Showing posts with label explanation. Show all posts
Showing posts with label explanation. Show all posts
Friday, 26 May 2017
An explanation of various treatments for neuropathy Warning! It aint gonna go viral on YouTube!
We're going to drop in on the 2006, Rare Neuroimmunologic Disorders Symposium to listen to and watch a talk given by Joanne Lynn MD. For the first two and a half minutes you may well wonder why, because the video takes some time to get to the point, or at least the points that are relevant to us. Apart from that, the good lady is not exactly the most inspiring speaker to listen to but stay with it because there is so much useful information and explanation which is specific to our problems. Apart from that, the slides that are shown, explain the difficult vocabulary that would normally go in one ear and out of the other.
You must remember that this is a medical professional talking to other medical professionals and therefore, there aren't very many fireworks to keep your attention but it's worth the effort. I've watched this three times and have learned something new and useful each time.
You can read the transcript of the video on: http://www.myelitis.org/newsletters/v7n2/newsletter7-2-02.htm
It helps!
Wednesday, 8 February 2017
A Simple Explanation Of Neuropathy For All Sufferers
Today's post from fosters.com (see link below) is something everybody learning to live with neuropathy should read - from beginners to those who've endured years of suffering. Strictly speaking it tells us nothing that can't be found in hundreds of other articles but it is so clearly written and so easily understood, it may well trigger several light-bulb moments in your brain and explain things you thought you knew and understood about the disease but really never got to the bottom of. Worth a read over your morning coffee.
By Karen Dandurant
news@seacoastonline.com
Posted May. 31, 2015
EXETER — Neuropathy, defined as a disease causing nerve pain, has many possible causes, but in more than half the cases it is associated with diabetes.
Dr. Geoffrey Starr, of Core Neurology at Exeter Hospital, said there are two types of neuropathy, polyneuropathy, meaning many nerves are affected, and peripheral neuropathy, dealing with pain in nerve endings.
“The most common is peripheral neuropathy, usually in the fingers and toes,” Starr said. “The patient can have numbness, tingling, a lack of sensation, cramps, muscle loss and imbalance and, in some cases, it affects the blood pressure.”
Starr said diabetes is the No. 1 cause and it affects people with both type 1 and type 2 diabetes. Other causes can be a thyroid problem, endocrine imbalances, a vitamin B12 deficiency or an excess of vitamin B6.
“Overuse of alcohol and smoking can cause neuropathy because of the toxins,” Starr said. “Chemotherapy can be another factor.”
For about 20 percent of the cases, there is no clear cause. Starr said it can be familial, genetic or age related.
Dr. Karen Lauze, a neurologist at Portsmouth Regional Hospital, said nerves have multiple functions in the body and which one is affected has a bearing on how treatable the disease is.
“The central nervous system controls the brain and the spine. Other systems control sensory perception, muscles and can be responsible for making the organs, like the heart, function. There are so many ways for nerves to be injured, so neuropathy is a very wide field.”
Lauze said a pinched nerve in the neck or carpal tunnel can cause the disease. Autoimmune diseases like lupus or rheumatoid arthritis can be responsible. Exposure to toxins such as heavy metals, imbalances in the B vitamins, Vitamin E or niacin, or a poor diet can be factors.
“If we can find the cause, we can usually treat it,” Starr said. “We may be able to correct it, control it or lessen the symptoms. We can deal with the pain. Tingling sensations do not respond well to medication but taking the pain away will help the person cope so the disease is not as functionally limiting.”
Diagnosing neuropathy involves sensory examination, assessing the nerve endings. Star said nerve conduction testing can be more definitive in sorting out the source of the problem.
“The initial signs are usually tingling in the fingers or toes,” Starr said. “People should seek help then, because addressing this early can have better results.”
Lauze said neuropathy usually starts with longer nerve fibers, because there is a larger area. That's why the feet are the most common initial site.
“Beside the pain and tingling, it can cause imbalances,” Lauze said. “That puts people at risk of falling and receiving other injuries.”
Autonomic nerves can be affected, resulting in the heart racing, or fainting. Lauze said doctors have little control over that condition.
Michael Davidson, DO, of Endocrinology and Diabetes Consultants, affiliated with Wentworth-Douglass Health Partners in Dover, said his practice deals mostly with diabetics, representing the largest population of people suffering from neuropathy.
“Twenty-six percent of people, at the time they are diagnosed with Type 2 diabetes, will have clinical manifestations of neuropathy,” Davidson said. “That's partly because type 2 diabetics are not diagnosed right away. Of the 29 million people with Type 2 diabetes in the U.S., it is estimated that 8 million do not know they have it. Neuropathy is often their first indication.”
