Leg Pain not always Neuropathy

This blog almost always relates HIV-related, foot and leg pain to Neuropathy but that's not always the case and it's always worth bearing in mind that there are other possible causes, before jumping to conclusions. When you're HIV positive, it's easy to pin a label on a problem at the first sign of trouble, after all, when it comes to secondary infections, virus, or drug related conditions, we're prone to almost everything (and they wonder why some people become hypochondriacs!) This article from Pain.com (see link below) outlines the commonest causes of leg pain. The true cause will eventually be discovered by your doctors but keeping an open mind before you get the diagnosis weeks or months later, is always advisable.

Leg Pain
May 21, 2011

In addition to injuries and muscle cramps, various medical conditions can cause leg pain. This article covers some of the medical conditions that can cause leg pain. Medical conditions involving the cardiovascular system will be discussed in a separate article in this series about leg pain.

Peripheral neuropathy is not a disease in itself, but a symptom of nerve damage in the limbs that is caused by other medical conditions. Peripheral neuropathy is common in patients with diabetes, HIV/AIDS, vitamin B12 deficiency, cancer, lupus, syphilis, lyme disease, rheumatoid arthritis, sarcoidosis, hypothyroidism, toxic exposure, certain genetic diseases and so on. Peripheral neuropathy is a common symptom and it can be inherited, caused by an infection, caused by exposure to certain chemicals, experienced as a side effect of some medications, caused by metabolic disorders or nutritional deficiencies, caused by inflammatory diseases, caused by oxygen starvation or caused by trauma to a peripheral nerve.

Peripheral neuropathy commonly affects the feet and legs. If a nerve that carries sensation from the body to the central nervous system is damaged, a person may experience pain, burning, numbness or tingling in the leg or foot. Proprioception, or the ability to sense where a body part is without looking, can also be affected and a person can become more uncoordinated. If a motor nerve that supplies a muscle is damaged, a muscle becomes weak because it can not contract as well. It is possible for some muscles to become paralyzed, depending on the extent of the nerve damage. In some cases, muscles may cramp up instead of becoming flaccid and weak. Treatment of peripheral neuropathy involves treating the underlying cause of the problem, along with symptomatic care for pain and physical or occupational therapy if necessary.

Another possible medical cause of leg pain is a bone infection, called osteomyelitis. Osteomyelitis is a bacterial infection that can be caused by several different types of bacteria. People can contract a bone infection via a wound, such as when an open fracture occurs or when a person has surgery, or an infection can spread to the bone from a different part of the body. A type of skin infection called cellulitis can spread to underlying tissues and bones in the leg, or an internal infection like a bladder infection can spread to other parts of the body through the bloodstream.

Any patient with a suppressed immune system due to aggressive immunosuppressive therapy or an immune deficiency like HIV/AIDS is more likely to develop infections, including osteomyelitis. Treatment for osteomyelitis includes antibiotic medications to get rid of the infection and medications to control pain. If the infection is not treated early, it is possible for the infection to spread to other tissues in the leg, making amputation of the leg necessary. It is also possible for a person with an untreated infection to go into septic shock when the bacteria infect the bloodstream.

If your leg pain is in your joints, you may have arthritis, or joint inflammation. There are many different types of arthritis, including osteoarthritis, gout and rheumatoid arthritis. More information about the various types of arthritis can be found at http://pain.com/library/2011/05/01-arthritis-awareness-month/. Infections in the joint capsule itself can also cause joint pain. Osteoarthritis, the most common type of arthritis, is caused by “wear and tear” on the cartilage of the joint. Rheumatoid arthritis is an autoimmune disease. Gout is caused by having too much of a substance called uric acid in your body, which builds up in the joints and causes pain and inflammation. Common symptoms of many different types of arthritis include joint pain, joint stiffness or decreased joint mobility and joint swelling. Treatment for arthritis varies depending on the type of arthritis. Talk to your doctor if you think you may have arthritis pain.

Fibromyalgia is a medical condition that can cause muscle pain in the legs and in other parts of the body. In addition to muscle pain, people with fibromyalgia may also have chronic fatigue, sleep disorders, tension headaches and mood disorders. The cause of fibromyalgia is unknown, but researchers think that people with fibromyalgia have a lowered tolerance to pain because of abnormalities in the way that their brains process pain signals. Treatment for fibromyalgia is symptomatic and aims to control pain, improve sleep and treat mood disorders. Not all aspects of fibromyalgia can be treated medically; for example, the frustration that a patient with fibromyalgia may feel in not knowing how to deal with chronic pain and fatigue may benefit from counseling.

