Update: July 10, 2015.

Pectoralis Major (RS) Right tricep and right bicep recovering. The increase toward normal strength came as suddenly as it left. It is amazing. Getting a physiological pump much better these days. Quads and calf muscles still down. Expect that larger muscle groups may take longer to repair.

Discontinued magnesium and Vit D. Getting more sunlight in this weather.

Still taking vit B1, B3, B6, B12; E, A.

Be careful of taking vit B3 and B6 at same time as B1 as these vitamins will fight for the same receptor sites. I space by two hours.

Otherwise, I'm doing fantastically well. Thank you!

Sober: 4 months. No longer dreaming of it. Satan no longer has a hold on me.

Dubinin, 4 months is great.

Good job !

Dubinin, any update? Hope you're well. Stay strong.

Thank you, Kiwi33!

Bobby78, Thank you for the encouragement! I'm strong, I was doing well!

paresthesias were decreasing week by week, until just last Sunday, when bang, I was hit hard with paresthesias that were similar to those leading me to post here the first ever time.

So, indeed! Time for an update:

Titled: "5 months forward! Now do it all again."

I was back to working out with some intensity - I worked out three days in a row last week, then bam - on came the symptoms. (Paresthesias in hands and feet - not relieved by elevation of feet or sleep as in previous months).

Other symptoms:

Insomnia (can not presently stay asleep longer than 4 to 5 hours - came on with paresthesias).

Some forgetfulness - I know where my keys are. But some words or place names elude me (they eventually come after minutes sometimes). This may be because of sleep deprivation. Butttt this and other symptoms I shall list do tie into something else.

Muscle wastage (recurred after many weeks, affecting left forearm. Legs are still down).

Anxiety episodes (I have fought with this a lot in the past; and as I moved on from teens and early twenties, those went away. Then after years - some anxiety episodes have occurred recently, which struck me as odd).

Lack of concentration (paying more attention to people walking behind me than to reading this for editing purpose, and having to re-read and re-read that which has been already re-read many times)

See? Now I just forgot the next thing I was going to list... Oh, right --

Tachycardia - (120+ bpm) on ridiculously simple tasks such as waking and stretching in bed. Skipped beats (not new for me, had that all my life. Used to play with this phenomenon - as a younger guy would hold breath, feel HR increase slightly. Then exhale and breath normally while taking pulse. And would feel pulse intensify, then skip a beat then resume normal course. Well - that don't happen lately! HR skips beats even during breath holding phase, and just does not fit the old and familiar pattern when having an episode of tachy, which usually lasts about 17 minutes; then bradycardia follows. Poor little heart! What the hell did I do to you, when you were only ever good to me and tried to keep me alive?!)

Lack of energy - feel heavy, lead-heavy these last 4 days; impacts on ability the last two days to work out according to my program.

Some breathlessness on exertion (when cycling, for example, to get B12 pills downtown).

Eyesight - muscles used for focus do not want to co-operate as they used to sometimes. Blurry vision.

Subtle loss of muscle mass from face, neck, and everywhere between neck to toenails.

Weight down by 10 pounds over the last three months.

And the good news, Dubinin? Gosh, give us the good news!

Can do 450 push ups with elevated feet in under an hour (up from 5 (not a typo- 5!) as of... 2 or 3 months ago? (Record was/is 660 in an hour)). I had reported here some time back massive loss of strength in right pec, right tri, and right everything else. Could not even do 10 normal pushups at that stage.

Can do 100 squats with 22 pounds in 6 minutes (3 x 1 minutes sessions with 2 x 1.5 minutes rests). Buttt legs feel like hell after, as does the rest of me. This feeling is contiguous with the big backflip I have gone through recently.

Now then- the solution, old chum? What is the solution to the current crisis?

B12. That is the solution and it is the one thing I managed to overlook. Well, not overlook. I overlook nothing. But I trusted a nutritionist, who never had a drink in his life, and didn't know the protocol for treating B12 deficiency.

