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Old 06-29-2008, 10:35 AM #51
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Lightbulb Patches for pain relief

The subject of patches has just come up.

Here is a short explanation of what is available now as of 6-08
for pain relief:

Okay... this a good time to explain patches, I guess!

There are several types.

1) Fentanyl (Duragesic) RX ONLY--this is a very potent narcotic and effective but has alot of warnings with it to NOT use in people who are not already using high doses of another narcotic.
(the term is opiate naive). There can be severe side effects and even death if it is improperly prescribed and monitored.
But for severe pain...it is effective.
http://www.duragesic.com/duragesic/
These CANNOT be cut or severe results will occur including death.

2) Lidoderm patchesRX ONLY -- these contain lidocaine which is a numbing agent. They were designed specifically for post herpetic neuralgia, but they have been shown to work very well for other chronic pain issues. I started these right when they came out.. and really like them. They help me tremendously.
(placement can be tricky, and failure with them may reflect where they are placed).
Their website:
http://www.lidoderm.com/
These MAY be cut to fit any size placement.

3) Salonpas OTC-- These are over the counter pain patches with different formulas. I use the ones with methyl salicylate in them. They are more effective than BenGay or IcyHot patches which only have menthol in them.
Salonpas(R) Pain Relief Patches & Sprays for Powerful Pain Relief When and Where You Need It.
These MAY be cut to fit fingers and toes.

4) Flector--RX ONLY these are new in USA, and I am trying to get some. It looks like I will have to wait until September, since my doctor is leary of new things...
These have the NSAID diclofenac in them. I expect them to work like the Salonpas. However the Salonpas cost pennies each and Flector costs mega DOLLARS!
They have been in Europe for about 15 years, and have just been approved for "short term pain" here around January 08.
FLECTOR(R) Patch (diclofenac epolamine patch) 1.3% | Safety Info
These may be cut (but the doctor I talked to at their website says the FDA has not approved cutting them however, yet, but that may be in the future approved)


5) There is an antidepressant in patch form, called Emsam. RX ONLY
However, as of now, the company that makes it is not targeting it for pain. That might change in the future, as many drugs become commonly prescribed off label.
44 - File or directory not found.
This is an MAOinhibitor, and requires careful supervision.
These MAY NOT be cut.

I personally like the patch idea. I use both Salonpas and Lidoderm with great success. (Lidoderms are expensive if your insurance does not cover them). Salonpas are extremely INexpensive.

Edit to add: as of Oct 2016 there are two new topical patch types that are OTC now. Salonpas has introduced a stronger patch with ingredients more like their arthritis one.. but still called "original". They are available at WalMart now in a 60 patch box. But Costco still does not have them. The other small ones are no longer in stores but some Ebay venders are still selling them. Read the ingredients on the box to see if you are using the old original or the new product (which has 10% methylsalicylate in it)

Aspercreme is now offering a 4% patch (this is the same strength as the lotion with Lidocaine the offer. The RX form of Lidocaine patches are 5% in comparison and much more expensive than the new Aspercreme 4% ones.
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These forums are for mutual support and information sharing only. The forums are not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. Always consult your doctor before trying anything you read here.

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Old 11-21-2008, 08:54 PM #52
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Default Just came across a new diagnostics web site....

It appears to ba a primer for Family Practice docs, so the viewpoint is in doc-speak.

If you go to the bottom of the page and back to the index, it too is interesting.

http://www.aan.com:80/familypractice/html/chp3.htm

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Old 12-20-2008, 09:29 AM #53
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Default Skin Biopsy Article

It's pretty thorough.

http://www.bmj.com/cgi/content/full/334/7604/1159

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Old 01-22-2009, 02:29 PM #54
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This is interesting; skin biopsies of healthy skin and skin with peripheral neuropathy. Imo this link wasn't posted yet, but I hope I searched well

http://www.nature.com/ncpneuro/journ...neuro0630.html
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Old 02-04-2009, 06:40 AM #55
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Default Any PN Limb Numbness Reduction, using Supplements/Exercise?

Quote:
Originally Posted by Wing42 View Post
These recommendations will help heal damage and reduce PN symptoms from many causes, such as diabetes, drug or other toxin damage, viral or bacterial attack, nerve entrapment, surgical damage, poor blood circulation, and hereditary or idiopathic peripheral neuropathy. What follows has been learned from years of research. All recommendations have some empirical and/or scientific basis. I urge you to check on each recommendation before trying it. A good way to check is to double click on www.google.com and enter the topic. For example entering “vitamin e peripheral neuropathy” (without the quotes) will generate a list of sources for research results for vitamin E and peripheral neuropathy.

