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"Imagine a woman in love with her own body,

A woman who believes her body is enough, 

just as it is.

Who celebrates her body's rhythms and cycles as an

exquisite resource."

~Patricia Lynn Reilly~

Pleasure Medicine Newsletter

Gabapentin And Pregabalin Lyrica Really Are A Danger To Your Neuropathic Health!

Today's post from pulsetoday.co.uk (see link below) is an impassioned plea from a home doctor who is seeing the consequences of long-term gabapentin and pregabalin (Lyrica) use in his surgery. Finally, a doctor who stands up to the hype that the pharmaceutical companies use to promote their drugs! Many, many neuropathy patients across the world have been prescribed either gabapentin or pregabalin for their nerve pain and other symptoms. This blog has long warned of the dangers of Lyrica (pregabalin) and advised patient to have serious discussions with their doctors if they are being prescribed these drugs. This article explains why and in terms you can't ignore. These drugs aren't the first and they won't be the last to display dangerous side effects years after the profit on them has been made. As Dr Spence says: "If it quacks like a duck and looks like a duck, then it’s a ducking duck"!

Gabapentinoids - the new diazepam?
Posted by: Dr Des Spence 9 September 2016

The establishment ignores GPs. It prefers the advice and glamour of ‘expert’ or media doctors. But the deference shown to the ‘expert’ is creating overtreatment, medicalisation and iatrogenic harm.

GPs have to ignore this advice. We won’t prescribe statins to everyone because it is irrational and stupid. We don’t accept that ‘pain is what the patient says it is’, because common sense dictates that it isn’t.

And we have seen the damage when experts have free rein. Diazepam was peddled as a safe and effective treatment for anxiety by companies and experts alike. When I started work in the early 1990s the consequence of this advice was evident everywhere. Herds of middle-aged patients zonked out and dependent on benzodiazepines. And benzodiazepines were being widely abused by a younger generation. My surgeries were spent dealing with drug-seeking behaviours, lies, confrontation, rebound agitation, insomnia and withdrawal seizures. It took the establishment decades to realise the harms we caused. Even today, we are still dealing with it.

GPs are first to notice the danger posed by psychoactive drugs. In the past five years my sensor has been off the scale with the gabapentinoids (gabapentin and pregabalin). Patients are seeking them using the crude acting skills that I used to witness with benzodiazepines: anger, tears and threats; constant requests for dose increases; stories of lost scripts; and a tag-team approach with friends who ‘corroborate’ stories.

If you google ‘gabapentinoids’, it is clear they are being widely abused. Large quantities are taken as single doses. Users describe them as the ‘ideal psychotropic drug’ with effects of ‘great euphoria’, ‘disassociation’ and an ‘opiate buzz’ as they boost the effects of these drugs.[1,2]

I wrote an article in the BMJ in 2013[3] highlighting these concerns. Since then, prescriptions have nearly doubled in three years to 10 million scripts and more than £300m in costs.[4] Such rapid increases are the signature of inappropriate prescribing and iatrogenic harm. Many practices started prescribing gabapentinoids on the back of specialist endorsement, despite the existence of effective and less harmful alternatives.[5,6] But requests from pain clinics and psychiatry come thick and fast. We decline many, then weather the storm of protest.

Do we have a problem with gabapentinoid abuse? If it quacks like a duck and looks like a duck, then it’s a ducking duck. Pregabalin is already a controlled medication in the US and there is debate about controls in the UK. The research base for the benefits of gabapentinoids is of short duration and in a small, defined population where as few as one in 10 benefits.[7] We need to change our prescribing policy now and limit the use of gabapentinoids.[2]

We know the pattern: GPs will be blamed even if we just follow orders. I get tired that no one listens to generalists. This is déjà vu. Do we want another benzodiazepines disaster?

Dr Des Spence is a GP in Maryhill, Glasgow, and a tutor at the University of Glasgow

References Schifano F, D’Offizi S, et al. Is there a recreational misuse potential for pregabalin? Analysis of anecdotal online reports in comparison with related gabapentin and clonazepam data. Psychother Psychosom 2011;80:118-22
Advice for prescribers on the risk of the misuse of pregabalin and gabapentin. Public Health England, 2014
Spence D. Bad medicine: gabapentin and pregabalin BMJ 2013; 347 08 November 2013
NHS Prescription Cost Analysis data. NHS Business Services Authority, 2016
Wiffen P, Derry S, et al. Antiepileptic drugs for neuropathic pain and fibromyalgia - an overview of Cochrane reviews Cochrane Database Syst Rev 11 November 2013; (11):CD010567
Moore R, Derry S, et al. Amitriptyline for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2012 Dec 12;12:CD008242
Advice on the anticonvulsant drugs pregabalin and gabapentin. Advisory Council on the Misuse of Drugs, 2106 

http://www.pulsetoday.co.uk/views/blogs/gabapentinoids-the-new-diazepam/20032721.blog

Why Neuropathy Means Your Brain Cant Avoid Falls

Today's post from sciencedaily.com (see link below) is an interesting one for many people living with neuropathy, irrespective of their age. If you have nerve damage problems in your feet and legs, balance becomes an issue, not only with normal walking but also if you happen to trip and fall. The article suggests that the younger you are, the better your chances of recovering from the stumble and avoiding a bone-breaking fall but the older you are increases the risk of a serious injury from loss of balance. The science shows that it has to do with the brain's reaction times to threatening situations. When you're young, your brain identifies the risk and takes measures to avoid it and correct your stance before you fall, whereas older people have slower reaction times and often can't correct the situation in time. What isn't completely clear is if the nerve damage has anything to do with the 'slowing down' of the brain's reactions, or whether, like with other bodily functions, age simply means a reduction of all optimal functioning. Whatever the exact reasons are, the facts are obvious:- the older we are, the more likely we are to fall and break something after a neuropathy induced stumble. Can we do anything about it? Well, neuropathy patients are well-practiced in training their brain to concentrate at all times when walking but occasionally, the wrong signals the brain is receiving mean that an accident is almost inevitable. Whatever our age, with nerve damage you always have to be as alert as humanly possible. Lack of feeling, numbness, foot pain, burning and tingling and critically, misinterpreting signals we've grown up getting used to, make life with neuropathy a bit of a lottery. Avoiding broken bones is a daily objective for neuropathy sufferers and I don't think you have to be elderly to be aware of that!

For geriatric falls, 'brain speed' may matter more than lower limb strength 
Date:December 21, 2016Source:University of Michigan Health System 

Summary: It's not only risk factors like lower limb strength and precise perception of the limb's position that determine if a geriatric patient will recover from a perturbation, but also complex and simple reaction times, say researchers.

"Why does a 30-year-old hit their foot against the curb in the parking lot and take a half step and recover, whereas a 71-year-old falls and an 82-year-old falls awkwardly and fractures their hip?" asks James Richardson, M.D., professor of physical medicine and rehabilitation at the University of Michigan Comprehensive Musculoskeletal Center.

For the last several years, Richardson and his team set out to answer these questions, attempting to find which specific factors determine whether, and why, an older person successfully recovers from a trip or stumble. All this in an effort to help prevent the serious injuries, disability, and even death, that too often follow accidental falls.

"Falls research has been sort of stuck, with investigators re-massaging over 100 identified fall 'risk factors,' many of which are repetitive and circular," Richardson explains. "For example, a 2014 review lists the following three leading risk factors for falls: poor gait/balance, taking a large number of prescription medications and having a history of a fall in the prior year."

Richardson continues, "If engineers were asked why a specific class of boat sank frequently and the answer came back: poor flotation and navigational ability, history of sinking in the prior year and the captain took drugs, we would fire the engineers! Our goal has been to develop an understanding of the specific, discrete characteristics that are responsible for success after a trip or stumble while walking, and to make those characteristics measurable in the clinic."

