Friday, 29 August 2014

Can Schwann Cells Revive Old Peripheral Nerves?

Today's post from vectorblog.org (see link below) looks at the role of Schwann cells in nerve regeneration. These cells play a vital role in nerve health and are thought to contain a nerve-regeneration factor which they can release to encourage nerve re-growth after damage. Perhaps not surprisingly, age is an important factor - the older we are, the less likely nerves will be able to 'self-heal' so to speak.  It sounds complex but this article explains it very simply and is an interesting read.


Can old peripheral nerves learn new tricks? Only the Schwann cells know for sure 
by Nancy Fliesler on August 25, 2014

Healing from nerve injuries gets slower as we age--here's why. About six weeks ago, a glass shattered in my hand, severing the nerve in my pinky finger. The feeling in my fingertip still hasn’t returned, and now I know why: I’m too old.

Going back to World War II, it’s been speculated that recovery of peripheral nerve injuries—like those in limbs and extremities—is influenced by age. And studies indicate that peripheral neuropathy is common in people over 65 and often unexplained.

“When you’re very young, the system is very plastic and able to regenerate,” Michio Painter told me recently. He is a graduate student in the laboratory of Clifford Woolf, PhD, director of the F.M. Kirby Neurobiology Center at Boston Children’s Hospital. “After that, there’s a gradual decline. By the age of 30, much of this plasticity is gone.”

Traditionally, this decline has been thought to reflect age-related differences in neurons’ ability to regrow, but when Painter studied neurons in a dish, he couldn’t confirm this.

“We were surprised to see that old neurons were able to grow just fine,” he says. When they looked at gene activation in injured sensory neurons, all of the right growth signals seemed to switch on.


The older the mouse, the slower sensory function (A) and motor function (B) return after nerve injury.

So why do I still have this dead spot of feeling—and weird electrical sensations in the part of my finger cut by the glass?

Painter first speculated that older people might lack nerve-rejuvenating factors in their blood. This idea of “young blood” has some precedent: Several recent studies found that exposing older mice to the blood of younger mice made them last longer on the treadmill, increased blood flow in the brain and boosted performance on learning and memory tests.

Not so for peripheral nerve injuries, however.

“What we found was that the blood had no effect,” says Painter. “We then figured there must be something in the nerve environment itself that’s modulating the ability of the nerve to regenerate.”

He and his colleagues did a series of experiments, published last month in Neuron, working with both old and young mice. An old (24-month-old) mouse with a nerve injury recovered like a young (2-month-old) mouse if young nerve tissue was grafted on. But when a young injured mouse received nerve tissue from an older mouse, regeneration was severely reduced.

Eventually, they realized the missing link: In older mice, it was glial cells that were failing, not the neurons.


In young mice (top row), the Schwann cells, outlined in green, have begun to engulf and compact myelin (shown in yellow) by day 3 after injury. In older mice, this process is delayed.

In particular, Schwann cells, a type of glial cell in the peripheral nervous system, were defective. Normally, Schwann cells do three things to encourage axon regrowth after injury. First, they clear the area of myelin, the insulating coating on axons that is thought to inhibit regeneration after injury. Second, they form tracts—similar to roadways—along which axons can regrow. Third, they secrete growth factors that stimulate regeneration.

“That entire process was not happening as efficiently in the old mice,” says Painter.

Though many dots need to be connected, the findings open a new avenue for promoting nerve regeneration—at least for peripheral nerves. Perhaps young Schwann cells could be transplanted into older patients. Or perhaps chemical factors could be introduced to kick-start Schwann cell function. Other neuroscience research is converging on the importance of glial cells and glia-derived factors.

Painter, who has left Boston Children’s to start his postdoctoral fellowship at the Harvard Stem Cell Institute, hopes to explore what is causing the age-related defects in Schwann cells and whether the same defects start to accumulate in other kinds of glial cells, like those in the brain. “That would be very important in the context of neurodegenerative disorders like Alzheimer’s disease,” he says.

If so, I’d consider donating my poorly healing pinky to science.

http://vectorblog.org/2014/08/can-old-peripheral-nerves-learn-new-tricks-only-the-schwann-cells-know-for-sure/

Thursday, 28 August 2014

Rare Neuropathies: Facebook Chat: Sept.17th

Today's post from neuropathy.org (see link below) is a pre-announcement of a Facebook chat about the rarer forms of neuropathy on September 17th. As you probably know, there are over 100 forms of neuropathy, with over 100 different causes and that can make life extremely difficult for doctors and patients alike. Identifying and diagnosing your particular sort of neuropathy can be time consuming and frustrating but in the end, it's how the medical professionals go about treating your symptoms that is the most important. This Facebook chat could be very interesting.

The Neuropathy Association to Host a “Rare Neuropathies: Getting Diagnosed, Getting Help” Facebook Chat on September 17th

In the U.S., the Rare Disease Act of 2002 defines a rare (or orphan) disease as any disease or condition affecting less than 200,000 people (or about 1 in 1,500). Of the over 100+ different types of neuropathies impacting millions in the U.S. alone, there are several neuropathies that are considered rare diseases including hereditary neuropathies like Charcot-Marie Tooth (CMT), familial amyloidotic polyneuropathy (FAP) and familial amyloidotic cardiomyopathy (FAC), Lambert-Eaton Myasthenic Syndrome (or LEMS), sarcoidosis, Fabry’s disease, adult polyglucosan body disease (APBD), multifocal motor neuropathy (MMN) and chronic inflammatory demyelinating polyneuropathy (CIDP) among 

others.
Facebook Chat Image - Association Logo
Related articles:
- Diagnosing neuropathy: the key to understanding the cause
- “Ask the Doctor” Column: Multifocal Motor Neuropathy
- The Link Between Neuropathy and Fabry Disease
- “Ask the Doctor” Column: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Diagnostics
- The Link Between Neuropathy and POEMS Syndrome
- Understanding Lambert-Eaton Myasthenic Syndrome
- The Link Between Neuropathy and Transthyretin Amyloidosis/FAP
- Clinical Trial: Study of Efficacy of ARA 290 on Corneal Nerve Fiber Density and Neuropathic Symptoms of Subjects With Sarcoidosis
- Living with CMT
- HNF founder—Allison Moore—shares her CMT story


Because these neuropathies are rare (and rarely seen), diagnosis for many can be a difficult and drawn-out experience; many who have been successfully diagnosed have had to be their own patient advocate to achieve that diagnosis. Still, a diagnosis can hold the promise for improved care and the hope of therapies already available and several more in development.

FACEBOOK CHAT: “Rare Neuropathies: Getting Diagnosed, Getting Help”
WHEN: September 17, 2014 (7-8:30 p.m. ET)
WHERE: www.facebook.com/NeuropathyAssociation
GUEST HOSTS:
- David Epstein (Adult Polyglucosan Body Disease Foundation);
- Jack Johnson (Fabry Information & Support Group)
- Allison Moore (Hereditary Neuropathy Foundation);
- other guest hosts to be announced

While diabetic peripheral neuropathy is what primarily comes to mind for many when discussing neuropathy, there are actually over 100+ different types of neuropathies caused by a range of diseases and disorders. And approximately a third of all neuropathies are considered to be “idiopathic” or “of an unknown cause.” For people with rare neuropathies – many of which can be extremely debilitating – the path to diagnosis can be an arduous journey which may still lead to an “idiopathic” diagnosis without the help of specialists trained to recognize these rarer neuropathies which can have symptoms mimicking other diseases and disorders…or which simply don’t “fit” together. Being your own best advocate for a diagnosis becomes critical. However, diagnosis offers the opportunity for hope as some of these rarer neuropathies now have new treatments either available or on the horizon...if you have a confirmed diagnosis...

