Depression Caused by Neuropathic Pain

Today's post is the second in a week-long series from 4therapy.com (see link below). It talks about how chronic pain (pain lasting longer than a few weeks)conditions can cause depression and therefore affect all areas of your life. It's advisable to seek help if this happens and not attempt to bottle it up inside, because the spiral of pain and depression can be helped by the right doctors and sensible advice.

Unemployment, Chronic Pain and Depression Can Be Inextricably Connected

A high percentage of individuals develop a depressive illness within six months of becoming unemployed. In fact, after relationship difficulties, unemployment is the most likely thing to push someone into a bad depression. This isn’t surprising, since work is often a significant source of an individual’s sense of worth and self-esteem. When you lose your job you risk going from a position of feeling in control to facing an uncertain future and suffering from an eroded sense of self-confidence--especially if it takes a long time to find another job.

Frequently, depression first shows up in physical symptoms, such as headaches, gastrointestinal distress, and sexual dysfunction. When you're suffering from depression, you and others close to you may notice some of the following changes in your overall affect:

You’re more irritable than usual and may lash out at those who try to offer help;

You’re worrying--even obsessing--about things more than usual;

You're unusually quiet and seem unable to share what's bothering you;

You're sluggish, fatigued, and lack your usual interest in things you usually enjoy.

When you’re in the throes of depression, the shift from your usual way of acting and feeling can make it harder to get another job, putting into play a cycle of defeat and despair that makes your depression deepen. Instead of getting help for their symptoms of depression, too many too frequently try to make themselves feel better by "self medicating" with alcohol or drugs. This clearly makes things worse.

Depression is a serious medical condition that affects your body, mood, and thoughts. Like any illness, depression requires treatment—the sooner the better. While it may take courage to reach out and ask for help, seeking professional treatment will bring the relief you deserve and that you need to get your life headed in a positive direction.

http://www.4therapy.com/life-topics/chronic-pain/unemployment-chronic-pain-and-depression-can-be-inextricably-connected-2853

Guide Treatment for pinched sciatic nerve in leg

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Is Zonisamide A Good Idea For Neuropathic Pain

Today's post from onlinelibrary.wiley.com (see link below) looks at Zonisamide as a possibly effective drug for reducing neuropathic pain. Zonisamide is one of the anti-epileptic/ anti-convulsant drugs that are designed to treat epilepsy. Like some other anti-convulsants, it's now being prescribed to treat neuropathic pain and discomfort. However, this study shows that there is very little evidence to support its effectiveness in suppressing nerve pain and that other anti-epileptics are far more effective - for instance, Gabapentin and pregabalin (Lyrica). However, there are also questions surrounding the effectiveness of pregabalin especially for neuropathy caused by diabetes and HIV (see other articles on this blog), not least from the manufacturers themselves! Gabapentin has a far better reputation but as this article shows, Zonisamide hasn't proved to be effective at all. Worth discussing with your doctor or neurologist, if anti-convulsants are being prescribed for you.
 

Zonisamide for neuropathic pain in adults
R Andrew Moore1,*, Philip J Wiffen1, Sheena Derry1, Michael PT Lunn2 
Editorial Group: Cochrane Pain, Palliative and Supportive Care Group
Published Online: 22 JAN 2015

Abstract

Background

Antiepileptic drugs have been used in pain management since the 1960s; some have shown efficacy in treating different neuropathic pain conditions. The efficacy of zonisamide for the relief of neuropathic pain has not previously been reviewed.

Objectives

To assess the analgesic efficacy and associated adverse events of zonisamide for chronic neuropathic pain in adults.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (via CRSO), MEDLINE, EMBASE, and two clinical trials databases (ClinicalTrials.gov. and the World Health Organisation Clinical Trials Registry Platform) to 1 August 2014, together with reference lists of retrieved papers and reviews.

Selection criteria

We included randomised, double-blind studies of at least two weeks' duration comparing zonisamide with placebo or another active treatment in chronic neuropathic pain. Participants were adults aged 18 and over. We included only full journal publication articles and clinical trial summaries.

Data collection and analysis

Two review authors independently extracted efficacy and adverse event data, and examined issues of study quality. We considered the evidence using three tiers. First tier evidence derived from data meeting current best standards and subject to minimal risk of bias (outcome equivalent to substantial pain intensity reduction, intention-to-treat analysis without imputation for dropouts; at least 200 participants in the comparison, 8 to 12 weeks duration, parallel design); second tier evidence derived from data that failed to meet one or more of these criteria and were considered at some risk of bias but with adequate numbers in the comparison; and third tier evidence derived from data involving small numbers of participants that were considered very likely to be biased or used outcomes of limited clinical utility, or both.

We planned to calculate risk ratio (RR) and numbers needed to treat (NNT) and harm (NNH) for one additional event using standard methods expected by The Cochrane Collaboration.

Main results

We included a single study treating 25 participants (13 zonisamide, 12 placebo) with painful diabetic neuropathy over 12 weeks. No first or second tier evidence was available for any outcome. The small size of the study and potential major bias due to a high proportion of early study withdrawals with zonisamide precluded any conclusions being drawn. There were two serious adverse events (one death) in zonisamide-treated participants, which were apparently not related to treatment.

Authors' conclusions

The review found a lack of evidence suggesting that zonisamide provides pain relief in any neuropathic pain condition. Effective medicines with much greater supportive evidence are available.

Plain language summary

Zonisamide for neuropathic pain in adults

Neuropathic pain can arise from damage to nerves and injury to the central nervous system. It is different from pain messages carried along healthy nerves from damaged tissue (a fall, or cut, or arthritic knee). Neuropathic pain is treated by different medicines than those used for pain from damaged tissue. Medicines like paracetamol or ibuprofen are not usually effective in neuropathic pain, while medicines that are sometimes used to treat depression or epilepsy can be very effective in some people with neuropathic pain.

Zonisamide is one of a type of medicine normally used to treat epilepsy. Some of these medicines are also useful for treating neuropathic pain. We looked for clinical trials that used zonisamide to treat neuropathic pain. We found a single study with 25 participants treated either with zonisamide or placebo. Study reporting may have led to major over-estimation of any treatment effects because most (8/13) participants treated with zonisamide withdrew before the end of 12 weeks of treatment for a variety of reasons, mostly adverse events (side effects).

There was too little information, which was of inadequate quality, to give any guidance as to whether zonisamide works as a pain medicine in any neuropathic pain condition. Other medicines have been shown to be effective in some types of neuropathic pain.

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011241.pub2/abstract

BENEFITS RISK OF YOGA FOUND FOR BIPOLAR DISORDER

Right now no one can say whether yoga provides clinical benefits to people with bipolar disorder, but in a new article in the Journal of Psychiatric Practice, researchers report survey responses they gathered from scores of people with the condition who practice yoga. What the collective testimony suggests is that yoga can be a substantial help, but it sometimes carries risks, too.

There is no scientific literature on hatha yoga for bipolar disorder," said lead author Lisa Uebelacker, associate professor (research) of psychiatry and human behavior in the Alpert Medical School of Brown University and a staff psychologist at Butler Hospital. Hatha yoga is the practice, familiar in the West, in which people move between various poses. It often includes breathing practices and meditation. "There is reason to think that there are ways in which it might be wonderful and ways in which it might not be safe. We are interested in studying hatha yoga for bipolar as an adjunctive treatment to pharmacotherapy."

