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Michael-Chronic Inflammatory Demyelinating Polyradiculoneuropathy-(American)-Posted on Feb.15th, 2016

Author Zhangqi Views Posted at 2016/02/15

Name: Michael
Sex: Male
Nationality: American
Age: 44 Years
Diagnosis: 1. Chronic Inflammatory Demyelinating Polyradiculoneuropathy(CIDP) 2. Diabetes type 2 3. Hypertension level 2, extreme dangerous
Date of Admission: Jan.17, 2016
Treatment hospital/period: Wu Medical Center/14 days

Before treatment:
The patient's right upper limb was pain and he had muscle weakness without any reason 15 years ago, he also had muscular atrophy and hypesthesia. His left upper limb, left lower limb and then right lower limb became painful and weakness in some years, sometimes, the symptoms became better. He was diagnosed as Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) in 2013, his doctor gave him prednisone, azathioprin and gabapentin. His disease got worse in recent 2 years, he began to have lower muscle painful, muscle weakness and muscular atrophy in recent 3 months, the left side was worse. He has four limbs’ movement problems, the muscle power of his upper limbs is weak, he is not able to put on cloths. he can walk slowly, his left lower limb is limp, he can't go up the stairs. He wanted a better life, so he came to center and diagnosed as Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP), he had diabetes type 2 and hypertension level 2.

Admission PE:
Bp: 153/106mmHg; Hr: 108/min. Br: 20/min. Temperature: 36.5 degree. His spirit and nutrition were normal. There was no yellow stain or petechia on skin and mucous. All his lymph nodes didn't enlarge. His pharyngeal was not congestion. The tonsil was not enlarged. The respiration of both lungs was clear, there was no dry or moist rales. The rhythm of his heartbeat was normal and strong. There was no obvious murmur in the valves. The abdomen was soft and flat with no pressing pain or rebound tenderness. The liver and spleen were normal. His bowel sound was normal, there was no edema on both lower limbs. Fasting blood glucose: 12.4mmol/L, postprandial blood sugar: 19.5mmol/L.

Nervous System Examination:
Michael was alert and his spirit was good. His memory, comprehension, calculation and orientation abilities were normal. Both pupils were equal in size and round, the diameter was 3 mms, both eyes had sensitive response to light stimuli. Both eyeballs could move freely. He didn't have nystagmus. The forehead wrinkle pattern was symmetrical. The tongue was centered in the oral cavity. He didn't have teeth deflection. His neck movements were normal. The muscle strength of turning over or shrugging shoulders was weak, there was no pressing pain on his muscles, both upper limbs and left lower limb had muscular atrophy. The right lower limb was better. The muscle power of left upper limb was at level 3+, right upper limb was at level 4. The grip of both hands was at level 4. The muscle power of left lower limb was at level 3, right lower limb was at level 4. His left feet was not able to extend, the muscle tension was lower than normal. The tendon reflex of four limbs and abdominal reflexes were abnormal.

The acmesthesia below both shoulders and below both hips were decreased, the acmesthesia of his fingers and toes was little, the deep sensation and epicritic sensation of four limbs were decreased. Both side pathological sign was negative. The examination of coordinate movement of four limbs was normal. The meningeal irritation sign was negative. Before the treatment, his EMG showed: there were mulifocality sensorimotor peripheral neuropathy of his four limbs, conduction block, it was demyelinated peripheral neuropathy.

Treatment:
He was diagnosed with 1. Chronic Inflammatory Demyelinating Polyradiculoneuropathy(CIDP) 2. Diabetes type 2 3. Hypertension level 2, extreme dangerous. So he received 3 times of neural stem cell injection and 3 times of mesenchymal stem cell injection to activate the cells, improve circulation, regenerate nerve, improve nerve’s nutrition, remove the oxygen free radical, stable his blood pressure and blood glucose. We also gave him daily physical rehabilitation.

Post-treatment:
After 2 weeks of treatment, his energy was better, four limbs got more power, both upper limbs got more muscle power, adducent and abducent muscles power was at level 4, the grip was at level 5. He could walk better and stable, his left feet could extend, his tendon reflex of four limbs was normal. His blood glucose level was stable, fasting blood glucose: decreased from 12.4mmol/L to 4.9-6.0mmol/L, postprandial blood sugar: decreased from 19.5mmol/L to 7.1~9.8mmol/L.

E-mails:

Date:2016-2-18

Dear Dr Wu:
1-Blood pressure: systolic pressure 119 before take the drug
And 112 after one hour from taking the drug
Diastolic pressure 88 before taking the drug and 74 after taking the drug
Heart rate 98 before taking the drug and 
78 after taking the drug
2- weight :
Old weight from one month 68.2 kg
New weight 69.2 kg
3- movement:
Walking: step by step and it goes better
Fingers: small improve in finger control
Legs and shoulders: continuance fatigue feeling and small numb feeling in the extremities
Sleep and appetite : good

Date:2016-5-10

Dear Dr Wang ,
Thank you for your support
For first question :
Weight :72 kg
Tall : 168 cm
Appetite: very well
Sleep : it's interpreted every two hours
Because of some pain
Below movement: good.
For second question:
Blood pressure: it's normal
Heart rate : normal
For third question
Yes i take the medication as your instructions

Except Glucophage 500 form ten days i stop it because after I taking this drug i feel like there is direct reduced in glucose level in the blood (maybe hypoglycemia )
And after I stop this drug every thing is good 
For fourth question:
I follow the rehabilitation training for 15 days after I discharge from your center and stop after that for 65 days and start again until now
For fifth question:
For fingers tip :it's good and they are good controls  about 30% to 50%
For blood oxygen saturation sorry I didn't make this test
Over all I feeling good
But i have sometimes numbness,high temperature and fatigue in all body without doing any effort
I can't sleep except  special position
So i make sure there is no pressure on nerves in my left shoulder ( in my left shoulder there's no muscles enough so maybe I think that's why I feeling numbness I don't know )
For right shoulder there is no pain or numbness if i sleep
I can walking for 1500 m without help
I can go upstairs for two floors  with help for balance

For the sixth question
Kindly an attachment below and i will send the attachment alone with a another email to make sure you receive it
I hope it was good feedback for you
Kindly inform me if there is any updates in my medications

Best regards

Date:2016-7-7

Dear Dr Wang ,
Thank you for your support
For first question :
Weight :73 kg
Tall : 168 cm
Appetite: very well
Sleep : it's continue for 6 to 8 hours
Below movement: good.
For second question:
Blood pressure: last time it was 100/75
Heart rate : normal
For third question
Yes i take the medication as your instructions

Except All grug for glucose control
I already stopped it because my glucose Test was 70 and 80So i stop the drug
For fourth question:
I follow the rehabilitation training for 15 days after I discharge from your center and stop after that for 65 days and start again until now but in interrupted  way
For fifth question:
For fingers tip :it's good and they are good controls  about 30% from last email (from two months)
For blood oxygen saturation sorry I didn't make this test
Over all I feeling good from last email by 20%
But i have numbnessin my forehand in contusions way and fatigue is less from last email in all body
In my right shoulder the improvement is about 10 % only but in my left shoulder it is about 20 % so in my left shoulder is better from my right shoulder
 For my legs it better from my hand by 20%        
in control but I still don't have the conference to move quickly and normal
  I spend around 90 minutes in sports (walking and simple exercises)
I can go upstairs for two floors  with help no help
 
For the sixth question
Kindly an attachment below and i will send the attachment alone with a another email to make sure you receive it
I hope it was good feedback for you
Kindly inform me if there is any updates in my medications because it finish after 30 days

Best regards

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