Our Facebook Chat will feature a panel of experts who are not only well-versed on the latest tests and best practices to get to diagnosis, but who also are working on bringing new care and treatment options to those with rarer neuropathies. Our panelists will cover:
Signs and symptoms associated with these rarer neuropathies and the importance of recognizing them early;
Diagnostic tests available;
The value of partnering with neurologists specializing in neuromuscular diseases as well as other types of specialists who may be involved confirming a diagnosis;
Unique co-morbidities associated with some of these neuropathies which may provide diagnostic clues;
Treatments already available to those with rare neuropathies and treatments in development;
Current clinical trials and patient assistance programs;
Ways to improve access to care and quality of life.

P.S.: If you do not use Facebook: You can still access the Chat "live" by visiting The Neuropathy Association's Facebook page, but you will not be able to join the conversation by posting comments. View the Neuropathy Association's Facebook page!

http://www.neuropathy.org/site/News2?page=NewsArticle&id=8738&news_iv_ctrl=1101

Wednesday, 27 August 2014

Cannabis Inhaler Effective For Neuropathy

Today's short post from norml.org (see link below) reinforces the widely held belief that cannabis can relieve neuropathic symptoms as effectively as almost anything else. In this case, the cannabinoids are delivered via an inhaler which removes the need to smoke joints laced with tobacco (with all its associate dangers). Whatever, your opinion of cannabis, there is little doubt regarding its medicinal qualities and if you find that pills are not really helping you in your fight against neuropathic pain, it may be worthwhile looking into this option and at least trying it out. There are many other articles here on the blog about cannabis and neuropathy (see alphabetical list to the right).


Study: Cannabis Inhaler Delivers Effective Relief To Neuropathy Patients
Thursday, 21 August 2014

Haifa, Israel: The administration of a single dose of whole-plant cannabis via a thermal-metered inhaler is effective and well tolerated among patients suffering from neuropathy (nerve pain), according to clinical trial data published online ahead of print in the Journal of Pain and Palliative Care Pharmacotherapy.

Israeli investigators assessed the efficacy of a novel, portable metered-dose cannabis inhaler in eight subjects diagnosed with chronic neuropathic pain. Researchers reported that the vaporizing device administered an efficient, consistent, and therapeutically effective dosage of cannabinoids to all participants.

They concluded, "This trial suggests the potential use of the Syqe Inhaler device as a smokeless delivery system of medicinal cannabis, producing a delta-9-THC pharmacokinetic profile with low inter-individual variation of (maximum drug/plasma concentrations), achieving pharmaceutical standards for inhaled drugs."

A series of clinical trials conducted by investigators affiliated with the Center for Medicinal Cannabis Research at the University of California, San Diego previously determined that the inhalation of whole-plant cannabis is efficacious in the treatment of various types of neuropathic pain.

For more information, please contact Paul Armentano, NORML Deputy Director, at: paul@norml.org. Full text of the study, "The pharmacokinetics, efficacy, safety, and ease of use of a novel portable metered-dose cannabis inhaler in patients with chronic neuropathic pain: A phase 1a study," will appear in the Journal of Pain and Palliative Care Pharmacotherapy.

http://norml.org/news/2014/08/21/study-cannabis-inhaler-delivers-effective-relief-to-neuropathy-patients

Tuesday, 26 August 2014

Cancer Treatment And Peripheral Neuropathy: Why?

Today's post from mdanderson.org (see link below) looks at why cancer patients and patients undergoing cancer treatment, are susceptible to neuropathy. Most of you will have heard that cancer treatment is one of the more common causes of neuropathy, even if it's not the case with yourself but not many people know why this happens. This article doesn't go into impenetrable detail but does give a good general description of what's going on. Useful for cancer patients and their friends and family and also for everyone else living with neuropathy. Unfortunately none of us are immune to cancer and it can strike at any time. Worth a read.

Peripheral neuropathy in cancer patients
By Laura Nathan-Garner on June 18, 2014 

For many of our patients, peripheral neuropathy is among the unexpected side effects of cancer treatment.

It's caused by damage to your peripheral nerves -- that is, the nerves that are farther away from your brain and spinal cord. Certain complications of cancer or cancer treatments can cause or worsen neuropathy. So can some health conditions, such as diabetes, alcoholism, AIDS, hypothyroidism, rheumatoid arthritis and carpel tunnel syndrome.

We recently spoke with Julie Walker, advanced practice nurse in Neuro-Oncology, about peripheral neuropathy. Here's what she had to say.

What causes peripheral neuropathy in cancer patients?
The nerve damage that causes peripheral neuropathy may be the result of many different factors, including some chemotherapy drugs using vinca alkaloids, platinum compounds, taxanes and thalidomide.
Tumors themselves can cause nerve damage as well if they grow close to and press on the nerve.

And, patients with cancers of the nervous system -- such as brain tumors, spine tumors and skill base tumors -- are more likely to develop peripheral neuropathy due to nerve damage resulting from the tumor.

What are common peripheral neuropathy symptoms?

Symptoms depend on the type(s) and location(s) of the damaged nerves. The most common peripheral neuropathy symptoms include:

numbness
tingling
shooting pain or burning, especially in your fingers or toes. Other peripheral neuropathy symptoms include:

loss of balance, difficulty walking or frequent falls
clumsiness
difficulty picking up objects or buttoning your clothes
facial pain
hearing loss
loss of sensitivity to hot and cold
stomach pain
constipation



What can cancer patients do to relieve peripheral neuropathy?
If the neuropathy is related to something you can control, try to control the cause.

If your neuropathy is chemo-related, your oncologist can decide whether it's beneficial to reduce your chemotherapy dosage or switch to a different treatment regimen.

If it's related to diabetes, you can often slow down or stop the progression of peripheral neuropathy with better blood sugar control.

Beyond that, physical activity can help by keeping blood flowing in the affected areas. Some people also try acupuncture.

Over-the-counter pain relievers and prescription medications like carbamazepine and Lyrica may help in some cases. Non-prescription-type treatments -- such as acetyl l-carnitine, alpha lipoic acid, glutamin, calcium and magnesium -- may help, too. But more research is needed to better gauge their effectiveness. Be sure to speak with your health care provider before trying any of these.

What can cancer patients do to lower their chances of developing peripheral neuropathy?
If you have other health conditions, such as diabetes, that can make the neuropathy worse, manage them appropriately. Limit alcohol use. Maintain a well-balanced diet. And, discuss your neuropathy risks with your health care provider.

How long do peripheral neuropathy symptoms last?

Every case is different. Because neuropathy is caused by nerve damage, it depends largely on how well your nerves recover. And, that depends on the length of your treatment, extent of the damage and, in the case of chemotherapy-induced neuropathy, dosage intensity.

It's usually possible to manage peripheral neuropathy up to a certain point, but for many people, it never goes away.

As the nerves heal, some people may actually experience more tingling in the affected area. Speak with your health care provider to find out if a prescription might help relieve symptoms during this time.

People with peripheral neuropathy lose the ability to feel pain or extreme temperatures in the affected areas.

What can cancer patients with peripheral neuropathy do to avoid burning or injuring themselves?

Always wear shoes to protect your feet from an injury. Also, make sure you examine your feet every day to look for any wounds or sores that aren't healing.

Be careful when using sharp utensils or avoid them altogether. Likewise, since neuropathy typically inhibits your fine motor movements, be cautious around or avoid dangerous machinery.

Before touching water with your hands or feet, feel the water with a part of your body -- such as the underside of your forearm -- that can sense how warm it is. And, avoid using heating pads and hot water bottles.

Any other advice for cancer patients who are experiencing neuropathy?
People with neuropathy are more prone to falls because they struggle to feel the ground beneath them, especially in the dark or an enclosed space. So:

use a nightlight
keep clutter and throw rugs off the floor
use handrails when taking the stairs
put handrails in the shower
use skid-free shower and bath mats

Neuropathy also makes the body more prone to infection since circulation is decreased and wounds don't heal as well. So it's a good idea to keep your skin moist to prevent cracking and, in turn, infection.

