I saw John Smith earlier today.  He continues to do very well.  He gets occasional paresthesias but is fully functional.  He remains on Neurontin between 1000 and 1200 mg a day.  He remains on Curcumin, and evidently his myeloma is under control.   
  
On exam today, blood pressure is 120/78.  Pulse is 76 and regular.  He has normal gait and station.  Romberg sign is negative.  Strength is normal.  Reflexes are 2+ in the uppers, 2+ at his knees, and 1+ at his ankles.  His toes are silent bilaterally.  Pin is intact.  Position is minimally decreased in his right toe tip.  Otherwise, sensation is normal.    
  
In summary then, Mr. Smith is doing well, with no progression of his neuropathy.  I told him I would like to see him again at the end of the year and will contact you.   

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Michael Swerdlow, M.D.  

cc: Subhash Gulati, MD 

J#:  17080608
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