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Kamis, 11 Mei 2017

Eric Clapton Suffers From Neuropathy Too


Today's post from telegraph.co.uk (see link below) talks about Eric Clapton's life with neuropathy. We're always searching for role models to promote knowledge of the disease, although nobody would wish it on anybody, famous or not. Unfortunately, it's more common that you might think among musicians and often affects the hands and fingers. However, they should also maybe bear in mind that years of 'good living' can also bring on nerve damage, so playing their instruments may not be the only cause. That said, when a celebrity hits the headlines thanks to neuropathy, it brings the disease into the public spotlight and makes people ask questions as to what it is and how it works. So in that sense and with great sympathy for Clapton and others, we may all benefit in the long run from the increased publicity - that's a sad fact of life in itself!


The disease that could end Eric Clapton’s career: why musicians fear peripheral neuropathy
13 June 2016 Tristram Fane Saunders

Eric Clapton in New Orleans, 2014
Eric Clapton in New Orleans, 2014Credit:John Davisson/Invision/AP
Last week, Eric Clapton revealed the name of the condition which could spell the end of his musical career: peripheral neuropathy.
“I’ve had quite a lot of pain over the last year,” the guitarist told Classic Rock magazine. “You feel like you have electric shocks going down your leg.” The condition, which affects nerves in the body’s extremities and can cause numbness, shooting pains and loss of co-ordination, is making it hard for him to play.

Clapton is not the only famous musician to have had the condition. 

Procul Harum guitarist Dave Ball began suffering from peripheral neuropathy while undergoing chemotherapy in 2012.  In an article for Macmillan Cancer Support, he described the sensation as “finger tingles”.
“Basically it feels like your nerves are exposed to the outside world,” explained Ball, who died last year. “Any contact – particularly with cold – can make you ‘uncomfortable’. You end up wearing gloves a lot of the time... Not the best of side effects from my viewpoint,” he added. “I’m a guitarist by trade and as you probably know, we use our fingers to make a noise.”
Eric Clapton in the 1980s
The guitarist now feels "electric shocks" in his legsCredit:Chris van de Vooren/Sunshine International/REX
Andy Fraser, the bassist for Seventies hard rock pioneers Free, also suffered from the condition. Fraser, who died in 2015 aged 62, had been fighting “AIDS… bouts of cancer, peripheral neuropathy, and a long list of not so pleasant medical conditions,” according to an interview he gave in 2014.

And, before he took his own life in March this year, Keith Emerson (the keyboardist of Emerson Lake and Palmer) had been struggling with dystonia, a similar condition, caused by a motorcycle accident in 1994 which damaged the nerves in his right hand. “He had an operation a few years ago to take out a bad muscle but the pain and nerve issues in his right hand were getting worse," said his long-term partner, Mari Kawaguchi.
Andy Fraser (left) with Free in 1975
Andy Fraser (left) with Free in 1975Credit:Dezo Hoffman/Rex
In the UK, almost one in 10 people over the age of  55 suffer from the condition, which is painful but rarely fatal. Diabetes is the leading cause, but it can also be brought on by physical injury, chemotherapy or alcoholism. According to the Mayo Clinic, it can be provoked by nerve pressure from making repetitive motions, such as typing.

In a career spanning five decades, Clapton has written and performed countless hits, such as Layla, Tears in Heaven and Sunshine of Your Love. In the Sixties, the slogan “Eric Clapton is God” appeared graffitied on walls across London. But at 71, “God” now finds playing hard work: “This particular condition I’m living with isn’t necessarily going to get better,” he said.

People with peripheral neuropathy are often prescribed a period of rest, but this can be difficult for musicians. “One of the most frustrating things for a musician is to be told to stop playing if they have a problem,” says Dr Scott E Brown, who runs the Physical Medicine and Rehabilitation department at Sinai Hospital, Baltimore. 
Eric Clapton (centre) with Cream in the Sixties
Eric Clapton (centre) with Cream in the SixtiesCredit:Bill Wood/Rex Features
Brown is himself a musician, and a biographer of the jazz pianist James P Johnson.  “It’s rare where absolutely stopping all playing is required," he has said. "So it’s important [that] you counsel the musician in the proper way to keep playing while being able to heal and rehab from injury.”
According to the classical music magazine, Scena, peripheral neuropathy accounts for one in five diagnoses among musicians. However, a study by Dr Richard J Lederman ( ‘Peripheral nerve disorders in instrumentalists’, in the journal Annals of Neurology), suggests that instrumentalists are no more likely than other professional musicians to develop the condition.

The road has become unbearableEric Clapton, 2014
 
As Clapton’s neuropathy is in his legs, rather than his hands, it is unlikely that the condition was directly caused by his guitar-playing; the condition could have been brought on by his alcohol consumption, rather than any physical injury.
Clapton’s health has been a source of concern for several years. He cancelled a string of concerts in 2013, citing “extreme back pain”. The following year, he said he was “looking at retirement,” as he could no longer handle the strain of touring: “The road has become unbearable,” he told Uncut. “I don’t want to go off the boil to the point where I’m embarrassing myself."