Richardson's latest research finds that it's not only risk factors like lower limb strength and precise perception of the limb's position that determine if a geriatric patient will recover from a perturbation, but also complex and simple reaction times, or as he prefers to refer to it, a person's "brain speed." The work is published in the January 2017 edition of the American Journal of Physical Medicine & Rehabilitation.

"Our study wanted to identify relationships between complex and simple clinical measures of reaction time and indicators of balance in elderly subjects with diabetic peripheral neuropathy, nerve damage that can occur in those with diabetes," Richardson says.

"These patients fall twice as often as people their age typically do, so we wanted to examine each person's ability to make a decision in less than half a second, or around 400 milliseconds. Importantly, this is also about the length of time the foot is in the air before landing while walking, and about the time available to recover from a stumble or trip."

He realized they needed a new, easy way to measure that rapid decision-making ability.

Measuring simple and complex reaction time

Using a device developed with U-M co-inventors James T. Eckner, Hogene Kim and James A. Ashton-Miller, simple reaction time is measured much like a drop-ruler test used in many school science classes, but is a bit more standardized.

"The clinical reaction time assessment device consists of a long, lightweight stick attached to a rectangular box at one end. The box serves as a finger spacer to standardize initial hand position and finger closure distance, as well as a housing for the electronic components of the device," Richardson says.

To measure simple reaction time, the patient or subject sits with the forearm resting on a desk with the hand off the edge of the surface. The examiner stands and suspends the device with the box hanging between the subject's thumb and other fingers and lets the device drop at varying intervals. The subject catches it as quickly as possible and the device provides a display of the elapsed time between drop and catch, which serves as a measurement of simple reaction time.

Although measuring simple reaction time is useful, Richardson says that the complex reaction time accuracy has been more revealing. The initial set up of the device and subject is the same. However, in this instance, the subject's task is to catch the falling device only during the random 50 percent of trials where lights attached to the box illuminate at the moment the device is dropped, and to resist catching it when the lights do not illuminate.

"Resisting catching when the lights don't go off is the hard part," Richardson says. "We all want to catch something that is falling. The subject must perceive light illumination status and then act very quickly to withhold the natural tendency to catch a falling object."

In the study, Richardson and team used the device with a sample of 42 subjects, 26 with diabetic neuropathy and 16 without, with an average age of 69.1 years old, to examine their complex reaction time accuracy and their simple reaction time latency, in addition to the usual measures of leg strength and perception of motion.

They then looked to see how well these measures predicted one-legged balance time, the ability to control step width when walking on a hazardous uneven surface in the research lab and major fall-related injuries over the next 12 months.

Examining the results

In the subjects with diabetic peripheral neuropathy, good complex reaction time accuracy and quick simple reaction time were strongly associated with a longer one-legged balance time, and were the only predictors of good control of step width on the uneven surface. In addition, they appeared to identify those who sustained major fall-related injury during the one-year follow up. Surprisingly, the measures of leg strength and motion perception had no influence on step width control on the hazardous surface and did not appear to predict major injury.

"Essentially we found that those who were able to grab the device quickly, or quickly make the decision to let it drop, had quick brains that were somehow helping them stay balanced and avoid aberrant steps on the uneven surface," Richardson says.

He explains that the ability to avoid aberrant steps after hitting a bump while walking, and stay balanced while performing the trials, were likely based on the participant's brain processing speed. In particular, the ability to quickly withhold, or inhibit, a planned movement is required for good complex reaction accuracy and responding to a perturbation while walking. In both cases, the original plan of action must be aborted and a new one substituted within approximately a 400 milliseconds time interval.

"With this in mind, it makes perfect sense that brains fast enough to have good complex reaction time accuracy were also fast enough to quickly pay attention to the perturbation while walking, inhibit the step that was planned and quickly execute a safer alternative," Richardson says. "The faster your brain can oscillate between various external stimuli, or events, and your own internal thinking clutter, the better off you are. When an elderly person falls, it seems likely that their brain is not keeping up with what is happening and so it is not able to quickly, and selectively, attend to a particular stimulus, such as hitting a curb."

Richardson says this assessment, which cannot be produced from a computer or pen/pencil tests, could be valuable to other health care providers, such as primary care physicians, neurologists, geriatricians and a variety of rehabilitation professionals.

Story Source:

Materials provided by University of Michigan Health System. Note: Content may be edited for style and length.

Journal Reference:
James K. Richardson, James T. Eckner, Lara Allet, Hogene Kim, James A. Ashton-Miller. Complex and Simple Clinical Reaction Times Are Associated with Gait, Balance, and Major Fall Injury in Older Subjects with Diabetic Peripheral Neuropathy. American Journal of Physical Medicine & Rehabilitation, 2017; 96 (1): 8 DOI: 10.1097/PHM.0000000000000604

https://www.sciencedaily.com/releases/2016/12/161221090359.htm

What Your Doctor May Not Tell You About Neuropathy

Today's post from curediseases.pw (see link below) is very sensibly written and should appeal to all readers looking for just a little more information than their doctors are able to supply during a fifteen minute consultation. It addresses some of the myths surrounding neuropathy, many of them brought about because doctors just don't have the time to explain what's happening in any length. Time is the issue here...nobody is suggesting that doctors are being negligent...they just don't have the necessary time! The article fills in some of the blanks, with accurate and helpful information and you may well learn something you didn't know about this frustrating disease that's causing you so many problems. Worth a read.
 

11 Things Doctors Don’t Tell You About Neuropathy
November 19, 2016 ASHLEY

Have you ever learned a piece of valuable new information about neuropathy and thought to yourself, “I wish I would’ve known that when I was first diagnosed.” If you’re anything like me, this is a somewhat frequent occurrence. The reality is that while a lot has been (and is being) discovered about neuropathy in the scientific and medical communities, our understanding of it is an evolving process. Compared to a decade or two ago, we know considerably more now than we did – but even so, there is much that is yet to be fully understood about this silent but painful nerve condition.

As I look back on all I’ve learned about neuropathy over the years – from causes to treatments and everything in between – there is a lot I wish I’d been told about sooner. As with any battle against a chronic condition – knowledge is power. The more you know about your neuropathy – including its potential causes and the steps you can take to most effectively treat it and prevent it from spreading – the better your chances are of reducing your neuropathy related symptoms and preventing further nerve damage.

With that said, here are 11 things I wish I’d known about neuropathy when I was first diagnosed:

There are many potential causes – including medications

Some of the known causes of neuropathy include diabetes, chemotherapy, exposure to toxins, surgery, injury or trauma, vitamin B12 deficiency, excessive amounts of vitamin B6, autoimmune diseases, nutritional imbalances, excessive alcohol consumption and even medications. Knowing the cause of your neuropathy is one of the most important factors in determining how to treat it.



MORE: 7 Potential Causes of Your Neuropathy

In some cases, the cause of neuropathy will remain a mystery even after thorough testing and investigation. This is referred to as idiopathic neuropathy, meaning the cause is unknown. In most cases, however, doctors should be able to arrive at a cause (or number of causes).


Some Causes Are Reversible

One of the dreaded realities we often associated with neuropathy is that the damage is irreversible – that you’re stuck with the pain, tingling or numbness forever. While in many cases the damage and symptoms may last indefinitely, there are cases in which the damage may be reversible. This largely depends on the cause of your neuropathy and how quickly you catch it and take steps to reverse it (obviously, the earlier the better).

Among the causes in which damage has the potential to be stopped and even reversed are diabetes, vitamin B12 deficiencies, nutritional deficiencies, heavy alcohol consumption and medications. Of course, to have any hope of stopping or reversing the damage one must determine the cause of the damage and take immediate steps to remedy the problem.

For those with diabetes or nutritional deficiencies, managing blood sugar and improving diet is key to reversing the damage. Those with vitamin B12 deficiencies should work with their doctor to determine ways to eliminate the deficiency through diet or supplementation. Finally, those with neuropathy caused by alcohol or medications should restrict or eliminate the use of the substance causing the damage.

