DEAR DR. GOTT: I have been diagnosed with several health issues, including neuropathy of my feet and hands. I have suffered from fibromyalgia for over 25 years, RA and OA. I am not diabetic, although I have two brothers that are. I am overweight and also have sleep apnea and use a CPAP.
My latest problem is spinal stenosis involving C5, C6 and C7. It has been suggested I have injections to block nerves to relieve the pain from the stenosis and I also saw a neurosurgeon whose first question was “how long do you expect to live”? If it’s 10 to 15 more years, I might consider to put plastic pads between my discs. I am almost 78. Friends tell me to see someone who uses Reiki treatments and all my ailments will go away.
I take folic acid and B vitamins along with neurontin (Gabapentin), Plaquenel, MS Contin 60 mg twice daily, Mirapex and amitriptyline at bedtime. Lately when I wake up every morning my right hand is swollen to the point I can hardly close it and it is ice cold.
After writing this, I have to laugh when I remember that doctor asking me how much longer I planned to live. I am not ready to throw in the towel but don’t want to live with this pain.
DEAR READER: Fibromyalgia symptoms can come on gradually, causing widespread musculoskeletal pain, irritable bowel syndrome-like symptoms, fatigue, insomnia, TMJ issues, and more. There is no cure; however, medication and stress-reduction will go a long way toward bring the symptoms under control.
RA (rheumatoid arthritis) is an autoimmune disorder that, again, comes on gradually. Symptoms include joint pain, loss of motion, possible deformity, fatigue, numbness, and sleep difficulties. Life-long treatment includes medication, exercise, physical therapy, and more.
OA (osteoarthritis) is a form of arthritis that signifies inflammation of a joint or joints and loss of cartilage that can result from heredity, hormonal or congenital disorders, trauma, disease, gout, or the aging process. The disorder commonly affects the feet, hands, hips, knees, spine, and is exacerbated by obesity because of the amount of stress placed on joints. Symptoms include pain, stiffness and loss of cartilage cushion between bones. When it presents in the cervical spine, as is your case, severe pain with radiation, numbness, tingling and more can result. Unfortunately, there is no specific treatment that will stop the degeneration of cartilage; therefore, emphasis is placed on reducing pain and inflammation through rest, weight reduction, exercise, physical and/or occupational therapy, and perhaps even with the use of such devices as knee braces.
Sleep apnea indicates pauses in breathing that can last from several seconds to minutes. Sleep is interrupted as a result and the individual will likely suffer from daytime drowsiness. If you live alone, you likely won’t know the condition exists because it occurs during sleep. However, if you have someone sleeping near you, they will be very aware of the occurrence. The condition can affect anyone; however, it is most common in those who have specific medical conditions or are on specific medications. Treatment involves breathing devices such as the CPAP (continuous positive airway pressure) device you are using, a mouthpiece that can be prescribed by a dentist or orthodontist, or surgery. Medication is ineffective. Weight loss, the discontinuation of alcohol and smoking, and sleeping on one’s side may be beneficial.
Spinal stenosis is a narrowing of the spinal column that places pressure on the spinal cord. It generally occurs as a person ages and is linked with long-term inflammation, arthritis, herniated disc, congenital defects, and more. Symptoms include numbness in various parts of the body to include the neck, weakness of an arm or leg, gait abnormalities, and incontinence. Treatment includes physical therapy, medication to reduce the degree of pain, massage, acupuncture and – when all else fails – surgery to relieve the pressure on the spinal cord or nerves.
All in all, you have numerous conditions that cause pain, inflammation, numbness and tingling of the extremities, and your sleep apnea interferes by not allowing a beneficial full night’s rest. I believe you should be seen by a rheumatologist who can prescribe medication that may reduce your pain and swelling. You should also receive physical therapy and see a dietician – the first to work on those painful joints and muscles and the second to assist you in lowering your weight. Your daily exercise regimen might include the use of weights while sitting in a chair, water aerobics, tai chi, bending and stretching, and more. Massage, chiropractic, perhaps Reiki, and stress reduction can be included, as well. Ask your doctor’s office staff to help you with recommendations. It won’t be easy but if you can take it one day at a time under specific guidance by qualified professionals, you will find your pain lessened every day. Then when your doctor asks how long you expect to live, tell him “oh, at least another 10 or more years”.
Readers who would like related information can order my Health Reports “Fibromyalgia” and “Osteoarthritis” by sending a self-addressed, stamped number 10 envelope and $2 US dollars (for each report ordered) to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order form from my website www.AskDrGottMD.com.