Davidson said it is thought that neuropathy tingling is directly related to the length of time and the severity of blood sugar issues.
“Other factors can play a role, like high blood pressure, smoking and cholesterol, but blood sugar is the main factor,” Davidson said. “Diabetic amputations are directly related to neuropathy. If a patient cannot sense pain in their extremities, cannot feel temperature differences, or may not have a visual of the damage occurring, they may not respond appropriately. If they are not responding to the injury, or if another condition like heart failure is causing edema, that sensory deprivation and lack of self-care can be devastating.”
Davidson talked about a patient who had neuropathy and tended to wear Mary Jane style shoes. Her neuropathy got so bad, the strap of the shoe had cut right down to the bone. It sounds extreme, but he said he has had patients who have stepped on tacks and not discovered them for six months, after the damage has been done.
“Their symptoms are related to the distal nerves, farthest away from the body core,” Davidson said. “Generally it's the feet before the hands or legs. It travels in a predictable fashion.”
Treating diabetic neuropathy begins with treating blood sugar levels. Davidson said getting the blood sugar under control can lessen symptoms and will arrest the factors leading to the disease.
“For a diabetic, care of the feet is crucial,” Davidson said. “When patients come to see me, their shoes are off. Examination of the feet is always important. There is no way to stop nerve fibers from dying, but medication can change the perception of pain and calm the symptoms.”
Two drugs are approved by the Food and Drug Administration to treat diabetic neuropathy. They are Cymbalta (duloxetine) and Lyrica (pregabalin). Davidson said sometimes the use of specific antidepressants can help.
“The antidepressants change the way the brain processes the signals,” Davidson said. “By treating the central nervous system, it changes how patients perceive the symptoms. Pain relievers like Tramadol can also help.”
Over-the-counter medications can be tried first, with less invasive impacts. Davidson said alphalipoic acid or vitamin D have been shown to be effective in some patients.
Opiods for pain are the last line of defense because of addiction concerns.
“We have some success with capsaicin, a cream for the feet,” Lauze said. “The cream sucks out a specific protein in the pain fibers (protein C). Basically, it depletes the the fiber's ability to feel pain. Antiseizure medication might help. The sooner we find the cause, the better for the patient.”
http://www.fosters.com/article/20150531/ENTERTAINMENTLIFE/150539991
Friday, 26 August 2016
A Good Explanation Of Autonomic Neuropathy
Many people write to the blog worried that their peripheral neuropathy is turning into Autonomic neuropathy because essential involuntary functions in their bodies seem to be letting them down, alongside their normal neuropathic symptoms. Today's post from lodiseases.com (see link below) provides a comprehensive description of possible features of autonomic neuropathy and will give you enough information to begin a constructive discussion with your doctor or specialist. It is tempting to believe that more of these symptoms apply to you than you think; or that they are all neuropathy-based when in fact they can be the result of aging or other conditions. It's important to have the experts assess your neuropathy. If you have idiopathic neuropathy (no apparent cause) then your account of the progression of symptoms becomes very important - try to keep a record of what's happening and when - it will help your doctor enormously. Remember, individual symptoms of autonomic neuropathy may well be individually treatable, so try not to let it get you down too much.
List Of DiseaseS
Diseases Resource and Database
Autonomic neuropathy
lodiseases | December 30, 2012 |
Autonomic neuropathy
lodiseases | December 30, 2012 |
Definition:
Autonomic neuropathy is a nerve disorder that affects involuntary body functions, including heart rate, blood pressure, perspiration and digestion.
It isn’t a specific disease. Autonomic neuropathy refers to damage to the autonomic nerves. This damage disrupts signals between the brain and portions of the autonomic nervous system, such as the heart, blood vessels and sweat glands. This can cause decreased or abnormal performance of one or more involuntary body functions.
Autonomic neuropathy can be a complication of a number of diseases and conditions. And some medications can cause autonomic neuropathy as a side effect. Signs, symptoms and treatment of autonomic neuropathy vary depending on the cause, and on which nerves are affected.
Symptoms:
Signs and symptoms of autonomic neuropathy vary, depending on which parts of your autonomic nervous system are affected. They may include:
Dizziness and fainting upon standing caused by a drop in blood pressure.
Urinary problems, including difficulty starting urination, urinary incontinence and an inability to completely empty your bladder, which can lead to urinary tract infections.
