Once Again Certain Antibiotics Can Cause Neuropathy Vid

Today's post from click2houston.com (see link below) is another media report on the growing opposition to fluoroquinolone antibiotics, which can cause significant health problems as side effects. This especially applies to neuropathy patients and those susceptible to nerve damage. If your doctor is prescribing one of these antibiotics, ask him or her if he is aware of the potential health problems and if an alternative may be better for you. If you're at all worried, or not satisfied with your doctor's answer, do your research and if necessary, stamp your foot until a better option is presented - these drugs are clearly dangerous to many people with nerve damage, or potential nerve damage (diabetics, alcoholics, HIV patients, cancer patients and many more).

Thousands of adverse reactions reported from common antibiotics.
Patients claim they were not properly warned of side effects from Levaquin, Ciprofloxacin 
Author: Haley Hernandez, Reporter Published On: Apr 13 2015


 

HOUSTON -

Less than a year ago, David Crain, a healthy and vibrant 33-year-old musician and personal trainer, was in the prime of his life.

“I was running 6 miles in the August heat with my shirt off, screaming, yelling, listening to music effortlessly,” he said.

Now, he can barely play his guitar.

“Just about all I can do. It's hurting. If I do it now, I'll pay for it later,” Crain said.

Last June Crain went to the emergency room for what doctors believed was colitis. He was prescribed the antibiotic Ciprofloxacin, a generic form of Bayer’s Cipro, and began taking the recommended dosage.

“I think around about day seven or day eight, I just noticed like every time I would stand up I’d just be super-fatigued,” Crain said. “My ears rang all the time, I had trouble walking in the second month. My shoulders hurt, my tendons hurt.”

Tammy Renzi was prescribed the antibiotic Levaquin for a sinus infection. Six days into her 10-day dosage, she said she knew something wasn't right.

“I had a heaviness in my thighs. I had pressure in my lower spine. My vertebrae felt like they were rubbing on each other and I could hear the snapping in them,” Renzi said.

Both Crain and Renzi are not alone. From November 1997 to May 2011, more than 85,000 adverse reactions to Levaquin were reported to the Food and Drug Administration, including 1,174 deaths.

More than 67,000 adverse reactions to Cipro were also reported, including 1,257 deaths.

Dr. Charles Bennett, state chair of Medication Safety at the University of South Carolina, has been tracking the issue. He said Crain and Renzi's reactions may be caused by a mysterious genetic predisposition.

“Research should be done to identify those genetic factors,” Bennett said. “You certainly wouldn't want to take a drug if you knew you had a genetic predisposition to its side effects.”

Until that research is done, Bennett has petitioned the FDA, requesting stronger warnings.

“The current insert has a black box warning for tendon rupture and neurologic damage. It needs to be beyond the package insert,” he said.

Channel 2 Investigates reached out to both drug manufacturers.

According to Bayer Corporation, the FDA issued a drug safety communication requiring that "the drug labels and medication guides for all fluoroquinolone antibacterial drugs be updated to better describe the serious side effect of peripheral neuropathy."

Johnson & Johnson, Levaquin’s parent company, wrote, “Since 2004, the Levaquin label has informed physicians and patients about possible side effects related to peripheral neuropathy.”

Crain and Renzi said they want everyone to know the risks so that they don't end up with the same fate.

“I wouldn't take it again if my life depended on it,” Renzi said.

“My biggest fear is that I’m, you know, my son is never going to know who I was,” Crain said.

Renzi and Crain are not currently considering legal action, but in 2012 Johnson & Johnson settled lawsuits with 845 plaintiffs who claimed they were not properly warned about the risks.

http://www.click2houston.com/news/more-than-2000-adverse-reactions-reported-from-common-prescription-medications/32350128

Fatty Acids For Neuropathy Vid

Today's short video is from beatingneuropathy.tv (see link below) and is part of a very helpful series made by Dr. John Hayes Jr, who has appeared on this blog quite a few times. It talks about essential fatty acids being necessary for neuropathy and chronic pain patients and why.


Episode 16 – Essential Fatty Acids
Posted by John Hayes Jr Thursday, July 4th, 2013




Dr. Hayes talks about Omega-3 and Omega-6 fatty acids, how to achieve a balance of both, and why healthy fats are important for neuropathy and chronic pain patients.

http://beatingneuropathy.tv/2013/07/episode-16/

How Do Clinical Studies Work Vid

Today's animated video produced by Roche, looks at how clinical studies work. It's short and to the point and gives a little more information regarding clinical trials and studies. As neuropathy patients, we are used to the next 'hopeful treatment' being announced and entering the trial stages but we rarely think about what sort of process that is. Because it can be a very long process, the initial excitement at hearing of a potential new discovery can very quickly wear off and lead to frustrations that nothing is being done but there is little doubt that trials and studies are vital to ensure safety and achieve the necessary proof that something is what it says it is.

Drawn to Science: Clinical trials  
Published on 28 May 2014

Clinical trials are essential to providing the scientific data to determine whether new drugs, diagnostics or procedures are both safe and effective when used to diagnose and treat people.

Carefully conducted clinical trials are performed in human volunteers to provide answers to important questions. Every new treatment is usually tested in three phases of clinical trials before regulatory agencies consider it safe and effective. Depending on product type and development stage, investigators initially enroll volunteers and/or patients into small pilot studies and subsequently conduct progressively larger scale comparative studies. As positive safety and efficacy data are gathered, the number of patients typically increases. Clinical trials can vary in size, and can involve a single research entity in one country or multiple entities in multiple countries.

For more information about clinical trials at Roche visit http://www.roche.com/research_and_dev...


 https://www.youtube.com/watch?v=5zXuON7Rueo

Antibiotics And Nerve Damage A Professionals View Vid

Today's post from medscape.com (see link below) is text/transcript and video talking about the link between certain antibiotics and nerve damage. There are many more articles here on the blog about the dangers of fluoroquinolone antibiotics for actual and potential nerve pain patients but this one broadens the list to include other antibiotic types as well. The article is not really aimed at patients trying to understand what sort of risks they are facing but it's always useful to hear discussion among professionals on this sort of subject. The conclusion is that if you are prescribed antibiotics by your doctor, it's always wise to have a somewhat deeper discussion, mentioning that you are concerned about the side effects on your nervous system.

Antibiotics and Neuropathy: What's the Latest?
Paul G. Auwaerter, MD Disclosures September 17, 2013

Hello. This is Paul Auwaerter from the Johns Hopkins School of Medicine, talking about peripheral neuropathy and antibiotics. This is not a topic that many in the infectious diseases community spend much time dealing with, but it recently came to our attention because of upgraded warnings to the class of fluoroquinolone drugs (such as ciprofloxacin), which may be associated with an irreversible peripheral neuropathy. The US Food and Drug Administration's Adverse Event Reporting System has received increasing numbers of reports of neuropathy.[1] Peripheral neuropathy has been included on the labeling for fluoroquinolones going back to 2004 as a warning, but there is a paucity of medical literature about this association.[2] These drugs are widely used. Rare adverse effects, such as tendon rupture and tendinopathy, have received increased press as we have had more experience with this drug class. The fluoroquinolones have been very well accepted by most of the medical community because of a generally good side-effect profile, although they have many peculiarities, such as QT prolongation.

Peripheral neuropathy is not generally associated with antibiotics.[3] The drug most often associated with peripheral neuropathy is isoniazid (INH), which is used for tuberculosis.[4] INH interferes with pyridoxine -- the vitamin B6 component of the metabolism of bacteria -- and causes B6 deficiency. This effect is enhanced in humans who might be "slow acetylators," so they accumulate very high levels of isoniazid, which could lead to toxicity. The best estimate of risk for INH toxicity is 0.2%-2% of people on long-term therapy. It usually occurs after 6 months of therapy and is usually reversible when the drug is stopped. Generally, the people who develop this complication also have comorbid conditions such as HIV, alcoholism, diabetes, or renal insufficiency.

By no means is it clear to me, at least from available data, that the story is similar for the fluoroquinolones. Whether neuropathy occurs only with long-term therapy or can occur with short-course therapy is unclear. Other antibiotics can cause neuropathy, and in my experience this typically happens with long-term administration. The drugs capable of causing neuropathy include linezolid, chloramphenicol (a drug that we don't use very much anymore), metronidazole, sulfonamides, colistin, and dapsone. Even the penicillins are capable of causing neuropathy.
The cause is not clear, although some recent work has been done by James Collins and colleagues at Boston University.[5] They are beginning to look at a systems biology approach with respect to the effects of antibiotics, not only on bacteria but also on the host. They have found that some bactericidal (rather than bacteriostatic) antibiotics can increase reactive oxygen radicals and also affect mitochondrial function. These may be some of the ways that these drugs affect different cellular structures in humans.