Nerve Damage Can Spread If Underlying Cause Isn’t Addressed

The peripheral nervous system is comprised of nerves running from the brain and spinal chord to other parts of the body. Damage to the peripheral nerves typically manifests itself first in our extremities – usually the hands or feet. What many neuropathy patients don’t realize is that over time these symptoms can spread to other parts of the body – including the arms, ankles, legs and more – if the underlying cause isn’t addressed. This is why both early detection and treatment are so critical. 

Look Out For Early Indicators of Peripheral Neuropathy

The earlier you can catch neuropathy the better your chances of preventing the symptoms from spreading. Some of the early signs of neuropathy to watch out for include:
Gradual numbness or tingling sensations in the feet or hands (which may spread into the legs and arms)
Sharp, stabbing pains
Intense burning pain
Extreme sensitivity to touch
Loss of balance or coordination
Muscle weakness, loss of motor skills
Restless Leg Syndrome (RLS)

Neuropathy Can Affect Muscle Control

Within the peripheral nervous system there are three types of nerves: motor, autonomic and sensory. While the most recognizable symptoms of neuropathy are related to the sensory nerves (i.e. pain, tingling and numbness) – nerve damage can manifest itself in other ways as well. When neuropathy damages the motor nerves, it disrupts the nerves ability to relay messages from the brain and spinal cord to various muscle groups. This can result in difficulties such as loss of balance, difficulty walking, loss of dexterity, cramps or spasms, muscle weakness and loss of muscle control.

MORE: What No One Tells You About Neuropathy & Muscle Control


Neuropathy Can Affect Autonomic Functions

Another group of nerves that can be affected my neuropathy is the autonomic nerves. The autonomic nervous system is a division of the peripheral nervous system that influences various internal organs such as the heart, stomach, liver, adrenal gland and more. Damage to the autonomic nerves disrupts the signals sent from the brain and spinal cord to these various organs – sometimes resulting in a disruption to the involuntary functions these organs are involved in.

MORE: Heartburn, Indigestion and 25 Other Symptoms You Didn’t Know Were Caused By Neuropathy

Here are the most common organs affected by damage to the autonomic nerves and the symptoms generally associated with them:


Pain Medications Only Mask the Pain

There are a number of prescription medications available to help cope with neuropathic pain. These medications have been a lifesaver for many sufferers (myself included) as they help take the edge off the pain and make it more manageable. Unfortunately, their purpose is simply to help mask the pain rather than help correct the underlying problem. In addition, there can be negative side effects associated with any prescription medication – so one must be aware of the risks.

MORE: Strategies for Fighting Neuropathy Without Prescriptions

Understanding that these prescription medications would not necessarily stop or reverse my nerve damage – but merely mask the symptoms – helped me to recognize the importance of trying various approaches to help address the underlying causes of my neuropathy. 

Natural Herbs & Supplements May Help

While prescription medications typically only mask the symptoms, nutritional supplements and herbs may help both relieve symptoms and address underlying causes. By addressing underlying causes or problems, they may help to slow or even stop the nerve damage from spreading. Some of the best supplements and herbs for nerve pain include:
Vitamin B12
Vitamin D
Magnesium
Alpha Lipoic Acid
CoQ10
Acetyl-l-carnitine

Vitamin B12 is especially important for nerve health. It helps build up and support the myelin sheath – a protective coating around the nerves that shelters them from damage and infection. Studies have shown that high doses of vitamin B12 can promote nerve regeneration of damaged nerves.

MORE: Top 10 Herbs & Supplements for Nerve Pain 
 
Alternative Therapies Can Help (but be patient)

Like a lot of people, I was hesitant about alternative therapies and skeptical about the promised results. However, alternative therapies have proven to be very beneficial in both helping me to manage my pain as well as improving my overall health. That said – there is no miracle therapy or treatment that is going to relieve my nerve pain overnight. I’ve found that with alternative approaches, the results are gradual – but they tend to be lasting results.

Alternative therapies for neuropathy range from low-impact exercises like yoga or tai chi to ancient practices like acupuncture. Here is a good list of popular approaches you may want to explore if you are suffering from neuropathy:
Acupuncture
Massage
Yoga
Tai Chi
Walking or stationary bike
Biofeedback
TENS therapy (Transcutaneous electrical nerve stimulation)

MORE: 10 Little Known Ways to Relieve Nerve Pain 
 
Diet Could Be Helping or Hurting Nerve Pain

Something else I wish I’d known was the impact that diet can have on the symptoms of neuropathy. There are certain foods that can aggravate nerve pain as well as ones that can help boost nerve health. Knowing which foods or ingredients fall into which category can make a big difference!

Among the foods that can make neuropathy worse are casein-based products (commonly found in dairy products), artificial sweeteners, gluten, added sugars and refined grains. When consumed excessively, alcohol can also harm the nerves and block the absorption of essential vitamins like B12.

MORE: 4 Nutrient Deficiencies That Are Killing Your Nerves

Foods that promote healthier nerves include ones rich in B-complex vitamins such as B12 & B2. Other important vitamins and nutrients for strong nerves include vitamin D, vitamin E, Magnesium and Zinc.
Joining a Neuropathy Support Group Can Help

They say that experience is the mother of all wisdom, so what better way to learn about neuropathy than to join others who have been living with it for years? Joining a support group or online forum can give you insights into living with neuropathy that you might not find elsewhere. They are also safe environments to ask questions and learn what experience others have had with various medications, treatments and therapies.

To find a support group near you, the Neuropathy Support Network has a useful support group search tool. In addition to local support groups, there are a handful of online support groups or forums. For finding information and support online, check out these 10 Resources Every Neuropathy Sufferer Should Bookmark.

Life with neuropathy can be painful, overwhelming and frustrating. As with anything, the more experience one has the more wisdom and insight he or she will gain into how to better cope with the hand that has been dealt. For me, the process has been gradual and frustrating (of course) – but I’ve learned many things that have resulted in small yet meaningful changes to make the road a little smoother. What things do you wish you had known about neuropathy when you were first diagnosed?

http://curediseases.pw/11-things-doctors-dont-tell-you-about-neuropathy/

Take Care Of Your Toes And Feet With Neuropathy

Today's short post from journal.diabetes.org (see link below) contains advice you really need to follow if you have neuropathy in your feet. Many articles on this subject refer to diabetic neuropathy but as we all know by now, diabetes is just one of the many forms of neuropathy that can cause you to either lose feeling, or suffer extreme feeling in your feet. Listening to a friend's recent story of having painful and infected toenail wounds from clipping too close, led me to publishing this article. It's a very common problem but one that's easy to forget. Read carefully - with the Winter coming on in the northern hemisphere, care of our feet is especially important.

How To Avoid Foot Problems If You Have Neuropathy
Ingrid Kruse, DPM CLINICAL DIABETES VOL. 18 NO. 3 Summer 2000

Inspect Your Feet Daily.
Look at your feet every day. Check for blisters, cuts, scratches, or cracks in the skin (commonly in the heel). Remember to check between your toes. A mirror can help you see the bottom of your feet, or you can ask a family member or friend to help you.

If you experience flu-like symptoms or increased blood glucose levels, be sure to check your feet. They may provide the only warning signals you will receive when a foot infection is present.

Make the daily foot inspection a regular part of your morning or evening routine, just like brushing your teeth. This simple task has kept many people with diabetes from losing their feet by helping them identify problems early on.

Wear Proper Shoes and Socks
All shoes should be comfortable at the time of purchase. Choose a shoe with a soft leather upper, or try athletic shoes for everyday wear. Do not try to "break in" uncomfortable shoes. Buy your shoes at the end of the day when your feet tend to be more swollen than in the morning.

The first time you wear your shoes, wear them only for 1 hour and only around the house. Take them off and inspect your feet for blisters or red areas. Slowly increase the wearing time, giving yourself about a week before you wear a new pair all day.