We are each different from each other. Talk with your health care professional before starting any diet, supplement, or exercise program. For most of us, all of these recommendations are safe, but individuals may have conditions or be taking medications incompatible with some recommendations. An example is SAMe which should not be taken by people with bipolar disorder or taking certain mood changing drugs.

This is a special note about skeptical physicians. Your doctor may say something like, “Save your money and your energy. Nothing will help heal your PN. All you’ll do is create some very expensive urine.” In answer to that, everything recommended here has at least some empirical and/or scientific backing for being effective for PN (as opposed to anecdotal or conjectural backing).

Everything recommended here is safe. As far as I know at this point, no drugs are effective for promoting healing for hereditary or idiopathic PN. No drugs provide more than partial pain relief. All drugs have side effects. Side effects are cumulative the longer a drug is taken. Side effects for combinations of drugs are additive or multiply each other. A basic principle of healing is to first do no harm. Nothing recommended here will do harm as far as I know unless special circumstances exist.

So, talk with your doctor first, take his or her specific recommendations if you have a special condition that will be harmed by anything here. But this program gives you the possibility of safely and powerfully dealing with your PN, reducing symptoms, and even healing. If your doctor only recommends drugs for partial symptom relief without a complete diagnostic workup or any possibility of healing, I think the choice is clear. I had two neurologists offer me Elevil or Neurontin at the first appointment, with minimal testing. Neither is 100% safe, and neither is very effective. You can always try drugs after giving this program a chance. However, because of building drug tolerance, it is difficult to stop drugs once you’ve used them for an extended period for chronic pain.

A final caveat is that this does not take the place of medical treatment. Some of us have conditions that require medical care. Examples include diabetes, infectious disease, amyloidosis, etc. Even in these cases, what follows will be helpful.


This program to reduce pain and help heal your PN encompasses diet, supplements, exercise, dealing with emotional factors, and getting the help you need. In our lives, there is a spread effect, where optimizing one thing helps other areas in your life. Good builds on good and bad on bad. If you eat right, you will feel better and will be more willing to try supplements. As you heal you’ll be on a more emotional even keel. That will help you get the family and other support you need. You will be more apt to start an exercise program.

Generally, most research was done using only one factor such as a particular supplement, a diet change, exercise, etc. In the few cases where more than one factor was tested at the same time, a synergistic effect was found where the healing effect was greater than the effects of each factor alone. If you do the program, do the whole program for maximum benefit.

Diet

A PN diet provides the proper amounts and balance of essential fatty acids and is rich in protein, vitamins, minerals, and nerve healing phytochemicals. That is similar to the Omega diet as described in “The Omega Diet: The Lifesaving Nutritional Program Based on the Diet of the Island of Crete” by Dr. Artemis P. Simopoulos and Jo Robinson (Amazon page is http://www.amazon.com/exec/obidos/A...8941114/sr=8-2/ ref=sr_8_2/104-0955084-5711960 ). The book is an easy read and is full of good recipes and daily menus. I easily converted to the omega diet. My blood pressure came down 25 points in a year, and my PN is much better. I think the omega diet is one of the main reasons. A similar PN healthy diet is the Mediterranean Diet ( http://www.americanheart.org/presen...identifier=4644 , http://www.amazon.com/exec/obidos/A...0914342-4696631 ).

The bulk of your calories should come from vegetables, fruit, healthy protein sources, and whole grains. Eat easy to digest protein daily, such as one or two eggs (one yoke a day is OK), fish, tofu, beans. You don’t need meat for every meal. A little, like 4 oz. of lean meat once a day won’t hurt.

Dairy should be in small quantities if at all, like a little yogurt or cheese. Milk allergies are very common and can lead to or add to chronic fatigue syndrome, fibromyalgia, chronic sinusitis, irritated bowel syndrome, acid reflux, and other conditions with an autoimmune component. Most adults cannot digest milk sugar. On the other hand, the bacteria in live culture yogurt are good for your digestion and general healthy, so eat yogurt if you can handle it.

Avoid concentrated refined sugars or pure fructose. They are hard on your liver and pancreas, meaning they are hard on your nerves. A teaspoon of white sugar or honey in a cup of coffee or tea with a meal won’t hurt you. A 12 oz. Coke or Pepsi has 9-12 teaspoons of sugar! A Frappacino has about 20 teaspoons of sugar! That will hurt you. Apple juice is almost as bad. If you must have a sweet drink, mix apple juice ½ with water and ice it. That way, you’ll only get 5 teaspoons of sugar all at once. The best drink is plain water. If you must have sweets, try two Hershey’s Kisses a day. We all need sweet kisses in our lives!