Antibiotics have been a godsend to our ability to thwart illness, but they do have collateral damage. We have always known this, but it is becoming increasingly recognized. Therefore, it is always good to be as cautious as possible and, when using antibiotics, to be aware of the possible side effects. At least for now, I won't change my practices because of this warning, but with long-term use of fluoroquinolones, I will perhaps be more appreciative of this possibility and stop the antibiotics at the first signs of any numbness or tingling.
References
Medscape Infectious Diseases © 2013 WebMD, LLC
Cite this article: Antibiotics and Neuropathy: What's the Latest? - Medscape - Sep 17, 2013.

http://www.medscape.com/viewarticle/810905

Whats New On The Neuropathy Research Front Webinar Vid

Today's YouTube video is full of lots of useful information from a recent Neuropathy Association webinar. Unfortunately, the sound is somewhat disembodied and often sounds like those irritating, computer-generated voices but the content is valuable and worth looking at and listening to if you have a free half hour. Be warned, it can be somewhat technical but the slides do help explain the text.

"What New Neuropathy Research Can We Be Hopeful For?" - 2014 Webinar
Published on 17 Jul 2014




https://www.youtube.com/watch?v=wBbK5oKWHzA#t=169

How Your Neuropathy May Be Diagnosed Vid

Today's video from mskcc.org (see link below) is produced by the memorial Sloan Kettering Cancer Center and is naturally aimed at chemotherapy patients who have suffered nerve damage due to the drugs. It goes on to explain how a diagnosis is made and what possible procedures are used to do that. However, the testing procedures apply to neuropathy from all causes and it is therefore a useful guide to what may happen during your diagnostic process whether you have cancer or not. However, mainly due to cost, most doctors will come to the conclusion that you have peripheral neuropathy long before the results of such tests are known and decide not to carry them out. This doesn't mean that they are neglecting you, it just means that they are making a reasoned diagnosis based on the evidence they already have. Thanks to the unique symptoms of neuropathy, your own story may well give them enough to go on and begin treatment.

Video: Diagnosing Chemotherapy-Induced
Peripheral Neuropathy
Memorial Sloan Kettering Cancer Center

Memorial Sloan Kettering occupational therapist Gabrielle Miskovitz explains that your doctor or therapist will first review your chemotherapy regimen, symptoms, and preexisting medical conditions to identify causes of peripheral neuropathy. Your specialist may then examine your skin for cuts and injuries, which can occur due to decreased sensitivity from neuropathy, and also evaluate your reaction to light touch, sensitivity to sharp and dull stimulation, finger muscle strength, reflexes, balance, and autonomic symptoms.

Some doctors recommend neurophysiologic tests such as electromyography, nerve conduction studies, and quantitative sensory tests to further examine peripheral nerve function, although findings from these tests do not always correspond with symptoms. Your doctor may also recommend laboratory and imaging tests to look for metabolic disturbances, nutritional deficiencies, and other possible causes of nerve damage.
Physical and occupational therapists may perform several additional tests to assess the impact of chemotherapy-induced peripheral neuropathy on your balance, stability, and fine motor skills. Based on this assessment, your therapists will help you determine your functional goals and select the appropriate therapy to reduce the risk of injury and improve your quality of life.

http://www.mskcc.org/videos/diagnosing-chemotherapy-induced-peripheral-neuropathy

Socks With Sensors To Prevent Neuropathic Foot Damage Vid

Today's long post from healthline.com (see link below) is nevertheless an easy and interesting read that will appeal to many readers with neuropathy in their feet. It's important to state right from the start that these socks (subject of the article) will do nothing to prevent or improve your neuropathy but will alert you to any physical danger (e.g. ulcers) that you may not notice due to lack of feeling and as such can be seen as a valuable tool in harm prevention. As is clearly stated: "We don't prevent neuropathy, we prevent the complications that come with neuropathy. We prevent ulcers and amputations." That said, the article does read a little like an extended advertisement for a product and this blog tries to avoid anything with potential for commercial gain. However, the story behind the development of these socks does suggest a genuine interest in improving the lot of neuropathy sufferers and more than that...it makes sense. It's also clear evidence of the potential for modern technology to improve people's health. It's long but absolutely not tedious and is well-worth a read.

Siren Socks: Revolutionizing Diabetes Foot Care with the Internet of Things
Written by Amy Tenderich | Published on February 27, 2017

Got neuropathy in your feet?

We hope not, but if you do -- or suspect that you might -- you will absolutely want to know about a new company called Siren Care. It was founded by young Chinese-American entrepreneur Ran Ma, who after completing a Biomedical Engineering degree at Johns Hopkins University, freaked out her parents by spending hours holed up in her bedroom sewing socks.

She had a brilliant idea to embed tiny sensors that would connect to an app to track temperature and localized ulceration risk. It panned out big-time!





The socks she invented recently won the coveted TechCrunch "hottest new hardware" award at CES, and the 2016 Health 2.0 "best newcomer in digital health" competition. And medical experts are now saying "what they have done with embedded IoT (Internet of Things) sensors and smart materials will totally redefine how patients can self-manage complications as a routine part of their daily life." Wow!

Please join us for this chat wth Ran to learn about Siren Socks, and possibly win a set of your own!

Q and A with Ran Ma, on Siren Socks for Diabetic Foot Care

DM) Ran, pioneering ‘smart socks’ for diabetic neuropathy is a pretty unique path... Can you share a bit about how you got here?

RM) I was born in China but I grew up in Texas and then I lived in Baltimore, Chicago, Denmark, Sweden, Germany and now back to the States in San Francisco.

My background is biomedical engineering. I studied at Johns Hopkins, and then afterwards, I actually worked in the Department of Plastic Surgery at Northwestern, under Dr. Maldonado. While I was there, I worked on a project called Biomask. We actually developed a wearable mask that would regenerate your face, using stem cells, and this was targeted for burn victims and war veterans. This was right after the Iraq war and because of the research we did, I learned a lot about wound healing, wound formation, also wound prevention. My lab also worked on diabetic foot ulcers. That's just something that really stuck in my mind.

I also come from three generations of doctors -- so my grandparents, my aunts, uncles, and my parents are doctors. My father's actually a surgeon. He cuts people every day and for me, I want to dedicate my life further up in the chain of medicine, towards the side of prevention. I really want to make great tools that are easy to use, and give people the right data at the right time, so they can take control of their own health. I always say if I do my job right, I could put my parents out of a job.

Do you have a personal connection to diabetes?

No I don’t, but my co-founder Jie Fu has lots of diabetes in his family, and some of his relatives have unfortunately suffered some of the more severe consequences.

As noted, both my parents are physicians in China – my mom does hematology so mostly leukemia, and my father works on cervical and ovarian cancers, so very late-stage cancers and they lose a lot of their patients unfortunately because it is so late-stage. That's why I want to focus on prevention.

For me, it's about knowing that diabetic foot damage is a very serious problem with very severe consequences, but it's preventable and there's strong clinical research showing that temperature monitoring can make a big difference in prevention.

So you came up with this ‘crazy idea’ to embed sensors in socks?

Here I was a biomedical engineer who was going to go to medical school, and I told my parents, ‘You know what? I'm sewing socks in my room by myself.’ My parents thought I had lost my mind. I was buying components off the Internet and just sewing it together… because it's one thing to have an idea in your head, but another to put it into physical form.

So I had this sock that was all misshapen, connected to a circuit board with all these wires coming off it (and) I went to the big annual Diabetic Foot Conference DF Con two years ago and basically said, ‘Hey, podiatrists, I'm gonna make a sock, it's going to detect injuries in real-time and then it's going to connect to a phone and your patients are going to be able to wear this and it will be soft and washable.’ And they looked at me like I was crazy, basically... because the early prototype really was just crazy-looking, but we’ve come a long way.




Fill us in on your current team, headquarters and manufacturing facilities?

The company was founded in February 2015 by myself and two co-founders: Jie Fu, whose background is electrical engineering and hardware mass production, and Henk Jan, whose background is global textiles sourcing -- he worked in the textile industry and he set up one of the world's largest manufacturing groups for textiles.