The B complex I was/restarted taking has TEN times too much B6 (that's the one that will mess you up good, AND it can produce symptoms similar to those we're trying to deal with. So do be careful!) The same complex also had TEN times too little B12, in terms of dosage required to treat B12 deficiency. And yes, alcoholism (or whatever we choose to call it, without using such a 'shameful' and emotionally-charged 'sticker') will deplete B12.

I confess idiocy.

I thought I was on target with B12 - considering the 250mcg suggested by a high profile nutritionist that was supposed to be for "detox and recovery."

This strictly limited level of B12 is strict BS. If you're deficient in B12, this really will not begin to right the listing and paresthetic ship.

I have researched for many hours now over the last 4 days and, in sum, the published sources point to the following regimen for treating B12 deficiency.


FIRST TWO WEEKS:

SINGLE daily DOSE of 1000-2000mcg B12 (This high dose is required because of the variable absorption of oral vitamin B12 in doses of 500 mcg or less - hence the mess I was in with trusting for months in only 250mcg...)

NEXT TWO WEEKS:

1000mcg B12, once daily.

Re-check B12 levels:

"In ... vitamin B12 deficiency, we recommend repeat measurements of serum vitamin B12, homocysteine, and methylmalonic acid levels two to three months after initiating treatment." (Dr. Robert Oh: Vitamin B12 Deficiency. Published in: American Family Physician. 2003 Mar 1;67(5):979-986).

NOTE that serum B12 levels are NOT a fine measure of your actual B12 state. MORE accurately, we must check homocysteine, and methylmalonic acid levels (as is explained in Dr. Robert Oh's publication - link given below).

The ins, outs and in-betweens of B12 deficiency - signs, treatment and why testing only serum level B12 (without any reference to levels of homocysteine, and methylmalonic acid can be dubious) is all here:

http://www.aafp.org/afp/2003/0301/p979.html


I commenced this B12 therapy today. I expect no results for probably two weeks, but will keep notes, my own order of meticulous notes.

Make sure to treat B12 deficiency early. I have effectively let this go for months with very very scant oral B12, thinking I was doing okay. No wonder 180 B1 pills seemed to do nothing. I really do see that B12 deficiency ties in every symptom I have mentioned to date. Everything: paresthesia, the mimicry of PN (peripheral neuropathy), insomnia, cardiac symptoms, breathing symptoms, anxiety, muscle wastage, generalized lack of energy - the whole terrible lot.

I will let you know how I go...!

Peace and blessings to everyone!

<So, indeed! Time for an update:

Titled: "5 months forward! Now do it all again."

I was back to working out with some intensity - I worked out three days in a row last week, then bam - on came the symptoms. (Paresthesias in hands and feet - not relieved by elevation of feet or sleep as in previous months). >


Interesting post, dubinin. your observation here on exercise rings so true for me also in some respects. I wish I could predict how changes in exercise affect my symptoms, but it seems pretty random. It's hard to know if one is helping or hurting....thanks for the post.

Thanks for the detailed reply! It's much appreciated. I think we're in the same boat. And yes, I'd like to right that ship as well.

Yes, Dubinin . Some of us are sicker than others.

Hi newstown,

Random is the way of nerves, especially when they have been impacted by any kind of trauma. I can see it is a real nuisance, not being able to predict accurately how your nerves will go from day to day.

The temptation is to drop exercise. But, the general strategy should be to keep exercising, as far as energy levels and other factors will permit. The maxim that people have adopted with success is to keep working out as much as they can. Now, the problem is that if a peripheral nerve has been affected to the point strength is subsequently affected, then one needs to augment their work out for safety to avoid complicating things further through injury.

So it comes back to tediously applying oneself to adjusting loads and limits, and trying to start with a base minimum and trying to stimulate the muscle groups as best we can (and as far as restricted insights and random nerves permit).

At my worst, I was down to 7 pushups (or less) a day, with a few squats. But it was something. I decided that if that was my new starting point, so be it, and that I would build from there. Don't be afraid to "tear it down" to a new minimum. You will always be better able to gauge results from setting the bar too low than too high.