The preponderance of responses from more than 70 people who answered the study's online survey were that yoga has benefits for people with bipolar disorder. When asked, "What impact do you think yoga has on your life?" the vast majority of responses were positive and about one in five respondents characterized yoga as "life changing." One even said, "Yoga has saved my life. ... I might not be alive today were it not for yoga."

Twenty-nine other respondents said yoga decreased anxiety and promoted calm or provided other emotional benefits. Calm also emerged as a specific benefit for 23 survey respondents when asked how yoga affects mania symptoms. Other benefits that were mentioned repeatedly included distraction from depressive thoughts and increased clarity of thought.

"There is clearly evidence that yoga seems to be a powerful practice for some individuals with BD," the researchers wrote in the paper. "It was striking that some of our respondents clearly believed that yoga had a major positive impact on their lives."

Throughout the survey there was also evidence that yoga could be problematic for some people with BD, although fewer people cited problems.

In response to survey questions about whether yoga has had a negative impact, for example, five respondents cited cases in which rapid or energetic breathing made them feel agitated. Another became too relaxed after a slow, meditative practice: "I fell into a relaxed state ... near catatonic as my mind was depressed already. I was in bed for three days afterward."

And like some people in general who practice yoga, 11 respondents warned that there is the potential for physical injury or pain. Another four said they became self-critical or frustrated with their performance sometimes during yoga.

"It's possible that you want to avoid any extreme practice, such as extended periods of rapid breathing," Uebelacker said. The survey also raised some concerns about heated yoga, which is consistent with evidence that the use of certain medications for bipolar disorder, including lithium and antipsychotic medications, are associated with possible heat intolerance and resulting symptoms of physical illness.

Next: a pilot clinical trial

The online survey is the first stage in a research program that Uebelacker, who has spent several years studying yoga for unipolar depression, and colleague Lauren Weinstock, an expert in bipolar disorder, are developing to examine yoga for bipolar disorder. They now have a grant from the Depressive and Bipolar Disorder Alternative Treatment Foundation to run a pilot clinical trial in which they will compare outcomes from yoga to outcomes from using a well-regarded workbook for bipolar disorder.

Those results could set the stage for a larger trial with enough statistical power to rigorously identify benefits and risks, Uebelacker said.

For many bipolar patients, symptoms persist for decades despite multiple medications. The current studies of yoga, Uebelacker said, are part of a broader program at Butler and Brown to determine what else can help people who are already undergoing conventional therapies.

"We're looking at alternative ways to cope with suffering that is part of people's everyday lives so that there are other options in addition to ongoing medication and psychotherapy" Uebelacker said.

As their research continues, they will learn what role hatha yoga might play.

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For Which Neuropathies Is Lyrica Really Suitable

Today's post is a Pfizer Press release (see link below) concerning Lyrica being prescribed for a specific form of neuropathy. The American FDA has approved its use for neuropathy associated with spinal cord injuries (for which there was no approved treatment before). It's a Pfizer press release, so it positively glows with pride at the achievement, yet they have withdrawn the drug for treatment of HIV-related and other neuropathies. It doesn't make sense. The pain receptors that Lyrica targets are much the same for most forms of neuropathy, yet some are considered suitable for Lyrica treatment and others not. It is still widely prescribed for HIV-related neuropathy across the world, as different medical authorities try to decide what to do about it and what the truth is. Considering the court cases Pfizer have had to face concerning the side effects of Lyrica, it would be advisable to talk carefully with your doctor before starting a course of this drug - the possible side effects shouldn't be underestimated (more articles about this subject in the list on the right of the blog). Maybe Pfizer should consider explaining the situation in simple terms to the patients themselves?

FDA Approves Lyrica For The Management Of Neuropathic Pain Associated With Spinal Cord Injury Based On Priority Review

June 21, 2012

First and Only Treatment Option Approved in the U.S. for Pain Condition Affecting 40 Percent of Spinal Cord Injury Patients

NEW YORK--(BUSINESS WIRE)--Pfizer Inc. (NYSE: PFE) announced today that the U.S. Food and Drug Administration (FDA) approved the use of Lyrica^® (pregabalin) capsules CV for the management of neuropathic pain associated with spinal cord injury. Lyrica received a priority review designation for this new indication from the FDA. More than 100,000 patients – approximately 40 percent of the 270,000 patients with spinal cord injury in the United States - suffer from this chronic, complex pain condition. Neuropathic pain associated with spinal cord injury can be severely debilitating and may significantly hinder rehabilitation and the ability to regain function.
  
“This milestone represents an important opportunity for physicians to more effectively manage the debilitating neuropathic pain that often accompanies spinal cord injury,” said clinical study investigator Diana Cardenas, MD, MHA, professor and chair, department of rehabilitation medicine, University of Miami Miller School of Medicine and chief of service for rehabilitation medicine and medical director of Jackson Rehabilitation Hospital, Miami, Florida. “Given the clinical challenges of investigating neuropathic pain in this patient population, any advancements in treatment are welcome by physicians and patients alike.”
  
An estimated 12,000 new spinal cord injury patients are diagnosed in the U.S. each year. There are a wide variety of causes for spinal cord injury, including traumatic and non-traumatic causes. Traumatic causes may include motor vehicle accidents, violence, falls and sports injuries. In these instances, a spinal cord injury typically begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Non-traumatic causes may involve congenital and developmental abnormalities, genetics and metabolism, infections and inflammation, removal of a benign spinal tumor and spinal cord ischemic stroke.
  
Neuropathic pain can be experienced above, at or below the level of the spinal cord injury, and is typically not confined to one area in the body. Approximately one-third of spinal cord injury patients report below-level neuropathic pain that is severe or excruciating. Patients may experience neuropathic pain associated with spinal cord injury as early as two weeks after injury and it may persist for up to 25 years.
  
“Until now, no FDA approved treatment options were available in the U.S. for people with neuropathic pain associated with spinal cord injury, a condition which can be extremely disabling,” said Steven J. Romano, MD, senior vice president and head, medicines development group, Global Primary Care Business Unit, Pfizer. “The approval of Lyrica for this indication is a significant milestone, exemplifying Pfizer’s commitment to pursue scientific advancements that address unmet medical needs.”
  
About Lyrica Phase 3 Clinical Studies
The FDA approval is based on two randomized, double-blind, flexibly dosed (150–600 mg/day), placebo-controlled Phase 3 trials, which enrolled 357 patients. Among other medications, patients were allowed to continue taking other pain medications, including NSAIDs, opioids and non-opioids. The population of one study consisted of traumatic spinal cord injury patients. The population of the other study consisted of traumatic spinal cord injury patients and patients who had injury to the spinal cord from non-traumatic causes: e.g., removal of a benign spinal tumor or spinal cord ischemic stroke (five percent of patients).
  