So our leadership is made up of biomedical engineering (my background), electrical engineering, and textile manufacturing. We have a team of 5 and are currently expanding.

Our headquarters are in downtown San Francisco, and we’re currently doing some manufacturing in China, with final assembly in the U.S. We plan to move more of the production to the U.S., but that's still in the works right now.

Hasn’t it been common knowledge for a long time that temperature monitoring can help with foot health? If so, what’s really so revolutionary about using this technology in socks?

You're absolutely right. Temperature monitoring has been around for at least a decade or more and it's been published in Diabetes Care and other leading journals by Dr. Lavery and Dr. Armstrong. But there's been a lack of technology.

A few years ago the technology didn't exist to make a wearable device for temperature monitoring, right?
 In recent years sensors are getting smaller and cheaper and people are putting them in bands, like Jawbone, etc. and all of this has happened because of the emergence of IoT (Internet of Things) tech. Now sensors have gotten small enough that we can actually incorporate them into fabric.

The other thing that has happened is a revolution in design thinking. As you well know at DiabetesMine, even just a few years ago the focus was, ‘This works in clinic, great!’ but (no one was) thinking about it from the patient’s side – as in:

‘If I were living with diabetes, could I use this tool?’ Even though it works in clinics, even though my doctor can use it, does it actually make sense for me to take these bulky tools home? 


There are other solutions on the market: temperature monitoring wands like the TempTouch foot thermometer, a temperature monitoring carpet and a bathroom scale, and I think those are really great and very pioneering in the field. Our team's goal is at-home prevention, empowering the user by creating something that’s easy to use and monitors continuously, so you can have a sense of security at home. So that's why we're focused on a wearable solution.

OK, so how exactly do new ‘smart’ Siren Socks work?

They monitor six spots on your foot, based on the six most common sites of injury according to clinical trials, and we actually monitor your two feet and compare the temperature difference between the same spot on each foot.

When you have a difference of more than 4 degrees Fahrenheit or 2.2 degrees Celsius, then we know that inflammation is occurring, and that means your body is fighting off injury; that's when we give you an alert on your phone. The point is, something has happened and your body is fighting that injury, reacting with inflammation and that's followed by a rise in temperature. We pick up on that and we alert you. 



And you offer the first continuous temperature monitor for feet, right?

Yes, it's very important for us to be a continuous monitor: All the other solutions mentioned are point solutions, meaning you take one measurement a day. You don’t know what happened before or afterwards -- what about the other 23 hours and 50-something minutes in the day? Since there's no reference, it’s even harder to determine why changes might occur.

Because we take so many measurements over time, we're able to filter out false positives. If it's a random spike (in foot temp), we know that's not normal. Inflammation is a sustained temperature difference averaged over time, it's a very particular signature and that's what we can pick up with our socks.

Another benefit is personalization. Maybe for you, one of your feet is just warmer because you have circulation problems or it’s just genetic. Our technology creates a baseline per user over time, so it's a lot more powerful smart tool that can learn from you over time.

Wait, if you’re targeting people already living with neuropathy or other foot conditions, how are these socks ‘preventative’?

We don't prevent neuropathy, we prevent the complications that come with neuropathy. We prevent ulcers and amputations.

What happens to people with neuropathy is they have a foot injury and don't realize it for a week, two weeks, two months even I've seen. And then you go see your doctor and the first thing they do is wheel you into the surgery room!

With our socks, if you have an injury, you might not feel it but you’ll see it with temperature and we alert you. Then you go see your doctor and he/she makes a diagnosis with the X-ray or with a physical exam and then treats you for it. Just from temperature we cannot possibly know if it's just a callous, or a blister, or Charcot foot – so you need to see your physician. But the early detection helps you avoid ulcers or even needing an amputation.


Don’t the embedded sensors, and that little anklet disc on the side, make the socks lumpy?

No, we take very tiny proprietary temperature sensors, like a grain of sand, and incorporate them into the fabric of the sock, and they send data to our companion app via Bluetooth. The anklet holds the battery and BLE chip. We've designed it to have the thinnest profile and smallest surface area possible, and we are always working to further miniaturize this component.

Back when I was hand-sewing them two years ago, you could definitely feel everything, but now… they are really good diabetic socks. The key point to making smart clothing is you have to make really good clothing first. If I gave you the socks right now, you would never know they were smart socks because you couldn't find the sensors.

Can you wash them like normal socks?

Yes, our socks are machine washable and dry-able, you don't have to charge them, and they're completely soft and flexible. They're super-absorbent and have no seams on the outside or inside, and we all know that's important because diabetic socks should be seamless so you don't have any pressure points on your feet. Right?

So we're really creating a great diabetic sock to start with and then we give it intelligence, to protect your feet.




How does the Siren app work?

The basic functions are of course that you can see the current status of your feet and it's very easy to understand, color-coded green, yellow, and red. And of course we walk you through the recommendations when an injury or potential injury is detected. The app may suggest checking your feet, reducing activity or reaching out to your healthcare professional.

You can see your foot temperature over time, and your foot health over time and that helps you know, when did this inflammation begin? This is why continuous use is important. You can see for example if inflammation was caused because every day you're wearing a certain pair of shoes that are just too small. One of the main causes of diabetic foot ulcers are shoes that are too small -- because if you can't feel pain, you don't realize you're buying shoes that are too small. So our app actually helps people start looking at their habits.




Can you share the data directly with your doctor?

Right now the Siren app basically sends you alerts on your smartphone if there are significant changes in your foot temperature – it’s alerting you to go see your doctor. The data is in the cloud and you access your account on our website or though the app, where you can easily print it or send it to your doctor in file format, but we don’t have direct data-sharing yet. That’s something for the future.

Also, at the end of the year we're going to be rolling out a solution for people living with diabetes that don't have access to a smartphone, like what we're offering but online (instead of app-based) so you can also use our smart socks without a phone.

Eventually we’d like to have a Call Center that can alert users who can’t get those alerts and alarms on a phone.

Can you add notes into the app, like about what shoes you wore or what activity you did that day?

Yes, people can add notes like, ‘Wore my new whatever-shoes,’ and then you may notice the next day after wearing this pair, you're always getting inflamed, so you can think maybe it's those shoes. It really often is the shoes you wear, and that's something you can pick up on.




In the app you can also check the battery life of your socks, track how often you wore them, which ones you're wearing, and how often you washed them. I think one of the key items is, we can tell you this week you only wore your socks 40% of the time, so maybe next week you can aim to wear them 60% of the time. The more often you the wear socks the more protected your feet are. And if you have neuropathy, you have to wear good socks anyway. That's the number one recommendation, right? We help you quantify that.

So this has big potential to help anyone with diabetes, type 2 or type 1?

Neuropathy can happen to anyone. It does happen to people with type 1 and type 2. It's usually a little bit older population, but I've also seen it in people in their 20's and 30's. It just happens, your nerves start dying, getting eaten away and it usually happens in your feet and hands first, because those are your longest nerves. Hands are not as dangerous because you see your hands every day, but you don't check your feet every day or look at them as closely, so damage can go unnoticed. That's why it's very important to take care of your feet.

Have you completed clinical studies on Siren Socks, showing effectiveness?

We did an initial small test and are now scaling. We’re actually recruiting patients right now with Dr. Reyzelman, a podiatric surgeon at UC San Francisco. This will be a published result, ongoing into March including 30 patients.

I'm also giving a talk at this year’s DF Con Diabetic Foot Conference, at the end of March. That’s the biggest diabetic foot conference in the U.S. and I’ll be presenting the background of temperature monitoring, the current form factors, and why it was important to bring up a smart sock to fill the technology gap right now. And hopefully we'll have some initial results that I will present at that conference. It's a huge deal for me to be a speaker there, because as noted, I went to this conference a few years ago with a VERY rudimentary prototype and I think I scared some of the physicians there. So now two years later, we've progressed so much.

What’s the situation with regard to FDA approval?

We are very firm in saying that we are a tool and not a diagnostic, and that doesn't currently fall under FDA scrutiny.

The studies we’re doing are more to test compliance and user experience. We have entry interviews and exit interviews. So we ask, ‘Do you enjoy the solution? Is it easy to use? Do you like the colors?’ Very basic questions like that are important because we already know that temperature monitoring works, there's no doubt about that. But we need to know: can people use this solution? It’s important to do field studies where you even go into people’s homes to see how they use it, how does it work for them?