The most important thing you can do, though, is to speak with your health care provider as soon as you start to experience neuropathy symptoms. Together, you can hopefully find ways to manage your symptoms.

http://www2.mdanderson.org/cancerwise/2014/06/peripheral-neuropathy-in-cancer-patients.html

Monday, 25 August 2014

New FDA Rules For Gluten Free Labelling

Today's post from prevention.com (see link below) is another article looking at gluten free diets and what this exactly entails. The American FDA has done us a favour by stepping in to regulate the gluten 'industry' so that the term 'gluten free' genuinely means what it says. This of course doesn't mean that all countries are as well-regulated but it's a guide and when the FDA decides to act, the rest of the world generally follows soon after. That said, the hype that gluten-free is beneficial for the nervous system and neuropathy problems is exactly that - hype and nothing has been proved. There is no doubt however, that many people claim to have benefited from changing to gluten-free. It's not easy and can lead to a 'boring' diet but it may be worth doing the research and consulting your doctor to see if it's an option for you.

What The FDA's New "Gluten-Free" Label Really Means 
By Robin Hilmantel for Women's Health Published August 2014,

If you've been buying foods labeled "gluten-free," we have some good news and some bad news for you. The bad news: Nothing you've bought up until this point has had to adhere to a uniform standard of what it actually means to be "gluten-free." The good news? As of August 2, there's finally a definition to go along with the label.

MORE: Are Gluten-Free Diets Healthy?

Late last week, the FDA published a new regulation defining the term. To be considered "gluten-free," a product now must contain less than 20 parts per million of gluten. Products bearing the labels "free of gluten," "no gluten," and "without gluten" are also now required to meet this standard.

“Adherence to a gluten-free diet is the key to treating celiac disease, which can be very disruptive to everyday life,” FDA Commissioner Margaret A. Hamburg, M.D., said in a press release. “The FDA’s new ‘gluten-free’ definition will help people with this condition make food choices with confidence and allow them to better manage their health.”

MORE: Gluten-Free Foods That Make You Gain Weight

One word of warning: Food manufacturers have until August 2, 2015, to bring their products into compliance with this new criteria. Granted, some products on the market may already meet this standard (and items that have less than 20 parts per million of gluten aren't required to be listed as "gluten-free;" it's a voluntary label).

Even after companies are required to comply with the new ruling, they can still use the terms "made with no gluten-containing ingredients" or "not made with gluten-containing ingredients" on products that don't fit the definition of "gluten-free" (provided these other labels are true). The bottom line? Even with the new regulation, it's still a good idea to reach out to the company or restaurant making a food if you have any questions about how much gluten it might contain.

http://www.prevention.com/food/healthy-eating-tips/fda-changes-gluten-free-labeling

Sunday, 24 August 2014

Understanding Crohn's, Fibromyalgia, Neuropathy And Cluster Headaches (Vid)

Today's post and videos from pajamadaze.com (see link below) are a very useful description of what happens with certain serious neurological conditions. Crohn's disease, cluster headaches, neuropathy and Fibromyalgia can make people's lives a misery and most people have heard of them or know someone with one or more of these problems but understanding what's behind them is another matter. These videos explain what people go through if they are afflicted. They're easy to relate to and not difficult to follow and certainly worth a view.
.............................................................

Helping others understand your Crohn's, Fibromyalgia, Peripheral Neuropathy or Cluster Headache- 
videos to share and educate by Ken McKim 07/08/2014

Thanks to Ken McKim for these awesome videos

We've all been there. Maybe some of us still are there. We have illnesses that change our bodies and our lives. And the people who should support us the most - our friends and family - just don't get it! They can't understand what we are going through. They have expectations, judgments, advice and comments that sometimes hurt us more than help us.

Ken McKim has been creating a series of short videos to help us teach our loved ones about what we are going through. His videos are brief and powerful, with a touch of humor, and will really help others "get it!"

More videos about other chronic conditions are forthcoming! We look forward to those, and appreciate being able to share Ken's enlightening series!









http://www.pajamadaze.com/blog/helping-others-understand-your-crohns-fibromyalgia-or-peripheral-neuropathy-videos-to-share-and-educate

Saturday, 23 August 2014

Link Between Poor Sleep And Suicide

Today's post from medicinenet.com (see link below) looks at the serious problem of sleep-deprivation and the effect it can have on your mental health. People living with neuropathy very often have disturbed sleep patterns. For some reason that nobody seems to be sure of, neuropathy symptoms can flare up during the night and pains in legs and feet can seriously affect your quality of life. It's logical really that prolonged lack of quality sleep will leave you drained during the day. Over a period of time that lack of energy and constant tiredness can lead to depression. If this is the case with you and you feel yourself being impacted by this, don't hesitate to contact your doctor and get help and advice but remember, sleeping tablets may not be the answer because the symptoms will continue despite being masked by the drugs. One thing is sure, don't ignore it and hope it will go away; make sure your medical professionals are aware of the problem.
 

Study Hints at Link Between Poor Sleep, Suicide Risk
By Tara Haelle HealthDay Reporter
WEDNESDAY, Aug. 13, 2014 (HealthDay News) 
  

Sleeping difficulties may increase the risk of suicide in older adults even when other symptoms of depression aren't present, a new study suggests.

The study focused on adults 65 and older, and poor sleep included difficulty falling or staying asleep, waking up early in the morning, experiencing daytime sleepiness and not feeling fully rested after a night's sleep.

"These findings suggest that sleep disturbances stand alone as a valid risk factor -- independent of depressed mood -- and worthy of focus as a potential [suicide] risk factor, screening and intervention tool," said lead researcher Rebecca Bernert, an instructor of psychiatry at Stanford University School of Medicine. "Compared to many other known suicide risk factors, sleep disturbances are arguably less stigmatizing and may be undone, and are highly treatable."

Among the 20 study participants who died by suicide, 19 were men. The researchers randomly matched these 20 people to 400 living participants based on shared age, sex and location, and then compared their sleep quality and depression scores.

The study couldn't prove that sleeping problems cause suicidal thoughts or attempts, nor could it explain why the link may exist. But, Bernert said, it's likely that poor sleep affects the ability to regulate moods.

"The idea is simple: when we sleep poorly, it impacts how we feel and the way in which we manage our emotions, as well as decision-making," Bernert said. Past research has shown that fragmented sleep can result in more intense negative emotions, impaired judgment and difficulty managing fear or anger.

Those who reported having poor sleep quality at the start of the study had 40 percent greater odds of dying by suicide during the next 10 years before depression symptoms had been considered. Even after making calculations to remove the effects of depression symptoms, the odds of dying by suicide were 30 percent higher for those reporting poorer sleep quality, the study authors said.

Also, those who reported not feeling well-rested after sleeping had twice the odds of dying by suicide compared to those not reporting sleeping problems, even after symptoms of depression had been considered. And sleep disturbances better predicted who died by suicide over a decade than depression symptoms did, the study authors reported in the Aug. 13 online edition of JAMA Psychiatry.

The researchers used two separate questionnaires, one on sleep quality and one on depression symptoms, for their calculations.

Yet William Kohler, medical director of the Florida Sleep Institute in Spring Hill, Fla., said he's skeptical about how well the researchers could completely account for depression symptoms since they are so similar to the symptoms of poor sleep.

"We have to ask what's the cart and what's the horse because it's not common to be really sleep-deprived and then be wide-eyed and bushy-tailed and positive about things," Kohler said.

"We know that sleep disturbance causes depressive symptoms, such as lack of energy, lack of interest in things one enjoys and feeling a little down the next day, so I'm not sure how they would separate that out," he added.

Separating them out is what the researchers said they attempted to do.

