How Important Is Vitamin B In The Treatment Of Nerve Damage

Today's post  from cidpneuropathysupport.com (see link below) looks at the role of Vitamin B in both the prevention of and treatment of neuropathy. This article looks at it from the inflammatory neuropathy angle but it can be argued that all neuropathy is inflammatory by nature. The nerves become inflamed and/or damaged through inflammation and a vitamin B deficiency is often seen as contributing to that. That said, you need to be tested by your doctor to establish a deficiency before embarking on vast amounts of supplements. For neuropathy patients with a normal Vitamin B level, there'll be enough extra in your daily multivitamin. There are also different forms of vitamin B and excessive amounts can bring about side-effects - best discuss it with your doctor.

CIDP Type Neuropathy and Vitamin B
Author: Shiraz Abbas May 27, 2017

Studies are now suggesting that vitamin B may have an important role in healing or easing the pain of peripheral neuropathy and CIDP type of neuropathy in particular.

Peripheral neuropathy is a disorder of the peripheral nerves. It is often characterized by weakness of limbs, numbness and pain. CIDP type neuropathy is a form of neuropathy in which there is a progressive and gradual destruction of the nerves through inflammation.

The vitamin B family of vitamins (also known as B complex vitamins) are critical for the proper functioning of the human body. They play a role in our immune system, energy, and red blood cell formation. Vitamin B12 is particularly important for neurological health and is a vitamin of choice to help treat neuropathy.

Vitamin B is commonly used to treat neuropathy. According to one study, people given high doses of vitamin B for four weeks had their pain reduced and saw improvement in their vibration perception threshold (VPT), that is, a testing that is used to measure large nerve fiber function in the body. People with lesser doses in a 8 week span saw lesser improvement.

Deficiency in B vitamins may lead to neurological problems. B12 in particular is important for the development of the central and peripheral nervous system. It has a critical role in maintaining the myelin sheath which ensures the transmission of nerve signals in the central and peripheral nervous system.

In neuropathy, especially CIDP type neuropathy, the signals between the spinal cord and other parts of the body are disrupted. With CIDP in particular, the myelin sheath is gradually but progressively damaged through inflammation and hence leading to an impairment of the transmission of nerve signals. This process of demyelination leads to axonal destruction. The disease is thus characterized by the following symptoms: weakness of the limbs, numbness, tingling sensation and pain. Loss of sensation and activity also happens depending on where the damage is occurring.

As B vitamins, particularly vitamin B12 play a role in maintaining a healthy peripheral nervous system, the vitamin may also play a role in the reconstruction of the nerves and more particularly the myelin sheath and hence helping the reduction of pain and improving sensation.

Some people with neuropathy may not be able to absorb vitamin B12 due to the loss of the “intrinsic factor” that is produced in the stomach and hence the loss of ability to absorb B12 through the digestive tract. In these cases like these, B12 may be injected into the body. Please check with your doctor if you have digestion problems with it comes to B12.

For those who can absorb it through the digestive tract, the following foods are high in B12 in addition to B12 supplements:

Beef Liver (71 mcg for a three-ounce serving, provides 2951% of the daily recommended intake).
Mackerel (16 mcg for a three-ounce serving, provides 661% of the daily recommended intake).
Sardines (8 mcg for a three-ounce serving, provides 333% of the daily recommended intake).
Read Meat (5 mcg for a three-ounce serving, provides 208% of the daily recommended intake).
Salmon (4 mcg for a three-ounce serving, provides 167% of the daily recommended intake).


Shiraz Abbas is the founder and manager of the CIDP Neuropathy Support Group. He is also one of the main community educators of IVIG therapy. He resides in Fresno, California. Shiraz can be contacted through our free CIDP advice service at 1-855-782-0574.

http://cidpneuropathysupport.com/cidp-neuropathy-and-vitamin-b/

COULD READING GLASSES SOON BE A THING OF THE PAST

A thin ring inserted into the eye could soon offer a reading glasses-free remedy for presbyopia, the blurriness in near vision experienced by many people over the age of 40, according to a study released at AAO 2014, the 118th annual meeting of the American Academy of Ophthalmology. A corneal inlay device currently undergoing clinical review in the United States improved near vision well enough for 80 percent of the participating patients to read a newspaper without disturbing far distance vision needed for daily activities like driving.

Presbyopia affects more than 1 billion people worldwide.[1] As people age, the cornea becomes less flexible and bends in such a way that it becomes difficult to see up close. While the most common remedy is wearing reading glasses, a host of new corneal inlay products are in development to treat the condition, with three types currently under review by the U.S. Food and Drug Administration (FDA). The theoretical advantage of using corneal inlays over wearing reading glasses is that corneal inlays prevent the need for constantly putting on and taking off glasses, depending on whether the person needs to see near or far.

One of the devices is the KAMRA inlay, a thin, flexible doughnut-shaped ring that measures 3.8 millimeters in diameter, with a 1.6 millimeter hole in the middle. When dropped into a small pocket in the cornea covering the front of the eye, the device acts like a camera aperture, adjusting the depth of field so that the viewer can see near and far. The procedure to insert the implant is relatively quick, lasting about 10 minutes, and requires only topical anesthesia.

To test the inlay's efficacy, clinicians conducted a prospective non-randomized study of 507 patients between 45 and 60 years of age across the United States, Europe and Asia with presbyopia who were not nearsighted. The researchers implanted the ring in the patients and followed up with them over the course of three years. In 83 percent of eyes with the implant, the KAMRA corneal inlay allowed presbyopic patients to see with 20/40 vision or better over the three years. This is considered the standard for being able to read a newspaper or drive a vehicle without corrective lenses. On average, patients gained 2.9 lines on a reading chart. The researchers report that the results remained steady over a three-year period.

Complications from corneal inlays in general have included haziness that is treatable with steroids; however, improvements in inlay design have made the effect less common. If necessary, inlays can be removed, making it a reversible treatment, unlike other procedures such as LASIK for presbyopia.

"This is a solution that truly delivers near vision that transitions smoothly to far distance vision," said John Vukich, M.D., author of the poster and a clinical adjunct professor in ophthalmology and vision sciences at the University of Wisconsin, Madison. "Corneal inlays represent a great opportunity to improve vision with a safety net of removability."

The device is sold in regions including Asia, Europe and South America, but is not yet approved by the FDA for use in the United States. There are two other types of corneal inlays, Raindrop Near Vision Inlay and Presbia Flexivue Microlens, also in development for the U.S. market.

ULTRA THIN DETECTORS SEE BELOW THE SURFACE

New research at the University of Maryland could lead to a generation of light detectors that can see below the surface of bodies, walls, and other objects. Using the special properties of graphene, a two-dimensional form of carbon that is only one atom thick, a prototype detector is able to see an extraordinarily broad band of wavelengths. Included in this range is a band of light wavelengths that have exciting potential applications but are notoriously difficult to detect: terahertz waves, which are invisible to the human eye

A  research paper about the new detector was published online Sept. 7, 2014 in the journal Nature Nanotechnology. Lead author Xinghan Cai, a UMD physics graduate student, said a detector like the researchers' prototype "could find applications in emerging terahertz fields such as mobile communications, medical imaging, chemical sensing, night vision and security."

The light we see illuminating everyday objects is actually only a very narrow band of wavelengths and frequencies. Terahertz light waves' long wavelengths and low frequencies fall between microwaves and infrared waves. The light in these terahertz wavelengths can pass through materials that we normally think of as opaque, such as skin, plastics, clothing and cardboard. It can also be used to identify chemical signatures that are emitted only in the terahertz range.

Few technological applications for terahertz detection are currently realized, however, in part because it is difficult to detect light waves in this range. In order to maintain sensitivity, most detectors need to be kept extremely cold, around 4 Kelvin, or -452 degrees Fahrenheit. Existing detectors that work at room temperature are bulky, slow and prohibitively expensive.

The new room temperature detector, developed by the UMD team and colleagues at the U.S. Naval Research Lab and Monash University, Australia, gets around these problems by using graphene, a single layer of interconnected carbon atoms. By utilizing the special properties of graphene, the research team has been able to increase the speed and maintain the sensitivity of room temperature wave detection in the terahertz range.

Using a new operating principle called the "hot-electron photothermoelectric effect," the research team created a device that is "as sensitive as any existing room temperature detector in the terahertz range and more than a million times faster," says Michael Fuhrer, professor of physics at UMD and Monash University.