The primary finding in these studies was that Lyrica significantly reduced neuropathic pain associated with spinal cord injury from baseline throughout the duration of the studies (12 weeks and 16 weeks, respectively), compared to placebo. In addition, more patients receiving Lyrica showed a 30 percent and 50 percent reduction in pain than did patients receiving placebo. In some patients, the reduction in pain with Lyrica was significant as early as week one and continued throughout the duration of the trials.
  
The most common adverse events in these trials in patients receiving Lyrica were somnolence, dizziness, dry mouth, fatigue and peripheral edema.
  
About Lyrica
Lyrica is currently approved for various indications in 120 countries and regions globally. In the United States, Lyrica is indicated for diabetic nerve pain, post herpetic neuralgia (pain after shingles), fibromyalgia, neuropathic pain associated with spinal cord injury and partial onset seizures in adults with epilepsy who take one or more drugs for seizures. Antiepileptic drugs (AEDs) including Lyrica increase the risk of suicidal thoughts or behavior in patients taking AEDs for any indication.
There have been post-marketing reports of angioedema and hypersensitivity with Lyrica. Treatment with Lyrica may cause dizziness, somnolence, dry mouth, edema and blurred vision. Other most common adverse reactions include weight gain, constipation, euphoric mood, balance disorder, increased appetite and thinking abnormal (primarily difficulty with concentration/attention).
For Lyrica prescribing information, please visit www.lyrica.com.
  
Pfizer Inc.: Working together for a healthier world^®
At Pfizer, we apply science and our global resources to improve health and well-being at every stage of life. We strive to set the standard for quality, safety and value in the discovery, development and manufacturing of medicines for people and animals. Our diversified global health care portfolio includes human and animal biologic and small molecule medicines and vaccines, as well as nutritional products and many of the world’s best-known consumer products. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as the world’s leading biopharmaceutical company, we also collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, Pfizer has worked to make a difference for all who rely on us. To learn more about our commitments, please visit us at www.pfizer.com.

http://www.pfizer.com/news/press_releases/pfizer_press_release.jsp?guid=20120621005572en

Sexual Side Effects of Peripheral Neuropathy

It's not always the easiest subject to bring up in front of your doctor, especially if you're already over 50. However, if you have neuropathic problems, it doesn't have to be an 'It's just your age", diagnosis and can unfortunately be yet another symptom of nerve damage. For HIV-patients, it can be yet another reason why not everything works the way you want it but it is important to report it because science is moving so quickly in the sexual health area and you may well be able to be helped. One important old wives' tale to dismiss, is the fact that this is just a man's problem - not at all, on the contrary, women with peripheral neuropathy are just as likely to experience sexual problems caused by interrupted nerve signals. This article from livestrong.com (see link below) explains clearly why these problems occur.

Sexual Side Effects of Peripheral Neuropathy
Jul 12, 2010 | By Matthew Busse

Damage to the nerves of the peripheral nervous system is referred to as peripheral neuropathy. The peripheral nervous system is a network of neurons that connect the spinal cord and the brain to the rest of the body. Peripheral neurons are responsible for transmitting physical sensations, like touch and heat, from the skin to the brain. The peripheral neurons also allow the brain to control many processes throughout the body, such as movement, digestion, heart rate and sexual response. Damage to the peripheral neurons resulting from peripheral neuropathy can cause sexual side effects in both men and women.

Damage to Nerves Controlling the Sex Organs

The sexual organs in both men and women are connected to the brain by peripheral neurons. Sexual arousal occurs when the brain registers an excitatory signal and transmits that signal to the sex organs, explains the Boston University School of Medicine. When the sexual organs receive the excitatory signal, neurotransmitters are released that increase blood flow to the sex organs, causing erections in men and labial, vaginal and clitoral engorgement in women, in addition to stimulation of vaginal secretions. If the nerves that connect to the sex organs become damaged, these signals required for sexual arousal cannot reach the sex organs.

Sexual Side Effects in Men

In men affected by peripheral neuropathy, the neurons that connect the penis to the brain may become damaged. As a result, when the brain experiences sexually stimulating input, it cannot transmit that signal to the penis. An erection results from signals reaching the penis that cause its smooth muscles to relax and allow in increased blood flow. Without the signals from the brain, blood flow to the penis cannot be increased, and there is no erection. However, sex drive in men with peripheral neuropathy may remain unchanged. Alternatively, men with peripheral neuropathy may be able to achieve an erection, but they may experience sexual climax without normal ejaculation.

Sexual Side Effects in Women

Similar to men, women require signal transmission through peripheral neurons between the brain and the sex organs to induce the sexual response. When the brain receives a sexually stimulating signal, that signal is transmitted to the vagina. Similar to men, the signal induces the smooth muscles surrounding the vagina to relax and increase blood flow to the vagina, clitoris and labia. In addition to causing engorgement of these organs, the increased blood flow also stimulates vaginal secretions that lubricate the vagina. Women with peripheral neuropathy may not experience physical sexual arousal, leading to vaginal dryness. Women with damage to the peripheral nerves may also have difficulty achieving orgasm.

http://www.livestrong.com/article/171957-sexual-side-effects-of-peripheral-neuropathy/

Hooked on Hickory

Shagbark Hickory ~ Carya ovata ~ "the oval nut"

I've fallen madly in love with the Hickory tree.

I'm not sure exactly when it began, but a series of events has slowly lured me in.

Of course, I have always admired this beautiful , eccentric style tree for it's likeness in my mind to the Lorax. I wonder how on Earth I missed the telegram that the nuts were edible. Even with the ten acre parcel of land my parents owned when I was a child, which they dubbed "Hickory Haven", I was too busy with the Mulberry trees.

Last December, our Homeschool staff member brought back a bushel of Pignut Hickory nuts and with the students he made an intoxicating warm Hickory milk. Yet since the nuts were from Tennessee, I dismissed them as a local harvest possibility.

About five weeks ago I sent my Jr. Herbalist class to scout an appropriate habitat to plant the Bloodroot cuttings we were learning about and propagating. They returned with a confession of partial distraction after planting, when they discovered a mast of nuts on the ground and proceeded to target one another. My son, who happened to be involved in the aforementioned Hickory milk project, knew the nuts and announced they were better to eat than throw. Of course that resulted in children shape shifting into squirrels and filling pockets and packs so full that they all returned heavy and looking even more like hamster cheeks.

I watched one student sit himself down and feverishly smash a nut and pick out the meat, little by little, as though it were the most exquisite thing he'd ever eaten. I just watched, trying to figure out what nut it was. Of course, the kids already knew.

A little over a week ago, I went out behind my beehive looking for sweet fern. I'd been enjoying this as a lovely, Sage-like tea, and wanted to dig a root for my friend and mentor Kiva Rose, so she could plant it in her garden. However, when I got there I saw that my memory had not served me, and what I have growing is Maidenhair fern, not sweet fern. So I puttered around in the woods for a few minutes and took some photos of the trees.

I'd recently been lamenting about our New England acorns and the fact that I really don't even try to use them for they are so extraordinarily bitter that they require several leaching steps before they are palatable enough to use. Bother.

Slowly did I walk back from the beehive, as my camera often elicits slower walking, and what did I see before my very eyes?

A nut.

Light hazelnut in color, and a pretty oval shape. I picked it up to ponder. Towering in front of me were three, beautiful Shagbark Hickory Trees.