Do not wear sandals with thongs between the toes because they can rub deep gashes.

Never wear shoes without socks. Socks should be changed daily. Avoid wearing socks with holes or those that have been mended. In sporting good stores, you can find socks that have extra padding under the heel and ball of the foot for better shock-absorption.

Do not forget to check your shoes before you put them on by sliding your hand into them. Feel for nail-points and foreign objects such as keys, small toys, bird seed, or pebbles.

Practice Proper Foot Hygiene.
Wash your feet daily with mild soap, and dry them carefully, especially between the toes. Apply a moisturizing cream everywhere except between the toes. Too much moisture between toes will encourage the growth of microorganisms that can cause infection.

Trim your nails straight across with a slightly rounded edge. If you have trouble seeing, have neuropathy, or have difficulty trimming your nails yourself (because of thick fungus on your nails, for example), see a podiatrist. Avoid all types of "bathroom surgery," such as trying to fix an ingrown nail yourself or trimming your own corns and calluses. The results can be disastrous.

Do not walk barefoot—even in the house—because of danger from stepping on pins, needles, tacks, glass, or other items on the floor.

Be Mindful of Other Dangers to Your Feet.
Neuropathy can affect the set of nerves that detect heat. When these nerves are damaged, you cannot always tell when something is too hot, making burn injuries more likely. Always check bath water with your hands, or use a thermometer if you also have neuropathy in your hands.

Other heat-related problems that could cause serious burns include walking on hot pavement in the summer, using heating pads or hot water bottles to warm your feet, or putting your feet too close to radiators or space heaters in the winter.

If your feet feel cold at night, wear a pair of socks to bed. This is most likely due to neuropathy and not to poor circulation. Neuropathy can cause hot or cold sensations in your feet.

Permission is granted to reproduce this material for nonprofit educational purposes. Written permission is required for all other purposes.

http://journal.diabetes.org/clinicaldiabetes/V18N32000/pg119.htm

LOOSING SLEEP OVER YOUR DIVORCE YOUR BLOOD PRESSURE COULD SUFFER

Those who experience persistent sleep problems after a divorce stand to suffer from more than just dark circles. They might also be at risk for potentially harmful increases in blood pressure, a new study finds

A growing body of research links divorce to significant negative health effects and even early death, yet few studies have looked at why that connection may exist.

Divorce-related sleep troubles may be partly to blame, suggest the authors of a new study to be published in a forthcoming issue of the journal Health Psychology.

"In the initial few months after a separation, sleep problems are probably pretty normal, and this is an adjustment process that people can typically cope with well," said UA associate professor of psychology David Sbarra, who co-authored the paper with two of his former students -- lead author Kendra Krietsh and Ashley Mason.

"But sleep problems that persist for an extended period may mean something different. It may mean that people are potentially becoming depressed, that they're struggling with getting their life going again, and it is these people that are particularly susceptible to health problems," Sbarra said.

The study looked at 138 people who had physically separated from or divorced their partner about 16 weeks before the start of the study.

Participants were asked to report on their quality of sleep during three lab visits over a seven-and-a-half-month period, using the Pittsburgh Sleep Quality Index, which takes into consideration sleep issues ranging from tossing and turning to snoring to difficulty falling and staying asleep. Participants' blood pressure also was measured at each of the three lab visits.

Although researchers did not observe a relationship between sleep complaints and blood pressure levels at the participants' first lab visits, they did observe a delayed effect, with participants showing increased systolic and diastolic blood pressure in later visits as a function of earlier sleep problems.

"We saw changes in resting blood pressure were associated with sleep problems three months earlier. Earlier sleep problems predicted increases in resting blood pressure over time," Sbarra said.

In addition, the researchers found that the longer peoples' sleep problems persisted after their separation, the more likely those problems were to have an adverse effect on blood pressure.

"What we found was if you're having sleep problems up to about 10 weeks after your separation, they don't appear to be associated with your future increase in blood pressure," Sbarra said. "However, after 10 or so weeks -- after some sustained period of time -- there seems to be a cumulative bad effect."

For people who have high blood pressure to begin with, the increase is not to be taken lightly, Sbarra noted.

"Each standard deviation increase in sleep complaints corresponded to a roughly six unit increase in subsequent systolic blood pressure," Sbarra said. "If you're starting at the high average or low hypertensive range, this is a nontrivial bump."

Systolic is the top blood pressure number and measures the pressure in the arteries when the heart beats; diastolic is the bottom number and measures the pressure in the arteries between heartbeats. Normal blood pressure is around 120/80.

Lead study author Krietsh -- who began exploring the link between divorce, sleep and blood pressure as part of her honors thesis as a UA undergraduate -- suggests that people who have persistent difficulties sleeping after a divorce address the issue by seeking out cognitive behavioral therapy, making daily schedule adjustments that promote healthy sleep, or finding new ways to relax at bedtime.

"If somebody is going through a divorce and unable to sleep, they really need to get some help or it could lead to problems," said Krietsh, who earned her bachelor's degree in psychology from the UA in 2012 and is now pursuing her doctorate in clinical psychology at the University of Florida.

"We are all going to go through something stressful in our lives, whether it's a divorce or something else, Krietsh said, "and this shows how important it is for all of to value sleep and take care of ourselves."

Will Massage Therapy Help Your Neuropathy

Today's post from foundationforpn.org (see link below) looks at massage as a viable therapy for nerve pain. You'd be surprised how many people contact this blog regarding the benefits or not of massage. Then again, if you've tried almost everything else, including strong medication and nothing helps, then you're going to start exploring other options aren't you! It may be wise to avoid amateur masseurs (especially if you're paying good money) because of the potential for making things worse but that doesn't preclude your partner or close friend from helping you out because then you can set your own limits. This very useful article sets out the various massage therapies and explains how they work. This sort of information is helpful in making choices of what's best for you. Given that most people enjoy a massage anyway, irrespective of the medical benefits, why not give it a go but keep close control over the effects on your body. Even if a comfortable massage does very little to alleviate your nerve pain, it should make you feel better anyway if only because that's the nature of the beast. For many people the biggest hurdle is getting over the physical contact and the fact that someone else is exploring your body on an intimate level. However, if you don't try you'll never know and even if only your muscles and mind are relaxed, doesn't that make it worthwhile in itself? Maybe time to overcome your prejudgements and let your body make its own mind up!

Massage for Neuropathy
No date or author given but the source is reliable

Massage or massage therapy is a sytem of structured palpations or movements of the soft tissues of the body. The massage system may include, but is not limited to, such techniques as, stroking, kneading, gliding, percussion, friction, vibration, compression, passive or active stretching within the normal anatomical range of movement; effleurage (either firm or light soothing, stroking movement, without dragging the skin, using either padded parts of fingertips or palms); petrissage (lifting or picking up muscles and rolling the folds of skin); or tapotement (striking with the side of the hand, usually with partly flexed fingers, rhythmic movements with fingers or short rapid movements of sides of the hand).

These techniques may be applied with or without the aid of lubricants, salt or herbal preparations, hydromassage, thermal massage or a massage device that mimics or enhances the actions possible by human hands. The purpose of the practice of massage is to enhance the general health and well-being of the recipient. Massage does not include the diagnosis of a specific pathology, the prescription of drugs or controlled substances, spinal manipulation or those acts of physical therapy that are outside the scope of massage therapy.

Today, people use many different types of massage therapy for a variety of health-related purposes, such as pain management, prevent injuries, restore a healthy immune system, reduce stress, increase relaxation, address anxiety and depression, and facilitate overall wellness.

The benefits of neuropathy massage therapy

In the United States, massage therapy is often considered part of complementary and alternative medicine (CAM), although it does have some conventional uses. It is increasingly being offered along with standard treatment for a wide range of medical conditions and situations.