Avoid anything deep fried because the fat oxidizes and becomes filled with all kinds of nasty chemicals. The same is true with hydrogenated or partially hydrogenated vegetable oils. Read labels for this. The only way your body can handle hydrogenated oils is to turn them into cholesterol and free radicals. The SAD (standard American diet) is full of hydrogenated oil. It is in margarine (butter is better for you, not good but better), packaged pastry, chips, some cereals, candies, and many breads. This was the hardest for me to cut out, but I don’t miss that stuff at all now. This is thoroughly discussed in “The Omega Diet.” by Dr. Simopoulos. If you don’t believe her, just look up “partially hydrogenated oil health” in www.google.com . It will make a believer out of you. Thankfully, labeling is improving and more products made with healthier oils are available every day.

The right oils are essential for healing. You should only use olive and canola oil at home. Both help your nerves and your blood vessels. Canola oil is 50% omega 3 fatty acids which will help heal your nerves. Olive oil has cancer fighting components and helps clean your blood vessels. You should have at least 2 tablespoons of each oil daily. You can also get healthy oils with a small handful of nuts a day or some avocado on a sandwich instead of butter or mayo.

The Omega and Mediterranean Diets err on the side of being too starchy for us. Many of us PNers have insulin resistance. Starch acts just like sugar in this regard. An 8 oz. baked potato with or without skin yields more blood glucose than 8 oz. of pure sucrose, and it spikes just as quickly. The same holds true for any white flour product. Avoid starch. What starch you do have should be whole grain with other foods to slow down the digestion of the starch and absorption of the glucose and to supply healthy grain bran nutrients.

It sounds like a lot of don’ts and a lot of depriving yourself, but that’s not the case. I just started substituting one thing a week. It was easy, and the food is delicious. For example, for a typical dinner we'd have grilled salmon, brown rice or a baked yam, , zucchini and chopped onions sautéed in olive oil with herbs, a tossed salad with tomatoes and a dressing of 50/50 of canola and olive oil, lemon juice, pepper, garlic, and feta cheese. For desert, we’ll have some fresh fruit. We drink water or unsweetened tea most meals. Almost every meal at home is delicious unless I mess up in the preparation.

Three other diets perfect for PN are Syndrome X (http://www.amazon.com/exec/obidos/t...=glance&s=books ) , the Zone Diet (http://www.amazon.com/exec/obidos/A...0914342-4696631 , http://www.drsears.com/drsearspages/ ), and the South Beach Diet (http://www.amazon.com/exec/obidos/A...0914342-4696631 , http://www.southbeachdiet.com/landi...0D-D9B4A75063DB ).

These diets are similar to the Omega and Mediterranean diets. They stress controlling insulin resistance and glucose levels. They are more highly structured with menus, recipes, web pages, and many books. If you like structure, any of these three will do for you. If you are on a limited budget or are frugal, all of these are available in most libraries. The new USDA Food pyramid is similar to these recommendations (http://www.mypyramid.gov/ ).

This is the end of part 1. See part 2 below for vitamins, minerals, supplements, emotional factors, lifestyle, and other delightful goodies.
Wondering if you've had any success with PN "Limb-Numbness Reduction" using your "Supplements/Exercise Program..."..?

thanks...
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Old 02-20-2009, 10:14 PM #56
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thanks i hope this can help
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Old 02-27-2009, 09:24 PM #57
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Default Lyme

LYME is a not uncommon cause of what is usually diagnosed as idiopathic pn. Ordinary lab tests do NOT detect all the antibodies which help make this diagnosis. I highly recommend everyone with an undiagnosed neuropathy to have their blood sent to a lab which specializes in tick-borne disease.

These are three:

Top 5 lyme/tick diagnostic labs in USA:

1. Igenex, Calif.;
2. MD LABS, NJ; www.mdlab.com
3. Central Florida Research Florida .

In NY, Igenex is used a lot, even though it's in California. Independent labs will draw your blood, usually on a Monday or Tuesday, and mail it to the tick lab.

Here's a link to the international lyme association for more information: http://www.ilads.org/

This is from their site:

1. Lyme disease is transmitted by the bite of a tick, and the disease is prevalent across the United States and throughout the world. Ticks know no borders and respect no boundaries. A patient's county of residence does not accurately reflect his or her Lyme disease risk because people travel, pets travel, and ticks travel. This creates a dynamic situation with many opportunities for exposure to Lyme disease for each individual.