Graphene, a sheet of pure carbon only one atom thick, is uniquely suited to use in a terahertz detector because when light is absorbed by the electrons suspended in the honeycomb lattice of the graphene, they do not lose their heat to the lattice but instead retain that energy.

The concept behind the detector is simple, says UMD Physics Professor Dennis Drew. "Light is absorbed by the electrons in graphene, which heat up but don't lose their energy easily. So they remain hot while the carbon atomic lattice remains cold." These heated electrons escape the graphene through electrical leads, much like steam escaping a tea kettle. The prototype uses two electrical leads made of different metals, which conduct electrons at different rates. Because of this conductivity difference, more electrons will escape through one than the other, producing an electrical signal.

This electrical signal detects the presence of terahertz waves beneath the surface of materials that appear opaque to the human eye--or even X-rays. You cannot see through your skin, for example, and an X-ray goes right through the skin to the bone, missing the layers just beneath the skin's surface entirely. Terahertz waves see the in-between. The speed and sensitivity of the room temperature detector presented in this research opens the door to future discoveries in this in-between zone.

DRINKING DECAF OR REGULAR COFFEE MAY BE GOOD FOR THE LIVER

Researchers from the National Cancer Institute report that decaffeinated coffee drinking may benefit liver health. Results of the study published in Hepatology, a journal of the American Association for the Study of Liver Diseases, show that higher coffee consumption, regardless of caffeine content, was linked to lower levels of abnormal liver enzymes. This suggests that chemical compounds in coffee other than caffeine may help protect the liver

Coffee consumption is highly prevalent with more than half of all Americans over 18 drinking on average three cups each day according to a 2010 report from the National Coffee Association. Moreover, the International Coffee Association reports that coffee consumption has increased one percent each year since the 1980s, increasing to two percent in recent years. Previous studies found that coffee consumption may help lower the risk of developing diabetes, cardiovascular disease, non-alcoholic fatty liver disease, cirrhosis, and liver cancer.

"Prior research found that drinking coffee may have a possible protective effect on the liver. However, the evidence is not clear if that benefit may extend to decaffeinated coffee," explains lead researcher Dr. Qian Xiao from the National Cancer Institute in Bethesda, Maryland.

For the present study researchers used data from the U.S. National Health and Nutrition Examination Survey (NHANES, 1999-2010). The study population included 27,793 participants, 20 years of age or older, who provided coffee intake in a 24-hour period. The team measured blood levels of several markers of liver function, including aminotransferase (ALT), aminotransferase (AST), alkaline phosphatase (ALP) and gamma glutamyl transaminase (GGT) to determine liver health.

Participants who reported drinking three or more cups of coffee per day had lower levels of ALT, AST, ALP and GGT compared to those not consuming any coffee. Researchers also found low levels of these liver enzymes in participants drinking only decaffeinated coffee.

Dr. Xiao concludes, "Our findings link total and decaffeinated coffee intake to lower liver enzyme levels. These data suggest that ingredients in coffee, other than caffeine, may promote liver health. Further studies are needed to identify these components."

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Chronic Inflammatory Demyelinating Polyneuropathy CIPD More Than Meets The Eye

Today's post from hillandponton.com (see link below) has a long title, describing a severe form of neuropathy called chronic inflammatory demyelinating polyneuropathy but in fact, the content applies to practically everyone who suffers from neuropathy and in that respect, is a useful description of what neuropathy entails. The title is also a long-winded description of the form of nerve damage that many people suffer from but is more often called peripheral neuropathy, or just neuropathy. CIPD involves damage to the myelin sheath insulating the nerves but this also applies to most cases of peripheral neuropathy. However, it also suggests that the standard protocol for CIPD neuropathy treatment involves just three components: IVIG (intravenous immunoglobulin); Corticosteroids and plasma exchange. That this is misleading is an understatement. Treatment for CIDP is much wider than that and is certainly not limited to those three options as most patients will know. It's difficult to see where the author has got her information from and from what angle she's approaching the subject but this article is an example of how you need to be careful not to jump to conclusions from just reading one source of information.

What is Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)?
 March 6, 2017/in Veterans /by Brenda Duplantis, Accredited Claims Agent

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder characterized by gradually increasing sensory loss and weakness associated with the loss of deep tendon reflex in the legs and arms. The hallmark of a peripheral nerve disease is loss of ankle reflex. This is when your doctor hits your Achilles tendon and there is no reflex.

CIDP is a progressive motor and sensory neuropathy that is very painful and debilitating. CIDP is caused by damage to the covering of the nerves, called myelin.



The axon (nerve fiber) works like an electric wire. The myelin sheath around the axon is the insulation necessary for the nerve to conduct electrical impulses properly. In CIDP, myelin is attacked through very complex mechanisms. In such cases, the body sees the peripheral nerve as foreign and antibodies bind to the myelin and begin to break it down. In people with CIDP, this translates into symptoms. For example, if you want to move your finger, messages tell your brain to move the finger. Then electrical communication within your body tells your nerves and muscles to move the finger. When there is disruption in the myelin sheath, those messages are weakened. Your brain is telling your finger to move but the nerves are damaged and the movement is weakened, delayed, or absent. When the myelin sheath is completely damaged, the message is blocked and this is called paralysis.

The disease can be present in a person for years prior to diagnosis. Because it is a gradually progressing disorder and its symptoms may, at early stages, wax and wane, a definitive diagnosis may require invasive tests. However, a neurologist that has experience in this type of disease should be able to identify the gradual symptoms and rule out any other cause. Typically, a diagnosis of CIDP is based on the person’s symptoms. Common symptoms in CIDP patients include:

In extremities:
 
Pain
Tingling
Numbness
Weakness
Loss of deep tendon reflex
Foot drop
Difficulty walking (altered gait, stumbling)
Fatigue

In addition to the aforementioned symptoms, tests such as a nerve conduction study (NCS) and electromyography (EMG) – a diagnostic procedure to assess the health of muscles and the nerve cells that control them – may be administered to determine the extent of demyelinating disease. In demyelinating disease, there is damage to the lining of the nerves that are critical for electrical nerve conduction. This can be confirmed by EMG studies or nerve biopsy. A nerve biopsy is used to confirm inflammatory process in the patient’s nerve.

A spinal fluid analysis is another diagnostic test that helps determine if a patient has elevated protein with normal cell count, an abnormality found in CIDP patients. Finally, your doctor may order blood and urine tests to rule out other disorders that may cause neuropathy, such as diabetes, which is the number cause of peripheral neuropathy.

The therapy for CIDP includes these three primary protocols:
 
IVIG (intravenous immunoglobulin used to treat various autoimmune, infectious, and idiopathic diseases) – can aggravate kidney dysfunction, cardiovascular disease, cerebrovascular disease, and other.
Corticosteroids (oral prednisone, pulse oral dexamethasone, IV methylprednisolone) – often improve strength, are conveniently taken by mouth, and are inexpensive. Side effects, however, can limit long-term use.
Plasma exchange – a process by which some of the patient’s blood is removed and the blood cells returned without the liquid plasma portion of the patient’s blood. It may work by removing harmful antibodies contained in the plasma. Short-term relief.

If treated early, most CIDP people respond well to therapy that can reduce the damage to peripheral nerves and contribute to improved function and quality of life. If left untreated, 30% of CIDP patients will progress to wheelchair dependence.

https://www.hillandponton.com/cidp/

Was The Cuban Neuropathy Crisis Solved By Vitamins

Today's post from blog.easy-immune-health.com (see link below) is nothing more than a press story with exaggerated headlines that will undoubtedly lead people to think that vitamin supplements are the answer to all their neuropathy problems. That's nonsense of course but the story is fascinating none the less and makes you think. It talks about the embargo on trade with Cuba during the cold war years and how  enormous numbers of neuropathy patients were faced with little choice but to be given vitamin injections for their nerve damage because all other drug options were simply not available. The crux of the story claims that despite this limitation in treatment, up to 50,000 people were cured of their neuropathy. It's all extremely debatable but does raise questions as to whether the treatment we currently receive could be boosted by vitamins or other supplement options to achieve better results. The problem with current neuropathy treatment is that it does little to 'cure' the problem and at best, subdues the symptoms. Whether we believe the Cuban story or not, the point is that current medications are little more than stop-gap treatments and combination treatments are probably far more effective. The problem is finding the right combinations.
 

