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Old 01-05-2009, 07:55 PM #1
EHorst99 EHorst99 is offline
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Default Dealing with muscle weakness?

I've been dealing with PN for about a year with gabapentin succesfully most of the burning sensations for the last 4 months or so. I'm still currently labeled "idopathic", but I'm seeing my neuro on Monday with results of my latest tests.

It's been steadily progressing and in the last month, it's progressed into my hands along with muscle weakness -- most notable in arms and shoulders.

Has anyone found anything that can help deal with the muscle weakness and associated fatigue?

Thanks,

Ed
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Old 01-06-2009, 08:06 AM #2
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Lightbulb I think you need

to ask your doctor.

Most (but not all) PNs are sensory. Once they become motor,
you need more aggressive medical advice.

Plasmapharesis is sometimes used to treat motor issues, if immune complexes are the cause.

Your weakness could also be a manifestation of type II diabetes. Muscle weakness is one symptom of increasing insulin resistance. Also your neck should be evaluated for any stenosis there.
Hereditary neuropathies may also affect motor functions.
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Old 01-06-2009, 08:07 AM #3
Westie Westie is offline
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Default Muscle wasting and exercise

This is a area of interest for me too. I've only recently become aware of aching (muscle wasting ?) in my thigh area and am naturally anxious about it spreading or worsening.

I suppose I could get referred to an OT and perhaps I should. I don't swim, but do a reasonable amount of walking, mile a day average, up to 3-4 weekends. I haven't cycled for a long time but am pondering trying this or even an exercise bike, but don't want to do more harm than good !

Has anyone got any experience or advice they can share please ?

My PN is diagnosed as alcohol related - I've stopped completely - so hope things won't get worse.
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Old 01-06-2009, 12:01 PM #4
EHorst99 EHorst99 is offline
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Default Thanks for your feedback...

Quote:
Originally Posted by mrsD View Post
to ask your doctor.

Most (but not all) PNs are sensory. Once they become motor,
you need more aggressive medical advice.

Plasmapharesis is sometimes used to treat motor issues, if immune complexes are the cause.

Your weakness could also be a manifestation of type II diabetes. Muscle weakness is one symptom of increasing insulin resistance. Also your neck should be evaluated for any stenosis there.
Hereditary neuropathies may also affect motor functions.
Very interesting feedback for a couple reasons:

1. Although my glucose levels and A1c numbers have been normal, I just had a 2-hour glucose intolerance test done since I read about a number of cases where they had "normal" numbers for their everyday tests, but failed a later glucose tolerance test. I find out the results on Monday with my next visit to my neuro. In a strange way, I'm hoping I've failed and can be labeled "pre-diabetic" so that I have something definitive to work on.

2. Your "neck stenosis" suggestion is, again, spot on. Even before the muscle weakness became more noticeable, my neuro and I were talking about getting an MRI done of my neck because.... 5 years ago, I had two discs removed in my neck. During the surgery, he did a lot of a lot of clean-up of arthritis. Based on what I'm experiencing now, if I didn't have the PN feelings in my feet/legs first, I would be immediately guessing that I'm having another issue with my neck.

Keep the suggestions coming.

Ed
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Old 01-06-2009, 12:24 PM #5
ldlordel@yahoo.com ldlordel@yahoo.com is offline
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Default Re: Muscle weakness

I have been finally diagnose correctly a couple months ago from MS to PN. Yahoo! or not. All the glucose and blood work, skin biopsy come back normal. 2005 a spinal tap came back above normal protein level. Anyway, I to am on gabapentin. Found it had nothing to do with the muscle weakness in my arms and legs. Its frustrating..even folding laundry is a chore. I cannot stand for periods of time in one spot and my balance..well lets say I hope I never get pulled over for a DUI check...I totally fail on balance.

So this wll be a strong issue on next Neuro Dr. appt. The Gab stopped the burning to but everyday pain is an issue. I will take an oxcodine or a vicodin if really hurting and it helps.

I wish I could wave a magic wand and make all of feel better.... Best regards

Quote:
Originally Posted by EHorst99 View Post
I've been dealing with PN for about a year with gabapentin succesfully most of the burning sensations for the last 4 months or so. I'm still currently labeled "idopathic", but I'm seeing my neuro on Monday with results of my latest tests.