“It might be that I can't [keep playing], if it hurts too much,” he added. “I have odd ailments."

However, Clapton has no plans to stop recording. Earlier this month, The Sun reported that he recently been in the studio with The Rolling Stones, recording two tracks for their next album.

“I can still play,” he told Classic Rock magazine. “I mean, it’s hard work sometimes, the physical side of it - just getting old, man, is hard. I don’t know how I survived - the Seventies especially. There was one point there where they were flying me to hospital…  and I was dying, apparently - I had three ulcers and one of them was bleeding. I was drinking three bottles of brandy and taking handfuls of codeine, and I was close to checking out. It’s amazing that I’m still here, really.”

http://www.telegraph.co.uk/music/news/the-disease-that-could-end-eric-claptons-career-why-musicians-fe/ 

Selasa, 16 Agustus 2016

Neuropathy Often Affects Cancer Patients Too


Today's post from cancer.net (see link below) talks about neuropathies directly related to cancer treatment and yet as you read through the article, you quickly notice that much of what is written applies to many other neuropathy causes and is therefore relevant to the general reader. It's the nature of nerve damage - so many causes and so many types but very many symptoms, that everybody has in common. That applies to the treatments suggested here too. Irrespective of the cause of your neuropathy, you may find some of the suggestions here useful, although they're by no means extensive and there are many more options (also for cancer patients). Unfortunately as science advances and ageing is prolonged, more and more people are being diagnosed with cancer and because neuropathy is a common side effect of the cancer drugs, the information here may apply to many more people than the target group alone.


Peripheral Neuropathy
Approved by the Cancer.Net Editorial Board, 03/2016

The peripheral nervous system consists of the nerves outside of the brain and spinal cord. Your brain and spinal cord are called the central nervous system. Peripheral nerves carry information between your central nervous system and the rest of the body. Peripheral neuropathy is nerve damage to the peripheral nervous system. Depending on which nerves are affected by peripheral neuropathy, you may notice some of these symptoms:

Change in sensation, especially in your hands and feet, such as numbness, tingling, or pain

Muscle weakness, called myopathy

Changes in organ function, resulting in constipation or dizziness

Peripheral neuropathy can happen because of:

Disease, such as cancer, diabetes, or a thyroid disorder

Nutrition problems, such as too little vitamin B12

Inherited conditions, such as Charcot-Marie-Tooth disease

Cancer treatment may also cause this disorder or make it worse.
Cancer-related risk factors

Peripheral neuropathy is a relatively common side effect. Anyone diagnosed with cancer is at risk for this condition. These factors can increase the risk:

Tumor location. A tumor pressing on a peripheral nerve or one that grows into a nerve may damage the nerve.

Chemotherapy. Specific types of chemotherapy, particularly in high doses, can injure peripheral nerves. These drugs include:

Bortezomib (Velcade)

Platinums, including cisplatin (Platinol), oxaliplatin (Eloxatin), and carboplatin (Paraplatin)

Taxanes, including docetaxel (Docefrez, Taxotere) and paclitaxel (Taxol)

Thalidomide (Synovir, Thalomid)

Vinca alkaloids, including vincristine (Vincasar), vinorelbine (Navelbine), and vinblastine (Velban)

Radiation therapy. Radiation therapy may damage nerves. Symptoms may take years to appear.

Surgery. Operations on the lung or breast may lead to neuropathy. Having a leg or arm removed may cause it, too.

Cancer-related disorders. Paraneoplastic disorders are rare disorders. They arise when the immune system reacts to cancer cells. These disorders may cause peripheral neuropathy. These disorders are more common in people with lung cancer. Shingles is a viral infection that often causes pain and a rash in people with weakened immune systems. It may also cause neuropathy.

Before starting cancer treatment, tell your doctor if you already have symptoms of neuropathy. You should also discuss any of the other risk factors (listed below) that you may have. They are associated with peripheral neuropathy.
Other risk factors

The following preexisting conditions are known to cause neuropathy. Having any of these may put people with cancer at higher risk for developing neuropathy.

Diabetes

Alcohol abuse

Infections, such as HIV-AIDS

Autoimmune diseases, such as lupus and rheumatoid arthritis

Hypothyroidism (an underactive thyroid)

Kidney disease or kidney failure

Hereditary peripheral neuropathy conditions, such as Charcot-Marie-Tooth disease

Lead poisoning or exposure to pesticides

Extreme stress
 

Symptoms

Neuropathy is different for every person. The symptoms and their severity depend on which nerves are damaged and how many nerves are affected. Symptoms may develop during or shortly after cancer treatment. Neuropathy may also slowly develop or worsen after treatment has ended. This occurs most commonly in those who receive platinum drugs and drugs called taxanes. There are 3 types of peripheral nerves that can become damaged.

Sensory nerves. Peripheral neuropathy usually affects your sense of touch and feeling in the hands and feet. Here are the symptoms when the sensory nerves are affected.