Fifty Thousand Cured of Epidemic Nerve Disorder with Vitamin Supplements
By Kerri Knox, RN on September 27, 2010

For those that do not think vitamin supplements are effective, all one has to do is to look at he U.S. embargo of Cuba between 1991 and 1993. This embargo caused more than just economic consequences for the tiny island nation; it also caused interesting medical consequences that wealthier nations could learn from. The medical consequences of the embargo included an ‘outbreak’ of a painful nerve problem called ‘neuropathy’ that ended up affecting over 50,000 people.

While it was determined that this ‘epidemic’ was caused by a virus, this virus was not treated with antiviral medications, antibiotics or any other pharmaceuticals. This epidemic was completely stopped in its tracks and the more than 50,000 people affected were CURED simply by taking vitamin supplements. This phenomenon of nutritional deficiencies leading to viral infections is not new, and has been shown to be the case with a type of Heart Failure from Selenium Deficiency, known as Keshan disease, is actually caused by a viral infection that is ‘cured’ with selenium supplementation as well.

Peripheral Neuropathy is a nerve condition that causes pain and decreased sensation in many parts of the body but typically affects the lower extremities where it is called Peripheral Neuropathy. However, it may also affect the hands, the hearing, the face and even the nerves of the eyes causing not only pain and decreased sensation, but also deafness and blindness as well. The Cuban Neuropathy Epidemic, as this outbreak was later called, affected a combination of the extremities, the hearing and the eyes – sometimes in the same person. Young and old alike were affected and medical care was scarce due to many factors related to the embargo:

The poor economic conditions
The limited medical supplies entering the country and
The vast numbers of people that were seeking medical attention for the epidemic

But in this environment of minimal funds in a so-called ‘third world’ country, the majority of the 50,000 people affected were completely cured of their neuropathy with nothing more than plain Over the Counter Vitamin Supplements. Even those who were so severely affected that they required hospitalization simply received intravenous vitamin infusions in the hospital while the government instituted a free multivitamin distribution program for the rest of the population. Those with neuropathy were ‘cured’ and the neuropathy ‘epidemic’, except for a few isolated cases, ended completely.

Today in the US, there are tens of thousands of people – primarily diabetics and the elderly – who are suffering with neuropathy and are told that there is no cure. They have blood tests, CT scans, perfusion scans, electrical muscle tests and nerve conduction tests. In the end, they are given pain pills and told that they will have to live with excruciating nerve pain and decreased sensation for the rest of their lives. For diabetics, this decreased ability to feel their feet can mean wounds that don’t heal and amputated limbs; for the elderly, the ever-present risk of falling and breaking a bone is compounded.

Certainly not ALL cases of neuropathy can be cured with Multivitamin Supplements, but as the Cuban Neuropathy Epidemic teaches us, there certainly are some cases that CAN be improved or cured with vitamin supplements. Yet there are almost no doctors in ‘first world’ countries that will discuss vitamins for neuropathy despite the lessons from Cuba and from some liberated prisoner-of-war camps where the same phenomenon has been observed. Doctors in western countries require formal double-blind placebo-controlled trials to perceive a therapy as being worthwhile.

So the lack of studies using vitamins to treat Peripheral Neuropathy ensure that people in western countries with this debilitating life-altering illness will not be given the same option of simply trying a safe and inexpensive multivitamin supplement as they would be if they lived in a third world country.

http://blog.easy-immune-health.com/brain-health-neurologic/fifty-thousand-cured-of-epidemic-nerve-disorder-with-vitamin-supplements/

HEALING THE HEART WITH FAT

Too much dietary fat is bad for the heart, but the right kind of fat keeps the heart healthy, according to a paper published in The Journal of Experimental Medicine.

Unsaturated dietary fatty acids, such as eicosapentaenoic acid (EPA), are known to protect against cardiovascular diseases. However, the mechanism and the specific fat metabolites responsible for this protection were unknown.

A group of Japanese scientists now show that mice engineered to produce their own EPA are protected against heart disease and have improved cardiac function. One particular EPA metabolite, called 18-hydroxyeicosapentaenoic acid (18-HEPE), was required for this protection.

18-HEPE was produced by immune cells called macrophages, which dampened inflammation and fibrosis in the heart. Treatment with 18-HEPE confirmed its heart-protective effects.

A diet enriched in 18-HEPE might thus help prevent heart failure in patients with cardiovascular diseases.

The Pitfalls Of Caring For Someone In Chronic Pain

Today's post from paincommunity.org (see link below) is a very useful article describing how difficult it can be to be a care giver for someone living with chronic pain. As many of you will know, neuropathy pain can reduce the quality of someone's life dramatically but not only the patient suffers. Their family and friends and the person who has had the responsibility of primary care thrust upon him or her, has to learn to adapt to a whole new relationship scenario and that can be very difficult indeed. Via the writer's own personal experiences, this article sums up the main problems and gives some hints as to how to learn to cope. Certainly worth a read if you're in that position, either as patient or carer.

“Angry, Sad and Frustrated”– The Unspoken Feelings of a Caregiver
Posted by Jim Stemple | March 19, 2014

As a caregiver to a very special lady for the last 20+ years I have learned it is ok to be angry and frustrated. This understanding did not come overnight.
Here is what I learned.
 
1: Chronic pain comes along and turns the lives of everyone involved upside down. Everything you knew is no more. Your life isn’t your life anymore, it is now a life filled with uncertain days and nights. You see the pain doesn’t only affect the person living with pain, it affects all those around them. It affects the whole household and those close to them outside the home. I may not live with chronic pain myself but I do live with someone who does and I am affected on so many different levels.

All the plans you had made for the future are put on hold or forgotten about. You find that each day life can and does throw something new at you and your loved one. It can be breakthrough pain, it can be a new health issue, insurance problems, finding a provider or just plain old frustration that threatens to blow the top of your head off.

The stress of not being able to know from day to day what the pain is going to decide to do to your loved one is over-whelming some days. As a caregiver you constantly worry what each day will bring.
 
2: Sometimes the one who is living with pain doesn’t realize how much it affects those around them. You see they are so consumed with trying to deal with the pain each day that sometimes they forget about the ones around them. The one living with pain will feel as if their partner/ caregiver doesn’t care enough, is angry at them or doesn’t believe that they “really have pain”.

But you know, it isn’t that at all. We, as caregivers, are pulled in so many directions that sometimes we think our heads may spin off of our necks. We do not know if we are coming or going—I know that I have felt that way.

3: For many partners/caregivers the financial stability of the family is always on your mind. For some families you lose the 2nd income that you were dependent on when your loved one is no longer able to work due to the pain. This can and does cause much discomfort and friction within the family. You don’t lay the blame on your loved one because they are unable to work but you cannot help but to feel frustrated at what the pain has done to your family and your dreams.

So what is the secret to success?

Over the years I have found that the most important thing is to communicate. It is ok for the caregiver to lose it once in a while. It is ok to be angry, sad, frustrated and overwhelmed. Share what you are feeling with your family or loved one. Let them know that you aren’t feeling all these things because of them, you are feeling all of this because of the situation—the pain and what it has done to the family and the one for whom you care so deeply.
Communicate with each other.

It is a two-way street. Share those feelings rather than holding on to the frustration, fear and anger. You are borrowing trouble that you nor your loved ones need, if you do not remain open. Holding in those nasty feelings may come back and haunt you– one day you are going to blow and it is not going to be pretty. Don’t wait until the fuse is lit because then things are said that hurt your loved one. Things that cannot be taken back no matter how much you wish you could.

I have been guilty of opening my mouth in frustration and saying some very hurtful things to her. Things that I didn’t mean and things that I wish I could take back more than anything. I am thankful because she knows that it is the anger and frustration talking and she can and does let my slips of hurtful words roll on by her and doesn’t dwell on them.

Trust me, we were not always like that but over the years we have learned to understand that the pain can make each of we say things that we truly don’t mean. We have learned that the pain is a vixen waiting for the right moment to spring forward and turn our lives in to a “he said, she said” fight of the century.