"Sleep disturbances and suicidal ideation are both symptoms -- among a constellation of symptoms -- of depression, which is why it is crucial to disentangle them as risk factors and the way in which they may interact to increase risk," Bernert said. "It is important to note that suicide is the tragic outcome of multiple, often interacting risk factors and medical conditions."

Approximately 12 out of every 100,000 people die by suicide each year in the United States. Individuals thinking about suicide can reach a nearby certified crisis center by calling the National Suicide Prevention Lifeline at 1-800-273-TALK.

The U.S. Substance Abuse and Mental Health Services Administration ranks sleep difficulties as one of the top 10 warning signs of suicide. Past studies have linked insomnia, nightmares and overall poor sleep quality to an increased risk of suicidal thoughts and attempted suicide. But those studies did not usually control for depression.

This new study differs from past research because of its size, length and focus on older Americans. The researchers tracked more than 14,000 adults, aged 65 and older, for 10 years. The adults assessed their sleep quality and depression symptoms six times during that decade.

Bernert said she and her colleagues are now investigating why the link between poor sleep and suicide might exist.

The U.S. Centers for Disease Control and Prevention and the U.S. National Institutes of Health contributed funding for the study.

http://www.medicinenet.com/script/main/art.asp?articlekey=180048

Friday, 22 August 2014

Diet And Nutrition For Neuropathy

Today's post from neuropathydr.com (see link below) is another short article looking at the importance of what you eat for neuropathy sufferers. A well-balanced diet will include all the vitamins you need for a healthy nervous system but it is possible that you have other conditions which have resulted in deficiencies in certain vitamins and minerals (particularly the B vitamins, vitamins D and E). In that case, it may be worth supplementing even a good diet with store-bought vitamins or supplements. Take advice from your doctor or neurologist, or do your own research on the internet but first get your vitamin status established by means of a simple test your home doctor can do.

Neuropathic Nutrition and Diet
Posted by john on June 19, 2014

Get Started on a proper neuropathic nutrition and diet plan today!



One main factor in many cases of peripheral neuropathy is diet. You probably know that neuropathy is linked to diabetes and other conditions where daily intake of sugars and nutrients is important, but your diet can also influence the condition of nerves in more direct ways, such as in cases where a nutritional deficiency is causing neuropathic damage.

One of the most common links between neuropathy and nutrition is a deficiency in B vitamins, particularly vitamin B-12. Fight neuropathy by eating foods like meat, fish, and eggs that are all high in B vitamins. If you are a vegetarian or vegan, don’t worry! There are many kinds of fortified cereals that contain substantial amounts of B vitamins as well (in addition to supplements, which we’ll talk about in a moment).

The Mayo Clinic recommends a diet high in fruits and vegetables for people who suffer from neuropathy. Fruits and vegetables are high in nutrients that have been shown to be effective treating neuropathy. Additionally, if you suffer from diabetes, fresh produce can mellow your blood sugar levels. If numbness or pain in your extremities is severe, keep pre-cut fruit and vegetables at the ready, so you don’t have to worry about the stress involved with preparing them! Just be careful of too much fruit sugars. This means a serving is 1/2 apple, banana, etc. Most non-starchy vegetables like greens and asparagus especially are great for most of us.

Foods that are high in Vitamin E are also good for a neuropathic diet, according to neurology.com. A deficiency of Vitamin E can happen in cases where malabsorption or malnutrition are taking place, such as the case with alcoholic neuropathy. Breakfast cereals, whole grains, vegetables and nuts are all excellent sources of vitamin E.

Lean proteins are also an important part of a healthy diet for people with neuropathy. Saturated fats and fried foods increase risk of diabetes and heart disease, in addition to aggravating nerve decay from lack of nutrients. A variety of foods—skinless white-meat poultry, legumes, tofu, fish, and low-fat yogurt—are good sources of lean protein. If you suffer from diabetes, lean proteins also help to regulate blood sugar levels. Fatty fish such as salmon, tuna, mackerel, and sardines are good for maintaining levels of Omega-3 acids, healthy fats the body needs but cannot produce on its own.

For specific types of neuropathy, research shows that specific antioxidants may help slow or even reverse nerve damage that has not existed for too long a time. For HIV sensory neuropathy, Acetyl-L-Carnitine has demonstrated good results, and Alpha lipoic acid is being studied for its effects on diabetic nerve damage. Consult your NeuropathyDR® specialist for the latest research before beginning any supplementation or treatment, even with antioxidants.

Use Tools Like Journaling and Blood Sugar Monitoring Every Day…

So what are the best ways to monitor what you are eating? The easiest way is to keep a food journal. Record everything you eat at meals, for snacks, and any vitamin supplements you might be taking. Your journal will help you and your NeuropathyDR® clinician determine if your diet could be a factor in your neuropathy symptoms! As a bonus, food journaling is a great way to be accountable for your overall nutrition, as well as to help avoid dietary-related conditions other than neuropathy. If you have a goal for weight loss, weight gain, or better overall energy, those are other areas in which keeping a food journal can help! Other ways to monitor what you eat include cooking at home as opposed to going out to restaurants, keeping a shopping list instead of deciding what groceries to buy at the store, and consulting a nutritionist or qualified NeuropathyDR® clinician about the best ways to meet your specific needs.

Dietary supplements can also help manage neuropathic symptoms and nerve degeneration. Supplementing B Vitamins, particularly vitamin B-12, can help regulate your nutrient levels and prevent neuropathy symptoms. Supplementing with fish oil can help replenish Omega-3 fatty acids, which are important if you suffer from type-II diabetes. Many other types of supplements can be beneficial if you suffer from neuropathy; consult your NeuropathyDR® clinician for specific recommendations.

Contact us if you have any questions about a proper neuropathic nutrition and diet plan. We can help you find the information you need and put you in touch with a NeuropathyDR® clinician who can help you with this and other neuropathy-related questions!

Join our conversation today on Facebook by clicking HERE!

http://www.mayoclinic.com/health/peripheral-neuropathy/DS00131/DSECTION=lifestyle-and-home-remedies

http://www.foundationforpn.org/livingwithperipheralneuropathy/neuropathynutrition/

http://www.livestrong.com/article/82184-foods-fight-neuropathy/

http://www.livestrong.com/article/121841-nutrients-neuropathy/

http://neuropathydr.com/neuropathic-nutrition-diet/

Thursday, 21 August 2014

Vitamins B12 And D3 Important For HIV And Neuropathy

Today's post from nybc.wordpress.com (see link below) looks at the importance of vitamins B12 and D3 for people suffering from either or both, HIV and Neuropathy. A large number of people with HIV have been found to be both B12 and vitamin D deficient and it may not be coincidental that both vitamins are also essential for nerve health. If you're not sure, your doctor can do a simple blood test to establish if you are deficient in either or both and this applies to all neuropathy patients whether or not you also have HIV in the picture. If that is the case, then supplementation is easy and relatively inexpensive and could make a great deal of difference to your symptoms. Worth a read.

Why Vitamins B12 and D3 Are Especially Important to People with HIV 
Posted by jarebe
December 8, 2013
 
Our friends at the Canadian AIDS Treatment Information Exchange (CATIE), a Canadian government-supported education and prevention organization, recently published an excellent guide to managing HIV medication side effects. This online guide covers the territory from body shape changes, to gastrointestinal disorders, to neurological effects, to emotional wellness, to fatigue, to sexual difficulties.

The Appendix to this guide focuses on two vitamins, both of which have been highlighted as especially important for people with HIV: B12 and D3. Deficiency of these two vitamins appears to be common among people with HIV, and supplementing to correct the deficiency can bring about major improvements in health. So it’s definitely worthwhile to check your B12 and D3 status, and, if you’re deficient, find a good supplementation strategy. Note that NYBC stocks both of these inexpensive vitamins: the methylcobalamin form of Vitamin B12 recommended below; and several strengths of Vitamin D3, including the commonly recommended D3 – 2500IU format.