Something in that moment clicked and I wish I could remember what words accompanied my epiphany, but next thing I knew I was tickling the leaves all around me and filling my basket with nuts.

As I gathered, the squirrels around me took it upon themselves to target me with falling twigs, Hemlock bits, and nuts, just as the children had done to each other. This spirited, mischievous play was clearly part and parcel of Hickory's message. Go on, get a little nutty. It's fun!

So who, then, would I ask how to prepare these morsels? My kids, of course. "Smash the nut and boil 'em. The bad ones float to the top." I was instructed - correctly. I have to interject here with honor for our previous instructor and co-founder of our Whole Earth Home-school program, the wonderful Ethan Elgersma, and his sweetheart wife Melissa, for bringing back those nuts from the South and teaching the kids how to use them. Will they know in their hearts the wisdom they gifted has grown and flourished? Perhaps, like the Hickory, many of the seeds they have planted won't bear fruit until 15-40 years have passed.

My daughter was the first to crack the nut with a heavy bread knife. This quartered the nut nicely, but as we soon discovered, the nut needs a better smashing to render a good strong brew. It turns out our lucky rock, a quartz from the riverside which fits nicely in the palm, was just right. This same rock is a beloved tool in my apothecary, as it holds layers of grape leaves so they stay submerged in brine, and used similarly to other fresh, floating plant material.

Now it's a treasured nut smasher, and has been working diligently, day after day, for the last 8 days.

From the moment I first inhaled the steam of this brew, I knew I was hooked. There is nothing like it. It's rich, maple-y, hazel-nutty, and utterly mouth watering. Not to mention, free for the gathering in my very own backyard - now that just takes the cake.

Lucky for me, Kiva has been making exquisite creations with her native acorns, and so along this journey I have had the blessings of like-minded inspiration and side-splitting laughter to accompany me.

If you have Hickory trees near you, well get to it because the season is closing and those squirrels and chipmunks are very busy.

Hickory Brew

~1 part smashed hickory nuts, shell and all

~3 parts water

~Simmer for 30 + minutes

~Strain a cup at a time, leaving the rest to continue steeping.

~Add milk and sweetener if desired

Hickory nuts are among the most delicious and nutritious of the tree nuts. They are especially rich in protein, healthy fats, amino acids, Vitamins A, B6, E and K, Calcium, and vital minerals. As a Native Tree of North America, it has been a valued food source throughout history. Native North Americans, particularly the Algonquins, favored their winter survival food of Hickory butter; a smooth, fatty-sweet spread they rendered from skimming the top layer off a multi-day long process of reducing a concentrated brew.

Mammals are dependent on Hickory for both food and habitat. Birds nest in their high branches, as this tree can grow to 100 feet tall, between 200 and 300 years old. Opossum like to make their homes inside the base of larger Hickories, and bats use the shingles of the bark for their shelter. Omnivores of the forest including black bear, snack on the nuts, but for the Eastern Chipmunks and Eastern Grey Squirrel who depend on them for up to 25 % of their diet, they are vital.

For their slow growing and long wait before nut harvest, they are often (sadly) disregarded for landscaping projects. Considering the ratio of building to replanting, this is a grim outlook for Hickory trees. Lucky for us, there are plenty of them for the time being, as long as we take notice of land clearing and work to stop it, to prevent future devastation. Another pressure which adds to this concern, is its remarkable lumber. Hickory is prized as a flavorful smoking wood; hickory smoked ham and BBQ sauce might remind you of summer parties with the yummiest of meals. The wood is extremely hard, and treasured as fuel for it's high B.T.U. output and long burning time. Natives fashioned precise hunting bows from Hickory wood, and many generations of craftspeople have made durable furniture to pass down to their own descendants. Easy kitchen cutting boards can be acquired by purchasing a slab of untreated hickory lumber from your local lumber yard, or should you have enough abundance to cut one of your own for you and your family, you could fashion a number of long lasting household objects.

The striking, shaggy bark of this tree (my particular spp., Carya ovata) has also been used in special recipes to flavor maple syrup as well as for a delicious syrup in it's own rite. I wanted Hickory syrup too, so I made up my own version using the nuts.

Hickory Syrup

~1 part smashed Hickory nuts, shells and all

~2 1/2 parts water

~Simmer down (the nuts and water) for at least an hour, or until very rich and almost creamy looking. You will see the yummy natural oils swirling on top

~Strain the brew, reserve the nuts for a second round later

~Return the liquid to a pot, and add 3/4 part brown sugar

~Simmer well while stirring until reduced a little more and a little more syrupy

~In a separate bowl, mix some corn starch with a little cold water.

~Drizzle the corn starch/water mixture into the syrup while whisking to combine. Use just a little at a time, as it thickens quickly.

~ When you have the consistency you want (pourable like maple), transfer to a cream pitcher or gravy boat.

~Use right away on top of pancakes, oatmeal, or however you like.

~Your syrup will thicken now throughout the day. You can rewarm to use again, or use is as a jelly-like spread on cookies or banana bread.

~Store remainder in the fridge.

The trick to getting the best nuts is not to use the bad ones, :) When collecting or just after, look at each of the nuts, remove the husk and compost or throw back any of the following:

*Nuts which have a small hole. This means it is home to larvae - which, if you like, you can eat, but most do not like that.

*Nuts that have a damaged shell implying rot or larvae

*Moldy nuts

The darker colored nuts and even the ones with a slimy coating between shell and husk have proven inconsistent in their goodness, so I harvest those anyway.

Store your nuts in shallow flat baskets and check on them each day, removing any critters who may have hatched and checking again for nuts with small holes.

I always smash them one at a time, so as not to mix any bad ones in with the good. Which isn't too big a deal if you're making a big batch as they will float - but not as reliably as I would like. Plus I just don't want to taint the incredible flavor.

And it *is* incredible.

Quite near my Hickories are more medicinal trees. This made it easy for me to be inspired to create my own Wild Woodland Morning Brew, inspired by Kiva Rose who I mentioned above. Kiva has been sharing with us her delectable Acorn recipes, including Acorn infused butter! And if you live in the Southwest, you'll appreciate her Woodland brew before mine. Our acorns here in New England are simply for those who have more time that I, to put through rounds of boiling water.

For my tonic I use Black Birch twigs, Hemlock tips, and Hickory Nuts. It's a complex, wild woman's tonic, not for the tamed senses. Clearly this is a gift of Fey.

Wild Woman's Forest Brew

~1 cup smashed Hickory nuts (yep, you guessed it, shells and all!)

~3 small Hemlock tree bough tips or hand full of fresh White Pine needles

~1 small handful of Black Birch twigs

~3 cups water or until covered fairly well

Simmer, covered, for 30 minutes. Strain cup by cup, adding more water and continuing to steep a warm brew. This pot can render at least a few rounds of rich flavored Forest Brew for up to 2 full days without refrigeration.

Sip savoringly under the trees or by the fire. Add milk or honey as desired, and of course tweak the recipe to your preference as well. More delicious tree magic additions are: Wild Cherry bark, Slippery Elm bark, or Sassafras roots. Chai spices are perfectly suited as well.