It's been steadily progressing and in the last month, it's progressed into my hands along with muscle weakness -- most notable in arms and shoulders.

Has anyone found anything that can help deal with the muscle weakness and associated fatigue?

Thanks,

Ed
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Old 01-06-2009, 04:28 PM #6
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Lightbulb

Quote:
Originally Posted by EHorst99 View Post
Very interesting feedback for a couple reasons:

1. Although my glucose levels and A1c numbers have been normal, I just had a 2-hour glucose intolerance test done since I read about a number of cases where they had "normal" numbers for their everyday tests, but failed a later glucose tolerance test. I find out the results on Monday with my next visit to my neuro. In a strange way, I'm hoping I've failed and can be labeled "pre-diabetic" so that I have something definitive to work on.

2. Your "neck stenosis" suggestion is, again, spot on. Even before the muscle weakness became more noticeable, my neuro and I were talking about getting an MRI done of my neck because.... 5 years ago, I had two discs removed in my neck. During the surgery, he did a lot of a lot of clean-up of arthritis. Based on what I'm experiencing now, if I didn't have the PN feelings in my feet/legs first, I would be immediately guessing that I'm having another issue with my neck.

Keep the suggestions coming.

Ed
Ed, you can have a fasting INSULIN run. It is easier than the GTT. Elevated levels indicate you are insulin resistant.

In some ways this is a more valuable test as it does not require so much interpretation.
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Old 01-07-2009, 01:02 PM #7
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Default My results are in. "Unfortunately", I'm not pre-diabetic...

Quote:
Originally Posted by mrsD View Post
Ed, you can have a fasting INSULIN run. It is easier than the GTT. Elevated levels indicate you are insulin resistant.

In some ways this is a more valuable test as it does not require so much interpretation.
My glucose tolerance test was quite normal. My blood sugar levels were well back to normal (80's) in short order after drinking the glucose.

Neck MRI is next, but I'm starting to run out of options and am dangerously approaching permanent joining the "idopathic" camp.

Ed
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Old 01-07-2009, 03:16 PM #8
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Lightbulb

Quote:
Originally Posted by EHorst99 View Post
My glucose tolerance test was quite normal. My blood sugar levels were well back to normal (80's) in short order after drinking the glucose.

Neck MRI is next, but I'm starting to run out of options and am dangerously approaching permanent joining the "idopathic" camp.

Ed
Ed, when insulin levels are going up on a daily basis, you clear sugar quickly for a while. Then all of a sudden the system fails, and the sugars go up.
Your test does not show elevated sugars YET, but your insulin levels may be high already....and this is what you need to know. Interpretation of GTT can be pretty fuzzy...or outdated.

This link may be helpful for you:
http://lightning.prohosting.com/~hyp...20Hypoglycemia

Many people show reactive hypoglycemia as a prelude to real diabetes.
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Old 01-07-2009, 06:58 PM #9
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Default

Ed,

I also have problems with weakness and fatigue. I take Neurontin too. I've heard Neurontin can cause fatigue, but so can PN. Maybe adjusting your dose would help? Also, I know there are several meds available for fatigue..Provigil and Amantadine (older med).

I had luck with an Occupational therapist. She showed me different ways of doing things that conserved energy. I also had some exercises to help strengthen my muscles.

Good luck.
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Old 01-07-2009, 10:17 PM #10
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Quote:
Originally Posted by mrsD View Post
Ed, when insulin levels are going up on a daily basis, you clear sugar quickly for a while. Then all of a sudden the system fails, and the sugars go up.
Your test does not show elevated sugars YET, but your insulin levels may be high already....and this is what you need to know. Interpretation of GTT can be pretty fuzzy...or outdated.

This link may be helpful for you:
http://lightning.prohosting.com/~hyp...20Hypoglycemia

Many people show reactive hypoglycemia as a prelude to real diabetes.
I appreciate your continued dialog on this.

I was not checked for insulin levels, only glucose levels.

If I was hypoglycemic, to some degree, what would the treatment be to prevent it from turning into full diabetes? Would it basically be a lifestyle change -- exercise, avoid high carb foods, etc?

Unfortunately, my test was only 2 hour (and ended at 83) so it doesn't show if there could have been a possible upward swing a bit later. It's probably going to be hard to convince my doctors and my insurance company to repeat the test for 5 hours.
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