Common symptoms are tingling, burning, a buzzing “electricity” sensation, or numbness. It usually starts in the toes and fingers. It can continue along the hands and feet toward the center of the body

You may feel like you're wearing tight gloves or stockings, even though you aren't

You may have an uncomfortable sensation in your hands or feet that may get worse when you touch something

Objects on your feet that usually aren't painful, such as a shoe or bedcovers, may cause pain.

You may notice an increased sense of pain, usually described as pinching, sharp stabs, burning, and electrical shocks

You may notice that it is difficult to feel hot and cold temperatures or to know if you've injured yourself

You may have a hard time knowing where your feet and hands are in space. This is called loss of position sense. It may make walking or picking up objects more difficult, especially if you are in a dark room or working with small objects

Motor nerves. Motor nerves send information between your brain and muscles. When these nerves are injured, you may have these symptoms:

Trouble walking and moving around

Your legs and arms may feel heavy or weak, causing balance and coordination problems

It may be difficult to use your hands and arms

You may have trouble with everyday tasks, such as texting or buttoning a shirt

You may have muscle cramps and notice muscle loss in the hands and feet

Autonomic nerves. These nerves control the body functions you don’t think about to make happen, such as blood pressure and bowel and bladder function.


Symptoms include:

Inability to sweat normally

Gastrointestinal problems, such as diarrhea and constipation

Dizziness or lightheadedness

Trouble swallowing

Sexual problems


If you have any of these symptoms, talk with your doctor or another member of your health care team so that you can get help managing them.
Preventing neuropathy related to chemotherapy

There is no proven way to prevent neuropathy from chemotherapy. There is no good evidence that any medications, vitamins, or supplements can help you avoid neuropathy. Several antidepressants and other medications are being studied, but there has not been a proven benefit in preventing neuropathy from chemotherapy. The American Society of Clinical Oncology (ASCO) does not recommend using the following vitamins or supplements to prevent neuropathy from chemotherapy:

Acetyl-L-carnitine

Calcium and magnesium

Glutathione

Vitamin E 


Managing neuropathy

Relieving side effects, also called palliative care, is an important part of cancer care and treatment. Talk with your health care team about any symptoms you have, including new ones or a change in symptoms.

How peripheral neuropathy is treated depends on what caused it and its symptoms. Many people fully recover in a few months or a few years. Sometimes, the condition may be more difficult to treat and may require long-term management. Your doctor will work to diagnose and remove the cause of your neuropathy and manage its symptoms. There are a number of methods to provide relief from symptoms:

Medication. Although medication cannot cure neuropathy, it may relieve the pain. However, it does not relieve numbness. The most common medications to treat neuropathy pain are anticonvulsants and antidepressants. For neuropathy related to chemotherapy, ASCO recommends the antidepressant duloxetine (Cymbalta). Over-the-counter pain medications may be recommended for mild pain. Prescription nonsteroidal anti-inflammatory drugs or very strong painkillers called analgesics may be prescribed for severe pain. Topical treatments, such as lidocaine patches and creams, may also help control pain. Topical 1% menthol also seems to be helpful, based on early studies.

Better nutrition. Eating a diet rich in B vitamins (including B1 and B12), folic acid, and antioxidants may help manage neuropathy. You should also eat a balanced diet and avoid drinking too much alcohol.

Physical and/or occupational therapy and interventional treatments. Physical and/or occupational therapy can keep muscles strong and improve coordination and balance. Therapists can often recommend devices that may allow you to more easily complete your usual daily activities. Regular exercise may also help reduce pain. Devices that stimulate the skin with electricity may also be useful for treating neuropathy pain, but more research is needed.

Integrative medicine. Massage, acupuncture, and relaxation techniques may help decrease pain and reduce mental stress. Additional tips:

Place stress mats in your home and work environment to cushion your feet

Wear shoes with a rocker-bottom sole


Safety at home

Having peripheral neuropathy increases your chances of hurting yourself, especially in the home. If you have sensory or motor difficulties, these tips may help you avoid injury:

Keep all rooms, hallways, and stairways well lit.

Install handrails on both sides of stairways.

Remove tripping and slipping hazards, like small area rugs and clutter.

Install grab bars in the shower or handgrips in the tub. Lay down skid-free mats in the tub.

Make sure that your shower or bathwater is below 110 degrees Fahrenheit. Use a thermometer to check. Set your water heater at a lower temperature.

Clean up spilled water or liquids immediately.

Use nonbreakable dishes.

Use potholders while cooking and rubber gloves when washing dishes.

If you drive, make sure you can fully feel the gas and brake pedals and the steering wheel. Make sure you can quickly move your foot from the gas pedal to the brake pedal.

If your doctor prescribes a cane or walker, use it when moving from one room to the next. 


More Information

Nervous System Side Effects

American Society of Clinical Oncology Clinical Practice Guideline: Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers

Side Effects

 
Additional Resources

LIVESTRONG: Neuropathy

Foundation for Peripheral Neuropathy: What Is Peripheral Neuropathy

http://www.cancer.net/navigating-cancer-care/side-effects/peripheral-neuropathy