Peripheral neuropathy, infections, arthritis and fibromyalgia are just a sampling of the medical conditions that may cause leg pain. These conditions are not as common as muscle cramps and injuries, but a good proportion of older people develop some degree of osteoarthritis and peripheral neuropathy can be caused by a variety of medical conditions. Always talk to your doctor if you have persistent leg pain and you do not know what is causing it.

http://pain.com/library/2011/05/21-leg-pain-3/

FACIAL MASCULINITY NOT ALWAYS A TELLING FACTOR IN MATE SELECTION

Women living where rates of infectious disease are high, according to theory, prefer men with faces that shout testosterone when choosing a mate. However, an international study says not so much, says University of Oregon anthropologist Lawrence S. Sugiyama

The new study, on which Sugiyama is one of 22 co-authors, ended with that theory crumbling amid patterns too subtle to detect when tested with 962 adults drawn from 12 populations living in various economic systems in 10 nations.

The study -- coordinated by Ian S. Penton-Voak of the School of Experimental Biology at the University of Bristol in the United Kingdom -- appears online ahead of print this week in the Early Edition of the Proceedings of the National Academy of Sciences.

"It's not the case that women have a universal preference for high testosterone faces, and it's not the case that such a preference is greater in a high-pathogen environment," Sugiyama said. "And the opposite is also the case. Men don't uniformly appear to have a preference for more feminine faces, at least within the ranges of cultures shown in this study. In cultures tied to pastoralism, agriculture, foraging, fishing and horticulture, not so much, the authors concluded.

The closest the theory came to confirmation was in market economies in the study populations in the U.K., Canada and China, perhaps because, as Sugiyama's prior work has shown, preferences shift in response to the local range of variation in traits, and men in market economies have higher testosterone.

Also, Sugiyama said: "In large-scale societies like ours we encounter many unfamiliar people, so using appearance to infer personality traits can help cope with the overwhelming amount of social information. For instance, in all cultures tested, high testosterone faces were judged to be more aggressive, and this is useful information when encountering strangers."

Sugiyama and three other UO co-authors contributed to the study based on their work with the Shuar, a rural population with a long history of warfare in Ecuador and whose mixed economy today is based on horticulture, hunting, foraging and small-scale agro-pastoralism.

The Shuar did not come into contact with the outside world until the 1880s, and only since the 1960s have they organized into communities, Sugiyama said. The UO's research there is looking at the impacts of culture change on Shuar health. Data for the PNAS study were collected during routine sessions with 30 males and 31 females.

Each was shown culturally appropriate facial representations of potential opposite-sex mates and asked which one they'd prefer. Shuar women didn't like the faces of men whose faces suggested high testosterone levels. "Shuar women preferred slightly less testosterone-looking faces," Sugiyama said. The reason why was not clear, but he suggests that maybe Shuar women possibly have grown weary of years of warfare and would prefer mates who would be less likely to participate and encourage their offspring to engage in violent behaviors.

UO co-authors are J. Josh Snodgrass, a professor of biological anthropology, doctoral student Melissa A. Liebert, who has spent seven research seasons with the Shuar, and undergraduate student Ruby Fried, who has since earned a bachelor's degree from the UO and now is a doctoral student in anthropology at Northwestern University in Evanston, Illinois.

As with the UO team, the paper's other researchers contributed with data collected from the populations that they study. The study encompassed students and Cree populations in Canada, students and urban residents in two Chinese cities, the Tuvans in Russia, students in the United Kingdom, the Kadazan-Dusun in Malaysia, villagers in Fiji, the Miskitu in Nicaragua, the Tchimba in Namibia and the Aka in the Central African Republic.

"Performance by the different populations wasn't chance," Sugiyama said. "For each society there was a pattern. There were significant preferences in each culture. Market economies do play a part, but something more was going on.

"I think the real message of this study is that we in this field need to stop and rethink how we have been thinking about these things," he said. "Maybe the idea of infectious disease -- the presence of pathogens -- isn't the main driving factor. The underlying adaptations are likely to track other ecological considerations and local cultural factors that we don't have data on and may eventually be very important in understanding attractiveness."

