[Colt]

Good day to everyone. I have been lurking here since last October taking in information. My situation with PN is a bit different and I've finally built up enough nerve to share it here with the hope of getting some input.

In 2008 I lost my job to the economic down turn in the housing industry. At the same time my father who suffered from Alzheimer’s began to decline dramatically and I started helping my mother with him. I became very depressed and started drinking heavily. Last year my father died in February and I basically went off the deep end drinking even more.

In early April I quit drinking and went through a fairly severe week long withdrawal. In May I got severely depressed again and went on a week long drinking binge. I woke up at 6:00 am in the morning with my legs shaking uncontrollably and very disoriented in withdrawal. I went to the ER, was admitted, stabilized and released two days later.

On the day I was released I noticed that my feet felt swollen and tingly. I didn't know anything about PN at the time. As days passed my feet began to hurt and ache. Felt like huge bee stings in the balls of my feet. Walking became painful as if walking on spikes. My toes began to swell with dysthesia, paresthesia and pain. One toe actually disfigured. I developed severe " knots / lumps " in the balls of both feet.

I went to a podiatrist in July and he suggested metatarsalgia which I now know is absurd and injected one toe joint on both feet. No results.

I didn't drink anything for three months, the condition persisted and got worse. During this time I also started researching foot pain and discovered that my symptoms corresponded to PN / nerve damage.

In August I tried acupuncture for a month without results.

In October I tried another podiatrist and he grasped what I was dealing with. He prescribed Diclofenac and injected the worst of the " knots " / capsulitis sites in both feet. I did see and feel some relief over the next month. The swelling in two toes went away and the knots of those metatarsal joints dissipated as well.

I began taking B1 and B12 in late October after reading this board. I also got rid of all my old shoes and replaced them.

In November I was in to see my GP for bronchitis and mentioned my feet. He immediately made the obvious neurological connection and suggested medication for the pain. He had me stop the diclofenac and prescribed Lexapro, Wellbutrin, Celebrex and Gabapentin.

Three weeks later I didn't have any results so discontinued Celebrex and Gabapentin and started Indomethacin and Lyrica with the Wellbutrin and Lexapro. A Vitamin B12 test returned normal at 490 PC.

In mid February discontinued Indomethacin and Lyrica due to weight gain, ringing ears, numb / cold hands. Doctor prescribed Amitryptaline and continue Wellbutrin and Lexapro. Thyroid test and blood panel returned normal.

In two weeks discontinued Amitryptaline due to intolerance. Prescribed Desipramine. One week discontinued Desipramine due to intolerance.

End of February I discontinued Lexapro and Wellbutrin due to perceived autonomic neuropathy symptoms with urination, sexual dysfunction, etc.. My advice re meds like Neurontin and Lyrica from recent experience - don't do it.

Currently my feet feel like walking on rocks and damaged bones with burning and pain. Burning and pain continues at rest. I have one toe that is now disfigured and “ hammered “. Difficulty sleeping and functioning. Instability when walking.

No response to ice, acupuncture, new shoes and socks, DMSO or Capsaicin, very limited response in pain relief to medications. Slight temporary relief from massage, stretching toes, legs and feet. Warm salts soaking feels good, but no real relief.

I had shots in both feet last week to try to get rid of the remaining three " knots " that I have, so right now my feet are really screwed up with paresthesia and more pain than normal. If I can get rid of these knots and swelling at least I will be able to walk better.

So there's my situation. I never had any symptoms of classic alcoholic neuropathy prior to May of 2010. The onset of this happened two days after my withdrawal episode overnight.

There's maybe more to the situation related to a reactive arthritic condition that I developed in the summer of 2007 and a foot surgery in October 2008, but I'll leave it here for now. I feel like the withdrawal episode is what caused my current condition.

FYI I am 51 Caucasian male, 6'3", 235#, blood pressure 120 / 75, decent diet, excellent health up till 2007. Take the following supplements:

Benfotiamine
Methylcobalamin
Folic Acid
B-6
B-Complex
Magnesium
Fish Oil
Vitamin C
Vitamin E
Multi-vitamin

Yes I do drink some again and yes I know it's stupid. Not excessively, no hard spirits and not all the time. If you want to bash me for it you'll have to stand in line behind me.