Tell us about the prestigious TechCrunch award you received for Siren Socks...?

We just won the TechCrunch Hardware Battlefield competition at CES in January, and that was a huge deal, as they screen I think somewhere around 1,000 of the newest, hottest hardware companies and they narrowed it down to 12.




Twelve went on stage and did a live demo and then they narrowed it down to four, who did a final demo, and they picked one, and we were actually that one! It was a huge honor, we didn't think we would get that far because most of the other companies were one or two or three years older than us.

But I think one of the reasons that we made it so far is that we actually brought a patient on stage, Judy, who has been living with diabetes for seven years. She is 73 and has retinopathy and neuropathy – we had to help her on stage because the lights were so bright. She actually wore our socks on stage and we live-streamed her foot data, so it really made the story make sense, you know when you see these socks in action. You could see how much Judy enjoyed wearing them, she was modeling them in front of the judges and we think that’s great because it helps raise awareness that diabetes touches the lives of so many people.

And you won an influential Health 2.0 competition as well?

Yes, in Fall we also won Health 2.0 Launch, which is strictly digital health, encompassing software and hardware. You know, they’ve had some really great companies that have won over the years, like Basis that was purchased by Intel, Glimpse that was a runner-up and they were recently acquired by Apple, and Castlight Health also went through there. They definitely pick winners.

That one is more bragging rights than an investment prize, but TechCrunch… really brought a lot of momentum to our fundraising. We are raising our seed round right now and I must say it's going very well, especially after CES.

Wait, so you did all this pre-seed funding?

Yes exactly. We had a very small pre-seed round of about $500K last year, but most of the other companies that went on stage with us had raised $4-$5 million seed round and they were raising their A Round financing already, so they are one to two years ahead of us. We move fast.

And you got a lot of great exposure… even at home?

Funny story about my mom, who as you know is a doctor in China. I was supposed to go there to visit for Chinese New Year and she was really disappointed that I had to cancel the trip because we had all of this going and we're fundraising.




But two or three weeks ago she turned on the TV to this channel called ‘Chinese People Around the World’ she watches every day during lunch and she actually saw me there, on Chinese National TV! She was making noodles and she almost burned them all because she was running all around the room trying to find her phone so she could record it, then she was texting me all frantically, ‘Oh my God, did you know you were on TV? Can you find it online can and send me the video?’ They even translated all of our presentation to Chinese, and I had no idea.

They look for entrepreneurial Chinese people who've done cool things around the world and they report about it, so I guess they found me somehow. I have no idea where they got my Chinese name from, but it was really cool.

Kudos to proud mamas around the world! So please tell us how you are reaching out to the PWD community in particular. Have you connected with any patient advocacy orgs?


We've been doing a lot of work within the podiatrist community and diabetes HCP groups to get the word out. I am also doing a few podcasts with diabetes experts, and we're coming out with a bunch of blogs (that offer) educational background on temperature monitoring, how important it is and the history of it.

We were also included in an article published in the November ADA Diabetes Forecast magazine on what makes a great diabetic sock.

As far as reaching the patient community directly, that's very important -- getting people involved and getting their feedback. So talking to you at the ‘Mine is one of our avenues…

Glad to help if we can! We see you have an introductory pre-order pricing set up. Tell us about the offer and when the socks are expected to ship?

Our socks are priced at $180 for seven pairs of socks, but right now we’re doing a pre-sale, at a $60 discount. So it’s $120 for a pack of seven, that should last you six months. There's also an option online to purchase smaller packs, of one, three, and five pairs.

Right now it’s all online ordering directly from us, and we expect the socks to ship in Summer. We’re also in talks with distributors to bring the socks into retail stores like Wal-Mart, CVS and Walgreens. But that won’t be rolling out until later this year.

You talked about design, but these socks currently only come in plain black and white versions, correct?

We're going to make our socks as attractive as possible. We have thought about different color variations, (and) we've already come up with Christmas designs, Halloween socks, summer, fashion versions, etc. for the future.





Of course, you shouldn't be wearing high-heeled or other fancy shoes if you have diabetic neuropathy. You should wear comfortable shoes that are well padded and fit your feet properly and we help you with that.

And the life expectancy of a pair of Siren Socks is six months?

Exactly, we replace all your socks every six months because that's standard in diabetic foot care -- every three to six months you need to replace all your socks to minimize spreading infection and also if there's a thin area in the sock material, that's where a foreign object can penetrate and get to your feet. The only line of defense is your socks, so you want to make sure they’re very thick and cushioned and the fabric is in the best shape possible.

And just a reminder: you don’t have to charge these socks, even though they’re outfitted with smart technology.

Finally, what’s a Twitter-style message you might want to send to the Diabetes Patient Community from your vantage point tackling foot damage?

I would say take care of your feet, and the future is here: we’ve dreamt of a world where we can have access to the right data at the right time and that future has arrived!

I don't know if that's a good Twitter message, but I’d want your readers to know there are lots of people – lots of other teams like us – working very hard to make tools easier to use and to bring science into your home in a way that addresses a problem and helps.

Thanks so much Ran -- That’s inspiring to say the least. We thank you for your ingenuity, down to our diabetic toes!

http://www.healthline.com/diabetesmine/siren-socks-revolutionizing-diabetes-foot-care#1

More Problems For Cipro And Other Antibiotics Vid

Today's post from naturalhealth365.com (see link below) is another hard-hitting article warning of the dangers of certain antibiotics (fluoroquinolones), with special reference to neuropathy. This blog has covered this subject many times before but while doctors across the world are still prescribing Cipro, Levaquin and the others, as the standard drug of choice, we have to continue warning of the inherent dangers associated with fluoroquinolones, especially for people who already have nerve damage of some sort. This article tells you all you need to know on the subject and the video is useful. That all said, in the end the best advice is to discuss the matter with your doctor and listen to what he or she says. If they claim that fluoroquinolones are perfectly safe then you may wish to produce some evidence that shows they're clearly not. Even the US FDA has expressed deep concern about these drugs and ordered warning labels to be put on all packaging. Your doctor will be able to prescribe an alternative - there are enough around.

Antibiotics cause peripheral neuropathy plus other damaging side effects
Posted by: Dena Schmidt, staff writer in Drug Dangers May 31, 2015 

(NaturalHealth365) A stunning 1 in 15 Americans – that’s 20 million people – have peripheral neuropathy. Peripheral neuropathy refers to issues with the peripheral nervous system that leads to nerve damage and symptoms such as muscle tingling, numbness and muscle weakness.

Sadly, in advance cases, this condition can lead to a persistent burning pain, muscle wasting, paralysis, organ and breathing issues, and even organ failure. And, to top it off, conventionally-trained physicians rarely provide a solution.

What are the causes of peripheral neuropathy?

While the causes of peripheral neuropathy are primary linked to diabetes, a recent article in the Journal Neurology reported that the risk of peripheral neuropathy doubles in anyone who takes fluoroquinolones. Fluoroquinolones are a class of antibiotics with a host of alarming side effects; one of the most prescribed has the brand name Cipro. While most of Western medicine doesn’t think much about this product, David Perlmutter, M.D. has many reservations and reveals the hazards of peripheral neuropathy and fluoroquinolones such as Cipro in this YouTube video below:



Those who are diabetic can take steps to change their diet and lifestyle to help minimize the risk of peripheral neuropathy. Peripheral neuropathy caused by Cipro, however, is another matter; the risk factors and side effects of Cipro tend to be grossly understated.

In fact, despite the clear health risks, this drug continues to be prescribed in hospitals and clinics all around the United States.

The side effects of Cipro are horrible

Adverse reactions and side effects of Cipro in adult patients include diarrhea, nausea, migraines, abnormal liver function, vomiting, skin rash, abdominal pain, and pain in the extremities. Cardiovascular effects include palpitation, ventricular ectopy, atrial flutter, hypertension, angina, cerebral thrombosis, myocardial infarction, and cardiopulmonary arrest.

There are also an alarming number of central nervous system effects as well as gastrointestinal, musculoskeletal, renal and respiratory risks, among others. The list of possible side effects of Cipro is truly staggering, and it is also a primary cause of peripheral neuropathy.

Warning: Fluoroquinolones can cause permanent disability

While just about every drug on the market has some potential side effects, most are transient and tend to cease when the person stops taking the drug. However, when it comes to Cipro, this is not the case; a great many of the side effects of Cipro can be permanent, causing lifelong disability. The maker of Cipro does not disclose this fact anywhere on the warning label.