Sexual difficulties, including problems achieving or maintaining an erection (erectile dysfunction) or ejaculation problems in men, and vaginal dryness and difficulties with arousal and orgasm in women.
Difficulty digesting food, due to abnormal digestive function and slow emptying of the stomach (gastroparesis). This can cause a feeling of fullness after eating little, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heartburn.
Sweating abnormalities, such as excessive or decreased sweating, which affects the ability to regulate body temperature.
Sluggish pupil reaction, making it difficult to adjust from light to dark and causing problems with driving at night.
Exercise intolerance, which may occur if your heart rate remains unchanged instead of appropriately increasing and decreasing in response to your activity level.
When to see a doctor
Seek medical care promptly if you begin experiencing any of the signs and symptoms of autonomic neuropathy. If you have diabetes, a compromised immune system or another chronic medical condition, see your doctor regularly to be checked for nerve damage.
The American Diabetes Association (ADA) recommends that people with type 2 diabetes be screened every year for autonomic neuropathy starting as soon as they receive their diabetes diagnosis. For people with type 1 diabetes, the ADA advises annual screening beginning five years after being diagnosed with diabetes.
Causes:
Autonomic neuropathy can be caused by a large number of diseases and conditions or can be a side effect of treatment for diseases unrelated to the nervous system. Some common causes of autonomic neuropathy include:
Abnormal protein buildup in organs (amyloidosis), which affects the organs and the nervous system.
Autoimmune diseases, in which your immune system attacks and damages parts of your body, including your nerves. Examples include Sjogren’s syndrome and systemic lupus erythematosus. Autonomic neuropathy may also be caused by an abnormal attack by the immune system that occurs as a result of some cancers (paraneoplastic syndrome).
Diabetes, which is the most common cause of autonomic neuropathy, can gradually cause nerve damage throughout the body.
Injury to nerves caused by surgery or radiation to the neck.
Treatment with certain medications, including some drugs used in cancer chemotherapy, some antidepressants and some heart medications.
Other chronic illnesses, such as Parkinson’s disease.
Certain infectious diseases. Some viruses and bacteria, such as botulism, leprosy and diphtheria, can cause autonomic neuropathy.
Inherited disorders. Certain hereditary disorders can cause autonomic neuropathy.
Treatments and drugs:Treatment of autonomic neuropathy includes:
Treating the underlying disease. The first goal of treating autonomic neuropathy is to manage the disease or condition damaging your nerves. For example, if the underlying cause is diabetes, you’ll need to control your blood sugar to keep it as close to normal as possible. Treating the underlying disease can help stop autonomic neuropathy from progressing.
Managing specific symptoms. Some treatments can relieve the symptoms of autonomic neuropathy. Treatment is based on what part of your body is most affected by nerve damage.
Digestive (gastrointestinal) symptoms
Your doctor may recommend:
Modifying your diet. This could include increasing the amount of fiber you eat and fluids you drink. Supplements containing fiber, such as Metamucil or Citrucel, also may help. Be sure to increase the fiber in your diet slowly to avoid gas and bloating.
Medication to help your stomach empty. A prescription drug called metoclopramide (Reglan) helps your stomach empty faster by increasing the contractions of the digestive tract. This medication may cause drowsiness, and its effectiveness wears off over time.
Medications to ease constipation. Over-the-counter laxatives may help ease constipation. Ask your doctor how often you should use these medications. In addition, increasing the amount of fiber in your diet may help relieve constipation.
Antidepressants. Tricyclic antidepressants, such as imipramine (Tofranil) or nortriptyline (Pamelor), can help treat diarrhea and abdominal pain. Dry mouth and urine retention are possible side effects of these medications.
Urinary symptoms
Your doctor may suggest:
Retraining your bladder. Following a schedule of when to drink fluids and when to urinate can help increase your bladder’s capacity and retrain your bladder to empty completely at the appropriate times.
Medication to help empty the bladder. Bethanechol is a medication that helps ensure complete emptying of the bladder. Possible side effects include headache, abdominal cramping, bloating, nausea and flushing.
Urinary assistance (catheterization). During this procedure, a tube is threaded through your urethra to empty your bladder.
Medications that decrease overactive bladder. These include tolterodine (Detrol) or oxybutynin (Ditropan XL). Possible side effects include dry mouth, headache, fatigue, constipation and abdominal pain.
Sexual dysfunction
For men with erectile dysfunction, your doctor may recommend:
Medications that enable erections. Drugs such as sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis) can help you achieve and maintain an erection. Possible side effects include mild headache, flushing, upset stomach and altered color vision. Men with a history of heart disease, stroke or high blood pressure need to use these medications with caution and medical supervision. Seek immediate medical assistance if you have an erection that lasts longer than four hours.