Below are the CATIE recommendations:


Vitamin B12

A number of studies have shown that vitamin B12 is deficient in a large percentage of people with HIV, and the deficiency can begin early in the disease. Vitamin B12 deficiency can result in neurologic symptoms — for example, numbness, tingling and loss of dexterity — and the deterioration of mental function, which causes symptoms such as foggy thinking, memory loss, confusion, disorientation, depression, irrational anger and paranoia. Deficiency can also cause anemia. (See the section on Fatigue for more discussion of anemia.) It has also been linked to lower production of the hormone melatonin, which can affect the wake-sleep cycle.

If you have developed any of the emotional or mental symptoms mentioned above, especially combined with chronic fatigue, vitamin B12 deficiency could be contributing. This is especially true if you also have other symptoms that this deficiency can cause, including neuropathy, weakness and difficulty with balance or walking. On the other hand, these symptoms can also be associated with HIV itself, with hypothyroidism or advanced cases of syphilis called neurosyphilis. A thorough workup for all potential diagnoses is key to determining the cause.

Research at Yale University has shown that the standard blood test for vitamin B12 deficiency is not always reliable. Some people who appear to have “normal” blood levels are actually deficient, and could potentially benefit from supplementation.

The dose of vitamin B12 required varies from individual to individual and working with a doctor or naturopathic doctor to determine the correct dose is recommended. Vitamin B12 can be taken orally, by nasal gel or by injection. The best way to take it depends on the underlying cause of the deficiency, so it’s important to be properly assessed before starting supplements. For oral therapy, a typical recommendation is 1,000 to 2,000 mcg daily.

One way to know if supplementation can help you is to do a trial run of vitamin B12 supplementation for at least six to eight weeks. If you are using pills or sublingual lozenges, the most useful form of vitamin B12 is methylcobalamin. Talk to your doctor before starting any new supplement to make sure it is safe for you.

Some people will see improvements after a few days of taking vitamin B12 and may do well taking it in a tablet or lozenge that goes under the tongue. Others will need several months to see results and may need nasal gel or injections for the best improvements. For many people, supplementation has been a very important part of an approach to resolving mental and emotional problems.

Vitamin D

Some studies show that vitamin D deficiency, and often quite severe deficiency, is a common problem in people with HIV. Vitamin D is intimately linked with calcium levels, and deficiency has been linked to a number of health problems, including bone problems, depression, sleep problems, peripheral neuropathy, joint and muscle pain and muscle weakness. It is worth noting that in many of these cases there is a link between vitamin D and the health condition, but it is not certain that a lack of vitamin D causes the health problem.

A blood test can determine whether or not you are deficient in vitamin D. If you are taking vitamin D, the test will show whether you are taking a proper dose for health, while avoiding any risk of taking an amount that could be toxic (although research has shown that toxicity is highly unlikely, even in doses up to 10,000 IU daily when done under medical supervision). The cost of the test may not be covered by all provincial or territorial healthcare plans or may be covered only in certain situations. Check with your doctor for availability in your region.

The best test for vitamin D is the 25-hydroxyvitamin D blood test. There is some debate about the best levels of vitamin D, but most experts believe that the minimum value for health is between 50 and 75 nmol/l. Many people use supplements to boost their levels to more than 100 nmol/l.

While sunlight and fortified foods are two possible sources of vitamin D, the surest way to get adequate levels of this vitamin is by taking a supplement. The best dose to take depends on the person. A daily dose of 1,000 to 2,000 IU is common, but your doctor may recommend a lower or higher dose for you, depending on the level of vitamin D in your blood and any health conditions you might have. People should not take more than 4,000 IU per day without letting their doctor know. Look for the D3 form of the vitamin rather than the D2 form. Vitamin D3 is the active form of the vitamin and there is some evidence that people with HIV have difficulty converting vitamin D2 to vitamin D3. Historically, vitamin D3 supplements are less commonly associated with reports of toxicity than the D2 form.

It is best to do a baseline test so you know your initial level of vitamin D. Then, have regular follow-up tests to see if supplementation has gotten you to an optimal level and that you are not taking too much. Regular testing is the only way to be sure you attain — and then maintain — the optimal level for health.

With proper supplementation, problems caused by vitamin D deficiency can usually be efficiently reversed.

http://nybc.wordpress.com/category/neuropathy/

Wednesday, 20 August 2014

Peripheral Nerves, Explained

Today's post from healthmeup.com (see link below) is a good and easy to follow description from India of the nervous system; the symptoms when there is nerve damage and the common testing process to make diagnoses. Many people with neuropathy aren't quite sure which nerves are which, what their functions are and why they go wrong - this article provides you with a simple explanation without overwhelming you with information. Definitely worth a read to top up your knowledge.



Understanding Peripheral Nerves : Types, Peripheral Neuropathy, Symptoms and Tests 
By Sobiya N. Moghul posted Aug 20th 2014 Healthy Living

The human nervous system consists of four parts: the brain, spinal cord, autonomic nervous system and peripheral nerves. Peripheral nerves are cord-like structures containing bundles of nerve fibres that transmit signals from the spinal cord to the rest of the body, or to transmit sensory information from the rest of the body to the spinal cord. Your peripheral nerves are the ones outside your brain and spinal cord. Like static on a telephone line, peripheral nerve disorders distort or interrupt the messages between the brain and the rest of the body.

The nerves in our bodies are very similar to electric cables. The brain and spinal cord send electrical signals through the nerves to different muscles. The muscles, in turn, have a specialised mechanism to properly understand the electrical signals and act accordingly, thereby moving different parts of the body.

There are three types of peripheral nerves: motor, sensory and autonomic. Some neuropathies affect all three types of nerves, while others involve only one or two.

Motor nerves send impulses from the brain and spinal cord to all of the muscles in the body. This permits people to perfom activities like walking, catching a ball, or moving the fingers to pick something up. Motor nerve damage can lead to muscle weakness, difficulty in walking or moving the arms, cramps and spasms.

Sensory nerves send messages in the other direction—from the muscles back to the spinal cord and the brain. Special sensors in the skin and deep inside the body help people identify if an object is sharp, rough, or smooth, if it's hot or cold, or if a body part is still or in motion. Sensory nerve damage often results in tingling, numbness, pain, and extreme sensitivity to touch.

Autonomic nerves control involuntary or semi-voluntary functions, such as heart rate, blood pressure, digestion, and sweating. When the autonomic nerves are damaged, a person's heart may beat faster or slower. They may get dizzy when standing up, sweat excessively, or have difficulty sweating at all.

There are various kinds of peripheral nerve disorders. They can affect one nerve( mononeuropathy) or many nerves( polyneuropathy). In some cases, like complex regional pain syndrome and brachial plexus injuries, the problem begins after an injury. Some people are born with peripheral nerve disorders.

Mononeuropathy is usually the result of damage to a single nerve or nerve group by trauma, injury, local compression, prolonged pressure, or inflammation. Examples include: Carpal tunnel syndrome (a painful wrist and hand disorder often associated with repetitive tasks), and Bell's palsy (a facial nerve disorder) .

The majority of people, however, suffer from polyneuropathy, an umbrella term for damage involving many nerves at the same time.

There are many causes of peripheral neuropathy, including diabetes, hereditary disorders, infections, inflammation, auto-immune diseases, protein abnormalities, exposure to toxic chemicals, poor nutrition, kidney failure, chronic alcoholism, and certain medications – especially those used to treat cancer and HIV/AIDS. In some cases, however, even with extensive evaluation, the cause of a person's peripheral neuropathy remains unknown – this is called idiopathic neuropathy.

