouraged MRI showed no
Enhancing…./// brain lesions but plaques consistent with MS /////He will call if
necessary before returning to clinic in months

/es/ MARYANN HOOKER MD
Staff Neurologist…………/////////////////////c-file yr, 2019 pg 4019////
Signed: 01/21/2004 12:45

Doctor Erion Spaho
I needed to add in a part of the first Brain Evaluation it was early in the year 2000, I seemed not to have included the total and both parts, it took them 2 different days.
I thanyou for your expert help.
But I would like also something very important, you have read all the above, could the symptoms of forearm, but mostly the right wrist come from the location of the mid brain and the spine at c-5 and c-6 as did the the non-vascular intracranial disorder intermitted Paroxysmal pains of Multiple Sclerosis. Was at the same time period for more than a year What I am asking to be more clear can the discomfort from the right wrist not have bin injured at the wrist but the uncertain undiagnosed situation was actually located in the brain, and possibly c-5 and c-6 ? Another Doctor stated this was most likely.
Here is the first Brain MRI results of 2000.....
ST FRANCIS HOSPITAL
7th XXXXXXX STREETS XXXXXXX DE 19805-0500
DEPARTMENT OF RADIOLOGY, 302 421 4300
CACKOWSKI XXXXXXX
PHONE (609) 264-9292
DOB 08/12/1958
DATE OF SVC 05/24/2000
ATTENDING DR UNK
ORDERING DR Hooker Maryann
***EXAMS BRAIN COMBINED 663044 (70553)***
COPIES TO Hooker, Maryann MD
EXAM REASON, DEMYELINATING DISEASE FOR 9 YEARS
VA PATIENT
** REPORT SIGNATURE ON FILE 05/25/2000**
READING DR Yoo,Jae-Mwi
FOR YEARS
ON FILE 0S/25/2000 **
SIGNED BY Yoo,Jae-Hwi
REPORT OF FINDINGS
MRI OF THE BRAIN WITHOUT AND WITH CONTRAST
DEPARTMENT OF
RADIOLOGY (302) 421-4300
MR# W0000 AccT# W0000 RM/BED. UNK
Sagittal, axial and corona' Ti-weighted images and axial T2 and FLAIR images Were obtained ..Diffusion-weighted images with ADC trace were also obtained.
\--After intravenous inject-on of gadolinium, axial and corona' Ti-weighted images were obtained
There are multiple small high signals in the deep cerebral white matter bilaterally on T2 and FLAIR images No ABNORMAL enhancing lesion is seen.
NO other abnormal signal is seen throughout the brain. The ventricles are normal
in size. No other intracranial pathology is seen..
//IMPRESSION :: Multiple small focal high signals in the deep cerebral white
matter bilaterally probably compatible with the patient known demyelinating disease, although
not specific. No abnormal enhancing lesion.

Dr. Sapho,
I wanted to add a note when they had thought possible Tendonitis at the end of year 1977. They then put a splint type cast on my right wrist and as stated the “ PATIENT” returned Nov. 1, 1977 to have splint removed, this did not help at all.
They thought possible tendonitis, then they began..” under water- ultrasound “ treatments, they tried several treatments, the under-water ultra-sound treatments…that did not help at all.
Now Moving on to when I returned to the clinic dated July 24, 1978 for right arm wrist pain “again”, there was no swelling noted, and there was a good range of motion.
I am very positive, although it is not noted here, at this “exact time period”, and more, I was having ongoing mid brain intermitting Paroxysmal pains that were for a few seconds at a time and it was several times a day.
I believe they were most certainly treating me for my Multiple Sclerosis, but perhaps not the perfect way.
This is why I am just trying to give you a clear evaluation of my symptoms.
Dr Sapho,
I don’t believe I have any more to add at all, I had thought it was important for you to know and if that was a part of causing the right wrist discomforts from the Brain, and maybe the c-5 and c-6 spine area.
Thankyou again
Gary Cackowski

Thank you Dr Spaho thank you very much. That will be all.