I am still unemployed as I’m not even sure if I can function working with my feet like this, no health insurance and no resources for neurologists, tests and such. The expensive medications I mentioned were all given to me by the doctor.

Any constructive input is welcome please. Thank you - you folks have a very positive community here.

[Dr. Smith]

Originally Posted by Colt

I feel like the withdrawal episode is what caused my current condition.
....
Yes I do drink some again and yes I know it's stupid.

Then why continue it?

I'm sorry, but there's a part of me that's wondering why we should help you then. So you can get better so you can keep drinking? Whatever anyone has to offer won't do a bit of good if you're going to continue; it would be self-defeating and enabling. On top of that, doctors won't describe serious pain meds to someone who exhibits addictive behaviors.

Another part of me does feel for you, and I'd really like to offer help & support, but I think it begins in another group.
http://neurotalk.psychcentral.com/forum31.html

Your doctor can help you with this now too. Please talk to him/her about it.

[mrsD]

Welcome to NeuroTalk.

What kind of surgery did you have? Both feet?
(have you taken antibiotics recently.... Cipro, Levaquin or Avelox?)

[ginnie]

I am never going to be the one to bash anyone for their addictions. Both my parents were alcoholic, and I lived it. I will only comfort, and ask you to get help for that if you can. There are groups that you well know about. It is truely up to you in the direction you choose for your life. I knew the demons my parents had. I wish for you better than that. Your pain was also evident in your thread, and I understand PN. I have that from ATTD, need two new ankles, and have had two cervical fussions. The pain and fear just about unhinged me. I found this site and began to get a grip on what to do. My conditions did cost all that I had, and all that my folks saved for me. I was not allowed to keep the money in a trust for me to live. I had no insurance eithor. I became destitute and borrowed money I did not replay from my son. I found the drs. that were able to help, and fought for social security dissabiltiy. Lots of times the real good pain specialists, are picky in who they give medications to. If you are drinking, these meds could kill you quite easily. The doctors don't want that to happen for sure. I would give up drinking in a second, to get the relief I did from the surgeries and the pain medications that allowed me to live a better life. It would't be a contest for me, as I wanted to keep walking, and get my neck fixed. If you really put your priority of your health first and examine what the doctors will expect of you, you should refrain. Then you would get some relief, maybe the PN will calm down. Pain specialist have to be picky, and actually neruologists are too, as they prescribe meds also. I do wish you all the best, I hope you see the PN thread, and keep in touch with us. I also hope you get some good information on your condition to move forward and feel better. ginnie

[mrsD]

Going thru quick alcohol withdrawal, can result in an overactive nervous system. Alcohol is a depressant. People who detox too quickly can have seizures! It takes time for the nervous system to settle down, during detox. Alcohol is anesthetic to pain. So increased pain anywhere is possible.

I think you should consult a good addiction doctor to find out if it is possible your foot issues are due to that.

But it is also possible your foot pain is due to something else entirely and the alcohol is just masking the pain. Also alcohol will raise triglycerides and this may make the blood thicker and impair circulation to the feet.

We don't get very many people here with alcohol PN. One would think there would be more wouldn't one?

[Colt]

Thank you for your responses.

Just to clarify, my condition does not correspond with alcohol induced neuropathy which occurs over time and with a different set of symptom parameters. As noted my condition started and increased in severity during a three month period of total abstinence from alcohol.

I have discussed this at length with my doctor and he concurs that it is not alcohol in itself that caused the condition, but more likely the withdrawal episode and the partial seizure that I experienced. He also feels that the damage may heal with time. I posted here in hopes that someone may have experienced / or knows someone who has had a similar experience as mine and might share information.

My surgery was for the repair of a dislocated fourth toe on my left foot. Following the procedure I developed severe dysthesia in that toe and the adjacent third toe. The metatarsal head is out of alignment and there seems to be a nerve entrapped that has caused pain and discomfort while walking and at rest since October 2008.

I have taken Avalox in the far past but not within the past five years. As for other drugs - I was offered opiate narcotics by two podiatrists and declined. Not interested.

I am looking for possible answers and suggestions, not miracles. I don't think anyone does that here realistically.