All fluoroquinolones have a black box warning, and Cipro now has two of them. More than half of the fluoroquinolones that were on the market in the past have been pulled due to their dangers and horrific side effects; however, Cipro and others such as Avelox and Levaquin remain in use.

The slogan of the medical profession is “Above all, do no harm.” The continued prescribing of fluoroquinolones like the antibiotic Cipro despite its grave risks is completely unethical. Cipro’s status as one of the top causes of peripheral neuropathy should result in a permanent ban.

Simply put, the fact that this crap is still on the market – despite being linked to so many health problems – is truly criminal.

References:
http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm
http://www.neurology.org/content/early/2014/08/22/WNL.0000000000000846.short
http://floxiehope.com/fluoroquinolones-links-resources
http://www.ciproispoison.com
https://www.youtube.com/watch?v=y98eHM0Z9-g

http://www.naturalhealth365.com/side-effects-of-cipro-fluoroquinolones-1440.html

Spinal Cord Stimulation For Neuropathy Vid

Today's post from spacecoastdaily.com (see link below) looks (with the help of a video) at the growing use of neurostimulation devices to control severe nerve pain. There are several systems on the market and you may have heard of them and be curious as to what's involved. Firstly, you should be aware that these devices may not be the best solution for your particular neuropathic problems and secondly, by watching the video, you will quickly realise that implanted devices in the spine is not your every day procedure and carries some risk with it. It's not just a question of getting some wired up pads attached and switching on to release an electrical current (although that type of device is available and works for some). What is explained in this article is a tricky procedure and probably one of the more extreme versions of electrical stimulation you will encounter. It's all a question of talking to your doctor and your specialist (preferably a neurologist) and discovering if this sort of procedure is applicable to your situation. You'll need to ask all the right questions; not least of which is 'what are the chances of success?' That all said, you've probably heard about these things in the course of your Googling, so it's fascinating to see exactly what's involved, even if it scares the bejeezeus out of you!!

Innovative Approach, Recommendations Dealing With Intractable Neuropathic Pain

By Dr. Richard Gayles With Dr. James Palermo, Editor-In-Chief // June 21, 2012


SPACE COAST MEDICINE Q&A

Although the precise number of Americans afflicted with pain is hard to determine with great accuracy, several key pain statistics from the National Pain Foundation show that the sheer quantity of individuals suffering from pain is staggering. 



NEUROSTIMULATION therapies are used for pain relief or symptom relief from certain types of chronic pain. Spinal cord stimulation (SCS) is actually a subcategory of neurostimulation, which also includes peripheral nerve stimulation.

Among the general population pain stats include:

• About 89% of Americans age over 18 suffer from pain at least once a month. Over a three year period, 76 million Americans reported pain lasting 24 hours or more;

• Approximately 42% of adults age 20+ who reported pain stated the pain lasted 1 year or more;

• Americans spend more than $100 billion annually to relieve pain;

• The trend toward even more people experiencing and living with pain will only grow as America’s baby-boomers age, making effective pain management an integral and very important aspect of healthcare services.

We are delighted to welcome Dr. Richard Gayles, who has touched countless lives through expert patient-centered pain management over the past 15 years here on the Space Coast, to bring us up to date on an innovative approach that he sometimes recommends when dealing with a broad scope of neuropathic pain.

SPACE COAST MEDICINE: What cutting edge treatments for pain do you advocate other than injections and medications?


At Florida Pain we routinely use a technique called Spinal Cord Stimulation (SCS). This is an FDA approved technique that utilizes a small wire, which emits a tiny electrical current blocking pain from damaged or irritated nerves.

DR. GAYLES: At Florida Pain we routinely use a technique called Spinal Cord Stimulation (SCS). This is an FDA approved technique that utilizes a small wire, which emits a tiny electrical current blocking pain from damaged or irritated nerves.

SPACE COAST MEDICINE: Is this the same as a TENS unit?

DR. GAYLES: That is a great question, but SCS and a TENS unit are two totally different treatments. SCS has been called a TENS unit on steroids by some patients. The TENS uses pads, which are placed on the surface of the skin over the painful areas, and an electrical current to stimulate only tissues close to the skin surface. The SCS uses a tiny wire or electrode placed carefully within the spinal canal to directly stimulate the spinal cord or an individual spinal nerve. The electrical stimulation of the SCS blocks pain from damaged nerves and substitutes the painful sensation for a pleasant, artificially produced sensation.

SPACE COAST MEDICINE: Can you walk with this device?

DR. GAYLES: When the SCS is used, a patient can certainly walk, and in fact, walking and exercising may be easier without pain. The purpose of the SCS is to reduce pain while increasing function and activity levels. After placement of the SCS, patients are strongly encouraged to begin a program of stretching and strengthening exercises.

SPACE COAST MEDICINE: How do you decide who gets a SCS?

DR. GAYLES: Most patients will get better with time, exercise, physical therapy, medication and/or injections. For patients who do not respond to the more conservative treatments, SCS may be considered after a thorough physical exam, review of MRIs, X-rays, and nerve testing. After a review of the medical records, to ensure that all conservative measures have been exhausted, and there is no urgent need for surgery, a trial of SCS may be scheduled.

SPACE COAST MEDICINE: What is the process of getting a SCS?


Spinal Cord Stimulation uses a tiny wire or electrode placed carefully within the spinal canal to directly stimulate the spinal cord or an individual spinal nerve. The electrical stimulation of the SCS blocks pain from damaged nerves and substitutes the painful sensation for a pleasant, artificially produced sensation.

DR. GAYLES: After careful patient selection, a temporary percutaneous SCS trial is scheduled. The trial is like a test drive to determine how much pain the SCS will relieve. During the trial, SCS wire electrodes are inserted trough a needle into the spinal canal under x-ray guidance and are placed over the spinal level where signals from the damaged nerves are processed. When the SCS is turned on the patient will feel a pleasant tingling sensation over the painful areas. The SCS wires are then secured in place sterilely on the back. The patient is sent home with a small external battery/programmer and is encouraged to perform activities, which may provoke their usual pain. This trial lasts for 5-7 days, and when completed the SCS wire electrodes are pulled out and a band-aid is placed over the injection site. If the patient has greater than 50% reduction in pain and much improved function then a permanent system is inserted.

SPACE COAST MEDICINE: What does insertion entail?

DR. GAYLES: Wire electrodes are inserted through a needle into the spinal canal in a similar fashion as described for the trial. For the most common type of pain—the back–the SCS generator is usually implanted in the lower abdominal area or in the back in the upper gluteal (butt) region, and should be in a location that patients can access with their dominant hand for adjustment of their settings with the patient-held remote control. The SCS is then connected to wire electrodes. The procedure is done as an outpatient either under local anesthesia with sedation or a general anesthetic.

SPACE COAST MEDICINE: How is the SCS powered?

DR. GAYLES: The SCS is battery powered, and the battery lasts approximately 5 to 7 years. There is now a rechargeable SCS, which can last 10 years and is charged by a special belt.

SPACE COAST MEDICINE: Is the implanted SCS permanent?

DR. GAYLES: No, the SCS can be easily removed if desired. There are no permanent changes to the body after removal of the SCS.

SPACE COAST MEDICINE: Does insurance cover the SCS?

DR. GAYLES: Yes, virtually all insurances cover the SCS, including Medicare.

SPACE COAST MEDICINE: What conditions does the SCS treat?


Wire electrodes are inserted through a needle into the spinal canal in a similar fashion as described for the trial. For the most common type of pain—the back–the SCS generator is usually implanted in the lower abdominal area or in the back in the upper gluteal (butt) region, and should be in a location that patients can access with their dominant hand for adjustment of their settings with the patient-held remote control. The SCS is then connected to wire electrodes. The procedure is done as an outpatient either under local anesthesia with sedation or a general anesthetic.

DR. GAYLES: The SCS treats chronic sciatica (radiculopathy), neuropathy, occipital neuralgia, reflex sympathetic dystrophy, phantom limb, pain from peripheral vascular disease, back pain and many other painful conditions caused by nerve damage. In Europe the SCS is also used quite extensively for chronic refractory angina and peripheral vascular disease.

SPACE COAST MEDICINE: Are there limitations after the SCS is implanted?

