CC Mrs. Bailey is a 38-year-old female here today complaining of paresthesias of her lower legs. The patient tells me since last Thursday she noticed that there is a different sensation to both of her lower legs. She says she first noticed it Thursday when she was shaving her legs in the shower. It was not until she touched the leg with the razor that she was aware that it had just a different sensory feel. She said since then she has noticed this "weird, numb feeling" in the lower half of her body, she notes that from the lower buttocks down her legs. The only area that she feels pins and needles sensation is in her feet intermittently. She says that both legs are affected equally, but she feels it more to the medial side of the legs than to the lateral sides of the legs. Since it has started, it has remained stable. It has not worsened, but it has not improved as well. She has had no …show more content…
We did talk about options and at this point, I think this does deserve further investigation and we reviewed options. She is going to start with some laboratory studies, which she plans on doing today and I should have the majority of them back before the end of the week. We talked about further evaluation with nerve conduction studies as well as the possibility of an MRI and neurology consultation. At this point, she was comfortable with starting with the labs and doing the testing in a stepwise fashion. She was advised in no uncertain terms that if her symptoms worsen acutely, with any progression of her neurologic symptoms, she is to seek care immediately at the emergency room and she is aware of what to be watching for. She plans on contacting me by the end of the week for the results of her testing and further investigation will be decided from there. She does voice understanding of these recommendations and was with comfortable this. All questions