One of the most wonderful, surprising benefits of this brew, is the serious energy and endurance I feel when I drink it. Really! For you herbal readers, I'll put it like this: it feels like when I eat a high protein meal and chase it with Oatstraw infusion and a spoon of Ashwagandha honey. Yep, real, solid energy - but not a stimulant. This is the perfect reminder of adaptability. How many winters has this one tree seen? 200? Far more than me. I believe one of the secrets to adapting to the winter season is sweetly delivered in the package of a nut.

Speaking of special deliveries, I took full advantage of my Hickory obsession and used it as my topic and activity for this week's plant class. It's the perfect choice for those who teach kids about plants, especially because noticing different tree barks is relevant this time of year, and kids will notice the shaggy bark easily. They love the interesting facts about Hickory trees, and of course, will go to the ends of the Earth to gather as many nuts as possible, even before they think of asking what you will do with them!

It's also a great topic because, as many herbal lessons do, it does not divert you back into the kitchen. you can make the delicious brew right over a campfire, thus keeping the kids immersed in nature, fun, learning, and a little hands on history. Not to mention, what could be more fun than finding rocks to smash nuts with? It's a satisfying art form tailored for kids.

What you'll need to bring as the teacher are:

A Large pot to be used over the fire

Another large pot to rinse nuts in (and a hand towel for a cold day)

Bags/baskets for the kids to put nuts in

Heat tolerant cups or lightweight camping mugs

A Ladle

A large mesh strainer

Milk and Honey or Cream

Flat trays or baskets to hold clean nuts

Reference book - I use The Tree Identification Book

Pot Holders or something to do the job
Access to water

Allow a good three hours for this segment, and pre-scout the area for a good mast and safe fire pit area. Here are a few more Hickory facts you can share with your students:

The botanical name is Carya ovata, meaning "oval nut"

It is in the Juglandaceae, or Walnut family.

It's relatives include the Black Walnut and Pecan.

It is a deciduous hardwood tree.

It's branching pattern is alternate, with opposite, odd pinnate leaflets; 5-7 per leaf.

The leaflets are larger towards the end of the leaf.

Leaflets bear little to no petiole, and have toothed margins and slightly tapered points which almost curl like a frosting tip.

The base of the lateral leaflets are lobed and asymmetrical, similar to to Witch Hazel.

The Bark of the younger trees or younger portion of a mature tree is much less furrowed, possibly smooth.