While more research is needed to confirm the benefits of massage, some studies have found neuropathy massage treatement may also be helpful for:
Alleviate low-back pain and improve range of motion.
Lessen depression and anxiety
Enhance immunity by stimulating lymph flow—the body’s natural defense system
Sports injuries
Improve the condition of the body’s largest organ—the skin
Increase joint flexibility
Pump oxygen and nutrients into tissues and vital organs, improving circulation
Paresthesia and nerve pain
Reduce spasms and cramping
Release endorphins—amino acids that work as the body’s natural painkiller
Arthritis
Relieve migraine pain

Studies of the benefits of massage demonstrate that it is an effective treatment for:
Decreased anxiety
Enhanced sleep quality
Greater energy
Improved concentration
Increased circulation
Reduced fatigue
Types of massage

There are many different types of massage, those that are for comfort and or those for specific conditions or diseases. Here are a few types:

Aromatherapy
 
Many essential oils that are derived from plants, herbs, flowers, and roots have beneficial therapeutic qualities. Aromatherapy involves the “burning” of essential oils to elicit a desired effect; for example, lavendar is known to induce calmness and relaxation. When combined with bodywork, aromatherapy can enrich the massage experience immensely. A few drops of essential oil can be added to massage cream or oil and applied to the skin. Professionally trained aromatherapists also blend oils to treat specific conditions. Only experienced professionals and/or those knowledable in the properties of aromatherapy should attempt to blend oils or utilize them in practice, as some oil combinations can be toxic, while others can burn the skin.

Connective Tissue Massage
 
Connective tissue massage is similar to myofascial release in that it involves working with the body’s fascia, or soft tissue, to relieve pain, tightness, and discomfort. The idea behind connective tissue massage is that restriction in one area of the body negatively affects other areas of the body. Practitioners of this technique “hook” their fingers into the connective tissue and utilize pulling strokes to lengthen the area. Benefits include pain reduction, tension relief, improved mobility and stress reduction.

Deep-Tissue Massage
 
Deep-tissue massage utilizes slow strokes, direct pressure or friction applied across the grain of the muscles with the fingers, thumbs or elbows. Deep-tissue massage works deeply into the muscles and connective tissue to release chronic aches and pains; its purpose is to reach the fascia beneath the surface muscles.

Practitioners must have a thorough understanding of the human body and have been trained to administer deep-tissue massage, as injury can occur if the technique is not performed properly. This technique is useful in treating chronic pain, inflammation and injury.

Geriatric Massage
 
Geriatric massage involves treating the elderly, often in resident-care facilities, and addressing their needs related to aging, depression and illness. Geriatric massage is usually shorter in duration, and involves the application of gentle techniques to facilitate pain relief, relaxation, and an overall feeling of wellness.

Lymph Drainage Therapy (LDT)
 
Developed by French physician Bruno Chikly, this technique involves the application of light, rhythmic strokes to help alleviate various conditions related to the body’s lymph system. Among other things, the lymph system is responsible for flushing out toxins and draining fluid, which supports a healthy immune system. When lymph circulation stagnates, however, fluid can build up and cause physical problems, such as inflammation, edemas and neuropathies.

LDT enables practitioners to restore proper lymph flow by using a “mapping” system to assess congested areas in the body, then apply gentle, pressure using the fingers and hands on these areas to reactivate proper circulation.

Massotherapy
 
Massotherapy involves working primarily with the muscles. Practitioners of massotherapy have a background in science, but often incorporate other modalities into their treatments when working with the muscle groups. Benefits of massotherapy include improved circulation and blood flow, as well as pain management.

Medical Massage
 
Practitioners of medical massage have a strong background in pathology, disease, illness and injury, and the contraindications of specific massage techniques related to various medical conditions. Medical massage therapists frequently work under the direction of or at the request of physicians.

Neuromuscular Therapy (NMT)
 
NMT is massage applied to specific muscles, often used to increase blood flow, release knots of muscle tension, or release pain/pressure on nerves. This therapy is also known as trigger-point therapy in that concentrated finger pressure is applied to “trigger points” to alleviate muscular pain.

Reflexology
 
This technique is based on a system of points on the hands, feet and ears that correspond, or “reflex,” to other areas of the body. Similar in theory to acupressure, reflexologists believe that applying appropriate pressure to these points stimulates the flow of energy, thus helping to relieve pain or blockages throughout the entire body. A very pleasurable form of bodywork, reflexology is also used to ease stress and promote relaxation.

Sports Massage
 
Sports massage therapies are both preventative and therapeutic, and used for athletes during warm ups, training and competition to treat and/or aid in the prevention of injuries; help improve flexibility, range of motion, and performance; and aid in mental clarity. Virtually every professional sports team employs professional sports massage therapists, and are often privately employed by professional athletes.

Swedish Massage
 
Generally regarded as the most common form of massage, Swedish massage involves a combination of five basic strokes and concentrates on the muscles and connective tissues of the body for improved circulation, relaxation, pain relief, and overall health maintenance and well-being. Swedish massage is also one of the less demanding techniques for massage therapists to practice as it usually does not involve deep-tissue work.

Talk to your healthcare providers about massage for peripheral neuropathy.

Despite its benefits, massage isn’t meant as a replacement for regular medical care. Let your doctor know you’re trying massage therapy and be sure to follow any standard treatment plans you have. Also ask about the number of treatments that might be needed, the cost, and insurance coverage. If a massage therapist suggests using other CAM practices (for example, herbs or other supplements, or a special diet), discuss it first with your regular health care provider. 

Risks of massage

Most people can benefit from massage for neuropathy. Massage therapy appears to have few serious risks — if it is performed by a properly trained therapist and if appropriate cautions are followed. Some forms of massage can leave you feeling a bit sore the next day. But ordinarily it shouldn’t be painful or uncomfortable. If any part of your massage doesn’t feel right or is painful, let your therapist know right away. Most serious problems come from too much pressure during massage or sensitivity or allergy to massage oils.

Cautions about massage therapy include the following:
Vigorous massage should be avoided by people with bleeding disorders or low blood platelet counts, and by people taking blood-thinning medications
Massage should not be done in any area of the body with blood clots, fractures, open or healing wounds, skin infections, or weakened bones (such as from osteoporosis or cancer), or where there has been a recent surgery.
Although massage therapy appears to be generally safe for cancer patients, they should consult their oncologist before having a massage that involves deep or intense pressure. Any direct pressure over a tumor usually is discouraged. Cancer patients should discuss any concerns about massage therapy with their oncologist.
Pregnant women should consult their health care provider before using massage therapy.
Licenses and certifications

Some common licenses or certifications for massage therapists include:
LMT Licensed Massage Therapist
LMP Licensed Massage Practitioner
CMT Certified Massage Therapist
NCTMB Has met the credentialing requirements (including passing an exam) of the National Certification Board for Therapeutic Massage and Bodywork, for practicing therapeutic massage and bodywork
NCTM Has met the credentialing requirements (including passing an exam) of the National Certification Board for Therapeutic Massage and Bodywork, for practicing therapeutic massage

Research

American Massage Therapy Association Consumer Survey Facts
75% of individuals surveyed claim their primary reason for receiving a massage in the past 12 months was medical (43%) and stress (32%) related.
87% of individuals view massage as being beneficial to overall health and wellness
61% of respondents said their physician has recommended they get a massage.

Source:

National Institutes of Health, National Center for Complementary and Alternative Medicine

American Massage Therapy Association: definition of massage therapy and basic massage therapy terms. www.amtamassage.org

Complementary and alternative methods: types of bodywork. Available at www.cancer.org

MassageTherapy.com. www.massagetherapy.com

https://www.foundationforpn.org/living-well/integrative-therapies/massage/

Neuropathy And Your Quality Of Life

Today's post from neuropathydr.com (see link below) talks about the quality of a person's life when they have neuropathic problems to deal with. Most doctors will only look at the physical aspects of neuropathy and only evaluate what can be proved scientifically (they may only have a limited time to do that) but the psychological effects and the effects on your quality of life are just as important. It's a no-brainer; a happier person will react better to treatment.
The article forms part of a large website promoting medical clinics but the information is well-sourced ,accurate and very helpful. Following the link to the original page will allow you to contact them if you wish.