As a caregiver, I have found times where I feel torn between providing for the family and being there when I am needed. This push and pull really sucks! My job consists of taking me out of state each week. There are Mondays that I want nothing more than to stay at home and comfort her. Yet, I know that this will not happen, as I must be the provider which means leaving her and heading out to work. It doesn’t matter how much pain she is in. I have to leave her and go to work.

Yes, there are times she gets angry at me as she wants me there with her. It isn’t that I can really do anything to make the pain better. It is just knowing that she isn’t alone. I understand that but I am helpless to do anything about it. Even though she gets upset, I know she understands that if I could, I would never leave her alone.

As a caregiver, don’t you feel pulled and pushed in a hundred different directions at the same time? Do you find yourself angry, sad and frustrated because you want nothing more than to help your loved one? Would you take the pain from them in a heartbeat? I know I would. After all, I feel it was my job to protect her and help make her life a fairy tale come true.

The pain changes all that but remember even though you are angry, sad and frustrated you can make the world of difference for your loved one by just being there for them. You can make a difference by just listening, by holding their hand or giving a gentle hug when they need it the most.

Help find the humor in this world of pain and share it with them. You will be surprised how much laughter can help both of you. My special gal tells people all the time that if she had a penny for every time I have made her laugh we would be millionaires. That makes me smile.
Here is the pearl:

Remember the pain affects the whole family unit and it is up to everyone in that unit to make the best of the situation. Sure, you can choose to be miserable, depressed and find yourselves fighting all the time. A better option is to choose to communicate with each other and find the love, laughter and the ability to still see all that is good in your lives. Live the life that you want to live and refuse to let the pain destroy what means the world to you.

http://paincommunity.org/angry-sad-frustrated-unspoken-feelings-caregiver/

The Shoe Problem For Neuropathy Sufferers

Today's post from pamspaulding.net (see link below) is a personal story of a woman trying to find the best shoes to suit her neuropathy symptoms. Many people will identify with her problems and although the suggestions are of American shoe brands, it does highlight the fact that we need to find footwear that is both reasonably stylish and comfortable and supportive. That's not an easy task!

When you have neuropathy-damaged feet, good (cute) shoes are hard to find. 
Posted by Pam Spaulding Saturday, June 8, 2013

 The stereotype is that lesbians wear "comfortable" shoes, as in unfashionable, or maybe work boots, I have no idea.

 Anyway, this lesbian has serious neuropathy in both feet. I've had insulin-dependent diabetes for 30 years, and thankfully my eyes and kidneys -- usual targets of long-term damage -- are fine, unfortunately the feet are what took the damage. My blood sugars have been in good control, but it's hard not to have some long-term effects having diabetes for this long. BTW, it runs on both sides of my family -- both of my parents had adult-onset but were not obese. My brother is fine; I seemed to be the one to get all of the horrid metabolic and immune disorders passed down. Even my RA, according to my rheumatologist, was spawned through the genes; my mom had sarcoidosis, which is in the same auto-immune family.

 Anyway, it's hard to describe what neuropathic pain feels like -- it's simultaneously numbness paired with extreme sensitivity at times to the touch, such as feeling like you're walking on hot coals, or someone is stabbing you with little knives on the soles of your feet. The duality of this is both frustrating and annoying because it can ramp up at any time. The worst-case scenario is an attack of it at night -- I've had pain so bad that even having the sheet touch my feet under the covers was excruciating.

 On the other hand, my feet are nearly completely numb to hot or cold, which can be dangerous. Burning hot water feels only warm on them; ice barely registers as cold. The numb aspect also makes it easy to slip in the shower, since my feet don't have the correct sensation to grip the wet floor well. I have to have bath mats all over the floor to make it to my slippers.

 One of the few topical things that help is capsaicin, derived from hot peppers. Mostly this is used by folks with osteoarthritis. In treating neuropathy, the heat sensation generated by it cancels out/breaks up the neuropathic signals causing the pain. Kate tried using it on a sore muscle and she couldn't bear the burning sensation; I barely feel anything warm on my feet, but after about a half-hour, some of the worst burning subsides and I'm able to finally sleep.

 But back to shoes... 

 Almost all my old shoes -- nice dress shoes, sandals -- had to be tossed out over the last couple of years because they either 1) hurt my feet by causing neuro-pain, or 2) didn't provide enough shock absorption to prevent knee and hip pain that I have from RA. What's left to wear? Well, lots of styles that look like Grandma Shoes. At this point, the only brand I trust to be comfortable are Easy Spirit's Athletic family. At least they come in all sorts of cool colors and styles.

 I took a risk on one shoe that looked kind of cool -- the Naturalizer BZees Mary Jane (right). While they aren't dress shoes or sneakers, they fall into middle ground for me. I'll wear these to work or out on the weekend. I've learned that comfort comes before style at this point. It's really not a choice.

 One of the brands that up until this about a year ago that I could reliably trust were Jambus and J-41s. I wore one pair last week and boy did I pay for it. They seemed comfy enough -- they have memory foam insoles -- but the next day my left knee and hip hurt so bad that I was limping for two days. I had to fall back on my trusty Easy Spirit Mary Janes to get enough support and shock absorption. I was crestfallen. I love those J-41s. I wanted to make a bargain with myself that I can still wear them in some limited way...oy.


 http://www.pamspaulding.net/2013/06/when-you-have-neuropathy-damaged-feet.html

HOW LEARNING TO TALK IS IN THE GENES

Researchers have found evidence that genetic factors may contribute to the development of language during infancy

Scientists from the Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol worked with colleagues around the world to discover a significant link between genetic changes near the ROBO2 gene and the number of words spoken by children in the early stages of language development.

Children produce words at about 10 to 15 months of age and our range of vocabulary expands as we grow -- from around 50 words at 15 to 18 months, 200 words at 18 to 30 months, 14,000 words at six-years-old and then over 50,000 words by the time we leave secondary school.

The researchers found the genetic link during the ages of 15 to 18 months when toddlers typically communicate with single words only before their linguistic skills advance to two-word combinations and more complex grammatical structures.

The results, published in Nature Communications today [16 Sept], shed further light on a specific genetic region on chromosome 3, which has been previously implicated in dyslexia and speech-related disorders.

The ROBO2 gene contains the instructions for making the ROBO2 protein. This protein directs chemicals in brain cells and other neuronal cell formations that may help infants to develop language but also to produce sounds.

The ROBO2 protein also closely interacts with other ROBO proteins that have previously been linked to problems with reading and the storage of speech sounds.

Dr Beate St Pourcain, who jointly led the research with Professor Davey Smith at the MRC Integrative Epidemiology Unit, said: "This research helps us to better understand the genetic factors which may be involved in the early language development in healthy children, particularly at a time when children speak with single words only, and strengthens the link between ROBO proteins and a variety of linguistic skills in humans."

Dr Claire Haworth, one of the lead authors, based at the University of Warwick, commented: "In this study we found that results using DNA confirm those we get from twin studies about the importance of genetic influences for language development. This is good news as it means that current DNA-based investigations can be used to detect most of the genetic factors that contribute to these early language skills."

The study was carried out by an international team of scientists from the EArly Genetics and Lifecourse Epidemiology Consortium (EAGLE) and involved data from over 10,000 children.

The Impact of Fluctuating Symptoms on People with HIV

One of the problems about neuropathy is that in the beginning, the symptoms can fluctuate. You can have periods with relatively few problems and other times where the neuropathy is clearly a part of your life. The same applies for many people in general with HIV, where neuropathy may only be just one of the health problems they have to live with. Today's post talks about the findings of a survey by the National Aids Trust and comes from aidsmap.com (see link below). The survey found that these fluctuating symptoms can have a significant effect on people's working lives as well as their mental state at any given time. The recommendation is that more studies need to be done.

Fluctuating symptoms have major impact on quality of life and fitness to work, survey finds
Gus Cairns:Published: 07 September 2011

Common but non-specific symptoms of uncertain cause can dominate the day-to-day life of some people with HIV, a survey by the National AIDS Trust has found. In many cases symptoms such as fatigue, insomnia, depression, diarrhoea and neuropathy make it hard to work and perform other daily activities, the report of the survey finds.

The survey also found a significant degree of overlap between symptoms; generally, if people had one symptom, more than two-thirds of them were likely to have at least one other. One other finding was that the majority of respondents found that the symptoms were not only fluctuating, but were also completely unpredictable. This made planned activities, both at work and socially, difficult. About 60% of respondents were employed.