DR. GAYLES: You can swim, walk, bicycle, jog, but be smart, and avoid the extremes of physical activity. SCS may be picked-up by the airport security machines, but patients avoid problems and carry a card to alert security to the presence of this device. The Medronic SCS has also been used successfully with patients with pacemakers.

To contact Dr. Gayles call 321-784-8211 or log on to FloridaPain.net
Florida Pain Doctor, Richard Gayles, MD

Dr. Richard Gayles brings a wealth of training and experience to Florida Pain. He received a Bachelor of Science in Psychobiology from the University of Michigan in 1987 and his Doctor of Medicine in 1991 at the University of Michigan’s School of Medicine. After graduation, Richard completed a residency and Pediatric Anesthesia Fellowship in the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins Hospital in Maryland.

Dr. Gayles obtained further clinical experience in anesthesiology at St. Bartholomew’s Hospital in London, England. He completed a Chronic Pain Fellowship at the Cleveland Clinic Foundation in Ohio, where he was awarded the “Fellow of the Year Award” in June of 1997. He currently utilizes his expertise at Florida Pain, Merritt Island Surgical Center and Space Coast Surgery Center (located at our facility).

In addition to his clinical experience, Dr. Gayles has participated in research over the past fourteen years, both here at home and abroad. Dr. Gayles is Board Certified by the American Board of Anesthesiology and a Diplomat of the American Academy of Pain Management. He is also certified by the American Board of Pain Medicine, National Board of Medical Examiners and by the American Heart Association in Basic and Advanced Cardiac Life Support. Dr. Gayles holds the Following Special Affiliations: Member of Coast Guard Auxiliary and FAA (an Aero Medical Examiner) ANGEL Flight.

http://spacecoastdaily.com/2012/06/innovative-approach-recommendations-dealing-with-intractable-neuropathic-pain/

Testing For Nerve Damage Vid

Today's post from news-medical.net (see link below) looks at common testing methods for neurological dysfunction. If you have ever been tested for nerve damage and been given a nerve damage diagnosis based on the results, you may be none the wiser coming out of the testing room than before you went in. This article explains exactly what sort of neurological testing is currently available and how each one works, so after reading it, you may be a little more enlightened as to what they were looking for. That said, many sensible doctors and neurologists can give you the same diagnosis based on your story and symptoms alone, without going to the expense of what can be an unreliable series of tests. Many people end up being given an idiopathic neuropathy diagnosis, purely based on the fact that the tests can't pin point the cause of your nerve damage and in many cases can't explain what seem to be 'negative' results. For that reason, many people leave the neurologist feeling somewhat cheated by the testing system and disbelieved and mistrusted as well. This leads to frustration on the part of the patient and delays in effective symptom treatment. Nevertheless, it's a double-edged coin because both doctor and patient may want the testing in order to prove the existence of your condition and not leave everybody in doubt. It's very unsatisfactory all round but if you are or have been tested, it's useful to know the why's and wherefore's of the tests and this article does just that.

Neurophysiology And Nerve Conduction StudiesBy Liji Thomas, MD Last Updated: Oct 31, 2016

Neurophysiology is a discipline within the health sciences which deals with the measurement and assessment of nervous system function rather than the anatomy of the nervous system. It helps to diagnose and monitor the progress of nervous disorders.

Neurophysiological assessment is performed via electrodes attached to the patient’s skin, and in many cases the patient’s cooperation is essential.





Clinical neurophysiology is a branch of this discipline which is hospital-based, and has to do with measuring neurological parameters, in a research setting, at the patient’s bedside, in intensive care units, or in a dedicated hospital laboratory. Clinical neurophysiologists test and record the function of the brain, spinal cord, spinal nerve roots, peripheral nerves (sensory and motor) and muscles, to help diagnose various disorders of the nervous system. They may use computerized imaging, magnetic, electrical, or electronic ways to record nervous activity, nerve impulse conduction, and coordination with the muscular response.

Some conditions in which this is useful include epilepsy, Parkinson’s disease, and motor neuron disease.

Tests used in neurophysiology

Diagnostic evaluations undertaken in the department of neurophysiology include:
Electroencephalogram (EEG)
Evoked Potentials (EPs)
Nerve conduction studies (NCS)
Electromyography (EMG) 

Electroencephalogram (EEG)

The EEG is a record of brain function. Electrodes are attached to the scalp in various areas, corresponding to the lobes of the brain, to pick up the electrical potentials from the cortex of the brain. This is of particular use in patients suffering from epilepsy.

Evoked potentials (EPs)

Evoked potentials occur in response to a visual stimulus. They are of use mainly in nervous diseases such as optic neuritis or multiple sclerosis.

Nerve conduction studies

In many conditions it is necessary to test the way the peripheral nervous system functions, by measuring the speed of passage of nerve impulses through the motor and sensory nerves. This is by recording the effect of applying a small electrical current to the nerves to be tested.

The test, also called a nerve conduction velocity test, helps to determine if the nerve has been damaged or destroyed.

Surface patch electrodes are attached to the skin. One supplies stimulation to the nerve. The other records the resulting nerve impulse. The speed of conduction is calculated using the distance between the electrodes and the time gap between the stimulation and the arrival of the resultant electrical impulse at the other electrode. Each nerve is tested separately.

Electromyography

Electromyography is a related test which inserts slender electrodes into the voluntary muscles, to diagnose conditions such as motor neuron disease and radiculopathy. It measures the electrical activity in the muscle fibers, and shows if the muscles or nerves are damaged, and if so, to what extent and at what location.

More specialized tests in neurophysiology include:
Ambulatory EEG for long-term monitoring
Video telemetry
Sleep studies
Monitoring patients during neurosurgical procedures, such as scoliosis surgery, where the spinal cord integrity has to be mapped throughout
Tests of visual neuron functioning

Neurophysiologists may develop a greater interest in specific areas such as epilepsy and its origin as well as corrective surgery, Parkinson’s disease and sub-thalamic nuclear ablation, and mapping the cortex in various disorders.

The responsibilities of a neurophysiologist include supervising and supporting technicians in the wards, operation theaters, and departmental laboratories. They must report EEGs and interpret EMGs to diagnose various neuromuscular conditions.

References
https://www.healthcareers.nhs.uk/explore-roles/medicine/clinical-neurophysiology
http://jnnp.bmj.com/content/76/suppl_2/ii23.full
https://www.uclh.nhs.uk/OurServices/ServiceA-Z/MEDSPEC/NPHYS/Pages/Home.aspx
http://www.uhs.nhs.uk/OurServices/Brainspineandneuromuscular/NeuromuscularWERMANS/Diagnosisandtreatment/Nerveconductionstudiesandelectromyography.aspx
http://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/nerve_conduction_velocity_ncv_92,P07657/
 
http://www.news-medical.net/health/Neurophysiology-Nerve-Conduction-Studies.aspx

Advice For If Your Pain Brings Depression Vid

Today's animated video produced by the World Health Organisation is both cute and extremely helpful for people driven to depression by chronic pain. There's no direct reference to neuropathy but people living with neuropathy symptoms day in, day out can become depressed over a period of time, sometimes without realising what's happening to them. This video gives a gentle reminder that there's no shame in asking for help and ignoring it, or repressing the feelings of serious depression can lead to problems just as serious as the cause itself. Worth a watch for everybody.

Living With a Black Dog
World Health Organization Published on 4 Sep 2014

Millions of people around the world live with depression. “Living with a black dog” is a guide for partners, carers and sufferers of depression. It advises those living with and caring for people with depression on what to do, what not to do, and where to go for help.

“Living with a Black dog” is a follow-up to “I had a black dog, his name was depression”, which offers practical advice for coming to terms with and overcoming depression.

Both videos were produced by writer and illustrator Matthew Johnstone, in collaboration with WHO, and were based on books of the same name.

For “I had a black dog, his name was depression” 

 
https://www.youtube.com/watch?v=XiCrniLQGYc&feature=youtu.be

Magnesium For Neuropathy Vid

Today's short video from beatingneuropathy.tv (see link below) by Dr. John Hayes Jr follows on from yesterday's video and talks about the benefits of magnesium in the diet of neuropathy sufferers. If you're concerned about any vitamin or mineral deficiencies in your system, a simple blood test via your home doctor should be able to highlight any deficiency problems you might have. If your levels are normal, there really is no need to supplement. A general, good quality multi-vitamin will be enough for most people unless you have a shortage in one particular area.  Different doctors will have differing opinions about supplementation but with regard to neuropathy, this sort of video will arm you with extra information to help your decision making.