I worked my 7 pushups into something a 3 year old could have pulled off - 7 push ups became three sets: 4-5-3 pushups, with an extra 1 or 2 every time I worked out again. But, I kept going, doing anything I could.

Low impact exercises minimize *injury* and will help cardio- pool, elliptical (exercise bike), walking over a known course (a safe course - one with no trip hazards or weird obstacles like stair wells and golf course bunkers - important if one is having foot drop or leg issues) and trying to better times - all of this will help minimize injury, if you can do it.

When large muscle groups are malfunctioning, then going back to "core" and physiotherapeutic exercises is still something.

It is the worst feeling when you know what you can do, and you just can't do it. But it can and does come back. A lot of literature uses the shallow doom of "PN can be permanent" without explaining exactly WHEN it will be permanent. It is useless, and should not be used as a formula for quitting exercise. Peripheral nerves are very capable of healing themselves, given the right nutrition and rest support (in cases of insomnia - this often comes back to high dose vitamin therapy as it did in my case and the cases of many many others).

It is also a horrible feeling when people don't just get it. We know what we are capable of, when nerves permit (and they will again). They say such things as "Well, you just have to accept this as the new you," as a nursing amour said to me during this time. Really? I resisted swallowing her glib and diffuse commentary and went at it against her fatefulness. People just don't get it. We give up expecting them to. But we focus on the important issues of never giving up - and always looking for the solutions that fit our issue.

I hope anything I said was useful. You will be better than you might feel you are today. It can be a demoralizing experience like no other when nerves go awry. But there is, generally, a solution for everything. So, hang in there!

You're welcome, Bobby78! Great that we are in the same boat (and what a boat to be in) because we just might be able to find the same solutions to right the ship.

Good news - B12 seems to be working wonders for me. Longer sleeps, clear dreams, daily reduction in paresthesias, better concentration, no anxiety now, body seems to be slowly "filling up" again from being slammed. And this was my big news that I was coming here to report. But B12 seems to have caused a breakthrough for me. So, this would be my recommendation for you, fellow shipmate - I have a hunch, a theory, that some people are not great absorbers of B12 anyway, and as long as they live like the Amish they tend not to encounter the plethora of problems that come when B12 goes low. However, drinking like crazy, as I did, highlights this and continued heavy drinking will bring on a bunch of problems that can be misdiagnosed; mismanaged; and if we are reaching for supplements, those can mask even a B12 deficiency.

So advice hot off the press is to check B12, (and B1, and don't overdo B6); and if in any doubt at all, consider starting the B12 therapy mentioned above in my last huge post!

I'm so convinced B12 is the answer for me that was lacking, and wish it was as straightforward for everyone!

Yes, Wiix, some are. But, yes, in the end, we all have the same darned thing, and don't worry, I have felt like hell, and there are times when I still do. In the end, it isn't who suffers more but that we suffer; and that we can encourage one another; and that we can share insights; and pan for golden solutions and give them out selflessly that will make the difference. I think anything - especially at the early stages - helps. Hang in there.

Notes from the past 7 days on high B12 protocol to treat B12 deficiency.

(B vitamins are pivotal in maintaining nerve and muscle health. B12, B1, B2, B3, B6 all have their role to play. It is easy enough to accidentally mask a B deficiency. B12 deficiency, in my case, was masked and overlooked. Symptoms persist needlessly in such cases. So, check your Bs! And make sure that more intense testing is done than just to check serum levels of B. In the case of B12 "a more sensitive method of screening for vitamin B12 deficiency is measurement of serum methylmalonic acid and homocysteine levels" (Dr. ROBERT C. OH and Dr DAVID L. BROWN: Am Fam Physician. 2003 Mar 1;67(5):979-986)).

My Study on Myself: High B12 protocol and results - WEEK ONE

SEP 18
======

SLEEP: Slept 5 hours, with vivid dreams (it's been a while).

PARESTHESIAS: right toes, left instep, heel, left hand on waking from sleep. right middle fingers.

COGNITIVE: Some "forgetfulness"

CARDIO: tachy on waking from naps. (3 naps from 12:30- 3:55pm)

78bpm at rest.