The symptoms of peripheral neuropathy often include:

• A sensation of wearing an invisible "glove" or "sock"

• Burning sensation or freezing pain

• Sharp, jabbing or electric-like pain

• Extreme sensitivity to touch

• Difficulty sleeping because of feet and leg pain

• Loss of balance and coordination

• Muscle weakness

• Difficulty walking or moving the arms

• Unusual sweating

• Abnormalities in blood pressure or pulse

There are specialised nerve tests like EMG, NCV and SSEP, which are designed to diagnose any abnormality in the functioning of these nerves.

EMG, or Electromyography is a technique used for evaluating and recording the electrical activity produced by muscles. The EMG helps doctors distinguish between muscle conditions that begin in the muscle and nerve disorders that cause muscle weakness.

NCV, or Nerve Conduction Velocity, is an electrical diagnostic test that provides information about abnormal conditions in the nerves.

SSEP, or Somatosensory Evoked Potential, is a test showing the electrical signals of sensation going from the body to the brain and spinal cord. The signals show whether the nerves that connect to the spinal cord are able to send and receive sensory information like pain, temperature and touch.

Treatment aims to treat any underlying problem, reduce pain and control symptoms. Injuries to the Brain and Spinal cord have only a very limited capacity to heal, because nerve regeneration tends not to occur. In contrast, peripheral nerves have a striking capacity for regeneration. Even completely severed peripheral nerves, if repaired in a timely fashion, can regrow, allowing the patients to enjoy complete, or nearly complete recovery in many cases.

The healing process almost invariably requires an extensive amount of time to occur. It is important for patients not to lose hope during this time. It is vital that they exercise, keeping the affected muscles and joints flexible and ready to be used once again when the axons regrow into them. It is not unusual for patients to undergo a lengthy, complex, peripheral nerve reconstruction procedure, only to see no evidence of recovery for a year or more. This can be immensely frustrating for the patient. Unfortunately, currently there is nothing in medical science that can make these axons grow any faster. Perhaps it is best to think of this delay as part of the healing process, paving the road to further recovery.

*Inputs : Dr Harleen Luther – Brain , Spine; Peripheral Nerve Surgeon, Seven Hills Hospital, Mumbai.

http://healthmeup.com/news-healthy-living/understanding-peripheral-nerves-types-peripheral-neuropathy-symptoms-and-tests/23706

Tuesday, 19 August 2014

Cardio Vascular Disease Associated With Neuropathy

Today's post from diabetesincontrol.com (see link below) looks at the connection between neuropathy and a higher risk of cardiovascular problems. It appears that people with peripheral neuropathy are more at risk anyway of cardiovascular disease. This may be a slightly slanted view in that diabetes patients are traditionally at risk of such problems and by far the greatest number of people with neuropathy also have diabetes. However, this study is the first to show that neuropathy patients have a greater risk of going on to develop cardiovascular disease and strokes, although if you don't have diabetes Type 2, your risk may be less.

Peripheral Neuropathy Associated with CV Disease and Stroke in Type 2 Diabetes Patients          

This article originally posted 15 August, 2014 and appeared in  CardiovascularType 2 DiabetesNeuropathyIssue 742

Testing for peripheral neuropathy may provide a way to identify individuals at higher risk of cardiovascular events.... 
Jack Brownrigg, a PhD student at St George's, University of London, UK, who conducted the research at St George's Vascular Institute, said, "While the risk of cardiovascular disease is known to be higher in patients with diabetes, predicting which patients may be at greatest risk is often difficult.

"We looked at data on individuals with no history of cardiovascular disease and found that those with peripheral neuropathy were more likely to develop cardiovascular disease."

Robert Hinchliffe, Senior Lecturer and Consultant in Vascular Surgery at St George's who co-led the study with Professor Kausik Ray, said: "While loss of sensation in the feet is known to be a key risk factor for foot ulcers, it may also provide additional useful information to guide patient management. This is the first study to show that it can also indicate an increased risk of cardiovascular problems like heart attacks or strokes.

"The good news is that peripheral neuropathy can be easily identified by simple tests carried out in GP surgeries. The results of the study warrant further investigation as to whether even greater control of risk factors including blood pressure and blood sugar can prevent or delay the onset of cardiovascular disease.

"There is likely an unmet potential to reduce cardiovascular disease in this group of patients through greater monitoring and simple treatments."
The researchers analyzed data from 13,000 patients diagnosed with type 2 diabetes with no history of cardiovascular diseases. They found that individuals with peripheral neuropathy were more likely to develop cardiovascular disease, noticing that patients who experienced loss of sensation in their feet also tended to have heart and circulation problems, and so, they suggested that the presence of peripheral neuropathy could be used as a simple way to indicate which high-risk patients with diabetes are in need of intensive care and monitoring.

Practice Pearls:
  • Patients with diabetes are at higher risk of developing cardiovascular disease and strokes.
  • Predicting which patients are at higher risk of developing cardiovascular disease is very difficult.
  • Patients with peripheral neuropathy are at a greater risk of developing heart and circulation problems, and therefore, peripheral neuropathy could be used as a way of identifying patients who are at high risk of cardiovascular disease.
Press Release, St. George's, University of London
Peripheral neuropathy and the risk of cardiovascular events in type 2 diabetes mellitus. Heart doi:10.1136/heartjnl-2014-305657,


http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=16752-peripheral-neuropathy-associated-with-cv-disease-and-stroke-in-type-2-diabetes-patients&catid=1&Itemid=8

Monday, 18 August 2014

Can A Vegan Diet Help Neuropathic Pain?

Today's post from medpagetoday.com (see link below) looks at the possible benefits of a vegan diet in reducing neuropathic pain. It specifies neuropathy caused by diabetes and in this case, the effects of a particular diet may be stronger for diabetes patients than for other people with neuropathy. However, dietary changes are gaining more and more attention when it comes to nerve damage of all types and it may be worth looking into what you eat and seeing if some adjustments could be made. Low carb, low dairy, lean protein, gluten-free and so on, all have their supporters but there are cases to be made for practically everything. You need to do your own research and come to your own conclusions but this article looks at a vegan diet in particular.

Vegan Diet Eases Diabetic Neuropathy Pain 
By Kristina Fiore, Staff Writer, MedPage Today Published: Aug 8, 2014

ORLANDO -- A plant-based diet may help relieve diabetic nerve pain, according to a randomized trial presented here.

In the 15-patient DINE study, patients with type 2 diabetes and diabetic neuropathy who were randomized to a vegan diet and B12 supplementation had greater improvement in pain scores than those who only took the vitamin, according to Anne Bunner, PhD, and Caroline Trapp, MSN, of the Physicians Committee for Responsible Medicine.

They reported their findings at the American Association of Diabetes Educators meeting here.

"Diabetic peripheral neuropathy is underdiagnosed, partially because there's not a whole lot for physicians to offer these patients," Bunner said. "We wanted to know if in the setting of a randomized controlled trial a low-fat vegan diet can make a difference in diabetic neuropathy pain."

Bunner noted that current treatments for diabetic neuropathy -- which occurs in about half of all type 2 diabetes patients -- only treat the pain, and do not treat the underlying cause of that pain.

An earlier observational study by Crane and Sample (J Nutr Med 1994; 4: 431-439) of 21 type 2 diabetics with nerve pain showed that being on a low-fat, high-fiber vegan diet for a month brought complete pain relief to 81% of participants, who lost about 11 pounds on average.

The majority of these patients were also able to reduce their diabetes medications and blood pressure medications.

To see whether similar benefits would hold in a randomized controlled trial, Bunner and Trapp conducted the DINE study (Dietary Intervention for chronic diabetic NEuropathy pain) in 15 patients with type 2 diabetes and neuropathy, who had a mean age of 57. About half were female and half had a college education or higher.

Patients were randomized to either a low-fat, high-fiber, plant-based diet with B12 supplementation or to B12 supplementation alone. Bunner noted that diabetic patients, especially those on metformin, tend to be deficient in B12.

