I agree with this advice it helps rule out the possibility of a underlying illness.
But dont expect to much.
I have SFN caused by i med that is called Dapsone,the crazy thing is there is nothing to find on the internet that you can get SFN because dapsone you can get motorNP or sensoryNP

Well I went to see my lung guy yesterday and got 'flamed' a little. I recently finished PT and her report probably stated I'd gotten some relief from neuropathy (and neck pain) from lowering anticholinergic dose. He made a few statements indicating he was insulted I had not discussed the matter with him, etc. I've been TRYING to do that with him and PCP for the past 3 years and no one would listen. Last year when I told him the pain varied with dose and asked him about parestheis listed as a side effect of med he stated it was coincidence. I took a couple of statistics courses, you can't prove it if it doesn't reach significance but you can't disprove it either, and I know from my experience the drug has an effect.

My referral for PT came from the local pain clinic, the PA there initially stated med could exacerbate PN, later denied he'd said it and refused to discuss anything further until I'd consulted Pulmo. I was planning to do that when I developed gastroparesis (which I was able to identify from reading this forum), I knew it would improve if I lowered med dose so I just did it myself because I was so tired of being dismissed. BAD PATIENT!! Yesterday Dr. agreed I had gastro, med lists ileus paralytic as a rarely occurring event and he agreed my lowered dose was ok. I guess if you develop a potentially fatal condition its significant but if your quality of life is destroyed it isn't.

I know they all feel my COPD is a life threatening condition and that treatment of that is first priority. I understand that but quality of life is an issue as well, and I just don't understand why no one has been willing to discuss a conservative compromise in treatment. I don't have a car anymore, took my pedometer yesterday and I ended up walking a total of 2 1/2 miles in 90 degree heat (missed the dumb bus). My PN hurt a little last night but last year I would have been in a LOT of pain. I know many of you would be thrilled to have that much improvement and I sincerely wish you could. There are a lot of COPD patients who would be happy to be able to walk that far as well.

I know my situation may not be typical but this forum has really helped and I appreciate it. Right now I'm going to get busy and go shopping for some easily digested food because I'm beginning to feel a little like I swallowed a rock again, learned that here too.

Sorry for the rant and thanks, have also learned here its not unusual for people in general with PN to have problems finding help.
Zygo

Zygo, I can't imagine walking 2 1/2 miles in 90 degree heat. wow. You do what you have to do, don't ya?

It's really not fair that most of us here have more than one major disorder. Sorry about your COPD, PN and gastroparesis.

Brenda

I have not hear of Gastroparesis before. Thank you for this information. I am struggleing with some stomach issues as well and you have really made me think. I am seldom hungry, a few bites fill me up, I don't have much desire for food as in nothing ever appeals so I don't know what to eat and I crave only carbs. Last week my stomach made so much noise constantly that it was embarrassing but nothing passed through. I thought that was very strange. Perhaps I should not be ignoring this. I have been blaming my med's (neurotin to be specific) but maybe it's not all drug related. I really appreciate you mentioning this, thank you.
Sharon

which medicine are you referring to? i also have asthma and copd.

i cannot agree at all with not bothering to see a neurologist because there is nothing to be done if it is PN. there are central nervous diseases and muscle diseases that have similiar symptoms as PN. There are also autoimmune conditions that cause pn that can be treated for a better quality of life. the same goes with diabetes and thyroid problems. there are also paraneoplatic cancers that can have PN symptoms, and those would need to be treated. get a workup and rule out what can be ruled out. it will give you some peace of mind and possibly a clue as to cause. people who give out advice about dont bother nothing can be done, are doing a disservice to new posters here.

I don't have to walk all the time Brenda, at least it gave me a good opportunity to 'test drive' my feet. lol

Norah, I may have misspoke to some degree, I know Neurontin can cause constipation, etc. and see stomach and intestinal inflammation listed as a rare side effect but it affects a different neurotransmitter and I don't know if it is implicated in actual gastroperesis, people here know a lot more about that than I do. I'm not clear on whether you still feel you have PN or if its limited to EM, PN can cause it. I WISH my stomach would growl, its just kind of sitting there.

Echos, I was talking about Spiriva but I'm also on Flovent, I take the latter separately but its in Advair and some of the other combos as well. Both are listed as a low incidence cause of paresthesias. I see patient reports of neuropathy.