The trunks are extremely straight, compared to a curvy cherry or apple.

~~~~

Hickory brew can be used for any recipe you like. Cookies, breads, or coffee can be made using the brew in place of water. Yum. You can also roast the nuts in the oven to help dry the shells for easier nut meat removal and to bring our the aroma and flavor. Experiment and get to know this strengthening woodland gift.

References from the web:

http://en.wikipedia.org/wiki/Carya_ovata

http://www.hickorytree.net/

http://www.cirrusimage.com/tree_shagbark_hickory.htm

http://www.na.fs.fed.us/pubs/silvics_manual/volume_2/carya/ovata.htm

http://plants.usda.gov/java/profile?symbol=CAOV2

http://www.cnr.vt.edu/DENDRO/DENDROLOGY/syllabus/factsheet.cfm?ID=20

Testing For Small Fibre Neuropathy Why It Matters

Today's post from neuropathyjournal.org (see link below) highlights the necessity for doctors to test properly for neuropathy (if they are going to test at all). Many patients go home with clear neuropathic symptoms but a negative diagnosis, purely because the neurologist hasn't tested for small fibre neuropathy and has instead concentrated on large fibre nerve damage by using EMGs and nerve conduct studies. Strictly speaking, the only way to confirm small fibre neuropathy is by conducting a skin biopsy but most neurologists and doctors won't do this because of cost and other difficulties. For this reason, many patients are simply misdiagnosed as not having neuropathy when in fact they do. This useful article provides the facts about small fibre neuropathy and if you recognise yourself in these descriptions, it may be worth having another discussion with your doctor about your original diagnosis.

Small Fiber Neuropathy
By LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS1 

So many neuropathy patients have heard these words from very qualified neurologists and health professionals. “Your EMG and Nerve Conduct Studies are normal and you do not have neuropathy!” Right? Wrong!

Dr. Norman Latov of Cornell University states clearly along with many other professionals that the EMG and Nerve Conduct Studies only measure damage to the large fibers. In fact it is well known that a patient can have symptoms of Peripheral Neuropathy long before damage is done to either the large or small fiber nerves! Plus small fiber damage can only be measured by a simple Skin Biopsy to determine if the patient has damage to the small fibers.

David Saperstein M.D. and Todd Levine M.D. write for the GBS/CIDP Foundation International in Summer 2012 in The Communicator: “Immune-Mediated Small Fiber Neuropathy: A Treatable Condition That Can Mimic GBS and CIDP” . The authors note that “some patients may have elevated spinal fluid protein levels as in (GBS and CIDP), while other patients will have evidence of a monoclonal protein in their blood (which can be associated with some kinds of CIDP) and note that acute onset SFN can be immune-mediated and may respond to the same therapies used for GBS, such as intravenous immunoglobulin (IVIg). In contrast to GBS, however patients with acute onset SFN may respond to corticosteroid medications such as prednisone.” The doctors continue with a recommendation that the skin biopsy is a very useful tool in the diagnosis of SFN.

Testing-Skin Biopsy

Therapath Pathology does epidermal nerve fiber density testing. Skin Biopsy

Small Fiber Neuropathy

Small fiber neuropathies affect the small, unmyelinated nerve fibers in the sensory nerves. These fibers convey pain and temperature sensations from the skin, as well as maintain autonomic functions (Stewart el al, 1992; Novak et al 2001). The diagnosis can easily be missed, as the neurological examination may reveal only minor sensory abnormalities and EMG and nerve conduction studies, that measure the large fibers, are frequently normal. Consequently, some patients with small fiber neuropathy are misdiagnosed as having a psychosomatic disorder, RSD, fibromyalgia, or restless leg syndrome instead. (Lacomia, 2002; Hermann et al, 2004; Polydefkis et al, 2005).

Symptoms of Small Fiber Neuropathy

Symptoms of small fiber neuropathy include numbness and annoying or painful spontaneous sensations, called paresthesias, that are variably described as tingling, stinging, burning, freezing, itching, aching, pulling, squeezing, or electric shock-like in character. Innocuous stimuli can provoke unpleasant sensations, called dysesthesias, as when clothes feel like sandpaper against the skin, the hands are hypersensitive to touch, and pressure from shoes or socks causes severe pain. These symptoms can occur anywhere in the body, including the arms, legs, torso, face, or even the mouth. (Walk et al, 2003; Lauria et al. 2005)

Causes of Small Fiber Neuropathy

Small fiber neuropathy can result from a number of causes and the neuropathy is often the first manifestation of an underlying systemic disease. It can be caused by diabetes mellitus or glucose intolerance (Polydefkis and McArthur, 2005) and by such autoimmune conditions as Sjogren’s syndrome (Chat et al, 2005) Lupus (Omdal et al, 2002), sarcoid (Hoitsman et al, 2005) vasculitis (Lacomis et al, 1997; Zafrir et al, 2004) Lee et al, 2005), inflammatory bowel disease (Gondim et al. 2005) or variants of Guillain-Barre syndrome (Seneviraine and Gunasekera, 2002). Other causes include nutritional deficiencies, celiac disease (Brannagan et al, 2005), Lyme disease, HIV-1 infection (Polydefkis et al. 2002) hereditary disease (Dyck et al, 1985) Dutsch et al, 2003), amyloid, alcohol abuse (Zambelis et al, 2005) or toxins (Kuo et al, 2005). Some sensory neuropathies that affect both the small and large nerve fibers can cause a reduction in epidermal nerve fiber density, before electrodiagnostic abnormalities.

How is SFN diagnosed

The diagnosis of small fiber neuropathy can be made with certainty, by demonstrating a reduction in the density of small nerve fibers in the skin. EMG and nerve conduction studies are usually normal in this condition, as they mostly measure the large nerve fibers in the motor or sensory nerves. The epidermal nerve fiber is normal in patients with central nervous system disease. (Latov; Brannagan)

About the Author

Col Richardson has suffered with severe neuropathy for over 45 years. A 27 year military veteran and veteran of the Vietnam War, he was diagnosed with a progressive chronic peripheral neuropathy resulting in severe disability. This diagnosis has been confirmed as due to exposure to Agent Orange. It was not until 2010, 42 years after his exposure to Agent Orange, that his diagnosis was recognized by Veterans Affairs as service connected.

https://neuropathyjournal.org/small-fiber-neuropathy/

Electric Current For Neuropathy Pain

Today's post from type2nation.com (see link below) talks about the Sensus, which is a new device designed to deliver electrical stimulus for neuropathy patients. It's by no means the first in this area and there have been ideas using an electrical stimulus to control nerve pain, for years but this one certainly seems promising. Worth reading to see whether it may be something useful for you. Discuss it with your doctor or specialist because it may not be available in your area. That said, nothing in the neuropathy world carries guarantees and as always, what works for some may not work for others but the scientific premise behind the device seems sound.

Electrical Current May Ease Neuropathy Pain
Published on October 15th, 2013 | by Chris Leach

Diabetic peripheral neuropathy (DPN) is a fact of life for millions of people with diabetes. The condition is characterized by a number of symptoms, including numbness, insensitivity, tingling, burning and prickly sensations, sharp pain and cramps in hands and feet, and loss of balance and coordination. Perversely, peripheral neuropathy also can include extreme sensitivity to touch, making it so even stepping barefooted on a pebble can cause shooting pain up the legs. Until recently there have been few treatment options, as the condition is not even very well understood. But now researchers are using electrical stimulation to relieve the pain the condition can cause. If such a treatment method proves successful, it might offer welcome relief and better health outcomes for people with diabetes.

One of the first devices to hit the market is Sensus, by NeuroMetrix. Available by prescription, it relies on external electrical stimulation of nerves and nerve pathways to lessen and control DPN pain in the feet and legs. The device is designed to wrap around the calf under your clothes, and is secured by a Velcro band that adjusts to fit almost any body size. The Sensus “brain” is controlled by a single push button and uses an array of electrodes that snap into place on the skin side of the device to send current into your leg. Sensus stimulates or “excites” the nerves that carry normal, non-painful sensations to the brain.

A growing number of insurers, including Medicare, reimburse for this Class II medical device, which was cleared by the FDA late in 2012 and began shipments to distributors about 6 months ago. It is the only device of its kind cleared for overnight use by patients.

Researchers are rooting for such devices to provide relief for people with diabetes, as neuropathy can curtail exercise routines and disrupt sleep patterns, two side effects which can create a downward health spiral for people with diabetes. The economic consequences of neuropathies in the U.S. run into the billions each year, according to the National Diabetes Information Clearinghouse.

About the Author
 
Chris Leach Chris Leach was the founding editor of numerous diabetes publications, including Insulin Nation, Type 2 Nation, and Health Matters. A lifelong entrepreneur, he also founded New Jersey Monthly and was part of the team that created ESPN, the Magazine. Chris passed away in 2013.

http://www.type2nation.com/treatment/electrical-current-may-ease-neuropathy-pain/

Why Do Our Hands And Or Feet Tingle