Those on the diet could only eat plant-based foods, and they had to limit fatty foods such as oils and nuts to 20 to 30 grams per day. They were also told to get at least 40 grams of fiber per day, and to choose foods that had a low glycemic index.

Bunner added that there were no portion limits since high-fiber foods are low in calories.

Diet intervention patients also went to 20 weekly nutrition classes that involved nutrition education, social support, cooking demonstrations, and food product sampling.

With good adherence (five of seven diet patients were fully adherent), those on the diet had significantly greater improvements in McGill Pain Questionnaire scores than those on B12 alone (P=0.04), Bunner said.

They also had significantly greater reductions in body mass index (BMI) compared with controls (P=0.01).

Many other parameters were also improved with the diet compared with supplementation alone, and while the changes were significantly different from baseline, they were not significantly greater than those in the B12 group.

Those included cholesterol lowering, which was greater in the diet group but was confounded by the fact that many in that group came off lipid medications, while those in the B12 group were put on more lipid drugs, so the graphs were artificially lowered, Bunner said.

They also had significant improvements in HbA1c that didn't differ at the end of the study, possibly because of similar medication changes, she said.

Those on the vegan diet also had significant improvements in neuropathy symptom scores (NTSS-6) not seen in the control group, along with similar changes for quality-of-life scores, but the differences weren't significant at the end of the trial, possibly because of the small number of patients or because of the effect of participating in a study on the control group, Bunner said.

Still, the researchers concluded that the study demonstrates the potential of a dietary intervention for treating diabetic neuropathy pain. They plan to follow patients through 1 year and report longer-term effects.

Trapp added that she doesn't use the word "vegan" to describe the diet to patients because it's a loaded word: "some people don't like it. It's an immediate turn-off." Instead, she calls it a "plant-based" diet, and patients appear to be more open to it.

Primary source:
American Association of Diabetes Educators
Source reference: Bunner A, Trapp C "A dietary intervention for chronic diabetic neuropathy pain" AADE 2014.

http://www.medpagetoday.com/MeetingCoverage/AADE/47120

Sunday, 17 August 2014

The Stigma Of Chronic Pain

Today's article from paincommunity.org (see link below) is a very relevant one for people with the sort of severe neuropathy that brings them chronic pain on a daily basis. Because strong pain medications have such a bad rap these days, being associated with addiction and social problems, chronic pain sufferers face a constant stigma from a largely unaware public. Being tarred with the same brush as junkies and dealers and criminal behaviour, is a cruel irony when all you want to do is to be able to get through the day relatively pain free. It's largely the fault of the media who gobble up stories of opioid addiction and lay the blame for society's ills at a supposed over-prescription of opiates for pleasure. Opioids are sometimes the only option remaining for chronic pain patients and if monitored and used properly, are a very useful tool but if you tell people you have to take methadon or oxycontin for your pain, you're immediately branded as being socially irresponsible. This article highlights the problem and has the complete support of this blog.
 
Enough is Enough! Stop the Stigma Against People Living with Pain
Posted by Teresa Shaffer | August 5, 2014

It seems like just about every media article talking about pain medications has become a feeding frenzy which reports one side of the story. They take advantage of the uninformed and promote fear with biased and unsubstantiated claims that everyone who is prescribed an opioid medication has or will become addicted to the medications. They feed into the fear that if you have a loved one or friend who is prescribed one of these medications then you had better watch them closely because once addicted they will steal, cheat and lie to get their “fix.” This, my friend, is propaganda [information which is biased or misleading nature and used to promote or publicize a particular political cause or point of view].

I am so sick of reading these articles. I am so angry at all those who continue to suggest, promote and endorse these types of stories to the media in an attempt to influence and sometimes brow beat government agencies and politicians to legislate tougher laws and regulations. They claim “their cause” is to address prescription drug abuse to prevent overdose and death, but their methods are short sighted. The so-called “un-intentional” consequence, to me, seems quite intentional. Why put the onus of substance abuse on people living with pain? We did not create this public health problem nor are most of us misusing, abusing or selling our pain medicine. We are too busy trying the best way we know how to live a worthwhile life with another public health problem—the undertreatment of pain! Why make it harder for the legitimate person with pain to obtain an effective medication needed to lessen their daily agony? Why scare our doctors out of wanting to help treat us? Don’t we have a right for some sense of normalcy in our lives?

You notice there is a lot of information missing from these articles. There is no mention of how pain medications allow some people living with pain to have functional lives. There is no mention of how pain medications allow some people living with pain to continue to work. There is no mention of how pain medications allow some people living with pain to have quality in their life. We want nothing more than to have our pain treated in a manner that allows us to live our lives just like people who have other chronic medical conditions, like heart disease, diabetes, cancer and so on. As with any chronic disease, it is not all about taking medications. As with other diseases, when you have chronic pain, it means a full treatment plan is required to help lessen the pain and regain function. People with pain often use exercise, physical therapy, water therapy, massage and so much more. It is NOT just a pill for every ill.

When someone reads one of these poorly researched and unbalanced articles, I can imagine that they start thinking about a family member or friend who lives with pain. Then, they may question whether that person has real or legitimate pain. I know readers must think that if you are taking an opioid pain medication for pain that you must be addicted to them. It’s no wonder; the definition of addiction as compared to physical dependence is often confused as one in the same and this is incorrect. This information is often touted and reinforced by so-called experts who know little about pain and its management and incorrectly equate pain treatment as all about the medications prescribed.

Please allow me to enlighten those of you who do not know the difference between tolerance, dependence, and addiction. These definitions have been recommended by respected medical societies, like the American Academy of Addiction Medicine (ASAM), the American Pain Society (APS) and the American Academy of Pain Medicine (AAPM).
Tolerance – Tolerance refers to a situation where a medicine becomes less effective over time. (Your body adapts and gets use to it.)
Dependence – Dependence means that a person who has been taking a medication for a long period of time can develop symptoms of withdrawal if the medication is suddenly stopped, the dose is lowered too quickly or another medication is given that reverses the effects. (Your body adapts and gets use to it.) This effect can happen with many medications not just pain medications, like steroids, certain heart medications and anti-depressants.
Addiction – Addiction is a primary, chronic disease of brain reward, motivation, memory and related [nervous system] circuitry (ASAM). It is a condition where there is craving for this substance, the compulsive use despite harm, and impulse control loss of how they use the medication. The person does not care that they are harming themselves or others; they will do whatever it takes to obtain medications. They will engage in unacceptable and unsafe behaviors.

If you have a past history or current history of substance abuse the chance you will develop a problem taking opioid medications is higher than someone who does not have that history. Your level of risk should be considered before opioids are recommended. Yet, with open communication and close monitoring by your health care professional, even those at higher risk can take these pain medications more safely.

It is important to emphasize that no matter what your circumstance that these medications can be prescribed appropriately by knowledgeable clinicians and you take the medication safely if you do so as directed and report any problems immediately.

So how do we change this growing stigma against people living with pain? How do we fight back?
We get out there and enjoy our lives. We get out and do what we want to do, when we want to do it. We don’t let the fact that we use a cane, walker, crutches, wheelchair and other medical devices define us as part of the problem of drug abuse.
We stay informed and share our knowledge. When a friend or family member questions about addiction, we make sure we can give them facts and direct them to reliable resources. We must stop all the myths that are out there.
We must fight back with truth. Get angry and use that energy in a positive way. Take the time—NO, MAKE THE TIME and read what is published by the media. Comment back. Give them the facts and remind them of the harm they are contributing to by fueling distortions and misconceptions. Make them learn the other side of the story; offer to be interviewed, submit a letter to the editor, write a blog—take them to task.