An external vacuum pump. This device helps pull blood into the penis using a hand pump. A tension ring helps keep the blood in place, maintaining the erection for up to 30 minutes.
For women with sexual symptoms, your doctor may recommend:
Vaginal lubricants. If vaginal dryness is a problem, vaginal lubricants may make sexual intercourse more comfortable and enjoyable.
Heart rhythm and blood pressure symptoms
Autonomic neuropathy can cause a number of heart rate and blood pressure problems. Your doctor may prescribe:
Medications that help raise your blood pressure. If you get dizzy or feel faint when you stand up, your doctor may suggest a drug called fludrocortisone acetate. This medication helps your body retain salt, which helps regulate your blood pressure. Other drugs that can help raise your blood pressure include midodrine (ProAmatine) and pyridostigmine (Mestinon). High blood pressure when lying down is a possible side effect of midodrine.
Medication that helps regulate your heart rate. A class of medications called beta blockers helps to regulate your heart rate if your heart rate doesn’t respond normally to changes in activity level.
A high-salt, high-fluid diet. If your blood pressure drops when you stand up, a high-salt, high fluid diet may help maintain your blood pressure.
Sweating
If you experience excessive sweating, your doctor may prescribe:
A medication that decreases perspiration. The drug glycopyrrolate (Robinul, Robinul Forte) can decrease sweating. Side effects may include dry mouth, urinary retention, blurred vision, changes in heart rate, loss of taste and drowsiness.
There is no medication to increase sweating if you have lost the ability to sweat.
Autonomic neuropathy is a nerve disorder that affects involuntary body functions, including heart rate, blood pressure, perspiration and digestion.
It isn’t a specific disease. Autonomic neuropathy refers to damage to the autonomic nerves. This damage disrupts signals between the brain and portions of the autonomic nervous system, such as the heart, blood vessels and sweat glands. This can cause decreased or abnormal performance of one or more involuntary body functions.
Autonomic neuropathy can be a complication of a number of diseases and conditions. And some medications can cause autonomic neuropathy as a side effect. Signs, symptoms and treatment of autonomic neuropathy vary depending on the cause, and on which nerves are affected.
Symptoms:
Signs and symptoms of autonomic neuropathy vary, depending on which parts of your autonomic nervous system are affected. They may include:
Dizziness and fainting upon standing caused by a drop in blood pressure.
Urinary problems, including difficulty starting urination, urinary incontinence and an inability to completely empty your bladder, which can lead to urinary tract infections.
Sexual difficulties, including problems achieving or maintaining an erection (erectile dysfunction) or ejaculation problems in men, and vaginal dryness and difficulties with arousal and orgasm in women.
Difficulty digesting food, due to abnormal digestive function and slow emptying of the stomach (gastroparesis). This can cause a feeling of fullness after eating little, loss of appetite, diarrhea, constipation, abdominal bloating, nausea, vomiting, difficulty swallowing and heartburn.
Sweating abnormalities, such as excessive or decreased sweating, which affects the ability to regulate body temperature.
Sluggish pupil reaction, making it difficult to adjust from light to dark and causing problems with driving at night.
Exercise intolerance, which may occur if your heart rate remains unchanged instead of appropriately increasing and decreasing in response to your activity level.
When to see a doctor
Seek medical care promptly if you begin experiencing any of the signs and symptoms of autonomic neuropathy. If you have diabetes, a compromised immune system or another chronic medical condition, see your doctor regularly to be checked for nerve damage.
The American Diabetes Association (ADA) recommends that people with type 2 diabetes be screened every year for autonomic neuropathy starting as soon as they receive their diabetes diagnosis. For people with type 1 diabetes, the ADA advises annual screening beginning five years after being diagnosed with diabetes.
Causes:
Autonomic neuropathy can be caused by a large number of diseases and conditions or can be a side effect of treatment for diseases unrelated to the nervous system. Some common causes of autonomic neuropathy include:
Abnormal protein buildup in organs (amyloidosis), which affects the organs and the nervous system.
Autoimmune diseases, in which your immune system attacks and damages parts of your body, including your nerves. Examples include Sjogren’s syndrome and systemic lupus erythematosus. Autonomic neuropathy may also be caused by an abnormal attack by the immune system that occurs as a result of some cancers (paraneoplastic syndrome).
Diabetes, which is the most common cause of autonomic neuropathy, can gradually cause nerve damage throughout the body.
