Gentes: Over

Sunday, 4 June 2017

Will Neuropathy Diagnosis Go Over The Fiscal Cliff

Today's post comes from the Neuropathy Association E-news letter for November 2012 (see link below) and highlights a potentially very difficult time for neuropathy patients in the United States. Hopefully solutions can be found, now that plunging off the fiscal cliff has been temporarily averted but these sort of spending cuts are just the sort that will remain on the statute books irrespective of macro decision making in Washington. Not that EMGs are the be all and end all of neuropathy testing (a patient's account of symptoms is more often than not enough to confirm diagnosis) but EMGs and the like are useful tools in establishing the extent of neuropathic damage and certainly in measuring its progress. If you are living in the USA it may well be worth reading and supporting this campaign by the Neuropathy Association.

A MESSAGE FROM THE PRESIDENT AND CEO
Tina Tockarshewsky November 2012

Dear Friend,

A clear and present danger for our community is now upon us, and your support is essential.

It was recently announced in the 2013 Medicare Physician Fee Schedule from the Centers for Medicare & Medicaid Services (CMS) that reimbursement payments to physicians for needle electromyography (EMG) tests and nerve conduction studies (NCSs) will be severely reduced by 30%-70% beginning on January 1, 2013. EMG and NCSs are the primary diagnostic tools for peripheral neuropathy as well as other neuromuscular diseases like ALS, MS, and Parkinson’s. Implementing these cuts will deny millions access to proper diagnosis and care.

We are hearing from many physicians that they will no longer be able to afford to practice neuromuscular medicine...and many currently in practice will simply stop seeing Medicare patients!

This Neurological Fiscal Cliff Will Hurt Neuropathy Patients!

This is a crisis unlike any we have ever known before…and is a potential game changer for ALL patients and medical professionals working with the neuropathy community. Early diagnoses will be reduced and misdiagnoses will increase. Patient access and care will suffer, exacerbating the challenges already facing neuropathy patients.

A 2010 poll by The Neuropathy Association showed that many patients already face significant delays in diagnosis, during which irreparable nerve damage continues:

Neuropathy Diagnosis 2012

Two Ways You Can Help

First: In the coming days, we will announce a process for contacting members of Congress and posting comments on these proposed changes on the Centers for Medicare & Medicaid Services website. Please watch your emails for this announcement and respond immediately. Please also know that we are working with our medical professional society partners to respond to this crisis.
And keep in mind that other insurers follow Medicare’s actions. So, even if you are not on Medicare, this change has the potential to impact everyone in the neuropathy community.

Second: Support our year-end fundraising efforts, and KEEP US IN THE FIGHT. In these difficult times for the economy and the Association, your generous contributions are our lifeline – and help protect your interests as well as those of untold numbers of future patients.
Thank you for taking action.

Neurologists to See Cuts in 2013 Medicare Payments
The Center for Medicare and Medicaid Services (CMS) recently released new code values that could result in decreased payments to neurologists. Specifically, physicians who provide nerve conduction and needle EMG services will face dramatic cuts of more than 50 percent for some services starting January 1, 2013. This is a drastic cut that will be especially hard on neurology practices large and small, many of which rely on these services to meet their bottom line. Patients also will pay the price with less access to these services. Private health insurers often follow Medicare payment rules as well, which will exacerbate the situation.
- American Academy of Neurology

Editor’s Note: Please refer to the President and CEO's message above for more information about this breaking issue that negatively impacts access to critical evaluation and care for people with neuropathy, and how The Neuropathy Association is working with the American Academy of Neurology, the American Association of Neuromuscular & Electrodiagnostic Medicine, and the American Academy of Physical Medicine & Rehabilitation to address this issue.

http://www.neuropathy.org/site/PageServer?pagename=Resources_PubArchivesM_E

Saturday, 25 June 2016

Neuropathy Over The Long Term

Today's post from livestrong.com (see link below) looks at the effects of neuropathy over the long term and although short and to the point, may help you understand what and why certain things are happening to you. It makes the point that ,"some types of peripheral neuropathy do not have a cure" when the truth is that, in fact very few types of neuropathy do have the potential for a cure but other than that, the information is accurate. Not happy reading for those living with nerve damage over several years but if you know what to look out for, you may be able to take steps to reduce the impact on your lives. Remember also, autonomic neuropathy is not a given by any means (you'll understand after reading the article).

Long-Term Effects of Peripheral Neuropathy
Last Updated: Sep 22, 2015 | By Lia Stannard

Overview

Peripheral neuropathy is a condition that affects the nerves outside of the brain or spinal cord. It can cause changes to sensation, movement and involuntary functions. Pressure on the nerves can cause peripheral neuropathy, as can certain conditions such as Charcot-Marie-Tooth disease, an inherited disorder. MedlinePlus, a website of the National Institutes of Health, points out that some types of peripheral neuropathy do not have a cure. The nerve damage from this condition can have lasting effects.

Reduced Feeling

Peripheral neuropathy affects three types of nerves: sensory, motor and autonomic. The sensory nerves relay information to the brain such as a change in temperature. When peripheral neuropathy damages the sensory nerves, patients can experience nerve pain, burning sensations or tingling. Some patients may have numbness that starts in the feet and moves up in the body. MayoClinic.com explains that with the numbness, patients can have reduced feeling in their limbs, which can affect their ability to sense changes. Problems can arise, such as in the case of a peripheral neuropathy patient who cannot feel pain in his feet and therefore does not notice a foot injury. If the injury goes untreated, an infection can develop.

Problems Moving

Since peripheral neuropathy can affect the motor nerves, patients may have a partial or total loss of movement and muscle control. For example, patients may experience paralysis of certain parts of the body such as the arms or legs. MedlinePlus points out that patients may fall from tripping over themselves. Peripheral neuropathy can cause muscle atrophy, in which patients lose some muscle tissue. Patients may have a lack of muscle control and dexterity, which can affect their ability to do tasks that require fine movements, such as writing with a pen. Damage to the autonomic nerves, which control the involuntary functions, can also impair movement. For example, patients can have dizziness when they stand up.

Weight Loss

Peripheral neuropathy patients may lose weight as a result of the autonomic nerve damage symptoms. MedlinePlus points out that peripheral neuropathy patients can lose more than 5 percent of their body weight. They may have nausea and vomiting after meals. The autonomic symptoms of peripheral neuropathy cause patients to feel full after eating a small amount of food, which can also affect weight. Motor nerve damage in the throat can affect patients' ability to swallow, which may cause them to eat less.

Low Self-esteem

MedlinePlus explains that the symptoms of peripheral neuropathy can cause patients to have low self-esteem. For example, male peripheral neuropathy patients may feel self-conscious about impotency problems. Urinary incontinence, or urine leakage, is another embarrassing problem related to peripheral neuropathy that can affect self-esteem.

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