Peripheral Neuropathy and Your Quality of Life

If you’re suffering from peripheral neuropathy, you know how much it affects your life.

Every single day…

Even the simplest tasks can be difficult if not impossible…

To anyone unfamiliar with peripheral neuropathy and its symptoms, they might just think “your nerves hurt a little…”

But at a peripheral neuropathy sufferer, you know better…

Peripheral neuropathy not only affects your health, it can wreck your quality of life.

How Do You Define Quality of Life?
Generally speaking, Quality of Life is a term used to measure a person’s overall well-being. In medical terms, it usually means how well a patient has adapted to a medical condition. It measures[1]:

• Your physical and material well being
• Your social relationships – how you interact with others
• Your social activities
• Your personal fulfillment – your career, any creative outlets you may have, how involved you are with other interests)
• Your recreational activities – your hobbies, sports, etc.
• Your actual health – what your health is really like and how healthy you believe you are

How do you feel about these aspects of your life? Your attitude and approach to your illness, both your neuropathy and the underlying cause of your neuropathy (i.e., diabetes, HIV/AIDS, lupus, etc.) can make a huge difference in how well you adapt to your neuropathy symptoms.
Neuropathy Symptoms Aren’t Just Physical
The pain of peripheral neuropathy falls into the category of what is considered chronic pain. It usually doesn’t just come and go. You can’t just pop a couple of aspirin and forget about it. It’s pain with its root cause in nerve damage.
The nerves that actually register pain are the actual cause of the pain. When you’re in that kind of pain on a consistent basis, it affects you in many different ways[2]:

• You become depressed and/or anxious
• Your productivity and interest at work is disrupted
• You can’t sleep
• It’s difficult for you to get out and interact with other people so you feel isolated
• You sometimes don’t understand why you’re not getting better

What You Can Do To Improve Your Quality of Life
You may feel like your situation is hopeless, especially if you’ve become mired in depression.
But it isn’t.
There are things you can do to lessen the physical (and emotional) effects of peripheral neuropathy and help you function as normally as possible:

• Pay special attention to caring for your feet. Inspect them daily for cuts, pressure spots, blisters or calluses (use a mirror to look at the bottom of your feet). The minute you notice anything out of the ordinary, call your doctor or your local NeuropathyDR® clinician for help. Never go barefoot – anywhere.
• Treat yourself to a good foot massage to improve your circulation and reduce pain. Check with your insurance company – if massage is actually prescribed by your doctor, they may cover some of the cost.
• Only wear shoes that are padded, supportive and comfortable and never wear tight socks.
• If you smoke, quit. Nicotine decreases circulation and if you’re a peripheral neuropathy patient, you can’t risk that.
• Cut back on your caffeine intake. Several studies have found that caffeine may actually make neuropathy pain worse.
• If you sit at a desk, never cross your knees or lean on your elbows. The pressure will only make your nerve damage worse.
• Be really careful when using hot water. Your peripheral neuropathy may affect the way you register changes in temperature and it’s really easy for you to burn yourself and not even realize it.
• Use a “bed cradle” to keep your sheets away from your feet if you experience pain when trying to sleep. That will help you rest.
• Try to be as active as possible. Moderate exercise is great for circulation and it can work wonders for your emotional and mental health.
• Make your home as injury proof as possible – install bath assists and/or hand rails and never leave anything on the floor that you can trip over.
• Eat a healthy, balanced diet. If you don’t know what you should and shouldn’t eat, talk to your NeuropathyDR® clinician about a personalized diet plan to maintain proper weight and give your body what it needs to heal.
• Try to get out as often as possible to socialize with others.

We hope this information helps you to better manage your peripheral neuropathy symptoms. Take a look at the list above and see how many of these things you’re already doing to help yourself. Then talk to your local NeuropathyDR® clinician about help with adding the others to your daily life.

http://neuropathydr.com/blog/general-information-on-nd-protocols/peripheral-neuropathy-and-your-quality-of-life-2/

Dont Worry If Your Pain Is Also Emotionally Based Its A Chicken And Egg Situation

Today's post from thelightmedia.com (see link below) doesn't seem to be directly related to neuropathy as such but if any group of pain patients understands the correlation between emotional states and their physical pain, it's nerve damage patients. They are also frequent victims of pain stigma; where outsiders accuse them of having a psychosomatic problem and in effect...faking it. You don't need telling that this makes the problem so much worse. However, if psychosomatic pain is pain that is 'created' and not 'real', then nerve pain is exactly that because nerve pain stems from faulty nerve cell signals moving to and from the brain cells. People living with neuropathy can also have other forms of pain that are nociceptive (stemming from injury and physical damage) and not neuropathic and this can cause all sorts of confusion, both for the patient and the concerned onlooker. This article takes a look at forms of pain that are influenced by and influence, emotions. If nothing else, it may help you sort out what you're feeling en help you better deal with it.

10 Types Of Pain That Are Directly Linked To Your Emotions
2017

“Psychosomatic means mind (psyche) and body (soma). A psychosomatic disorder is a disease which involves both mind and body. Some physical diseases are thought to be particularly prone to be made worse by mental factors such as stress and anxiety.”

(A quick note before we begin: it is extremely important that any severe physical symptoms must be attended to by a licensed medical professional, such as a physician.)

If there is a mental aspect to virtually every type of disease, isn’t it then rational to assume there is a mental aspect to virtually every type of physical pain? The simple truth is that mental states affect physical states and vice-versa.

Traditional medicine has labeled this the psychosomatic effect. Interestingly, the specialty of psychosomatic medicine is the latest sub-specialty in psychiatry to become board-certified. Board-certified physicians comprise the “best of the best” in 24 different medical specializations (e.g. neurology, dermatology, psychiatry, etc.) As important, these medical specialties are universally recognized by the medical and scientific communities as vital to public health.

Indeed, pain can be caused by emotional and mental states. In science, it has been demonstrated that both mental/emotional and physical pain activates the same areas of the brain: the anterior insula and the anterior cingulate cortex. So – a physiological connection between brain and body exists as well.

Here we are going to discuss 10 different types of pain that are directly linked to feelings, emotions and thoughts. Equipped with this knowledge, one can begin to make whatever adjustments necessary to feel better (we’ll also provide some recommendations).

Here are 10 types of pain caused by feelings/emotions/thoughts:

1. Back pain

Areas of the back and shoulders are arguably where we feel muscle tension the most. Chiropractors, osteopaths and other medical professionals have been explaining the stress/anxiety connection between back pain and mental/emotional health for years.

Making matters worse, this type of pain is cyclical. We begin to stress and worry about back pain, which tenses back the muscles; the muscles tense, and then we begin to feel things like frustration and anger.

2. Headaches and migraines

Dr. Christina Peterson, a board-certified physician, writes: “Stress comes in many varieties, including time stress, emotional stress, and the stress of physical fatigue…and (these) emotions pack a wallop for the migraine sufferer.” Furthermore, emotions like anger, anxiety, crying/sadness and depression trigger headache pains.

The good doctors recommend practicing relaxation techniques, meditation, and to seek the help of a counselor in the event that this pain doesn’t subside.

3. Neck pain

The buildup of emotions; more specifically, negative emotions, can affect virtually every area of the body. Neck pain, according to Calm Clinic, is one of the most common complaints of people suffering from anxiety-related disorders.

It’s nearly impossible to explain every one of the multitude of ways that anxiety can manifest. Financial problems/worries, relationship problems, sadness, fatigue, etc.

4. Shoulder pain

Many kinesiologists believe that our shoulders are the area of the body most prone to feeling the adverse effects from pressure. Ever wonder where the axiom “Carrying the weight of the world on your shoulders” comes from?