Today's post from webmd.com (see link below) is a thorough answer to the question why our hands and feet tingle. Many people ask this question long before having heard the word neuropathy and for many people, the symptoms are temporary but equally, for millions across the world, the symptoms never go away and become progressively worse. They then have a form of neuropathy or nerve damage. This article will set you on the right path as regards opening information; after that, you need to discuss your problem with your doctor and do as much further research of your own until you have built up sufficient knowledge to be best able to live with the disease.

Tingling in Hands and Feet
WebMD Medical Reference View Article Sources
Reviewed by Varnada Karriem-Norwood, MD on September 26, 2014

Tingling hands, feet, or both is an extremely common and bothersome symptom. Such tingling can sometimes be benign and temporary. For example, it could result from pressure on nerves when your arm is crooked under your head as you fall asleep. Or it could be from pressure on nerves when you cross your legs too long. In either case, the "pins and needles" effect -- which is usually painless -- is soon relieved by removing the pressure that caused it.

In many cases, however, tingling in the hands, feet, or both can be severe, episodic, or chronic. It also can accompany other symptoms. such as pain, itching, numbness, and muscle wasting. In such cases, tingling may be a sign of nerve damage, which can result from causes as varied as traumatic injuries or repetitive stress injuries, bacterial or viral infections, toxic exposures, and systemic diseases such as diabetes.

Such nerve damage is known as peripheral neuropathy because it affects nerves distant from the brain and spinal cord, often in the hands and feet. There are more than 100 different types of peripheral neuropathy. Over time, peripheral neuropathy can worsen, resulting in decreased mobility and even disability. More than 20 million Americans, most of them older adults, are estimated to have peripheral neuropathy.

It's important to seek prompt medical evaluation for any persistent tingling in your hands, feet, or both. The earlier the underlying cause of your tingling is identified and brought under control, the less likely you are to suffer potentially lifelong consequences.

Causes of Tingling in the Hands and Feet

Diabetes is one of the most common causes of peripheral neuropathy, accounting for about 30% of cases. In diabetic neuropathy, tingling and other symptoms often first develop in both feet and go up the legs, followed by tingling and other symptoms that affect both hands and go up the arms. About two-thirds of people with diabetes have mild to severe forms of nerve damage. In many cases, these symptoms are the first signs of diabetes.

In another 30% of peripheral neuropathy cases, the cause is unknown or "idiopathic."

The remaining 40% of cases have a variety of causes such as:

Nerve entrapment syndromes. These include carpal tunnel syndrome, ulnar nerve palsy, peroneal nerve palsy, and radial nerve palsy.

Systemic diseases. These include kidney disorders, liver disease, vascular damage and blood diseases, amyloidosis, connective tissue disorders and chronic inflammation, hormonal imbalances (including hypothyroidism), and cancers and benign tumors that impinge on nerves.

Vitamin deficiencies. Vitamins E, B1, B6, B12, and niacin are essential for healthy nerve function. A B12 deficiency, for example, can lead to pernicious anemia, an important cause of peripheral neuropathy. But too much B6 also can cause tingling in the hands and feet.

Alcoholism. Alcoholics are more likely to have a thiamine or other important vitamin deficiencies because of poor dietary habits, a common cause of peripheral neuropathy. It's also possible that alcoholism itself can cause nerve damage, a condition that some researchers call alcoholic neuropathy.

Toxins. These include heavy metals such as lead, arsenic, mercury, and thallium, and some industrial and environmental chemicals. They also include certain medications -- especially chemotherapy drugs used for lung cancer -- but also some antiviral and antibiotic drugs.

Infections. These include Lyme disease, shingles (varicella-zoster), cytomegalovirus, Epstein-Barr, herpes simplex, and HIV/AIDS.

Autoimmune diseases. These include Guillain-Barre syndrome, lupus, and rheumatoid arthritis.

Inherited disorders. These include a group of disorders collectively known as Charcot-Marie-Tooth disease.

Injury. Often related to trauma, nerves can be compressed, crushed, or damaged, resulting in nerve pain. Examples include nerve compression caused by a herniated disc or dislocated bone.

Diagnosis of Tingling Hands and Feet

If you seek care for your tingling hands or feet, your health care provider will do a physical exam and take an extensive medical history addressing your symptoms, work environment, social habits (including alcohol use), toxic exposure, risk of HIV or other infectious diseases, and family history of neurological disease.

He or she also may perform additional tests such as:
Blood tests. These can include tests to detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity.
An examination of cerebrospinal fluid. This can identify antibodies associated with peripheral neuropathy.
An electromyogram (EMG), a test of the electrical activity of muscle
Nerve conduction velocity (NCV)

Other tests may include:
Computed tomography (CT)
Magnetic resonance imaging (MRI)
Nerve biopsy
Skin biopsy to look at nerve fiber endings

Treatments for Tingling Hands and Feet

Successful treatment depends on an accurate diagnosis and treatment of the underlying cause of the tingling. As long as the peripheral nerve cells have not been killed, they have the ability to regenerate.

Although no treatments are available for inherited types of peripheral neuropathy, many of the acquired types can be improved with treatment. For example, good blood sugar control in diabetes can slow the progression of diabetic neuropathy; vitamin supplementation can correct peripheral neuropathy in people with vitamin deficiencies.

General lifestyle recommendations include maintaining an optimal weight, avoiding exposure to toxins, following a doctor-supervised exercise program, eating a balanced diet, and avoiding or limiting alcohol consumption. Recommendations also include quitting smoking, which constricts blood supply to blood vessels supplying nutrients to peripheral nerves.

In some cases, tingling and other symptoms of peripheral neuropathy may be reduced with prescriptions originally developed for treating seizures and depression.

http://www.webmd.com/brain/tingling-in-hands-and-feet

Mental disorders and sexual dysfunction

Mental disorders can cause sexual dysfunction because of deviated mind or lack of interest/concentration. Further, lack of satisfaction and interest in sex will make anyone stay away from it in future. Even though sexual dysfunction can occur in any one at any time, it is more common in depressed men or women. It may be because of emotional stress/disease or the side-effects of antidepressants. In males, Mind disorders can cause Erectile dysfunction (ED) – inability to attain or maintain an erection sufficient to permit satisfactory sexual intercourse and ends up without any satisfaction to himself or his partner Premature ejaculation (PME) - discharge of semen with minimal sexual stimulation before or during or shortly after penetration Hypoactive sexual desire disorder (HSDD) - persistent or recurrent extreme aversion to, or absence of, or avoidance of all genital sexual contact with sexual partner Hyper sexuality in males - Satyriasis – meant for abnormal, extreme and frequent sexual activities with constant craving or urge. It can be because of mind disorders or because of drugs/alcohol or sexual addiction In females, Female sexual dysfunctions (pain during sexual activity, difficulty in getting penetration, lack of interest in sex or inability to attain orgasm, etc.) are often caused by fear of pain and bleeding (during first day of sex) or hormonal imbalance (especially due to low level of oestrogen) and during menopausal with or without dryness of vagina. Sexual aversion disorder or sexual arousal disorder - refers to the lack of sexual passion or desire with persistent or recurrent inability of a woman to achieve or maintain an adequate lubrication in vagina (swelling response) during sexual activity. Vaginismus - occurs when the muscles around the outer third of the vagina contract involuntarily when vaginal penetration is attempted during sexual intercourse. Lack of libido (mood and interest) with no orgasm – This is often seen in depressed women and with the prescription of scheduled sex during ovulation in the treatment plan for infertility. Hyper sexuality in females - Nymphomania - refers to abnormal, extreme and frequent craving for sexual activities with sexual addictions. To suppress the feelings, they may often go for cold baths at erratic times. Homeopathic approach – For sexual dysfunction in psychological patients, treatment should not be just aimed at sexual passion, but should also be concentrated on their mental illnesses with counselling. Homeopathy is a wonder of scientific application and not a magical prescription. Homeopathy treats the person’s mind and physique on the whole to provide dramatic relief. Individualisation is the specialty of Homeopathy. There are many wonderful drugs for mental illness and sexual weakness or dysfunctions. Homeopathy can quarantine the progress of the disease and can cure the situation in due course without any recurrences. As the main message of this article, don't be depressed or fearful or feel hopeless. A hopeful heart always keeps you happy. Be optimistic. Be cheerful. To recapture your sexual passion, don't go for booster drugs, since they last only for a few minutes and create dependency. Homeopathy never acts as a booster. But it works to make a person normal or revive the active normal state. It will blend perfection, pleasure and happiness in one’s life. Homeopathic medicines commonly used in cases of sexual dysfunctions are Acid phos, Acid picric, Agnus castus, Arg nit, Avena sativa, Caladium, Cantharis, Conium, Damiana, Gelsemium, Kali brom, Lycopodium, Moschus, Nat mur, Nuphar luteum, Nux vom, Onosmodium, Pulsatilla, Sabal serrulata, Selenium, Sepia, Staphysagria, Titanium, Yohimbinum, Zinc met, etc. These medicines should be taken under the advice and diagnosis of a qualified Homoeopath. When the Homeopath approaches the case by analysing the cause, and psychological counselling, Homeopathy can reassure complete recovery. for new hope Dr. S. Chidambaranathan, BHMS, MD (Homeo) Laxmi Homeo Clinic 24 E. New Mahalipatti Road Madurai, TN 625 001 India Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob) Fax: +91-452-233-0196 E-mail:  drcheena@yahoo.com www.drcheena.com / www.drcheena.in