This study is a pilot survey of an independent working group brought together to review the Work Capability Assessment (WCA), the medical procedure under which claimants are assessed for Employment and Support Allowance. The WCA had been criticised, especially in an independent review conducted by occupational health expert Professor Malcolm Harrington, for being inflexible and for not being designed to accommodate illnesses characterised by fluctuating symptoms. See www.aidsmap.com/Whats-happening-to-benefits/page/1793223/ for more on the WCA and the Harrington Report.

Survey results in detail

The NAT study asked people with HIV to complete an online survey about their experience, during the previous six months, of five symptoms commonly associated with HIV: fatigue, anxiety or depression, insomnia, gastro-intestinal problems and neuropathy (nerve pain). There was space to mention other symptoms too.

It is not surprising that in a study inviting people to self-report, the majority of the 265 respondents had at least one of the symptoms on the list. The most common was fatigue, suffered by 57%, followed by depression or anxiety (55%), gastro-intestinal (GI) problems (48%), insomnia (46%) and neuropathy (33%).

More significant was the fact that more people experienced these symptoms as fluctuating rather than constant. Respondents described conditions as ‘constant’ with frequencies ranging from about 38% in insomnia to 24% in the case of GI problems, but as ‘varying over time’ with frequencies ranging from 53% in fatigue to 31% with neuropathy.

Fatigue was mentioned as a particularly common and troubling symptom. Very few respondents could usually predict when fatigue would hit them. One commented that “When I have it I am quite incapacitated and have no choice but to limit, stop or cancel plans to do things.” Another said “it is always there, lurking...if I do anything for more than an hour it begins to kick in.” One respondent managed to hold down a job but always required a nap of one to two hours immediately after coming home. Although 40% of respondents thought a combination of HIV and HIV medications caused their fatigue, 30% said they really had ‘no idea’ what caused it.

Depression and anxiety were nearly as common as fatigue, though respondents did not say they affected work so much. The main feature of these were their frequency: 90% of respondents said they had experienced either or both at some point in the last month. Given that a third of respondents said that bouts of depression or anxiety lasted more than a week at a time, many people must be living with severely disordered mood a lot of the time.

Diarrhoea, nausea and other GI problems were the symptoms most likely to be linked in people’s minds to HIV treatment. Thirty per cent of respondents thought these were the exclusive cause of their problems and 45% thought HIV and HIV treatments were both to blame. The frequency of bouts of diarrhoea varied from once to more than five times a month.

Insomnia and poor sleep, especially chronic, not only impacts on quality of life: it is a cause of significant physical and psychological illness. Although this has been associated with HIV drugs, especially efavirenz, 45% of respondents did not know why their sleep was so poor. Sleeplessness was very unpredictable – people would be fine one night and not the next. Forty-three per cent said having problems sleeping could last for more than a week. When insomnia is this prolonged, memory, mood and cognitive function can be severely affected. One respondent said sleep problems meant “I am unable to focus on my work, feeling like I have jet lag.”

Neuropathy (nerve pain) was the least-experienced of the conditions but was still suffered by a third of respondents. About equal numbers of people attributed it to HIV itself and to HIV drugs. In some cases the pain of neuropathy was constant – one person said his feet were always sore and this prevented standing or walking for more than 15 minutes. But the majority said that while some symptoms such as numbness were always there others, such as stabbing pains, were unpredictable and often severe.

Most respondents suffered from multiple symptoms: for instance, of those with depression or anxiety, 75% also had fatigue and 57% insomnia; of those with neuropathy, 61% had fatigue and 68% GI problems.

About 40% of respondents were unemployed, with a higher proportion among those reporting GI problems or fluctuating neuropathy. There was a generally positive attitude to work, with one respondent happy to have just started a job after 18 months of unemployment – “I am knackered but happy to be working,” s/he said.

In other cases however it was clear that fluctuating symptoms were significantly affecting people’s ability or willingness to work. One question asked “on how many occasions in the past four weeks have your symptoms significantly affected your ability to work”? A quarter of people with fatigue, 20% with neuropathy, and about 15% of those with depression and GI problems reported that this had happened more than five times in the past four weeks.

One respondent asked: “How do you work round this kind of thing unless you work for yourself or for an extremely understanding employer?”

Conclusions and recommendations

NAT concludes that the responses to their survey reveal that fluctuating symptoms are a cause of real morbidity and distress to people living with HIV and place significant barriers to work. They add that the variation and unpredictability of symptoms was often as much of a problem as the symptoms themselves.

Because the symptoms are fluctuating, ESAs may not capture them if the person is having a ‘good day’, but there are other methods of assessment, such as asking people to keep a symptom diary.

NAT recommends that more research needs to be undertaken into these common, fluctuating symptoms and that HIV organisations should raise awareness amongst employers, and with people with HIV themselves, about the importance of making reasonable adjustments at work to enable people with HIV to continue in employment.

In terms of the ESA itself, NAT recommends that ESAs need to take into account “the full range of barriers fluctuating symptoms present to participation in work and other daily activities,” including their unpredictability and the fact that they come in combination.

“Assessment should consider the impact of fluctuation and the cumulative impact of multiple, lower-level symptoms on people living with HIV,” they comment.

http://aidsmap.com/Fluctuating-symptoms-have-major-impact-on-quality-of-life-and-fitness-to-work-survey-finds/page/2066782/

Neuropathy In The Feet

Today's post from neuropathytreatments.com (see link below) is a useful but pretty general post about looking after your feet if you have neuropathy. From lack of feeling to extreme pain, our feet can receive strange signals from the nervous system but because we depend on them to carry us through our lives, it's very important to look after them as best we can. This article gives people new to foot problems some very useful advice and background information.

Foot Neuropathy 
Posted on February 12, 2014

I once knew someone who had a hard time walking. He couldn’t feel the coldness of the floor nor could he feel anything touching his feet. He would fall frequently, as if his legs just gave out from under him. He had numbness in his feet and perhaps even in his legs.

These symptoms stem from peripheral neuropathy. Peripheral neuropathy is damage of the peripheral nerves. Your peripheral nerves are the nerves in your toes and fingertips. When the nerves are damaged, they don’t function properly. Those with peripheral or foot neuropathy have decreased or abnormal sensation in their feet and toes. Sometimes, they develop problems moving these parts of the body as well. In my friend’s case, he had hard times walking or moving around.

Causes

Diabetes is perhaps the most common cause of foot neuropathy in the United States. About 60 to 70 percent of diabetics will develop neuropathy over their lifetimes. Of course, there are other causes for neuropathy besides diabetes. Other causes include:
Certain medications, including some chemotherapy drugs.
Heredity. Some people have a family history of peripheral neuropathy.
Advanced age. Peripheral neuropathy is more common as people age.
Arthritis. Certain type of arthritis can cause peripheral neuropathy.
Alcoholism. According to the US National Library of Medicine, up to half of all long-term heavy alcohol users develop peripheral neuropathy.
Neurological disorders. Certain neurological disorders, including spina bifida and fibromyalgia, are associated with peripheral neuropathy.
Injury. Acute injury to the peripheral nerves may also cause peripheral neuropathy.

In my friend’s case, the cause for neuropathy was a complication of an underlying medical condition.

Symptoms

The most common symptoms of peripheral or foot neuropathy are burning, numbness, tingling, or shooting or stabbing pain in the feet and/or toes. Any change in sensation in the toes may be a symptom of peripheral neuropathy and needs to be reported to your doctor. Any of these symptoms may be an early warning of diabetes.

Home Care

There are a lot of things you can do at home to help with peripheral or foot neuropathy. Perhaps one of the most important things you can do is check your feet every day. Those with foot neuropathy and decreased sensation in their feet could step on a tack and not realize it. Therefore, regularly inspect your feet so you can note any injuries or infections and seek appropriate medical attention as needed. Many patients with foot neuropathy had serious complications from this condition which resulted in advanced medical attention including amputation. So don’t neglect your feet. You only get two for a lifetime. If you have a hard time inspecting your feet, enlist a family member or friend. Any injuries must be treated properly to prevent infection from progressing.

Another important part in foot care at home is the foot wear. People with peripheral or foot neuropathy should wear properly fitted shoes and avoid walking barefoot to prevent injury. They should also get some good socks to help keep their feet comfortable in the shoes and prevent rubbing.