Us too. But it turns out there is a whole lot of truth to it.

5. Stomach aches and/or cramps

Our poor stomach is where we house most of our worries, fears, and anxieties. Experiencing these emotions repeatedly, without surprise, can cause stomach aches and pains. In fact, as it turns out, chronic stress can develop into stomach ulcers.

6. Elbow pain and/or stiffness

Dr. Alan Fogel, in a piece published by Psychology Today, writes, “All emotions have a motor component.” The elbow is no different. While medical conditions such as arthritis and others may be the reason for pain or stiffness; mental states such as anxiety and depression can also manifest in strange areas…including the elbows.

7. Pain in hands

Similar to the elbows, pain in the hands can arise from legitimate medical conditions. Some even say that hand pain may result from feelings of isolation or confinement. As Dr. Fogel said, every one of our emotions manifests into a physical symptom…so, anything is possible, right?

8. Hip pain

Aside from a documental medical condition, some type of emotional trigger is almost assuredly the cause of hip pain. The human body has more nerve connections in the hip than we would think; so distress can manifest into physical pain in this area as well.

9. Knee pain

The rationale given for knee pain experienced from emotions is pretty much the same as that given for hip pain. Of course, there are many nerve endings in the knee; hence, more of a brain/body connection. As such, it is perhaps more likely that emotional triggers such as anxiety, fear, depression, etc. will manifest into knee pain than other, less sensitive areas, such as the hip.

10. Foot pain

Here’s what one podiatrist says about the relationship between mental/emotional states and foot pain: “Stressed people present with a wide range of biomechanical issues. I am not trying to be a guru…but I am convinced there is an anecdotal connection between lower limb and foot presentation and their emotional status.”

Experts at Columbia University admit that “there’s some evidence that there are psychological conditions that may be associated with physical symptoms,” and that treating the real cause of the pain may be the answer.

Related article: This Simple Mind-Body Exercise Reduces Negative Thoughts and Improves Health

After investigating the physical pain or stress, it’s worthwhile to do the same with any emotional state(s). What are you feeling?

Relaxation techniques (e.g. progressive muscle relaxation), controlled breathing, meditation, guided imagery, and many other techniques and practices exist to help people who are experiencing both physical and/or emotional pain.

http://thelightmedia.com/posts/55199-10-types-of-pain-that-are-directly-linked-to-your-emotions

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

Is Your Neuropathy A Chronic Pain Pt 1

Today's post from hcmsgroup.com (see link below) is the first of two articles concerning chronic pain and what we understand that to be. The second part will appear tomorrow. It's a real problem for many people living with neuropathy describing what their pain feels like and convincing people from friends to doctors, that their pain and discomfort can often be called chronic by any measures of the word. These two articles may help you sort things out in your own mind.
 

Chronic Pain: An Overview
Posted on September 9, 2015 by KnovaSolutions

A Growing Public Health Concern

Chronic pain affects 100 million Americans according to the American Academy of Pain Medicine (AAPM). That’s more than those with diabetes (25.8 million), heart disease (16.3 million), stroke (7 million) and cancer (11.9 million) combined.

Experiencing pain can take a toll on everyday life. The AAPM reports that about four in 10 Americans have pain that interferes with their mood, activities, sleep, ability to work or enjoyment of life.

Chronic Pain Series

Stay tuned for future newsletters on these types of chronic pain:
Neuropathic pain (tingling, burning, stabbing pain involving the nervous system).
Muscle pain (neck, back, legs etc.)
Inflammatory pain (redness, swelling and pain associated with an infection, irritation or injury in a specific location).
Mechanical/compressive pain (any kind of back pain caused by stress and strain on the spinal column).

Is It Chronic?

Pain is an unpleasant sensory or emotional experience. When it resolves quickly, it is called acute pain (think pain after surgery or with broken bones). With acute pain, the nervous system sends signals to the brain alerting us to take care of ourselves. When pain persists, it is called chronic or persistent pain. The nervous system keeps sending pain signals for weeks, months or even years. Chronic pain can be caused by conditions such as rheumatoid arthritis and peripheral neuropathy; an injury or accident; or can occur without any past injury or illness.

Whether your pain is considered chronic pain depends upon who you ask. Some pain experts define chronic pain as pain that lasts for three months; others say six months or even 12 months. The International Association for the Study of Pain provides an alternate definition: pain that continues after the expected healing period.

Because of its prevalence, seriousness, cost, risk of overuse of opioid medications, and need for prevention, chronic pain is considered a public health concern. In a study published in The Journal of Pain, Johns Hopkins University health economists reported that chronic pain costs from $560 to $635 billion a year. This study sought to evaluate the total cost of chronic pain on society; it quantified healthcare costs associated with treating chronic pain ($261-$300 billion) as well as the value of lost productivity such as absences and lost wages ($299 to $335 billion).

Experts expect the number of people affected by chronic pain to continue to grow. The most common conditions reported are low back pain, severe headache or migraine pain and neck pain. Chronic pain is a major driver behind doctor visits, use of medications, cause of disability, and a key reason for loss of quality of life and productivity.

Loss of productivity can refer to missed days (sick days) or disability days but also as reduced work performance. Participants in the American Productivity Audit reported losing on average 4.6 hours per week of productive time at work due to a pain condition. Those with musculoskeletal pain cited 5.5 hours per week of lost productive time and headache caused 3.5 hours per week of lost productivity.

Since trouble sleeping is a common concern, the effects of sleeplessness can cause a recurring cycle of fatigue, difficulty with concentration and low energy levels. It’s no wonder then that depression and a lack of enjoyment of life are common challenges for those in chronic pain. In an American Pain Foundation survey of chronic pain sufferers, 86 percent said they were unable to sleep well, 70 percent had trouble concentrating, 74 percent described that their energy was affected by their pain, and 77 percent of participants said they felt depressed.

There are many approaches to treating chronic pain, including prescription and over-the-counter (OTC) medications and numerous alternative strategies. OTC medications such as ibuprofen and acetaminophen can offer pain relief and are generally safe for most people to take (see box). A variety of prescription drugs are also available. Many pain sufferers try various approaches to discover what works best for them. For example, one KnovaSolutions member said he felt better after taking ibuprofen at night so he could rest, going to exercise classes twice a week and using a heating pad for his low back pain. Another reported that massage, acupuncture and yoga helped reduce her migraine pain.

A Note of Caution

Prescription medicines called opioids (or narcotics) are powerful pain killers. Because they can cause physical dependence, providers often recommend them for short-term use, such as for acute pain. Besides the risk of dependence, it is possible to develop tolerance for pain relievers, which results in the need for increasing doses to receive the same level of relief.

Opioid use and misuse in the U.S. have risen dramatically since the 1990s. The U.S. Centers for Disease Control analyzed prescribing data from pharmacies that showed that healthcare providers wrote 259 million prescriptions for opioids in 2012 and that 46 people died each day that year from an overdose of opioids. Because opioids are increasingly used illegally, it is important for people with valid prescriptions to store their medications out of the reach of others. A National Survey on Drug Use and Health found that 29 percent of people over 12 years who used illicit drugs for the first time began by using prescriptions drugs for non-medical purposes.

If you or someone in your family struggles with chronic pain, your KnovaSolutions nurse is a source for additional information and support. Please come back to our website monthly to see more newsletters about chronic pain and other topics. Let us know how we can help — 800/355-0885.

Read Related KnovaSolutions Newsletters
Growing Evidence of Abuse Among Commonly Prescribed Medications.
NSAIDS: Popping Like Candy? Increase Safety by Knowing the Risks

Click here to view/download the full newsletter.

http://www.hcmsgroup.com/chronic-pain-overview-september-2015/

How To Change Your Lifestyle To Help Neuropathy Pain

Today's post from neuropathydr.com (see link below) is a 'self help' post designed to make you re-evaluate any daily habits you might have that may influence the amount of pain and discomfort you may have. Now nobody is suggesting that your pain isn't real and that your neuropathy symptoms can be cured by simply changing your attitude towards them. If there is any gain to be made by following the suggestions in this article, it's that you may be able to reduce the strength of the symptoms by adjusting certain habits you have and equally adjusting your lifestyle to make choices that will benefit you. Reading the article will probably make you wonder if, indeed, there are a few things that you could do better. Must be worth a try!