Together we can make a change for the better. We can help stop this feeding frenzy that is making our lives with pain much more difficult than it has to be. If we don’t, who will?


http://paincommunity.org/enough-enough-stop-stigma-people-living-pain/

Saturday, 16 August 2014

New Repair Technique For Nerve Injuries

Today's post from sciencedaily.com (see link below) talks about advances in nerve repair after injury, where the nerve is severed in some way. Many people suffer neuropathy from direct injury to the nerve, thanks to some sort of accident. In the past, nerve transplants or grafts have been possible in some cases but are fraught with problems and the chances of infection and rejection. The process has recently been refined by using nerves taken from cadavers (corpses). These are processed to remove all cellular material whilst preserving their integrity and this means a lesser chance of infection. These nerve grafts (called allografts) are proving far more efficient in nerve gap repair and the chances of nerve regeneration are far higher.
This is only applicable to those people who suffer nerve damage through injury and accident.


Promise for new nerve repair technique
 August 8, 2014  University of Kentucky 


Summary:

A new nerve repair technique yields better results and fewer side effects than other existing techniques, research shows. Traumatic nerve injuries are common, and when nerves are severed, they do not heal on their own and must be repaired surgically. Injuries that are not clean-cut -- such as saw injuries, farm equipment injuries, and gunshot wounds -- may result in a gap in the nerve.
 

A multicenter study including University of Kentucky researchers found that a new nerve repair technique yields better results and fewer side effects than other existing techniques.

Traumatic nerve injuries are common, and when nerves are severed, they do not heal on their own and must be repaired surgically. Injuries that are not clean-cut -- such as saw injuries, farm equipment injuries, and gunshot wounds -- may result in a gap in the nerve.

To fill these gaps, surgeons have traditionally used two methods: a nerve autograft (bridging the gap with a patient's own nerve taken from elsewhere in the body), which leads to a nerve deficit at the donor site; or nerve conduits (synthetic tubes), which can cause foreign body reactions or infections.

The prospective, randomized study, conducted by UK Medical Director of Hand Surgery Service Dr. Brian Rinker and others, compared the nerve conduit to a newer technique called a nerve allograft. The nerve allograft uses human nerves harvested from cadavers. The nerves are processed to remove all cellular material, preserving their architecture while preventing disease transmission or allergic reactions.

Participants with nerve injuries were randomized into either conduit or allograft repair groups. Following the surgeries, independent blind observers performed standardized assessments at set time points to determine the degree of sensory or motor recovery.

The results of the study suggested that nerve allografts had more consistent results and produced better outcomes than nerve conduits, while avoiding the donor site morbidity of a nerve autograft.

Rinker, a principal investigator of the study, describes it as a "game-changer."

"Nerve grafting has remained relatively unchanged for nearly 100 years, and both of the existing nerve repair options had serious drawbacks," Rinker said. "Our study showed that the new technique processed nerve allograft ­- provides a better, more predictable and safer nerve gap repair compared to the previous techniques."

Rinker also noted that work is underway to engineer nerve allografts with growth factors which would guide and promote nerve regeneration, theoretically leading to even faster recoveries and better results.

Story Source:


The above story is based on materials provided by University of Kentucky. Note: Materials may be edited for content and length. 


http://www.sciencedaily.com/releases/2014/08/140808163451.htm

Friday, 15 August 2014

Options For Managing Neuropathic Pain

Today's post from neuropathydr.com (see link below) is a well-defined and simply-explained article by Dr, John Hayes jr covering most of the bases if you are meeting neuropathy for the first time, or are having trouble understanding what your options are. Dr Hayes never tries to hide the truth about neuropathy and its treatment and that's refreshing in itself. Although this blog doesn't advertise, the article does include references to his own clinics and certain treatments that can be found there. Following up on those is a matter of choice for the reader but the rest of the information is very useful and certainly worth a read.
 

Pain Management Options for the Peripheral Neuropathy Patient
Posted by john on December 12, 2013

If you’re a patient suffering from peripheral neuropathy as a result of

· Diabetes

· Post-chemotherapy

· Shingles

· Guillian Barre Syndrome

· HIV

· Carpal Tunnel Syndrome

· Or any other peripheral neuropathic pain

One of your greatest challenges (other than dealing with the pain and disruption of your normal daily activities) may be finding a medical professional to treat you with empathy and a real understanding of what you’re dealing with as a peripheral neuropathy sufferer.

Neuropathy pain can be hard to describe and even harder to measure. You can’t put a number on it and you can’t always give a concrete definition or explanation for your symptoms. That makes it difficult for the medical community, a community of science, to effectively treat you as a neuropathy patient.

The difficulty in finding a doctor well versed in treating peripheral neuropathy, in all its various forms, can make your life an exercise in frustration. Not only are you dealing with your peripheral neuropathy pain but you can’t find anyone to treat you with any success.

It might help to know what your treatment options are so you can interview your potential treater with some background knowledge about the pain management options available to you as a neuropathy patient.

Here are some of the options for pain management in peripheral neuropathy patients:

Medication[1]

The first line of therapy for peripheral neuropathy patients is usually pain medication, sometimes in combination with antidepressants. There has been some success with drugs used to treat epilepsy as well as opioids. Opioids may be effective but the dosages are very high and only help specific patients.

Always ask your treating physician about side effects from any medication prescribed. Many of the drugs used to treat neuropathy pain can have serious side effects and you need to take that into consideration before you use them.

Topical Treatments


Some creams can be help if you have small areas affected by your neuropathy.

Topical treatments usually don’t provide long lasting relief so talk to your doctor about a more permanent therapy if that doesn’t interest you. The exception are the cremes used in conjunction with the NeuropathyDR Treatments you’ll find HERE

Physical Therapy

Study after study has shown that active people heal faster. Period. By exercising your muscles, you will more easily adapt to your other physical limitations such as balance or gait issues.

Another benefit of physical therapy is that by keeping your muscles active and loose, you are less likely to suffer from severe muscle spasms, a common symptom in neuropathy patients.

But be prepared. NOT all PT is good and many PTs are NOT trained to help Neuropathy specifically.

When you first begin a course of physical therapy to treat your neuropathy pain, you will probably experience a little more pain than usual. You probably haven’t used those muscles in a while and they’re adapting to the treatment. If you need a boost in your pain medication until the muscle pain subsides, ask for it.

Psychotherapy[2]


Chronic pain or chronic illness leads to depression in many neuropathy patients. Treating the psychological aspects of your peripheral neuropathy pain is just as important as treating the physical symptoms. Any successful pain management therapy should include psychological counseling. Ask your doctor for a referral to a good therapist to talk about the emotional and psychological aspects of your neuropathy. You’re not overreacting to your pain and you’re not imagining it!

Other and “Alternative” Therapies


A good body/mind therapy regimen can be really helpful in dealing with your peripheral neuropathy. Consider yoga, acupuncture, relaxation techniques, hypnosis, or any other meditation technique as a complement to your pain management program. Any of these alternative therapies can increase the production of endorphins in your brain and help the body manage your pain in unison with any other medical treatment.

Neurostimulation And Laser

Applying small amounts energy via light AND or electrical stimulation (NDGen(TM) in various shapes or waves to the nerves and muscles may be successful in cutting pain levels dramatically and aiding them in functioning normally again. There are home AND clinic options with this unique tool!

Far from ordinary TENS, this combination treatment when properly applied cuts pain often dramatically and may even stimulate the nerve to function more normally again.

Learn more about the NDGen™ Home and Clinic treatment protocol or better yet, go visit a NeuropathyDR clinician in your area.

Our NeuropathyDR Clinician is a specialist in using the NDGen™ treatment protocol to cut your pain and drug use in many cases helping them to function more normally again.

For more information on coping with your peripheral neuropathy, get your Free E-Book and subscription to our Bi-Weekly Ezine “Beating Neuropathy” at http://neuropathydr.com.




[1][1][1][1] See www.touchneurology.com/articles/treatment-options-neuropathy-patients

[2] See http://www.supportiveoncology.net/journal/articles/0102107.pdf


http://neuropathydr.com/pain-management-options-for-the-peripheral-neuropathy-patient/