WEIGH IN: (2 pair socks, track pants, t): 209LBS (95 kg).

---------------------------------------

SEP 19

SLEEP: Slept 6 hours with wakefulness in middle, after going to bed late

PARESTHESIAS: less than yesterday. Right hand TINGLING on waking. Elevated to pillow and alleviated.

CARDIO: Did not notice as forceful tachy on waking. But still present, only to lesser degree.

76 bpm at rest

------------------------------------

SEP 20

SLEEP: Slept 5 hours solidly. Reclined for a further two. Dreams are very vivid. Sleep is very deep. Wish it was longer.

PARESTHESIAS: Finger tips both hands paresthetic. Some minor shake. Greatly reduced tingling in feet. Very very faint tingle in left foot. Fingers on both sides feel tight. Thumb on left feels tight.

COGNITIVE: Concetration is better. Able to more quickly retrieve lost thoughts/names.

CARDIO: Valsalvas and stretching with tensing of body on waking lead to pronounced tachycardia. (120 BPM, bounding).

68 bpm at rest


-------------------------------

SEP 21


SLEEP: Slept 5 hours then a further 3 or more - one break, clear dreams and deep sleep.

PARESTHESIAS / NEURO: Legs feel a little weak, trembly, but not visible. Can carry groceries up three flights of stairs without much problem. Still wish I hadn't. See a little more meatiness to my slightly trembling hands.

This afternoon, a strange thrumming sensation at coccyx. How to tell anyone about that one?

RH less tight feeling. LH a little tight esp around thumb.

L sole tingly (3/10 rating) R sole - not tingly. Some numb patches on outer sole RF.

COGNITIVE: Concentration is better, able to focus on jeopardy better.

CARDIO: No notable tachy on waking and stretching.

74bpm resting


-------------------------------

SEP 22

SLEEP: Slept 5 hours then a further 3 again. Clear dreams. (it has been so long!)

PARESTHESIAS / NEURO: feeling generally tired. 3/10 left sole paresthesia. L quad seems to be coming back a little! Calves still have "missing pieces".

Very slight tingle left fingers. RH no tingling.

CARDIO: 70 bpm resting. Minimal tachy on waking.

------------------------------
Sep 23

SLEEP: slept almost 6 hours straight.

PARESTHESIAS / NEURO: Awoke tingle free. Just starting to get tingly now 5 hours after waking. About level 3.3/10

Twitch in inner right thigh since midnight last night (17 hours worth of inner thigh getting its groove on by 5:20pm today).

CARDIO: No tachy of note to report.

64 bpm resting.

------------------------

SEP 24

SLEEP: Slept 7.5 hours with tiny wakefulness after the 5 hour mark, I think it may have been. Vivid dreams - Schwarzenegger was in a red long sleeve shirt, and I was assisting him in avoiding the Predator. Lawd... my dreams are undeniable jejune today. But very clear - and yes, we do dream in color.

PARESTHESIAS / NEURO: Awoke with no symptoms in feet. Some tingling faintly in right middle fingers. Just starting to feel tingle in left sole now (on standing, 1.5 hours after waking).

Oh! Twitch has gone, thank heavens.

CARDIO: No tachy on waking.

68bpm rest

MUSCULAR: Body is "filling up again." Face feels fuller; cleft in chin returning (didn't know that was a muscle thing) can sense how tight hands have been. I stretch them better now, and can feel the burning measure of their new freedom. Legs changing shape for the better. L quad/thigh really returning. Was scared, frankly, when thighs were "straight!" Now the quad is hooping our a little more, as it should in my case.

Ab muscles are much more willing to tense (have been slack and "distant"). deltoids coming back. Junction of neck and traps- I again have such a junction. Not as pronounced as before, but it is there.

WEIGH IN: 209 lbs steady.

OTHER: Skin color and texture even looks much better. It must be said: I even feel more calm - tranquil - on the B12. Must look into that. How much anxiety is caused by B being low? Anyway, it feels like a drug and thank heavens it isn't one. I'm probably high on levels of this and that, as they return to normal.