Very short and simple but very useful for people new to neuropathy, todays post from interohealthcare.com (see link below) sums up nerve damage and which nerves are involved in a nutshell. Thanks to the complex nature of neuropathy, it's so easy to forget the basic details of what's happening to your body. This short article is a useful refresher for everybody living with neuropathy.
Neuropathy and Nerve Damage Info from WebMD: Never Damage
Your nervous system is involved in everything your body does, from regulating your breathing to controlling your muscles and sensing heat and cold.
There are three types of nerves, or neurons, in the body:
Autonomic nerves. These nerves control the involuntary or partially voluntary activities of your body, including heart rate, blood pressure, digestion, and temperature regulation.
Motor nerves. These nerves control your movements and actions by passing information from your brain and spinal cord to your muscles.
Sensory nerves. These nerves relay information from your skin and muscles back to your spinal cord and brain. The information is then processed to let you feel pain and other sensations.
Nerve pain and nerve damage can be mild. But, because nerves are essential to all you do, nerve pain and damage can seriously affect your quality of life.
What Are the Symptoms of Nerve Pain and Nerve Damage?
With nerve damage there can be a wide array of symptoms. Which ones you may have depends on the location and type of nerves that are affected. Damage can occur to nerves in your brain and spinal cord. It can also occur in the peripheral nerves, which are located throughout the rest of your body.
Autonomic nerve damage may produce the following symptoms:
inability to sense chest pain, such as angina or heart attack
too much sweating (known as hyperhidrosis) or too little sweating (known as anhidrosis)
lightheadedness
dry eyes and mouth
constipation
bladder dysfunction
sexual dysfunction
Damage to motor nerves may produce the following symptoms:
weakness
muscle atrophy
twitching, also known as fasciculation
paralysis
Sensory nerve damage may produce the following symptoms:
pain
sensitivity
numbness
tingling or prickling
burning
problems with positional awareness
In some instances, people with nerve damage will have symptoms that indicate damage to two, or even three, different types of nerves. For instance, you might experience weakness and burning of your legs at the same time.
http://www.interohealthcare.com/conditions-helped-2/nerve-damage/
Today's post from neuropathysupportnetwork.org (see link below) is written by the very well respected campaigner for better treatment for neuropathy, Lt. Col. Eugene B. Richardson. He talks about his own neuropathy but especially in this case, he tries to answer the question whether someone's neuropathy will get worse. It's almost unanswerable because everybody's case is different and neuropathy is one disease that hardly ever obeys the rules that most normal diseases do. This article is very much worth a read because I am sure it's a question that almost 100% of neuropathy sufferers have asked at one time or another.Will My Neuropathy Get Worse?
Posted May 25th, 2011 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 than any other issue.
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. Too many doctors still fail to understand this reality for the neuropathy patient, yet these patterns are a medically confirmed fact. 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 and polyneuropathies 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 would guess that this was 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 in the clinical approaches to neuropathy then to waste energy on worry. I needed a doctor, not worry, to focus on my symptoms, a doctor working with me as a partner, while treating the symptoms and looking for the 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 underlying cause? Spend your energy looking for the 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 72. Thirty-one years into the symptoms with a million denials with a diagnosis beyond crazy 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. Many times it is a matter of the doctor taking the time, helping the doctor think and pushing the system to do the testing that is now available.
Tests that are available will with good thinking and clinical training 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 cause that is more helpful than idiopathic. Unfortunately many neuropathy patients are simply tossed into the pile of idiopathic and sent home.
RESOURCE: Read Dr. Scott Berman’s book, as this book may provide insight and is available at the website www.neuropathysupportnetwork.org RESOURCE TAB. 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.
