Q: I am a 79-year-old man and a colon cancer survivor. My surgeon removed the cancerous segment of my colon and fortunately, the bad tissue was confined to the lumen of the colon.
Since then and about seven years ago, I have not experienced any health problems except for minor aches and pains, until recently that is. I began to have episodes of instability. My physician was unable to determine the cause and referred me to a neurologist, a friend of mine. He diagnosed my problem as neuropathy and said it was idiopathic and there was nothing I could do about it. “Just be careful and learn to live with it” was his advice.
Reportedly, 22 million people in the US suffer from neuropathy, about the same number as those who have diabetes. But seldom, if ever, does the news media mention the disease. I am confident that many readers of your column would appreciate you addressing the subject of neuropathy.
A: Well, by golly, I will mention it now.
Peripheral neuropathy refers to damage to the peripheral nerves. The condition causes numbness, pain and weakness – most commonly to the hands and feet, although other areas of the body may be affected. Other signs and symptoms may include a sensitivity to touch, paralysis if motor nerves are affected, an intolerance to heat, lack of coordination, digestive issues, dizziness and lightheadedness caused by modifications in blood pressure, and gait abnormality. Perhaps this is what you refer to as instability. It may be that you have a form of motor neuropathy that has resulted in impaired balance and coordination.
The purpose of the peripheral nervous system is to send information from the brain and central nervous system throughout the body and to send information from the far parts of the body back to the brain. However, when such conditions as an injury, toxin exposure, infection, metabolic issues, nerve diseases, certain protein diseases, and inherited issues are involved, neuropathy may result. When one peripheral nerve is affected, the condition is known as mononeuropathy. When two or more nerves in different areas of the body are affected, the condition is known as polyneuropathy. The condition may be genetic and present from birth, or it may be idiopathic (without a known cause). Peripheral neuropathy may be chronic or acute. The chronic form is long-term with symptoms that may initially be subtle and progress slowly. The acute form may have a sudden onset with rapid progression and slow resolution.
There are specific circumstances that may increase an individual’s risk for peripheral neuropathy. They include having diabetes, Charcot-Marie-Tooth disease (an inherited disorder), being on specific medications that include chemotherapy, having Sjogren’s syndrome, kidney or liver disease, rheumatoid arthritis, Guillain-Barre syndrome, and alcoholism (because of the potential for vitamin deficiencies). Those vitamin deficiencies most likely in the case of alcoholism include vitamin E, niacin, and B1, 6 and 12 – all of which are vital for good nerve health. Diagnosis may include a neurological examination, nerve function testing, as well as specific blood tests and nerve and skin biopsies.
Treatment may begin with over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs), vitamin B supplements, or capsaicin for mild symptoms. More severe cases may respond well to opioids, antidepressants and anti-seizure drugs. Physical therapy and TENS (transcutaneous electrical nerve stimulation) or IV immune globulin may be considered.
On the home front, avoid excessive alcohol consumption and discontinue any smoking habit. Exercise to improve muscle strength. Consider yoga, tai chi and acupuncture. Eat well-balanced meals.
Thank you for your articulate letter and clear understanding of your condition.