Also, if your foot neuropathy is caused by diabetes, always take your medications and work at controlling your blood sugar level. Out-of-control blood sugar leads to increased nerve damage.

When to Visit a Podiatrist

A podiatrist is essential for everyone with peripheral neuropathy of the feet. Podiatrists are doctors who are specially trained to preserve the health of the feet. They can help with toe nail clipping and give other tips on how to keep your feet healthy.

Diagnosis and Treatment

It is important that you tell your doctor about any symptoms with your feet. A podiatrist, family physician, internist, or physician who specializes in diabetes can diagnose peripheral or foot neuropathy. They diagnose foot neuropathy based on a physical exam, health history, and the reporting of symptoms. Your doctor may order a blood test to check your blood sugar level because high blood sugar levels and diabetes are an important cause of peripheral neuropathy.

There is no cure for neuropathy. Most treatments are geared for relieving symptoms and preventing the neuropathy from progressing further.

Your doctor or podiatrist may prescribe oral medication to help with pain. A thorough foot check will be performed to look for any injuries or infections and your doctor will teach you how to take care of your feet at home. People who have peripheral neuropathy should have their feet examined by a podiatrist at least once per year.

Prevention

The best thing you can do to prevent foot neuropathy is to stay healthy. Control your blood sugar level if you have diabetes and take your medications faithfully. Watch for the health of your feet and inspect them regularly. If you notice any symptoms like numbness, tingling, or pain, check with your doctor immediately to prevent further nerve damage and any other effects of foot neuropathy.

http://neuropathytreatments.com/2014/02/

Anaesthetics And The Treatment Of Neuropathy

Today's post from asahq.org (see link below) is a general assessment of neuropathy treatment at the moment, from the American Society of Anaesthesiologists and looks particularly at anaesthetics as pain killers, including such drugs as ketamine. The problem is that there are no definite conclusions here. Ketamine is seen as a promising analgesic agent for neuropathy sufferers but there's little discussion of opioids in general and no mention of methadone for instance, which is proving very successful in nerve pain cases. Nevertheless, this does look at neuropathy treatment from the point of view of anaesthesiologists and as such gives us another angle on the subject.

Causes of Neuropathic Pain Guide Treatments
Timothy Lubenow, M.D., Philip Peng, M.B.B.S., and Jianguo Cheng, M.D., Ph.D. 2014

Neuropathic pain is one of the most complex and difficult management challenges physician anesthesiologists face. Hundreds of distinct neuropathic pain syndromes have been documented and many are refractory to multiple treatments.

“Neuropathic pain affects 18 percent of the general U.S. population,” said Jianguo Cheng, M.D., Ph.D., Professor and Director of the Pain Medicine Fellowship Program at the Cleveland Clinic in Cleveland. “It is a major part of our practice and very resource-intensive. Medical costs for neuropathic pain patients are threefold higher compared with matched control subjects.”

Neuropathic pain is caused by a lesion or insult in the peripheral or central nervous system. The resulting plasticity in the peripheral and central nervous system leads to sensitization and hyperexcitability of neurons in the dorsal root ganglion, the spinal cord and the brain. The result is hyperalgesia, allodynia and spontaneous pain.

Causes include post-surgical, post-traumatic or post-herpetic neuralgia, diabetic neuropathy, HIV neuropathy, hypothyroidism, toxic exposures, lesions of the central nervous system, complex regional pain syndromes and more.

“Treatment of neuropathic pain has two goals,” said Timothy Lubenow, M.D., Professor of Anesthesiology, Rush University Medical Center, Chicago. “We want to alleviate or eliminate the cause of the underlying disease and to relieve symptoms.”

Treating the underlying cause is vital to long-term control, he said. For example, it is virtually impossible to successfully treat diabetic neuropathy until the underlying diabetes is brought under control.

Step therapy is standard for treating neuropathic pain, Dr. Lubenow said. Most patients can be treated with drug therapy, typically combinations of agents with different mechanisms of action. Multiple medical societies have issued guidelines for neuropathic pain, most with somewhat different recommendations. There are a wealth of anecdotal reports and open-label studies, and a dearth of strong evidence.

“When the evidence is soft, it is more open to interpretation and opinion,” he said. “You want a drug or a combination of drugs that are useful in alleviating pain, but you also want to minimize side effects.”

Pregabalin, gabapentin and duloxetine appear as preferred agents in most guidelines, Dr. Lubenow said. Other agents frequently recommended include sodium valproate, oxycarbazepine, venlafaxine, amitriptyline, dextromethorphan tramadol, morphine, oxycodone and capsaicin.

For patients with recalcitrant pain, spinal cord stimulation and intravenous infusion may be viable alternatives.

There are data supporting the use of I.V. lidocaine, bisphosphonates, phentolamine and immunoglobulin, said Philip Peng, M.B.B.S., Professor of Anesthesiology and Pain Management at Toronto Western Hospital, University of Toronto. But the duration of analgesia tends to be short, and severe adverse events are common.

Ketamine is one of the most promising I.V. agents for neuropathic pain, he said. Most studies use 50 mg or less infused over 30 minutes to two hours and the analgesic effect lasts less than two days. Trials using larger doses over longer infusion periods show much greater effect.

A study using anesthetic doses infused over five days showed significant pain relief up to six months following treatment, but there were significant psychotropic effects, muscle weakness and infections. Later trials using lower doses showed less severe adverse events but also less analgesia.

Early data from a Toronto Western Hospital trial using six-hour outpatient infusions for five days showed slightly more non-responders than responders, Dr. Peng reported. But responders showed greater than 50 percent pain relief up to three months after treatment.

“Responders tend to have less pain by the end of the second day,” he said. “At this point, we have no good tool for predicting responders. We are hoping for more robust data as the protocol progresses.”

http://www.asahq.org/annual%20meeting/go%20anesthesiology%202015/asa%20daily%20news/causes%20of%20neuropathic%20pain%20guide%20treatments

The Mystery Of Neuropathy

Today's post from daytondailynews.com (see link below) is a reader-friendly description of neuropathy and how it affects us. Less focussed on the science but more on how we feel when we have neuropathic symptoms. Relating it to other systems which we're more aware of, is always useful - it helps put neuropathy in a meaningful context in people's minds and especially reassures them that they're not alone in feeling as they do. It includes the very sensible statement that the best neuropathy diagnosis is obtained by listening to the patient's testimony but can be followed up by certain diagnostic tests - if only most doctors agreed with that order of events!

Peripheral neuropathy’s cause remains mystery for millions of Americans
By Premier Health Monday, June 22, 2015

A person’s brain and spinal cord serve as the mainframe from which important messages are sent throughout the body via the peripheral nervous system.

The peripheral nervous system helps the body’s internal organs function properly and provides important signals regarding its response to the outside environment such as when a person’s feet are hot or their hands are cold. Trauma, infections, disease and injury can all cause damage to the peripheral nervous system and when this happens, a person may notice the feelings they have taken for granted all these years have become distorted or are suddenly gone.

This condition, known as peripheral neuropathy, causes numbness and tingling in a person’s extremities, and in extreme cases, can limit a person’s mobility and affect their ability to breathe. According to the National Institute of Neurological Disorders and Stroke (NINDS), peripheral neuropathy affects more than 20 million Americans, and for a significant number of individuals the cause of the disease is unknown.

“Peripheral neuropathy distorts the messages that travel from the brain and spinal cord to the outlying parts of the body including hands, feet and sometimes a person’s face,” said Christopher Scheiner, MD, PhD, a neurologist with the Clinical Neuroscience Institute. As the NINDS describes it, the disease is much like static on a telephone line, interrupting messages that should be carried throughout a person’s body, but which never properly reach their destination.

Dr. Scheiner said in most cases, symptoms of peripheral neuropathy happen gradually. As a result, individuals may dismiss symptoms until the disorder progresses to a point where they can no longer deny their existence. Carpal tunnel syndrome, where the median nerve in the wrist is damaged, is one of the better known peripheral neuropathies where this is often played out, Dr. Scheiner said.

“People may attribute the loss of sensation in their hands simply to their positioning on the steering wheel,” Dr. Scheiner said. “However, they will begin to notice that it is happening more often and becoming more painful. But it is when they do something outside of their normal routine such as holding a paintbrush for five minutes that they realize something is wrong.”