PATIENT TO PATIENT – Disclaimer: Patient to Patient articles are intended to be educational, not diagnostic or prescriptive and the patient is encouraged to seek help from their own private physician.
http://neuropathysupportnetwork.org/blog/2011/05/will-my-neuropathy-get-worse/
Today's short post from sciencedaily.com (see link below) raises more questions than answers as far as this blog's concerned and doesn't necessarily appreciate the nature of chronic nerve pain. Any article that suggests: "For less severe (nerve) pain, many over-the-counter medications, such as ibuprofen or naproxen, may be as effective as an opioid" has to be suspect because it just can't be true. Neuropathy patients are prescribed opioid drugs for their pain when all else has failed and to suggest that over-the-counter analgesics may be just as effective, shows lack of understanding of how nerve pain works on the brain and nervous system. That said, any article that threatens opioid users with a much increased risk of death has to be taken seriously, read and examined. It feels like an article that is written in response to the current 'crisis' with medication overdose problems and Professor Ray doesn't leave any doubt as to which side of the fence he sits on. He states: "We found that the opioid patients had a 64 percent increased risk of death for any reason and a 65 percent increased risk of cardiovascular death," but doesn't deliver the scientific evidence or context behind their findings. Should we be worried about this sort of headline? Of course we should but then we need to know how the conclusions have been reached. If you are a neuropathy patient in severe pain and having to rely on opioids to dampen that pain, then I suggest you have another talk with your prescribing doctor or specialist if you're worried. 99% of opioid users don't want to be taking opioids but have no choice and they take their medication with the greatest care and will do anything to avoid becoming addicted or harming themselves. They form a partnership with their doctors and their medication use is controlled and checked regularly to avoid any problems. The 1% who don't are the ones behind the current prescription drug hysteria...sledgehammer to crack a nut much!!!
Long-acting opioids are associated with a significantly increased risk of death when compared with alternative medications for moderate-to-severe chronic pain, according to a Vanderbilt study released today in JAMA.
Not only did long-acting opioids increase the risk of unintentional overdose deaths, but they were also shown to increase mortality from cardiorespiratory events and other causes.
Lead author Wayne Ray, Ph.D., and colleagues with the Vanderbilt Department of Health Policy studied Tennessee Medicaid patients between 1999-2012 with chronic pain, primarily back and other musculoskeletal pain, who did not have cancer or other serious illnesses.
Researchers compared those starting a long-acting opioid to those taking an alternative medication for moderate-to-severe pain.
Alternative medications included both anticonvulsants -- typically prescribed to prevent seizure activity in the brain, treat bipolar disorder or neuropathic pain -- and low doses of cyclic antidepressants, which are taken for depression, some pain and migraines.
"We found that the opioid patients had a 64 percent increased risk of death for any reason and a 65 percent increased risk of cardiovascular death," said Ray, professor of Health Policy at Vanderbilt University School of Medicine.
"The take-home message for patients with the kinds of pain we studied is to avoid long-acting opioids whenever possible. This is consistent with recent Centers for Disease Control and Prevention guidelines. This advice is particularly important for patients with high risk for cardiovascular disease, such as those with diabetes or a prior heart attack."
If a long-acting opioid is the only option for effective pain relief, patients should start with the lowest possible dose and only gradually increase it, he said.
The study group had a collective 22,912 new episodes of prescribed therapy for the medications, with 185 deaths in the long-acting opioid group and 87 deaths in the control group.
Long-acting opioid users had 69 excess deaths per 10,000 users. In other words, for every 145 patients who started a long-acting opioid, there was one excess death.
"We knew opioids increase the risk of overdose. However, opioids can interfere with breathing during the night, which can cause heart arrhythmias," Ray said.
"We were concerned that long-acting opioids might increase cardiovascular death risk, which is what we found. Because most patient populations have more cardiovascular deaths than overdose deaths, our finding means that prior studies may have underestimated the harms of long-acting opioids."
Ray said the findings add urgency to measures to restrict long-acting opioid use to those for whom benefits outweigh harms.
"Data are limited as to the best medicine for the kinds of pain we studied, such as back pain, although for pain involving the nerves, the non-opioids may be better," Ray said. "For less severe pain, many over-the-counter medications, such as ibuprofen or naproxen, may be as effective as an opioid."
Story Source:
The above post is reprinted from materials provided by Vanderbilt University Medical Center. Note: Materials may be edited for content and length.
Journal Reference:
Wayne A. Ray, Cecilia P. Chung, Katherine T. Murray, Kathi Hall, C. Michael Stein. Prescription of Long-Acting Opioids and Mortality in Patients With Chronic Noncancer Pain. JAMA, 2016; 315 (22): 2415 DOI: 10.1001/jama.2016.7789https://www.sciencedaily.com/releases/2016/06/160614121312.htm