[glenntaj]

--people with long histories of alcohol use often suffer from malnutrition--alcohol leaches B-vitamins and certain minerals from the body, in particular--and that is an avenue that should be explored, even given that you are now supplementing. (There's still some controversy as to whether "alcoholic neuropathy" comes directly from the action of alcohol on nerves or from the nutrient deficiencies that result--perhaps both.)

I notice that you didn't mention how much of each supplement you were taking--that would be useful.

That 490 B-12 reading was a red flag, from my perspective. That's too low, no matter what the standard ranges say. Most of us like our B-12 levels nearer to 4 digits; Mrs. D's B-12 thread has a number of examples of papers showing symptoms of deficiency in people at that level or even higher, and suggest methylomaic acid (MMA) and homocysteine testing as being better indicators of B12 deficiency. And you may be suffering from other low levels as well (as you mention, this is not one of the things doctors think to test for immediately).

It would seem that you would need a more comprehensive work-up with a lot of other testing for autoimmune markers and the like, just to rule out some sources of acute/sub-acute neuropathy symptoms. And yes, such symptoms can be mimicked by brain/spinal cord problems, such as seizures or nerve root compromise.

And, at the risk of sounding simple, have you had any testing beyond a fasting blood sugar for diabetes/impaired glucose tolerance/insulin resistance (certainly common for your age/demographic)? Neuropathy symptoms are increasingly found in people with impaired glucose regulation well before frank diabetes can be diagnosed.

[darlindeb25]

I agree with Glenntag, were my thoughts exactly. So, just double those thoughts and welcome to the forum.

[Colt]

Thank you for your input. Supplement levels.

Benfotiamine 300 mg / decreased from 1 month at 600 mg
Methylcobalamin 3000 mcg
Folic Acid 600 mcg
B-6 100 mg
Magnesium 250 mg
Fish Oil 1000 iu
Vitamin C 500 mg
Vitamin E 400 iu

Conventional B-Complex
Multi-vitamin

I will look in to the testing suggested to see if it something I can consider at this time.

Interesting that you mention the auto immune markers. In June of 2007 I began to experience symptoms of arthritis that manifested in my arms, shoulders, sternum and neck. Shortly thereafter the symptoms spread body wide. My left knee then developed severe swelling and cysts. In 2008 my right knee followed suit. My ortho referred me to a rheumatologist and I underwent extensive testing for a period of ten months without any definitive diagnosis. Shortly prior to the onset of the condition I had suffered a serious bout with a bronchial infection. The rheumatologist offered that my condition could be classified as reactive arthritis. I still suffer from it currently generalized over my entire body.

[mrsD]

Can you please explain what the "knots" in your feet are?

Are they swellings at the joints? On the tendons...? or just tight feelings?

I am getting an impression you have an inflammatory thing going on since you had that synovitis in you knee.

It may be a combo of things with you. Inflammation, left over issues from the surgery, etc. What injections did you get in the feet? What was in them?

Have you ever been tested for gout (uric acid)? Or pseudogout (calcium)?

I think you have more than one thing happening and it is confusing your issues.

For inflammation you will need much more fish oil. More like 3 a day. I'd also stop taking extra B6 if you are taking a multiB complex.

I'd also make sure your magnesium is NOT OXIDE form.

And get tested for Vit D3. ASAP and take appropriate doses determined by your test results. Do not accept the RX 50,000 that doctors write for...as it doesn't work well.
Figure 1000IU D3 for every 10 points you want to raise based on your blood work. Proper Vit D levels will prevent upper respiratory infections and calm the immune system.

There are anti-inflammatory antioxidants. The most affordable one that works is grapeseed extract. At least 200mg a day of this may help with arthritis. There are others... enhanced absorption curcumin and also astaxanthin. Eat as much antioxidant containing foods that you can. Blueberries, strawberries etc.

People very low in Omega-3's often have inflammatory problems, poor stomach lining and poor lining of the lungs. (this latter issue results in many infections and pneumonias.)
Our Vitamin forum has EFA information and a Vit D thread. Both can help you, I believe.

If your magnesium is Oxide...then change that to a chelate that is better absorbed. Omega-3s need magnesium to be metabolized properly.

I think you have some very complex issues, and they are not going to go away quickly. So you have to be patient, and try to read the posts here that we have amassed over the years.