I went to the neurologist in town following my general practitioners referral. He said small fiber neuropathy. He was not a specialist. I looked for a specialty clinic on my own and asked a neurologist to send the referral. I just had that visit about 10 days ago. They did a couple additional blood tests and nothing came up. They did EMG and NCS. Nothing came up. I wasn't expecting anything because I was suspecting small fiber neuropathy and that is not measured with those tests. But they also did do the skin biopsy. My skin biopsy shows axonal swelling in the distal site. They are increasing my nortriptyline to 25 mg a day. This is still a small dose and most literature doesn't find nor tryptoling better than placebo. They're also starting me on gabapentin. The doctors warned me that gabapentin doesn't really do much for small fiber neuropathy. I've done lots of research. I am in my 6th decade. Literature seems to say that it can arise in people of a certain age. And 30 to 50% remain without a known cause. You can find hopeful paragraphs in literature that say it will plateau. You will also hear horror stories at some people lose all sensitivity in all of their skin. Getting the skin biopsy has actually made me more depressed. I obviously knew that something was wrong. Anyone can read my initial post. But just seeing that pathology was found, ie axonal swelling makes it all too real. When axons swell it is often a prelude to further degeneration. So the question for me will be how widespread will this ultimately go. I hear people's suggestions about stopping sugar, stopping alcohol, etc etc. I have not made any real life changes yet. Sometimes I think we should do like Caroline and avoid the doctors and simply live our lives. I wish you best of luck. We have to make a choice when we are faced with going down the rabbit hole of traditional medicine or avoiding it all together. I do have a follow-up appointment with the neurology clinic in May. I will go I suppose. But something deep inside of me tells me that this will play out however it is meant to. Learning to live life in the moment is more important now than ever.