Episode 32 – Magnesium 
Posted by John Hayes Jr Sunday, November 3rd, 2013

Dr. Hayes discusses magnesium, how common this deficiency is, and foods we can consume to increase magnesium levels. This is important for Neuropathy and chronic pain patients in particular! Magnesium is an aid in sleep, energy and many forms of chronic pain like fibromyalgia and back pain. Watch and learn more!




http://beatingneuropathy.tv/2013/11/episode-32-magnesium-neuropathy/

Zinc And Neuropathy Vid

Today's short video from beatingneuropathytv (see link below) is another valuable piece of information from Dr John Hayes Jr in which he talks about both the usefulness and the dangers of zinc as a supplement. As with all supplements, you have to know what you're doing and know which dosage is best for your particular situation. What seem to be harmless, over the counter supplements may compromise your system without you knowing it. It's best to talk it over with your doctor or specialist but very often he or she may not have the information to hand. In that case, you need to do as much research as possible yourself. Dr. Hayes' videos are often a useful place to start.


Episode 34 – Zinc Posted by John Hayes Jr Thursday, November 14th, 2013


Dr. Hayes talks about zinc and its relationship to neuropathy and chronic pain. It is critical to keep zinc intake low, as higher then needed intakes can actually cause neuropathy,suppress your immune system and more!


 http://beatingneuropathy.tv/2013/11/episode-34-zinc-neuropathy/

Life With Neuropathy Personal Video Vid

Listen to this Youtube video account - you'll all have been there and struggled just the same in dealing with neuropathy and wondering what the best approach is. Rachelmarye is trying to avoid drugs in favour of as many natural treatments as possible including exercise and diet.

Neuropathy SUCKS :(
rachelmarye Published on 11 Sep 2014

 

We like to call these videos our homemade reality show. No scripts and no fake celebrities! We are as real as you can get. These are our videos all about how we live our lives as a military couple. We met and married in Hawaii, then moved to Kentucky, and now we live in Georgia! Come hang out with us, kick back, relax and have fun! Don't forget to SUBSCRIBE!

https://www.youtube.com/watch?v=TQe8cuo6D1o

Turmeric Curcuma The Next Big Thing For Neuropathy Vid

Today's posts from livestrong.com and turmericforhealth.com (see links below) revisit Turmeric (Curcuma) as a potential aid for nerve pain and neuropathy. There are other articles here on the blog about Turmeric but it seems to be making a come-back in the news at the moment because of the many claims as to its efficacy for various health problems. However, there are two major problems associated with Turmeric (also known as Curcuma) and they are that science regards current evidence as being 'theoretical' meaning there's just not enough of it to justify the hype...yet and the fact that its bio-availability is very poor (basically meaning that it's out of your body before you can blink and it's very difficult to absorb in sufficient quantities. That all said, the hype rumbles on and thousands of testimonies swear that it genuinely helps a multitude of conditions. Now science can't really explain neuropathic pain itself, or why it happens, so dismissing turmeric because of a shortage of study evidence doesn't necessarily mean that it can't help you. Nevertheless, it does still seem to fall into the group of treatments including homeopathic cures and even acupuncture and massage and as such, desperately needs more serious investigation. So, given the difficulty the body has in absorbing it, what can you do if you decide to give it a go (if only a tenth of the claims on its behalf are only half true, you're not going to damage yourself by trying it out). Turmeric supplements are everywhere in the health food shops but may not provide you with the absorption you need so read the two articles below regarding the benefits of turmeric and improving it's bio-availability; do some more research (there are thousands of articles available on the Net) and then make a decision as to whether it's worth a gamble. There don't seem to be any harmful side effects and most of the Indian/Asian subcontinent can't be wrong when it comes to including it in their diet, so why not. Remember however, it'll take some time before you notice any effects. I'll be interested to hear your experiences.

Turmeric to Help Peripheral Neuropathy
by LINDA TARR KENT Last Updated: Aug 27, 2013

Turmeric has a theoretical benefit for you if you have peripheral neuropathy. While scientific evidence for turmeric appears promising as of 2010, clinical studies are needed before the medical community can recommend turmeric as therapy for peripheral neuropathy and other conditions, according to a 2010 scientific review in “The Indian Journal of Pharmaceutical Sciences.” Always consult your doctor before trying an alternative medicine therapy, especially if you have a health condition or take medication.

Peripheral Neuropathy

Peripheral neuropathy is the term for damage to your peripheral nervous system. There are more than 100 types of peripheral neuropathy. Symptoms vary from prickling sensations, tingling and numbness to burning pain to muscle wasting to organ dysfunction. You can inherit this condition or acquire it. Physical injury, an infection or a systemic disease like an endocrine disorder, cancer or diabetes can lead to peripheral neuropathy. Other causes include hormonal imbalances, alcoholism, vitamin deficiency and vascular damage.

Evidence

Turmeric’s benefits for you if you suffer from nerve damage are largely theoretical. The evidence for using turmeric is mainly anecdotal and based on animal studies, according to “The People’s Pharmacy Quick and Handy Home Remedies.” For example, a 2007 study published in the “American Journal of Human Genetics” concludes that turmeric’s active ingredient, curcumin, may be a good therapy for inherited peripheral neuropathies. This study was done on mice, however, and benefits found in animal studies don’t always translate to benefits for humans. 

Mechanism

Just how the curcumin in turmeric produces neuroprotective action is under scientific investigation. Top theories as of 2010 are that its benefits are mainly due to curcumin’s anti-inflammatory and antioxidant properties, note S. K. Kulkarni and A. Dhir, authors for the review published in “The Indian Journal of Pharmaceutical Sciences.” The fact that it affects neurotransmitter levels in the brain and also helps prevents cell death are another part of the dynamic, note Kulkarni and Dhir. 

Bioavailability

While curcumin demonstrates protective action for neuropathy and other disorders of the body, it has poor oral bioavailability, according to Kulkarni and Dhir. Bioavailability refers to your body’s ability to absorb and utilize a substance. Curcumin’s bioavailability is limited due to rapid metabolism in your liver and intestinal wall. However, curcumin’s bioavailability can be enhanced, according to a 1998 study published in “Planta Medica.” This is done by combining it with the bioavailability-enhancing agent called piperine, a constituent of black pepper.

http://www.livestrong.com/article/482025-turmeric-for-peripheral-neuropathy/




 https://youtu.be/5N3iLhjLF5s

How to Improve Absorption or Bio-availability of Turmeric? 
(You may be a little worried about the language use in this article but that arises because of its cultural origin and the fact that it may also have been translated from another language. You should be able to get the gist of what is said. Ed.)

Turmeric is scientifically called Curcuma longa. It is a rhizome, kind of herb of the ginger family. Turmeric is bitter in taste with a slight evocative fragrance of orange and ginger. It is one of the major ingredients of the Indian curries. It is derived from the root of the plant and has a brown upper covering and orange colored flesh. It was also known as “Indian saffron” because of its orange-yellow color. It has been used for quite a long time for medicinal purposes.

 A few things about turmeric (if you know this, please skip this section) Turmeric is generally habituated in tropical regions of India like Tamilnadu because it requires 20-30 ®C temperature range for growth and an ample amount of rainfall. The nutritive quality of turmeric is due to its constituents. Turmeric has Manganese, Iron , Vitamin B6 , Fiber, copper, potassium, etc. Thus the nutritional value of turmeric is quite high. Turmeric is being used for the treatment of inflammatory and bowel diseases for quite a long time. Turmeric is used as an ingredient in curry, as a healing agent and used for textile dyeing purposes. 

Curcumin is the most active constituent of turmeric (3-4%curcumin, depends on the species, growth stage and cultivation area of the spice) and it has been shown to exhibits anti-oxidant and anti-inflammatory properties. Turmeric has been found to exhibit many therapeutic properties and hence is being used for centuries in the traditional Indian or Ayurvedic medicines. Turmeric has been discovered to have anti-cancerous properties. Also turmeric is being used for the treatment of inflammatory diseases such as tendinitis, liver cirrhosis, Alzheimer’s disease and many other digestive and blood related problems. It has other significant properties like anti-bacterial, liver and kidney protective nature, blood clot suppressing property and also helps in the prevention of heart attack and hypoglycemia.

 What is Bioavailability of turmeric? 