Injury to nerves caused by surgery or radiation to the neck.
Treatment with certain medications, including some drugs used in cancer chemotherapy, some antidepressants and some heart medications.
Other chronic illnesses, such as Parkinson’s disease.
Certain infectious diseases. Some viruses and bacteria, such as botulism, leprosy and diphtheria, can cause autonomic neuropathy.
Inherited disorders. Certain hereditary disorders can cause autonomic neuropathy.
Treatments and drugs:Treatment of autonomic neuropathy includes:
Treating the underlying disease. The first goal of treating autonomic neuropathy is to manage the disease or condition damaging your nerves. For example, if the underlying cause is diabetes, you’ll need to control your blood sugar to keep it as close to normal as possible. Treating the underlying disease can help stop autonomic neuropathy from progressing.
Managing specific symptoms. Some treatments can relieve the symptoms of autonomic neuropathy. Treatment is based on what part of your body is most affected by nerve damage.
Digestive (gastrointestinal) symptoms
Your doctor may recommend:
Modifying your diet. This could include increasing the amount of fiber you eat and fluids you drink. Supplements containing fiber, such as Metamucil or Citrucel, also may help. Be sure to increase the fiber in your diet slowly to avoid gas and bloating.
Medication to help your stomach empty. A prescription drug called metoclopramide (Reglan) helps your stomach empty faster by increasing the contractions of the digestive tract. This medication may cause drowsiness, and its effectiveness wears off over time.
Medications to ease constipation. Over-the-counter laxatives may help ease constipation. Ask your doctor how often you should use these medications. In addition, increasing the amount of fiber in your diet may help relieve constipation.
Antidepressants. Tricyclic antidepressants, such as imipramine (Tofranil) or nortriptyline (Pamelor), can help treat diarrhea and abdominal pain. Dry mouth and urine retention are possible side effects of these medications.
Urinary symptoms
Your doctor may suggest:
Retraining your bladder. Following a schedule of when to drink fluids and when to urinate can help increase your bladder’s capacity and retrain your bladder to empty completely at the appropriate times.
Medication to help empty the bladder. Bethanechol is a medication that helps ensure complete emptying of the bladder. Possible side effects include headache, abdominal cramping, bloating, nausea and flushing.
Urinary assistance (catheterization). During this procedure, a tube is threaded through your urethra to empty your bladder.
Medications that decrease overactive bladder. These include tolterodine (Detrol) or oxybutynin (Ditropan XL). Possible side effects include dry mouth, headache, fatigue, constipation and abdominal pain.
Sexual dysfunction
For men with erectile dysfunction, your doctor may recommend:
Medications that enable erections. Drugs such as sildenafil (Viagra), vardenafil (Levitra) or tadalafil (Cialis) can help you achieve and maintain an erection. Possible side effects include mild headache, flushing, upset stomach and altered color vision. Men with a history of heart disease, stroke or high blood pressure need to use these medications with caution and medical supervision. Seek immediate medical assistance if you have an erection that lasts longer than four hours.
An external vacuum pump. This device helps pull blood into the penis using a hand pump. A tension ring helps keep the blood in place, maintaining the erection for up to 30 minutes.
For women with sexual symptoms, your doctor may recommend:
Vaginal lubricants. If vaginal dryness is a problem, vaginal lubricants may make sexual intercourse more comfortable and enjoyable.
Heart rhythm and blood pressure symptoms
Autonomic neuropathy can cause a number of heart rate and blood pressure problems. Your doctor may prescribe:
Medications that help raise your blood pressure. If you get dizzy or feel faint when you stand up, your doctor may suggest a drug called fludrocortisone acetate. This medication helps your body retain salt, which helps regulate your blood pressure. Other drugs that can help raise your blood pressure include midodrine (ProAmatine) and pyridostigmine (Mestinon). High blood pressure when lying down is a possible side effect of midodrine.
Medication that helps regulate your heart rate. A class of medications called beta blockers helps to regulate your heart rate if your heart rate doesn’t respond normally to changes in activity level.
A high-salt, high-fluid diet. If your blood pressure drops when you stand up, a high-salt, high fluid diet may help maintain your blood pressure.
Sweating
If you experience excessive sweating, your doctor may prescribe:
A medication that decreases perspiration. The drug glycopyrrolate (Robinul, Robinul Forte) can decrease sweating. Side effects may include dry mouth, urinary retention, blurred vision, changes in heart rate, loss of taste and drowsiness.
There is no medication to increase sweating if you have lost the ability to sweat.
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