Peripheral neuropathy is best diagnosed through a clinical exam in which a neurologist will ask a series of questions about a patient’s symptoms. A physician’s diagnosis can then be supported through additional testing. One common test that is done is an electrodiagnostic test called an electromyography (EMG). An EMG delivers electricity through a small shock to the areas of the body where a patient is having symptoms. This enables a doctor to determine any damage to the nerves in that area.

Dr. Scheiner said it’s important to be evaluated for peripheral neuropathy because in some cases it could signal an underlying health issue that needs immediate attention. The most common form of peripheral neuropathy is diabetes. Up to 70 percent of diabetics have the disorder, according to the Foundation for Peripheral Neuropathy. In some cases, diabetes may be discovered through the presence of peripheral neuropathy, he said.

HIV/AIDS patients and those taking certain chemotherapy drugs also experience the disorder. According to the Foundation for Peripheral Neuropathy, the disorders affect up to 40 percent of chemotherapy patients and a third of all HIV/AIDs patients.

The disorder can sometimes be cured when an underlying health issue is brought under control. In some cases, peripheral neuropathy can cause a person pain and when this happens medication can be prescribed to help alleviate it.

“These medications help to turn off the nerves that are causing pain,” Dr. Scheiner said. “They are different than what a patient would receive from an over-the-counter medication like Tylenol, but still allow a patient to function without the sensation that they are being controlled by a substance.”

ABOUT PREMIER HEALTH SPECIALISTS: Premier Health Specialists is one of the largest groups of specialty care practices in Southwest Ohio. More than 130 physicians serve patients in a variety of specialties such as bariatric, breast care, burn and wound, cardiology, cardiothoracic surgery, cardiovascular-thoracic surgery, general surgery, gynecologic oncology, hand and reconstructive surgery, infectious diseases, maternal-fetal medicine, neurosciences, obstetrics and gynecology, orthopedic surgery, orthopedic spine surgery, ophthalmology, palliative care, physiatry, plastic surgery, podiatry, psychology, pulmonology, sports medicine and urology. Premier Health Specialists is part of Premier Health, which includes Miami Valley Hospital, Good Samaritan Hospital Dayton, Atrium Medical Center and Upper Valley Medical Center. For more information, visit www.premierhealthspecialists.org.

http://www.daytondailynews.com/news/lifestyles/health/peripheral-neuropathys-cause-remains-mystery-for-m/nmhw7/

HOMOEOPATHIC REMEDIES FOR THE THIRD STAGE OF LABOUR

The third stage of labor refers to the period following the completed delivery of the newborn until the completed delivery of the placenta. Relatively little thought or teaching seems to be devoted to the third stage of labor compared with that given to the first and second stages. The third stage is otherwise known as placental delivery is very important and should be carefully watched. This extends from the complete expulsion of the fetus to the complete expulsion of placenta and membranes, and firm contraction and retraction of the uterus subsequently. The average duration of this stage, when spontaneously completed may extent from a few minutes to fifteen minutes.

The  phenomena of the third stage of labour are- characteristic uterine contractions, separation of placenta, expulsion of placenta, control of haemorrhage, permanent contraction and retraction of uterus .

The objective of management is mainly control postpartum haemorrhage and complete expulsion of placenta.

HOMOEOPATHIC REMEDIES

Well selected Homoeopathic medicines are effective for the management of labour. Some of the important remedies are given below

ARSENIC ALBUM30– Arsenic album is one of the top remedies for for the last stage of labour when the placenta remains adherent to uterus. Labour is weak and the uterus is flabby , therefore there is profuse bleeding after labour. Discharge is profuse and acrid. Cutting pain in lower part of abdomen running upwards. Patient is prostrated and there is sinking of the vital state. Great burning pain with nervous prostration. Mentally the patient express fear, anxiety and restlessness.Shehas fear of death.

ARNICA MONTANA 30- Arnica is the top remedy for excessive bleeding in the third stage of labour. It soothes the muscles of vagina , gives a great sense of relief and comfort after delivery. Arnica will absorb the blood  and induce maximum recovery of the damaged nerve tissue

BELLIS PERENNIS 30 – Bellisperennis is another top remedy to reduce bleeding in third stage of labour. There is sore and aching pain after childbirth. The uterus  feels sore as if squeezed.

PULSATILLA NIG 30-.-Pulsatilla is an excellent remedy for bleeding from retained placenta. Here the uterine contractions are very weak

CANTHARIS 30- Cantharis is another useful remedy for retention of placenta  with painful urination

CACUSTICUM 30-Causticum is used for retention of urine after  delivery

VISCUM ALB 30 – It is also used for retention of placenta.

BELLADONNA30–Belladonna is another remedy for retention of placenta  with profuse hot blood. Here the lochia is hot and scanty

SABINA 30 – Sabina is one of the top remedies for retention of placenta from the atonic conditions of uterus.

CAULOPHYLLUM 30 –Caulophylum is another top remedy in labour. Haemorrhage after hasty labour due to lack of tonicity. In Caulophyllum the lochia is protracted. Great atony and passive oozing for days  from relaxed vessels

CHINA 30– Excessive bleeding in third stage. Great weakness with blood loss

KREOSOTUM 30-  In case of Kreosotum the lochia is dark brown , lumpy , offensive and acrid. The special feature is that it almost ceases then refreshes up again.

PYROGEN30-InPyrogen the lochia is thin, acrid, brown and very fetid. Lochia suppressed followed by chills. There is fever and profuse perspiration.

SECALE COR-30 Retention of placenta. There is no expulsive action, though everything is relaxed. Dark offensive green lochia.Severe after pains.

Educating The Nervous System To Ignore Pain

Today's post from pbs.org (see link below) is an excellent explanation of the complexity of chronic pain as a condition and how modern drugs are frequently ineffective in dealing with it. The need is for new drug compounds to address new neural receptors but although progress is being made, it will still take a very long time before the processes and drugs can be explored and refined. It is thought that by interrupting the signal between the pain and the brain (to put it very simply) there is a brief period when old pain memories can be erased. It's working in this area that may bring the most progress for nerve damage patients in the future. A fascinating article - definitely worth a read.

Teaching the Nervous System to Forget Chronic PainBy Eleanor Nelsen on Wed, 13 Aug 2014

“It was an emergency situation,” she says. The horse Sally was riding was barreling straight towards another, younger horse, and the only way to stop him was to pull back on one rein, hard. She felt a pop in her wrist. Heat shot up her arm, excruciating pain fast on its heels.

That was four years ago. No one knows quite what happened to her wrist that day, but whatever it was has left her with constant pain that stretches from her fingertips to her neck, and sometimes creeps into her ribs. On the really bad days, even a hug is unbearably painful.

Sally is my youngest sister, and she is one of an unlucky fraction of people for whom an injury catapults their nervous system into a state of chronic pain. The injury itself heals, but like an insidious memory, the pain lingers. We don’t know why. “The whole issue of the transition from acute pain to chronic pain—why some individuals develop that chronic pain and many don’t—is a major, major question,” says Allan Basbaum, a professor at the University of California, San Francisco. Genetics may play a role. So can the severity of the original injury. 
Today's painkillers are based on well-known compounds like morphine and are often highly addictive.

But what we do know is that once that pain has gotten a foothold, doctors and patients don’t have very many choices. “The irony is that morphine, the 2,000-year-old drug, still remains the number-one weapon against pain,” says Yves De Koninck, a professor of neuroscience at Université Laval in Canada.

And it’s not a weapon that anyone enjoys using. Opioids like morphine and oxycodone are famously addictive, and the numbers of people who abuse them are climbing. Painkiller overdoses now kill more people than cocaine and heroin combined. And while opioids are invaluable for acute pain, they’re less effective for persistent, chronic pain. In fact—in a particularly cruel irony—long-term opioid treatment can actually make pain worse. Non-opioid pain medications exist, but they don’t work for the majority of patients, and even then they are only partly effective. Chronic pain is like “a maladaptive memory.”

Opioids work so well for acute pain because they bind to the receptors the body has designed for its own painkillers—molecules like endorphins and dynorphins that blunt the pain response. Finding good alternatives to opioids for treating chronic pain will mean finding different neurological mechanisms to target—mechanisms that explain not just why people hurt, but why some people hurt for so long.

