Neuropathy In Old Age

Todays' post from ctpost.com (see link below) is a question and answer session about one older person's experiences with neuropathy and the doctor's sympathetic and informative answer. We can all learn a little about how to cope with neuropathy from this post; especially as the person in question is 90 years old and clearly someone who knows how to put things into perspective!

Witty reader has concerns about neuropathy and mobility issues

Wednesday, August 1, 2012

Q: I will be 90 years old in August (I hope). My husband died of Alzheimer's disease and I've buried six children too early in life. Now it seems as if every week or so, a new ailment arrives -- very annoying to say the least. About six months ago, the soles of my feet started burning. I did go to my doctor who wanted me to take Lyrica. It does help a little. At age 83 I had a knee implant. Being a long-time walker, I wanted to keep doing that but the other knee got bad too. Sitting a lot is bad and causes belly fat which I now have.

What is neuropathy? I thought it only happened to diabetics, but I guess I was wrong. I am not diabetic. I don't drink and never smoked and our entire family is not overweight. Do you think an exercise program would help me at all or is it of any use when my knees kill?
Aging has some fun and surprises attached to it. You wake up every day with wrinkles and brown spots you didn't have the day before. Your nose is wrinkle free, but that's because of the blackheads there. Thanks for listening.
K
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A: Wow -- what a wit! With that amount of brain power, I am sure that K has more successful life ahead.
We have covered neuropathy before. I am going to bring back some of the concepts discussed and add some advice for K and our readers.

Neuropathy, from Latin, literally means "abnormal nerves." Your nervous system consists of two main parts. The brain and spinal cord are called the central system and everything else is called the peripheral system. This includes nerves that are responsible for feeling; nerves responsible for movement, and nerves controlling automatic functions like breathing and digestion. The last system is also called the autonomic (independent) system, since it does not rely on our thinking. At any rate, the nerves affected first by neuropathy are the longest nerves. The nerves responsible for feeling are involved most often. The symptoms are what K has described and more -- numbness, tingling, burning, and sharp, electric-like pain. One can also experience sensitivity to touch, muscle weakness and bowel and bladder problems.

If the autonomic system gets affected, patients lose some of the control of their blood pressure when getting up and get dizzy or even faint. As you can figure out, neuropathy is a group of problems and not just one particular disease.

What causes neuropathy? If only one nerve or group of nerves is involved, the most common reason is trauma (like typing too much). As K mentioned, diabetes is another major cause and can affect all parts of the peripheral system. This is why controlling the level of glucose is so important. A vitamin problem, especially from the B group, is another possible factor in neuropathy, as are an underactive thyroid, kidney and liver diseases and excess of alcohol intake. Alcohol is important, because many people will not report how much they really drink to their physician. Infections, especially HIV, can also be responsible. Sometimes we will see neuropathy among those with autoimmune diseases, or diseases when our own defenses systems turn against us.

At times, patients inherit neuropathy. However, nearly 40 to 50 percent of neuropathy cases are never clearly explained. Thus, sorting it out will require a doctor's help. You need a solid physical, a set of blood tests and even direct nerve testing called EMG (electromyography). This test will measure the electric activity of the nerves and is very helpful. Once all the testing is done, the doctor will tell you which type of neuropathy you have and, hopefully, what is causing it. If untreated, neuropathy can give a lot of symptoms and lead to a loss of function.

The treatment of neuropathy focuses on its cause, if one is discovered. For instance, treating neuropathy could entail controlling blood glucose, or supplementing thyroid if it is low. The other very important goal of therapy is to control neuropathy symptoms. Many medications are used -- including pain medications, anti-seizure medications, antidepressants and topical anesthetic (numbing medication). When used under a doctor's careful supervision, these medications improve function and help with pain and numbness.

I am glad that the current treatment is helping K some, but I also want to say that no one should be in constant pain. I do realize how many of you, just like K, are truly against taking pills. But pain medications, when taken safely and under a doctor's supervision, can be life-changing for people with chronic symptoms. Most physicians are comfortable dealing with arthritic pain. The doctor would start with certain medications and move on to more sophisticated ones if the initial selection did not give enough relief. Then we have the question about continuing physical activity. If there is a single thing you could do to improve you longevity, mood, and sleep -- and decrease your risk of Alzheimer's disease, stroke and heart attack -- it is physical activity. There is just nothing else with this degree of impact on all aspects of our lives.

Finally, please do not worry about the little abdominal fat you have. The newest research strongly discourages people over 75 from being too skinny. The studies published over the last two years clearly indicate that slightly "chubby" seniors live longer. With that, I hope for more letters from K.

Dr. Beata Skudlarska is a Bridgeport geriatrician. Send questions to Bridgeport Hospital Center for Geriatrics, 95 Armory Road, Stratford CT 06614 or geriatricmd@aol.com.

http://www.ctpost.com/news/article/Witty-reader-has-concerns-about-neuropathy-and-3750034.php