MORE EXERCISE IS NOT ALWAYS BETTER

There is strong epidemiological evidence of the importance of regular physical activity, such as brisk walking and jogging, in the management and rehabilitation of cardiovascular disease and in lowering the risk of death from other diseases such as hypertension, stroke, and type 2 diabetes. The Physical Activity Guidelines for Americans recommends about 150 minutes per week of moderate-intensity exercise or about 75 minutes of vigorous-intensity exercise. But there is clear evidence of an increase in cardiovascular deaths in heart attack survivors who exercise to excess, according to a new study published in Mayo Clinic Proceedings.

Paul T. Williams, PhD, of the Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, and Paul D. Thompson, MD, of the Department of Cardiology, Hartford Hospital, Hartford, CT, studied the relationship between exercise and cardiovascular disease-related deaths in about 2,400 physically active heart attack survivors. They conducted a prospective long-term study using the National Walkers' and Runners' Health Studies databases. This study confirmed previous reports indicating that the cardiovascular benefits for walking and running were equivalent, as long as the energy expenditures were the same (although when walking, as compared to running, it will take about twice as long to burn the same number of calories).

Remarkable dose-dependent reductions in deaths from cardiovascular events of up to 65% were seen among patients who were running less than 30 miles or walking less than 46 miles per week. Beyond this point however much of the benefit of exercise was lost, in what is described as a reverse J-curve pattern.

"These analyses provide what is to our knowledge the first data in humans demonstrating a statistically significant increase in cardiovascular risk with the highest levels of exercise," say Williams and Thompson. "Results suggest that the benefits of running or walking do not accrue indefinitely and that above some level, perhaps 30 miles per week of running, there is a significant increase in risk. Competitive running events also appear to increase the risk of an acute event." However, they point out that "our study population consisted of heart attack survivors and so the findings cannot be readily generalized to the entire population of heavy exercisers."

In the same issue, investigators in Spain report on a meta-analysis of ten cohort studies aimed at providing an accurate overview of mortality in elite athletes. The studies included over 42,000 top athletes (707 women) who had participated in a range of sports including football, baseball, track and field, and cycling, including Olympic level athletes and participants in the Tour de France.

"What we found on the evidence available was that elite athletes (mostly men) live longer than the general population, which suggests that the beneficial health effects of exercise, particularly in decreasing cardiovascular disease and cancer risk, are not necessarily confined to moderate doses," comments senior investigator Alejandro Lucia, MD, PhD, of the European University Madrid, Spain. "More research is needed however, using more homogeneous cohorts and a more proportional representation of both sexes."

"Extrapolation of the data from the current Williams and Thompson study to the general population would suggest that approximately one out of twenty people is overdoing exercise," comments James H. O'Keefe, MD, from the Mid America Heart Institute in Kansas City, MO, and first author of an editorial on "Exercising for Health and Longevity versus Peak Performance: Different Regimens for Different Goals," which appears in the same issue. Along with co-authors Carl "Chip" Lavie, MD, and Barry Franklin, PhD, he explains that "we have suggested the term 'cardiac overuse injury' for this increasingly common consequence of the 'more exercise is better' strategy." Even so, these authors state that about 10 out of every twenty people are not getting the minimum recommended amount of physical activity (>150 minutes/week of moderate exercise).

O'Keefe, Franklin and Lavie point out that a weekly cumulative dose of vigorous exercise of not more than about five hours has been identified in several studies to be the safe upper range for long-term cardiovascular health and life expectancy, and that it may also be beneficial to take one or two days a week off from vigorous exercise, and to refrain from high-intensity exercise on an everyday basis. They propose that individuals from either end of the exercise spectrum (sedentary people and over-exercisers) would probably reap long-term health benefits by changing their physical activity levels to be in the moderate range.

"For patients with heart disease, almost all should be exercising, and generally most should be exercising 30-40 minutes most days, but from a health stand-point, there is no reason to exercise much longer than that and especially not more than 60 minutes on most days," says Lavie, who is a cardiologist at the John Ochsner Heart and Vascular Institute, New Orleans, LA. "As Hippocrates said more than 2,000 years ago, 'if we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health.' I and my co-authors believe this assessment continues to provide wise guidance," he concludes.

