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DEAR DR. GOTT: I’ve been diagnosed with neuropathy of the feet. The nerves are dying and it is a permanent loss.
Then I was told that a chiropractor could help. He said the nerves can be revived to some extent, but not fully. Question. Who is right, the neurologist or the chiropractor? Your answer will be greatly appreciated.
DEAR READER: Let’s review things before I attempt to answer your question.
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DEAR DR. GOTT: I am a 70-year-old woman who developed shingles on my right leg last June and am now left with neuropathy. It went from the middle of my leg all the way down to my foot and toes. I was immediately put on an antiviral and a prednisone pack, so the doctor was surprised that I developed post-herpetic neuralgia. My leg and foot are completely numb and I cannot bend the right foot upward, so I wear a boot and go from a wheelchair to crutches and then to bed. It is causing excruciating pain.
I have seen two neurologists, who both ordered MRIs of my spine, an EMG and nerve conduction tests. Both dismissed me, saying there is nothing more they can do for me. The last neurologist suggested I see a pain management doctor. I saw one two weeks ago and am getting epidurals in my spine. The first one didn’t help, so I am hoping to get some relief with the second one, because as soon as I can get out of some of this pain, I can try a physical therapist to help me walk with this dropped foot.
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DEAR DR. GOTT: Four years ago, I was told that I have both neuropathy and myopathy. I’m finding it more difficult to walk and even to lie down comfortably. Is there anything new I can take to eliminate the nerve- and muscle-damage discomfort I’m experiencing?
I take one 300 mg gabapentin at night. I’ll be 74 this year and take no other drugs.
DEAR READER: Neuropathy, as you know, is caused by damage to nerves. It can occur anywhere in the body, but it is most common in the extremities, especially the feet and legs. Unfortunately, you don’t specify what type of neuropathy you have, and there are many from which to choose.
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DEAR DR. GOTT: I am always interested in peripheral neuropathy because it was one of the many later symptoms I developed when I acquired bartonella henselae. However, I apparently acquired the bartonella approximately 16 years ago. I recall a cat scratch from a feral kitten that did not heal for several months. I wasn’t diagnosed until a little over two years ago when I failed to respond to Lyme-disease treatment.
In addition to alpha-lipoic acid, my doctor put me on Levaquin. Amazingly, the shoulder pain, chronic gall-bladder infection, swallowing problems, ankle swelling and chronic stomach ulcer went away. The numbness in my feet and fibromyalgia did not disappear but got better.
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DEAR DR. GOTT: Please comment on neuropathy. How does one get it, what medication treats it, and is it curable? Can it be caused by a broken toe?
DEAR READER: Neuropathy can be defined as a disorder or disease of the nervous system. Because you provide limited information, I cannot determine which form, if any, you might have. Unless your toe fracture was quite traumatic, it’s my guess it’s not likely to have resulted in neuropathy.
Autonomic neuropathy refers to damage to nerves over which we have no control, such as those of digestion, perspiration, blood pressure and heartbeat. Symptoms can include dizziness and fainting on standing (orthostatic hypotension), caused by a drop in blood pressure; gastroparesis (difficulty digesting food), causing diarrhea, constipation, nausea, vomiting, heartburn, loss of appetite and bloating; exercise intolerance, during which the heart rate remains stable despite the level of activity; hypoglycemia (low blood sugar) [Read more...]
DEAR DR. GOTT:
I have received information from a friend that you have a theory that spraying nitroglycerin on the hands and feet of a neuropathy patient may be of some help. I’d like to know where I can get this spray.
My husband has peripheral neuropathy. He is not diabetic and the pain is mild. He needs a cane to keep his balance when walking and is losing function of his hands. In November 2006 he was in hospital for treatment with massive IV steroids and IV immunoglobulin. Each treatment lasted four hours. Unfortunately, they made him very sick and he was forced to stop.
We are willing to try anything to improve the function of his hands. Where can I get nitroglycerin spray for him?
DEAR READERS: Nitroglycerin is a prescription medication. Most pharmacies carry it but without physician approval you cannot purchase it. Speak with your husband’s neurologist about this possibility.
He may also wish to try prescription Neurontin which has been proven useful in lessening the pain of neuropathy.
A final option is Vicks VapoRub or similar store brands. Many of my readers have had amazing success by simply rubbing the product on the affected areas two to three times a day. It is also inexpensive, safe, easy and best of all, doesn’t require a prescription. I recommend your husband give this a try first and move onto the other options should it not work.
To give you related information, I am sending you a copy of my Health Report “Dr. Gott’s Compelling Home Remedies”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
DEAR DR. GOTT:
Like most of your fans, I would like to start with a compliment. You always seem to have the answer to the questions that many of us have but believe are too insignificant or unimportant to ask our doctor. They are questions to which we really to want to have answers. You never respond in a manner that will belittle the person asking and for that I say thanks.
Now my question. It is a bit complex but I will try to be concise. In 2005 I started developing symptoms of peripheral neuropathy. After a consult with my family practitioner and a few preliminary tests that were negative, I was referred to a neurologist. While waiting for the appointment, I discontinued my Zocor and a mild antidepressant to see if symptoms declined. (One of Zocor’s side effects is neuropathy.) Within a few weeks to a month the symptoms declined somewhat. The neurologist continued with more tests. Most of them were normal. The milder neuropathy symptoms were and still are present but intermittent.
When the results of my protein studies came back, including the paraneoplastic panel, my striated muscle levels were elevated. Because of this, my neurologist ordered a lung scan which was negative. At that point I was told to just wait and see if I had any symptoms that might suggest lung cancer.
Since I am proactive in my health care, I did my own research online and found that small cell lung cancer can be preceded by peripheral neuropathy before the onset of disease. Several existing studies suggested that regular follow up testing was advised because waiting for symptoms can result in poor prognosis if covert cancer is present. I reviewed this information with my family physician who agreed with the wait and see approach of the neurologist.
I had a repeat paraneoplastic panel one year later (2006) and the striated muscle portion was still elevated but lower than the first test.
Is there anything you would recommend? Should I ask for a referral to a different specialty? I am not looking for trouble but on the other hand, I do not want to ignore a problem if there is something I should or could be doing.
DEAR READER:
Your physicians have addressed your problem using excellent medical care. If agree with the wait and see approach, especially given the fact that your blood test improved during 2006. I do not know the cause of your neuropathy (nerve malfunction). If your symptoms are stable or improving, I would not worry too much. If you truly feel uncomfortable, speak with your neurologist or ask for a referral to another doctor for a second opinion. If your symptoms start to worsen, see your neurologist who should order more tests and address possible issues, including treatment options.
Continue with your yearly monitoring and follow your physician’s advice. Good luck and let me know how this turns out.
Disclaimer: All information contained herein is the opinion and view of the writer. It is intended to provide helpful and informative material on the subjects addressed and is not meant to malign any pharmaceutical company, organization, religion, ethnic group, or individual. Readers should consult their personal physicians or specialists before adopting any of the recommendations or drawing inference from information contained herein. The writer specifically disclaims all responsibility for any liability, loss, risk -- personal or otherwise -- incurred as a consequence, directly or indirectly, from the use and application of any material provided.
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