De Koninck has found such a mechanism. One of the keys to understanding chronic pain, he believes, is to pay attention to the similarities between long-lasting pain and another, very familiar, neurological process that makes some connections stick around longer than others: memory.

Chronic pain is like “a maladaptive memory,” Basbaum explains. Both constitute patterns etched in your brain and nervous system that quicken the connections between “snake” and “poison” or between “bump” and “ouch.” Evidence has been piling up that chronic pain and memory share some of the same cellular mechanisms—and now, De Koninck’s work has shown that a neurochemical trick used to erase memory may be able to turn off chronic pain, too. An Unmet Need

The number of people struggling with chronic pain has been hotly debated, and the fact that chronic pain is broadly defined and difficult to quantify doesn’t help. But even conservative estimates suggest that about 20% of the population have had at least one episode of serious, chronic pain. In the United States alone, that’s more than 60 million people. “It’s a major unmet need,” De Koninck says.

Pain is physically and psychologically debilitating in way that few other conditions are. “In fact, it’s often the most debilitating component of many diseases,” De Koninck notes. And it sharply circumscribes the lives of people who suffer from it. People can find a way to live with the other challenges of painful conditions like arthritis, cancer, even paralysis, he says, but “if you actually ask the patient, their number-one concern, and the one thing that they want us to cure, is the pain.” When pain pathways are functioning properly, they play a protective role.

When chronic pain gets severe, many patients withdraw, sometimes even from their families. Sally says that she’s constantly nervous, afraid to accept invitations or do things that she loves—like riding horses—in case it makes her arm even worse. The ride that day, Sally says, “changed my life.” For some patients, chronic pain can lead to serious mental health problems—it’s strongly correlated with depression and suicide risk.

When pain pathways are functioning properly, they play a protective role. They are a relay of chemical and electrical signals that move from nerve endings to our brains. Pain teaches us to avoid things that are sharp, prickly, or hot. It’s the way our nervous system has adapted to living in a hazardous world. People who can’t feel any pain typically don’t live very long.

Our skin is packed with millions of specialized nerve endings, programmed to detect dangerous conditions like heat or pressure. When one of these pathways is activated, the neuron sends an electrical current shooting up its long, thin axon towards the spinal cord. When it reaches the end of the neuron, that electrical signal prompts the release of chemicals called neurotransmitters into the synapse, or the gap between the first neuron and the next. The neurotransmitters dock in receptors on the next neuron, triggering pores to open in the cell’s membrane. Charged particles rush in through these open pores, creating a new electrical current that carries the signal farther up the nervous system.
Nerve cells, like these seen here from a mouse's spinal cord, send impulses along their axons and connect over synapses.

The first handoff occurs in a region of the spinal cord known as the dorsal horn, a column of grey matter that looks, in cross-section, like a butterfly. From this first relay point, the signal travels to the thalamus, one of the brain’s switchboards, and eventually to the cerebral cortex, where the signal is processed and decoded.

After an injury, it’s normal for the damage sensors near the trauma site to be touchy for a little while. During that time, your nervous system is encouraging you to protect the damaged tissue while it’s healing. But sometimes that extra sensitivity, called “hyperalgesia,” sticks around long after it’s useful. Hyperalgesia is often a major component of chronic pain, and it means that people with chronic pain have to be unceasingly alert. For example, Sally says, before she hurt her arm, hot coffee sloshing onto her hand might have hurt for a few seconds. Now, a careless moment like that means days of burning pain.

Symptoms like this suggest that changes in the nervous system have migrated to the spinal cord. De Koninck believes that a major factor is the number of receptors on the signal-receiving neurons in the dorsal horn. If those neurons synthesize too many receptors, they’ll pick up too many neurotransmitter molecules. Then the neurons’ pores will flutter open to let charged particles in more often than they should, sending electrical signals shooting up to the brain at too high a frequency. The result is a pain signal that’s much stronger than it should be. De Koninck’s work gives us a new window into how it happens, and how to stop it. Recall, Then Erase

The key lies in a study about memory that was published nearly 15 years ago. Long-term memories seem to depend on the synthesis of extra receptors, too, and scientists knew that blocking the synthesis of those receptors during a memorable event could keep memories from forming.

But what a group of researchers at New York University discovered was that there is a brief period when interrupting receptor synthesis can actually erase old memories. Memories are reinforced when they’re retrieved, but, paradoxically, during that process, even well-established memories have a brief window of vulnerability—like jewelry in a safe deposit box, memories are useless when they’re stored but accessible to thieves when they’re being used. A chemical called anisomycin blocks the production of receptors that neurons need to form memories. When the researchers injected anisomycin into rats’ brains right after triggering a particular memory, that memory didn’t just fail to get reinforced—it was erased altogether. The right chemical injected at just the right place at just the right time could erase the physiological “memory” of pain.

Accumulating evidence that pain and memory use similar mechanisms led De Koninck to wonder if this same neurochemical trick could erase chronic hyperalgesia. De Koninck and his colleagues made mice hypersensitive to pain by injecting their paws with capsaicin, the chemical responsible for chili peppers’ fiery bite. Capsaicin activates the same pain sensors that respond to extreme heat and can turn on hyperalgesia without the tissue damage that an actual burn would cause. After their capsaicin injection, the mice’s paws were more sensitive to pressure for hours afterward.

Before that sensitivity had had a chance to wear off, the team gave the mice a second capsaicin injection—and this time, they added an injection of anisomycin. What happened after this second injection is “like magic,” De Koninck says. When the second injection initiated the same flurry of neurotransmitters and electrical signals that encoded the hyperalgesia the first time—the pain analogue of recalling a memory—anisomycin shut down the pain-amplifying mechanism by keeping the spinal cord neurons from making extra receptors. “It’s in the process of reorganizing itself,” De Koninck explains, “and there there’s that window of opportunity to actually shut it back down.” The mice lost seventy percent of their hypersensitivity to pain.

The theory that overdeveloped connections other than memories could be attenuated by retriggering them “is not a new idea,” Basbaum says, “but the fact is, there really has been very little evidence that it’s doable.” De Koninck’s results suggest that the right chemical injected at just the right place at just the right time, can erase the physiological “memory” of pain. Ted Price, a professor at the University of Texas-Dallas, says that this “ paves the road to disease modification instead of just palliatively treating people with these terrible drugs like opioids, which everybody, everybody in the field wants to get away from.” New Options

For now, there are a few other types of treatment doctors can turn to besides opioids. Antidepressants help some people, as do certain antiseizure medications. A controversial technique called “transcutaneous electrical nerve stimulation” may work by making sure that there are plenty of receptors in the dorsal horn for the body’s natural opioid chemicals; a wearable device using this technology was just approved for over-the-counter sale by the FDA.

Treatments based on De Konick’s capsaicin-anisomycin model would constitute an entirely new category of drugs. “When you find a new mechanism,” De Koninck says, “boy, it opens a whole new array of things.” But finding the right combination of chemicals won’t be easy. Capsaicin patches are already sold over the counter at drugstores, but anisomycin is far too indiscriminate for clinical use. Brian Wainger, a physician and researcher at Massachusetts General Hospital, says, “It’s obviously going to be a long time for a discovery like this to work towards a clinical approach, but I think it sort of sets a framework for some options.”

“Options” is a word that seems to come up a lot among pain specialists. One of the reasons chronic pain is so difficult to treat is because “there’s a lot of different forms of chronic pain,” De Koninck says. “But the arsenal that we have so far to treat it is still quite meager.” And the weapons we do have are woefully inadequate.

Still, discovering that this retrigger-and-erase phenomenon works for hyperalgesia, as well as for memory, suggests that it may be useful in other parts of the nervous system. If that’s true, these kinds of treatments could help with pain syndromes more complicated than hyperalgesia—conditions that are so severe that even light touches become painful, or in cases where patients experience pain with no stimulus at all.

One big advantage of De Koninck’s strategy is that it isn’t just an incremental improvement, a way to make a slightly more effective or slightly less addictive analgesic. It’s a totally different angle on the problem. It targets the “chronic” part of chronic pain. “What the field I think really needs is options,” Price says. “And more importantly, patients need options.” For millions of people, and their doctors, a totally different angle is exactly what they’ve been looking for.

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Eleanor Nelsen
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Eleanor Nelsen is NOVA's 2014 AAAS Mass Media Fellow. She has also written for QUEST Science and Wisconsin Public Television.

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