Is HIV always the big bad wolf

This is part of an article by Bradford McIntyre on the site http://www.hivaidspositivestories.com and raises an important question for all people with HIV. Is the blame for every disease or complaint that you get, transferred onto HIV and if so, is that really the case? It's certainly easy for health professionals to blame HIV and/or the HIV medication for your neuropathy but the fact is that there are about 100 possible causes for neuropathy (see elsewhere here on the blog). It makes you think!

So much fear has been created around HIV infection and AIDS. The camouflage uniforms worn in the army, disguise and hide, so not to draw attention, able to blend in. The fear associated with HIV/AIDS has kept us in the dark, many fear losing their family. friends, home and job, causing people to hide the fact they have been infected with the HIV virus. So no one can see, hear, or know the truths of those living with HIV and AIDS. Most often when individuals die from HIV related illness or AIDS, the funeral announcements rarely say HIV/AIDS was the cause, but use cancer, heart disease or any other camouflage.


How can we tell the real number of HIV related deaths? How can the public know and understand HIV/AIDS, without the truth? Individuals dealing with HIV and all those around them who are affected but not infected, they know these truths!
Science, pharmaceutical companies, the medical profession and government, have all but ignored much of what many people living with HIV/AIDS have to say, which is a major contribution in the understanding of this virus. Science and the medical profession provide HIV/AIDS information to the media. The media takes this information and in so doing, does it without a real balance of understanding. Unfortunately the fear has undermined our understanding. We see people dying, and certainly in many parts of the world there is malnutrition, lack of medical attention and affordable pharmaceutical resources, causing countless deaths. We see the fear associated with sex and the need for safe sex practices! We hear about the deaths.


We hear about drug cocktails, medications being approved. We see people taking a handful of pills. We hear about the resistance to drugs, and we visually, through the media, see those sick with wasting syndrome, PCP pneumonia, kaposi's sarcoma , or crippled by neuropathy.


What is alarming about this situation is the medical profession holds the HIV virus responsible for any and all illness when a patient is diagnosed infected with HIV, using the excuse that a condition is HIV related. It is because of this rampant over diagnosis that little or no search is undertaken for what is causing the health problem. Many have died, many suffered greatly due to mis-diagnosis or no diagnosis. Other diseases occur, and with a condition in progress or out of control and very little attention given it, this allows for many suffering and dying. Not from HIV, but from an invasion of bacteria, fungi, viruses and cancers, unaware to those not looking.
We don't see individuals living a happy and full life, whether it be with or without drug treatments. And we don't see it because the fear has people afraid to talk about HIV/AIDS or disclose they have been infected. So we don't have people coming forward to tell their side of HIV/AIDS. How are we going to get people to come forward when the stigma attached to HIV/AIDS has created so much fear. People are hiding their HIV infection! This is likened to the early days of cancer, hiding the fact, only whispering the C word! Everyone who develops cancer does not die, it makes no sense to believe everyone who is infected with HIV will get sick or die either! We don't see those who get sick but benefit from the drugs and have their health restored, many returning to the work force. We don't see or hear about individuals who test positive for HIV or have AIDS, in relationships, falling in love. We don't see the many relationships where one partner is infected and one is not, and the partner who is negative, is not infected.


The public needs to understand HIV and let go of the fear, each person taking part in a global prevention strategy. These days pharmaceutical resistance is evident, with HIV, not only is a person infected with a strain or possible multiple strains, but along with it, comes the possibility of resistance to all the drugs the infected individual has taken.
We don't know how each person will react to HIV infection. We need to put money back into wellness!
We must not wane from our efforts in safe sex education, prevention, and research. Never was it more important to keep up our efforts, creating less toxic and affordable drugs, and providing proper health care including alternative therapies and supplements.


With proper awareness and education, we can go about living our lives responsibly, " showing up for life", without fear. Not afraid of talking about HIV/AIDS or conversations about safe sex.
Letting go of the fear, we can all talk to our family and friends and co-workers we discuss our personal lives with. Our employer can know health related information. And, if need be, we can ask for help and receive help! We can also eliminate false perceptions and judgments due to shear ignorance. There is more power in people knowing the truth, than there ever was in the fear and hiding! A shift in perception is nothing short of a Miracle!

by Bradford McIntyre

http://www.positivelypositive.ca