Many studies have shown that turmeric is safe even at higher dosage. The efficacy of turmeric has also been proved by many clinical studies. This efficacy and safety makes turmeric a potent compound for the treatment of wide range of human diseases. Besides all these reasons turmeric has not yet been officially declared as a therapeutic agent and the major reason behind this is the relative low bioavailability of turmeric. The reason behind the low availability of any agent within the body is its low indwelling activity, inactivity of metabolic compound or its rapid removal from the body. Studies rule out the first option of low intrinsic activity of turmeric. Turmeric’s efficacy and strong activity has helped in its establishment as a therapeutic component in the treatment of many ailments. However studies regarding absorption, transportation, assimilation and elimination of curcumin have revealed low absorption and its rapid metabolism which leads to relatively low bio-availability of turmeric.

 Why turmeric has low bioavailability? 

The major factors that affect the bio-availability of turmeric are sorted below Serum concentration Tissue distributions Rapid metabolism Short half-life Serum concentrations how to improve turmeric bioavailability One of the major considerations in the study of curcumin involves low serum levels. The very first study reported related to the uptake, assimilation and excretion of curcumin was by Whalstrom and Blennow in 1978 using rats. In their studies they showed poor absorption of curcumin from the gut. When 1g/kg of curcumin was administered orally in the rats only negligible amount of curcumin was found in their blood plasma. Again in 1980, Ravindranath et al showed that when only 400 mg of curcumin was ingested by the rat, no trace of curcumin was found in the heart blood while only a small trace was found in the portal blood within 15 min to 24 hours of administration. In a very recent study Yang et al showed that administration of 10 mg/kg of curcumin results in only 0.36 µg/ml of curcumin in the blood serum. These studies show that the route of administration has a role to play in the metabolism of turmeric. Also the absorption of curcumin is a major factor responsible for low bio-availability of turmeric. 

Tissue distribution Ingestion and distribution of curcumin to various tissues of body is actively responsible for its bio-availability. But this topic has not got the attention of the scientists studying about the bio-availability of turmeric. Studies of Ravindranath revealed that only a trace amount of curcumin was present in the stomach and intestine. Many other studies in this filed have shown that even higher dosage of curcumin does not increase the absorption of curcumin as well as its distributions. Metabolites Liver is the major organ involved in the metabolism of curcumin. After absorption curcumin undergoes conjugations like sulfation and glucuronidation. When metabolized in liver, the major metabolic product of curcumin are glucuronides of Tetrahydrocurcumin (THC) and Hexahydrocurcumin (HHC).

 Most of the studies have shown that these metabolites are actually less active as compared to Curcumin itself. So when metabolized the activity of curcumin seems to be lost.

 Half-life Systemic excretion of curcumin from the body is also a major factor responsible for its activity. Studies by Whalstrom and Blennow showed that when 1g/kg curcumin was ingested by the rat, around 75% of the curcumin was excreted and only a trace amount was found in the urine. Thus low half-life of curcumin decreases its activity in the body. There is not much information about half-life of curcumin has an important role to play in its biological activity. But still it is a topic to be concentrated on in the future. how to improve turmeric absoption in body How can turmeric’s Low bioavailability be addressed? These are the problems causing the low availability of curcumin.

 But some of these problems can be solved using various ways listed below Adjuvants Nanoparticles Liposomes, phospholipids and micelles Adjuvants Adjuvants generally improve the bio-availability of curcumin by blocking its metabolic pathway. Shoba et al combined Piperine which has the property to inhibit glucuronidation in the liver and intestine, then administered it in the rats and healthy humans. In rats when 2g/kg of only curcumin was administered, 1.35 µg/ml of curcumin was found in the blood serum. But when it was administered in combination with piperine (20mg/kg), the serum level was increased, time required to reach the peak level also increased, elimination and half-life were decreased reasonably. Bio-availability of curcumin was increased up to 154%. In humans when 2g curcumin was administered, the serum concentration was found to be either very low or were undetectable. Curcumin combined with piperine introduced in the humans, resulted in 2000% increased bio-availability. Thus the effect of introduction of piperine is much more significant in humans than in rats.

 The effect of piperine on tissue uptake has also been shown in many studies. Piperine is one such agent used. There are many other adjuvants that can be used to serve this purpose like genistein. Thus all these studies have shown that curcumin activity can be modulated both at cellular and organismic levels.

 Nanoparticles 

Recently nanoparticles are being used as targeted and triggered drug delivery mechanisms. These nanoparticles have also emerged as solutions for the bio-availability of certain therapeutic agents. Curcumin is hydrophobic in nature and the solubility in aqueous solutions arises a problem. Nanoparticles can be used to serve such purposes in a recent study by Bish et al polymer based nanoparticles with size less than 100 nm have been synthesized named “nanocurcumin”. Nanocurcumin has been found to have the similar biological activity as that of free curcumin. It has the same anti-oxidant and anti-inflammatory effects as the free curcumin has. There haven’t been much studies related to nanocurcumin increasing the efficacy of curcumin. But solid lipid nanoparticles when loaded with curcuminoids are found to be stable and release curcumin for 12 hours.

 Research work is going on to study the role of nanoparticles in increasing the efficacy of curcumin. 

 Phospholipids, micelles and liposomes Liposomes are nice drug delivery systems as they have the ability to carry both hydrophobic as well as hydrophilic molecules. Li et al studies revealed that liposomal curcumin has anti-tumor property for human pancreatic tumor cells. It prevents the growth of pancreatic tumor cells and also has the anti-angiogenic properties. Evaluation of exact efficacy of liposomal curcumin over the free curcumin is still under process. The liposomal carrier has more loading capacity of curcumin and also plays a great role in increasing the bio-availability of curcumin. Micelles and phospholipid complexes increase the absorption of drugs from the gastrointestinal tracts resulting in higher blood plasma concentration and lower elimination and thus increasing the bioavailability. Many studies suggest that the absorption of curcumin increases from 47% to 56% when it is present in the micelles. Ma et al studied that the half-life of polymeric micellar curcumin is 60 folds higher than free curcumin. In a study by Liu et al, curcumin (100 mg/kg) and curcumin-phospholipid complex (corresponding to 100 mg/kg) were administered in rats. Curcumin-phospholipid complex yielded 600 ng/ml of serum curcumin level while only 267 ng/ml in case of free curcumin. Also the half-life increases 1.5 folds in case of curcumin-phospholipid complex.

 Easy ways to make turmeric bioavailable in body The main reason behind the non-availability of curcumin in body for regular users is due to its low solubility in water. But there are other ways by which one can take curcumin without its solubility coming in its way. Black Pepper: One can use the mixture of curcumin with pepper. Bioperine is an extract from the fruit of Piper nigrum (black pepper). It is one of the best ways to take turmeric by mixing it with Bioperine. Including black pepper in your diet or taking it with turmeric should help in absorption of turmeric in body. Mixing with fats: Also mixing curcumin with fat will do. Curcumin can be mixed with coconut oil, flaxseed oil, olive oil etc. 

Mixing with Quercetin: Curcumin can be taken as a mixture of curcumin and quercetin. Quercetin is flavonoid and is found in many plants and foods such as apple, red grapes, onion, citrus fruit etc. Quercetin inhibits the sulfotransferase enzyme that inactivates curcumin. Also bicurcumax is available which has curcumin dissolved in fat of 10-15% by weight. You may also get results by using Apple Cider vinegar as it has Quercetin in it.

 Using Silibinin : This is the major active constituent of silymarin, a standardized extract of the milk thistle seeds. It is also know to increase the bioavailability of turmeric.

 Heated water: It can be taken with water too only if its solubility is enhanced (else it generally has to be taken with fats as part of food). Probably the bioavailability of curcumin can also be enhanced with heat because heat increases the solubility of curcumin in water. Studies have shown that boiling turmeric in water for 10 min increases its solubility 12 fold (remember its solubility, not absorption). The verdict is still not out on how much it impacts the absorption. But this may be the reason why taking turmeric with warm milk (golden milk!) is considered great!

 Special tablets: These can be the ones which already have absorption enhancing agents such as black pepper or other chemicals which can do that. 

Summary As detailed above all these problems causing low bio-availability of curcumin can thus be overcome by the above given strategies, some of them I know are very tech. but others such as black pepper and with fat are easy to follow. As curcumin is very important in our day to day life as well as it has found its role in the medical field too, it needs to be modulated for proper utilization. The above explained modulation can thus overcome the situation of low bio-availability of curcumin.

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