I have been able to separate what happens well enough to be fairly sure the Spiriva makes me numb and in a way that's hard to explain intensifies pain and makes it more diffuse. Flovent seems to create a burst of burning pain. One or both of them seem to be causing weakness (noodle arms, etc), I thought it was Flovent but am not sure. I've also had killer muscle pain from it but its hard to tell the difference between that and nerve pain when I take Spiriva because I'm numb. PT gave me a diagram of nerves and there was frequently a nerve where I had pain ie sural nerve.
I've also dropped dose of Flovent which helped as well. Pulmo told me I could go off it if I wanted, he didn't admit it caused any problems though. I will probably try that.

I've read that paresthesias can be very painful if they are severe enough, I don't know what kind of pain they mean and thought a neuro would be better able to tell the difference between something like that and SFN. I also think Glentaj is right that it depends on the neuro.
I just had thyroid panel and biopsy (eek) and its all fine. Don't think I have paraneoplastic syndrome because I have relatively frequent CT scans as I did have lung cancer 7 years ago, it was never advanced enough to cause it and if I had something new they should see it. I wasn't diabetic 1 1/2 years ago, PCP said I'm stable and I don't need yearly blood work anymore.(?) I have wondered about an immune problem, Flovent can cause neuropathy associated with Churg Strauss Syndrome, I don't have that but thought there might be other issues.

Echos I don't know what your PN status is or if you are on either of these, but I'd think about talking to Dr if you are (hope hes nicer than mine). there is something going on in some people with those meds.
Zygo

im currently taking advair, spiriva, hfa rescue inhaler and duoneb for the nebulizer. i was taking singulaire but was taken off of that when the pulmonary doctor ran across information that it may be contraindicated for those with PN. nothing firm yet but he took me off anyway. i havent noticed the spiriva having any differing effect either way on my pn than singulaire did. its such a tradeoff between taking medication and side effects. i not sure if you are familiar with FEV1 (forced expiratory volume) on pulmonary function tests but mine have dropped from 115% of expected down to now 43% of expected over the years.

I totally agree. It would be like burying your head in the sand and giving up.

It sound like you had a rough day Echos, I your read post last night but it was late and I'm on Pacific time so waited until today to respond. It is hard to accept what has happened to us, the only solution I've found is to continue to try to make your life as much better as you can, and that can get discouraging too. Its difficult for me to be so powerless, I used to work in a nursing home and advocate for the residents, now some of the same things are happening to me and there isn't anything I can do about it. I also get tired of medical procedures, its hard not to be able to do what you used to and to have it replaced by a seemingly endless round of medical tests. Last spring I just wanted to go live in the woods.

Are you having much pain from your back? I have a friend with similar problems. I have some arthritis, disc issues, etc. in my neck. I had PT which helped some but towards the end discovered lowering Flovent dose helped more. The package insert says it can cause muscle rigidity, stiffness etc. but I didn't realize it sometimes tended to 'target' the neck until I replaced my computer and saw complaints in asthma sites. I think my pulmo knew that and decided it was something I didn't need to know. I'm probably going to have to change Drs, I've been going to him for over 10 years and its a little scarey to change. I think Advair is a little different because its a combo.

My cancer started in a scar/nodule but the info I had said it was rare for that to occur. I have a couple more they watch too nothing has happened with them.

Don't be too embarassed because you didn't like the MRI, I don't think you are the only person that has happened to. I had one last spring, I didn't expect it to bother me but I sort of felt like I was buried alive and had to keep my eyes closed the whole time. It wouldn't be so bad of they didn't take so long. I'm probably becoming known as 'that person who blames everything on meds' and I don't know if it is happening to you, but Advair can kind of intensify those kind of negative feelings. I'm partially O2 dependent, I wasn't supposed to be and I used to have a little panic attack every time I had to go in and be tested to see if I could wean off it, I thought I was just upset but it quit when I stopped the drug. It was just enough to make the anxiety a little worse. I can't remember exactly how it works, I think Salmeteral ramps up the same part of the brain involved in the 'fight or flight' response. Fluticasone make me crabby. Its kind of funny now, I like animals but there is an individual in my apartment complex with an obnoxious little dog that looks like a cross between a chihuahua and a pot bellied pig (really). He lets her run loose around the complex and she barks and wakes me up when I try to nap. I still don't like it but don't feel like I want to go out and wring her neck anymore since I dropped Flovent dose.
So try not to be so hard on yourself, blame the meds. lol Thats a joke but they could be making you feel a little worse, even if you can't fix that part of it consider that there might be a little brain chemistry involved rather than a character flaw. I don't know if they give people a little tranquilizer sometimes to help them tolerate the procedure? I'd have taken one if it had been offered.

I'm never sure if I'm too far off topic, there are so many hassles involved in being disabled...Zygo