Saturday, February 9, 2013

re: Symptoms Yams and toes

My friend TimL_SF commented on my last but one blog post and when I answered it, I realized that I wanted to be sure everyone could read it so I elevated the comments to a whole post and here they are:

From TimL_SF:

Hi Mary,

good post! Lots that I can relate to on the patient side here.

"they get a few days where they intermittently have the sensation of a piece of yarn wrapped around their big toe".

is this a humorous hyperbolic example or a real thing? Inquiring minds want to know, particularly since I first read it as "piece of yam". These old eyes ain't what they used to be. ;^)


  1. Thanks.
    This is actually a real thing that has happened to me. Initially I thought it was probably MS (because that is about the least likely and most catastrophic thing it could be and that is where I always go), but when nothing else consistent with MS developed, I figured it was probably something else. Eventually I decided it was probably a B12 deficiency symptom and then when I got my first set of labs in March, they were consistent with B12 deficiency, too, so I worried less about them than I would have if I hadn't had intermittent neuropathies over the years.
    A really interesting thing is that I know my doctors would be at least a little interested in neuropathy (it is also on the list of side effects from the chemo I got) and it just never seemed appropriate to mention it. No one asked me specifically about it and even though lots of residents and attendings spent lots of time with me, it just never seemed like something to mention.
    It feels stupid to mention it apropos nothing and the conversation never got around to someplace where I felt it would make sense to mention it. I know it's not an important thing--it's mild; it's intermittent--so I haven't felt any imperative to mention it. 
    It's really an interesting thing. People will get all kinds of variations on symptoms and specifically deny the official symptom, but agree to some unusual symptom that might be a cousin of the symptom you are looking for. I've made a bunch of diagnoses at various points in patients because I was willing to think "outside the box" when they said they had symptom X, could it really be part of Q or Q filtered through their particular nervous system/cognitive processing of the raw sensation.
    It would be fun to have a list of all the varieties of things that people endorse instead of what we doctors think of as a standard symptom. Hmm. This is the sort of thing that the internet was made for, isn't it? I know that I am a member of a perfect discussion group for this kind of thing, but I can't figure out if it was on google+ or linkedin or somewhere else. It's a good thing we have computers to make our lives easier, isn't it?


  1. I know that feeling... will get my vit B12 checked. Figured it is just my flat feet reminding me to wear shoes :)

    1. Could be either, both or neither, but seems like a good thing to check. And you have a story about it too; that you have flat feet and should wear shoes. It's interesting the stories we tell ourselves.

  2. Just a thought: if you live with a young child and take naps, be sure to check if there's a piece of yarn tied on your toe.