(Disclaimer - The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)

Pregnancy Trimesters

First 1st Trimester Of Pregnancy

Pregnancy lasts about 40 weeks, and has three phases or stages; the 1st, 2nd, 3rd trimesters. Early symptoms of pregnancy may include constipation, headache .What are the changes that happen to a woman's body during the 1st, 2nd, and 3rd trimester of her pregnancy? Body aches Breast changes.Pregnancy massage therapy and labour support doula - services for prospective parents, postgraduate training for registered massage therapists..A normal, full-term pregnancy is divided into three trimesters. Each trimester lasts between weeks. Learn what happens during each trimester..Pregnancy stages are the three trimesters during which your baby progresses from an embryo to a fetus, to the time it is born as a recognizable tiny human..Your body and your developing baby change trimester by trimester. Read about your pregnancy trimesters here..Pregnancy, also known as gravidity or gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one .Pregnancy has three trimesters, each of which is marked by specific fetal developments. A pregnancy is considered full-term at 40 weeks; infants delivered before the .In general, the average pregnancy lasts 40 weeks and is divided into three periods of time, called trimesters. The first trimester lasts until week 13, the second .Come walk through all three trimesters of pregnancy as each is unique in how the changes are in your body and with your baby..

First 1st Trimester Of Pregnancy

Pregnancy Weight Gain By Trimester Chart

Pregnancy stages are the three trimesters during which your baby progresses from an embryo to a fetus, to the time it is born as a recognizable tiny human..Pregnancy lasts about 40 weeks, and has three phases or stages; the 1st, 2nd, 3rd trimesters. Early symptoms of pregnancy may include constipation, headache .What are the changes that happen to a woman's body during the 1st, 2nd, and 3rd trimester of her pregnancy? Body aches Breast changes.Pregnancy massage therapy and labour support doula - services for prospective parents, postgraduate training for registered massage therapists..In general, the average pregnancy lasts 40 weeks and is divided into three periods of time, called trimesters. The first trimester lasts until week 13, the second .Pregnancy has three trimesters, each of which is marked by specific fetal developments. A pregnancy is considered full-term at 40 weeks; infants delivered .Pregnancy, also known as gravidity or gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one .Your body and your developing baby change trimester by trimester. Read about your pregnancy trimesters here..A normal, full-term pregnancy is divided into three trimesters. Each trimester lasts between weeks. Learn what happens during each trimester..Come walk through all three trimesters of pregnancy as each is unique in how the changes are in your body and with your baby..

Will My Neuropathy Get Better

Today's post from neuropathyjournal.org (see link below) asks the simple question that every neuropathy patient asks shortly after hearing the diagnosis for the first time: will it get worse? The answer is that nobody can say with any 100% certainty how the disease will develop and LtCol Richardson makes the point that it's pointless expending too much energy on something that you can't change anyway. He suggests that it's better to find the cause and also a doctor who knows what he/she's doing and concentrate your energies on improving your symptoms and situation, rather than worrying about unknown factors regarding the disease getting worse or not. I'm not sure I agree with him about concentrating on finding the cause. In the end, you have nerve damage; there's no cure for that and you share symptoms with millions of others, irrespective of the cause. It's far better to follow his second suggestion and put all your energies into reducing the impact of the symptoms. Your medical history will point to the cause and various standard tests will indicate the extent of the nerve damage in your system but further than that, all you want as patient, is that the symptoms become bearable enough to live a normal life. Worth a read and worth following the Lt Col's links for more ideas on the subject.

Will My Neuropathy Get Worse?
By LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS

One issue neuropathy patient’s face is the fear that their neuropathy will grow progressively worse. Neurologists call this a progressive polyneuropathy. The truth: no one really knows if your neuropathy will worsen, stay the same or disappear. A neurologist shared that this may have more to do with the underlying cause of the neuropathy, genetics, and heaven only knows, issues.

I speak of this very fear in chapter twelve, Focus, in the DVD “Coping with Chronic Neuropathy”, and if you have not viewed this chapter, I suggest that you do so. The viewing will provide a better perspective.

Neuropathy patient fears are often increased by the coming and going (remitting and relapsing) of neuropathy symptoms. These patterns are a medically confirmed fact and also occur in many other chronic illnesses. Better recognized are the same patterns for some forms of MS (Multiple Sclerosis)!

Neurologists confirm that there are acute neuropathies that come on suddenly and then the symptoms disappear. In other neuropathies symptoms occur, disappear and then return at the same level. Other neuropathies occur, disappear and then return at increased levels and in more places of the body. Others come, go and then go away for years only to return with a vengeance!

The chronic neuropathies (affect one set of nerves) and polyneuropathies (affect many nerves), which increase for years are often referred to as progressive polyneuropathies. The mystery is increased as there seems to be no rhyme or reason for these patterns. The only thing I noticed is that when I increased activity, I have increased burning, pain or other symptoms and I neurologist tell me that this is due to making damaged nerves work.

For years between the emotional highs when my symptoms remitted (“Hurrah, they’re gone!”) and the emotional lows when they relapsed (“Oh no, they’re back!”), I was tempted to worry that my symptoms were going to worsen and guess what, they did! But one has to ask the question, did the energy spent on worry change anything? No! What I re-discovered was what I learned in Sunday school. It was better to spend my time and energy finding a doctor who was trained (neuromuscular neurologist) in the clinical approaches to neuropathy then to waste energy on worry. I needed a doctor, not worry, to focus on my symptoms. I needed a doctor working with me as a partner, while treating the symptoms and looking for the TYPE and/or CA– USE. Why finding the type of neuropathy important? Because as Dr. Latov in his book tells us, this can often point in the direction of a cause! I needed a medical Sherlock Holmes, not time worrying about what might happen.

This approach maintained a focus on self empowerment by learning all I could, while prodding the doctors with questions that helped them think and act. The most important question for you is not, will my neuropathy get worse, but what is the type of neuropathy and/or the underlying cause? Spend your energy looking for the type and/or cause, as no one knows if your neuropathy will worsen or not.

I know that for so many of you neuropathy has been a progressive illness which worsened over the years. Conversely, my progressive polyneuropathy has not killed me, for my neuropathy symptoms began at age 31 and I am now 76. Thirty-five years into the symptoms with a million denials with a diagnosis from mentally ill to idiopathic neuropathy. I was given one drug which drove me to talk backwards and then another that reduced pain by 80%. Five years later with the miracle of IVIg I am able to keep breathing and the chest muscle spasms stopped while reducing other mind numbing symptoms. This took many doctors, lots of research and knowledge, while asking good questions and giving doctors documents from experts. It may have been fear and anger which drove me forward, but it was these focused actions that brought help, not dwelling on my fears!

It is important to know which issue is important as you set goals for getting help. It is important to focus your energy on learning, getting help with symptoms and finding the cause and solutions for the diagnosed illness. I do not mean idiopathic neuropathy (of unknown cause). It is very difficult to find a solution, other than for symptoms, when the neuropathy is of unknown cause. Help the doctor think and pushing the system to do the testing that is now available. Click here to read about my opinion on Idiopathic Neuropathy.

Tests that are available will allow the doctor to know if the neuropathy is large or small fiber, motor, sensory or autonomic, axonal, immune-mediated, demyelinating or inflammatory and these clues can lead to a possible identification of the type and/or cause that is more helpful than idiopathic.

RESOURCE: Read Dr. Scott Berman’s book, as this book may provide insight on these issues. Click here to view the recommended Books On Neuropathy. Dr. Berman has untreatable CIDP (chronic inflammatory demyelinating polyneuropathy) and his book speaks to all neuropathy patients as one who has been in our shoes with many neuropathies. Dr. Berman empowers us to face creatively the emotional issues we ALL face in chronic illness.

https://www.neuropathyjournal.org/will-my-neuropathy-get-worse/