Dear Doctor H:
I apologize for being unable to deliver this letter during at our meeting yesterday, August 17th, 2016. I tried to complete it but was not able to do so in time.
In a review of recent Accident Log entries, I find I have documented multiple fasciculation events. These are as follows (all spelling as found in the original source text).
Accident Log Fasciculation Events
=====================
2016-07-28 02:38:39
FASISCULATION IN AREA OF LEFT CHEEK MASS. FIRST IN ;ONG TIME.
=====================
2016-08-10 00:53:50
Also
- had strange sense of eyeborw flutter on falling aslepp. Was like a fasiculation of the eyebrows.
persisted for a period and then was no longer present
- Also had prior fasiculation event on left cheek below area of atrophy. Believe I logged this event.
=====================
2016-08-13 15:48:23
hAVE FASISCULATION LEFT CHEEK BELOW ATROPHY AREA
BRING THIS UP WITH DRT H
=====================
2016-08-16 17:53:20
Yesterday felt a “face tighten” No vibration
See no reason for this.
Did have intermittent worry over muscle weakness with leg unable to support me.
Difficulty in climbing stairs.
Worried over the fact I tend to discount things.
End of Accident Log Fasciculation Events
My last experience of similar events was in the period November 2013 to January 2014. These events were documented in the following blog posts (it is easier for me to locate data in the blog than in the Accident Log).
December 2nd, 2013
http://facticity.ca/als-cte-acronyms/
December 4th, 2013
http://facticity.ca/a-day-in-the-life/
December 6th, 2013
http://facticity.ca/headaches/
December 7th, 2013
http://facticity.ca/working-fear/
December 20th, 2013
http://facticity.ca/behavioural-changes/
In November 2013, I retained the services of Mr. Serge Dubé, avocat and raised my concern to locate a neurologist or physiatrist in Montréal. At the time of my last meeting with Dr. X on May 31st 2013, I communicated to him Dr. Taylor’s request for an urgent referral of me to a physiatrist. Dr. Taylor’s concern was with the lost and destroyed teeth due to night seizure events, the various suppurating lesions which occurred post-accident, and the atrophy of my left side.
When this request was communicated to Dr. X, his response was to state “there are two physiatrists in Gatineau and neither of them are available to you,” and that I should attempt to locate a recently retired physiatrist residing in Ottawa, Ontario. At this meeting, I lost all confidence in Dr. X.
When the flutter events and fasciculations of December 2013 increased in severity and frequency, I became concerned and brought these events to the attention of Mr. Dubé thinking he might be able to locate an appropriate resource in Montréal. Dr. X had been totally dismissive of my injuries. It is my belief that his professional circle would remain loyal to him and would fail to treat me in an objective manner. Finding an appropriate resource in Montréal represented a possible solution to this issue.
Mr. Dubé contacted a number of physicians on my behalf and supplied them with the assessments written by you, by Dr D, and with materials written by Dr. X. Unbeknownst to me, the materials authored by Dr. X included his letter containing defamatory statement of me. I was unaware of this letter until July 2015 and it is only within the last month that I became aware of the fact his letter had been included as part of the SAAQ file transmitted by SAAQ to Mr. Dubé in December 2013. This now explains why he had such difficulty in making a successful referral of me to those Montréal physicians who reviewed the defamatory material authored by Dr. X.
In a blog post of February 1st, 2014 found at the following URL:
http://facticity.ca/good-news/
I include the following statement regarding my first meeting with Dr. N:
“I failed to adequately describe my concerns over development of ALS or CTE. This was the entire reason I sought him out. And I completely forgot.”
Subsequent to this meeting, the flutters and fasciculation events tapered off. I am still searching the Accident Log in search of any similar events logged this year. My memory (which is not to be trusted) is one of infrequent “strange events.” These include:
Problems With Swallowing
I have on multiple occasions found myself getting food stuck in my windpipe and having need to self-perform a Heimlich maneuver. I had no similar experience pre-accident. These events have been intermittent. I am uncertain if I have logged them all.
Problems With Muscle Weakness
Despite walking 250 miles a month (an average of 8 miles a day. I can easily walk 15 miles in a day without problem, or ill effect), I encounter an intermittent sudden weakness in my hip, or in one of my legs, where it suddenly appears unable to bear my weight. At times this has made it very difficult to ascend and descend stairs. I go up on all fours and descend slowly and carefully.
Problems With Breathing
This occurred last summer when I was crossing the Westboro Super-Store parking lot. There seemed to be something wrong with my chest muscles on the left side such that I had momentary difficulty in breathing. There was one other similar event around the same time period. I have not experienced this recently.
These events have not been regular and continuous (apart from the events of December 2013 which occurred on a regular daily basis with increasing frequency and severity). Because these events are not continuous, I tend to discount them. I did the same thing with various other events post-accident and this has caused me a great deal of difficulty due to SAAQ’s imposition of a nonsensical “few days” rule.
The professional circle of Gatineau neurologists, or similar professionals, is likely to be quite small and well known to Dr. X. I do not therefore have any faith in obtaining an objective assessment. If I approach Dr. N, he would likely need to make a local referral. Appropriate physicians in Montréal have already likely been approached by Mr. Dubé and will have formed a negative opinion of me due to the defamatory statements of Dr. X.
It is entirely possible these events will again go into remission as they did in December 2013 / January 2014. I thought this letter may be of assistance if you are aware of an appropriate physician in Ottawa. If the letter is forwarded to them they will then have the opportunity to form an independent opinion as to the circumstance created by physicians in Québec.
In closing, I wish to note that I do not believe this to be critical at this point. I underwent a much more severe and frequent cycle of similar events in 2013. If the current events do not progress there is likely no need for further action. My present plan is to ensure I log all present similar events to determine if frequency is increasing, while at the same time searching back through the Accident Log to verify any prior events which I may have logged, but have forgotten. I hope to complete this review before our next meeting and perhaps we can discuss it at that time.