Lifestyle Change for Chronic Pain: How Do You Do It?
Posted by Editor on October 16, 2014

Knowing the Benefits Isn’t Enough to Elicit Lifestyle Change for Chronic Pain… So What Is?
By Carol Jeffrey

The World Health Organization (WHO) has defined “health” as not merely the absence of disease but as a “state of complete physical, mental, and social well-being.” That’s a rather rigid utopian view, however; an increasing amount of research is showing that patients fare much better when a multifactorial treatment approach is used to combat disease. In sharing my experience, I will expound on the physical, mental and social factors associated with making a healthy lifestyle change for chronic pain in our mindset and diets.

REFRAMING

Whenever I heard the word “diet” my thoughts went directly to lack of comfort food, deprivation and fear of failure, but these were misguided thoughts. This reminded me of a study which showed that one’s mindset could alter a person’s visual acuity. “Because the letters get progressively smaller on successive lines, participants expected only to be able to read the first few lines on a traditional eye chart. When the participants viewed a shifted and reversed chart, they were able to see letters in which they previously couldn’t identify. This showed that mindset manipulation can counteract physiological limits imposed on vision.” (Believing Is Seeing…, Langer E, Dept. of Psych, Harvard.) Shifting my view allowed me to see not only the gains of feeling better from eating a well balanced diet, but the losses that I had incurred from making poor nutritional choices. I used this information to reframe the word “diet” into new thoughts of nutrition, health, and well-being. The success of healthy eating depends not only on our mindset, but understanding how the mind-body connection affects our eating habits.

MIND-BODY CONNECTION

Let me briefly explain what the mind-body connection is about. It’s important to “be present to one’s self” in a way that fosters self-awareness and acceptance…this allows us to change. I used to work in a physician’s office, and I usually scarfed down my lunch between patients and phone calls. This ended up being a mindless task of squelching my hunger pains with food devoid of nutritional value, leaving me lethargic by the end of the day. Often, after the long commute home I would be too tired to cook, so I’d stop for fast food, only to ingest more food devoid of nourishment. My mindlessness carried on into the late evening when I would find myself absent mindedly munching on snacks as I relaxed. My poor eating habits extended Into my weekend, not due to lack of time but due to the social pressures of eating out with friends…where healthy food choices were limited. I was not psychologically present while eating nor mindful of my food choices.

BEING MINDFUL

Unfortunately, prolonged psychological stress, years of detrimental lifestyle, and poor eating habits had greatly contributed to my poor health. This eventually led to physical disability, unemployment, and the inability to do many of the things that I once loved. I was finally ready to break this cycle, and needed to become aware of the circumstances which led to my poor lifestyle choices and eating habits. I began paying attention to my internal dialogue (i.e., I don’t want to let them down, I’m expected to “…” I know I should choose the salad but I’ve had a difficult day so I deserve to eat what I want. I’m feeling anxious…Ice cream is always soothing. I’m not overweight so it isn’t like I’m pigging out). When I quit accepting my excuses, I became more mindful of my thoughts and choices, and discovered that I had much more control over my health than I had previously realized.

MISGUIDED DEPENDENCE

By this time I had reframed my thoughts about diet, understood the mind-body connection, was mindful of my choices, realized I had control over many aspects of my health. Yet, I was still depending upon my physician to heal me, or at least make me feel better with pharmaceuticals. Which leads me to the next issue I needed to address.

ENCULTURED

I had been encultured into believing that it was my physician’s job to heal, and the pharmaceutical company’s job to relieve my pain. If I failed to get better, it wasn’t my fault, or was it? “In 2012, the pharmaceutical industry spent more than $24 billion on marketing to influence physicians, and over $3 billion in advertising to consumers.” (Cegedim Strategic Data) Traditionally, very few non-M.D. or non-D.O. practitioner appointments or treatments have been covered by insurance. These practices enculture and direct us into accepting the limitations that Western medicine on its own has to offer. It also moves us further away from more natural treatments and the means of self-healing. The strategies used by insurance and BigPharm are contrary to obtaining optimal health, since integrative medicine has shown to be most effective in managing disease. Now that I understood why I was so dependent on my physician, what could I do about it?

SELF-HEALING BEHAVIOR

Fabrega Horacio, Jr. wrote an interesting article (Sickness and Healing and the Evolutionary Foundations of Mind and Minding) which shows how non-human primates (i.e., chimpanzees) are reliant on self-healing behaviors that not only remedy illness but prevent many illnesses, through social functions and diet. I had been relying on my doctors to heal me and a pill to ease my pain, instead of taking personal responsibility, and using preventive and self-healing behaviors…like the chimps. I understood that eating a healthy diet along with living a well balanced life was essential for pain reduction, but I still wasn’t motivated to change.

MOTIVATION

Pain is fundamentally unpleasant, and is designed to protect by promoting motivation and learning. I was now enlightened to the fact that my lifestyle and poor diet were fueling the raging fire within my damaged nerves. However, like many others, I have an aversion to change and even though the reward of pain relief should have provided enough motivation to elicit change…it wasn’t. It is said that most people are motivated by one of two things, “inspiration” or (in my situation) “desperation.” My chronic pain was extremely difficult to handle, but it was the lack of being able to engage in life that made me desperate enough to make changes. My attitude and desire toward change had evolved from I wish, I want, to I must. My reason to change had now been clarified and my need for change had transformed from I should, I intend, to “I am” making a lifestyle change for chronic pain. However, what would keep me motivated? This is where goal setting came into play.

GOAL SETTING

“Remember the word ‘SMART.’ Successful goals are Specific, Measurable, Achievable, Realistic and Timely.” This is based on research conducted by Dr. Edwin A. Lock of the University of Maryland.
Specific: I asked myself what my life was currently missing and what I wanted in my life. Connecting life goals to specific health-related goals clarified the reason I wished to be well and what I would do once my health improved. Thereby answering the questions what, where and why.
Measurable: I then determined how I would accomplish and measure my success. (i.e. Add three new organic, non processed foods to my grocery cart each week. Actively work with my doctor on natural pain relief techniques at each visit. Exercise as tolerated but do it two times a week. Do one thing each day to prepare me for a less stressful career.)
Achievable: I then asked myself if I had the skill, tools, and resources needed. (i.e. I researched YouTube, and I borrowed books from the library to learn about natural pain relief techniques, meditation, healthy diet, etc., and sought out physicians who practiced integrative medicine.)
Realistic: To avoid frustration, I focused on honest goals that I believed were obtainable. There was plenty of evidence to show that changing my lifestyle and eating a healthy diet would decrease my pain and improve my quality of life. It was realistic to train for a less stressful career. Total health and no pain was impossible; however, controlling diet, decreasing narcotic use and learning healthier ways of dealing with pain were within my control.
Timely: I gave myself one year to turn my health around and begin a new career. This goal challenged me but it was possible. I set daily, weekly and monthly goals which were frequently reviewed and revised as necessary.

There aren’t any shortcuts to change, including a lifestyle change for chronic pain. I had to reframe my negative thoughts, become more self-aware and mindful of my decisions, accept personal responsibility for my health, incorporate self-healing behavior, determine what would motivate me, set and commit to my goals.

The rewards of an improved quality of life came by default as I achieved my goals. I have not yet reached the utopia of health that the WHO refers to, but I have significantly decreased my pain level and again live an active and meaningful life. This article reflects my journey, but more importantly, I hope it encourages and guides you to make your own changes so that you too may live life to its fullest.

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