2. Lyme disease is a clinical diagnosis. The disease is caused by a spiral-shaped bacteria (spirochete) called Borrelia burgdorferi. The Lyme spirochete can cause infection of multiple organs and produce a wide range of symptoms. Case reports in the medical literature document the protean manifestations of Lyme disease, and familiarity with its varied presentations is key to recognizing disseminated disease.

3. Fewer than 50% of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in culture-proven infection with the Lyme spirochete.

4. Fewer than 50% of patients with Lyme disease recall any rash. Although the erythema migrans (EM) or “bull’s-eye” rash is considered classic, it is not the most common dermatologic manifestation of early-localized Lyme infection. Atypical forms of this rash are seen far more commonly. It is important to know that the EM rash is pathognomonic of Lyme disease and requires no further verification prior to starting an appropriate course of antibiotic therapy.

5. The Centers for Disease Control and Prevention (CDC) surveillance criteria for Lyme disease were devised to track a narrow band of cases for epidemiologic purposes. As stated on the CDC website, the surveillance criteria were never intended to be used as diagnostic criteria, nor were they meant to define the entire scope of Lyme disease.

6. The ELISA screening test is unreliable. The test misses 35% of culture proven Lyme disease (only 65% sensitivity) and is unacceptable as the first step of a two-step screening protocol. By definition, a screening test should have at least 95% sensitivity.

7. Of patients with acute culture-proven Lyme disease, 20–30% remain seronegative on serial Western Blot sampling. Antibody titers also appear to decline over time; thus while the Western Blot may remain positive for months, it may not always be sensitive enough to detect chronic infection with the Lyme spirochete. For “epidemiological purposes” the CDC eliminated from the Western Blot analysis the reading of bands 31 and 34. These bands are so specific to Borrelia burgdorferi that they were chosen for vaccine development. Since a vaccine for Lyme disease is currently unavailable, however, a positive 31 or 34 band is highly indicative of Borrelia burgdorferi exposure. Yet these bands are not reported in commercial Lyme tests.

8. When used as part of a diagnostic evaluation for Lyme disease, the Western Blot should be performed by a laboratory that reads and reports all of the bands related to Borrelia burgdorferi. Laboratories that use FDA approved kits (for instance, the Mardx Marblot®) are restricted from reporting all of the bands, as they must abide by the rules of the manufacturer. These rules are set up in accordance with the CDCs surveillance criteria and increase the risk of false-negative results. The commercial kits may be useful for surveillance purposes, but they offer too little information to be useful in patient management.

9. There are 5 subspecies of Borrelia burgdorferi, over 100 strains in the US, and 300 strains worldwide. This diversity is thought to contribute to the antigenic variability of the spirochete and its ability to evade the immune system and antibiotic therapy, leading to chronic infection.

10. Testing for Babesia, Anaplasma, Ehrlichia and Bartonella (other tick-transmitted organisms) should be performed. The presence of co-infection with these organisms points to probable infection with the Lyme spirochete as well. If these coinfections are left untreated, their continued presence increases morbidity and prevents successful treatment of Lyme disease.

11. A preponderance of evidence indicates that active ongoing spirochetal infection with or without other tick-borne coinfections is the cause of the persistent symptoms in chronic Lyme disease.

12. There has never been a study demonstrating that 30 days of antibiotic treatment cures chronic Lyme disease. However there is a plethora of documentation in the US and European medical literature demonstrating by histology and culture techniques that short courses of antibiotic treatment fail to eradicate the Lyme spirochete. Short treatment courses have resulted in upwards of a 40% relapse rate, especially if treatment is delayed.

13. Most cases of chronic Lyme disease require an extended course of antibiotic therapy to achieve symptomatic relief. The return of symptoms and evidence of the continued presence of Borrelia burgdorferi indicates the need for further treatment. The very real consequences of untreated chronic persistent Lyme infection far outweigh the potential consequences of long-term antibiotic therapy.

14. Many patients with chronic Lyme disease require prolonged treatment until the patient is symptom-free. Relapses occur and retreatment may be required. There are no tests currently available to prove that the organism is eradicated or that the patient with chronic Lyme disease is cured.

15. Like syphilis in the 19th century, Lyme disease has been called the great imitator and should be considered in the differential diagnosis of rheumatologic and neurologic conditions, as well as chronic fatigue syndrome, fibromyalgia, somatization disorder and any difficult-to-diagnose multi-system illness.

Disclaimer: The foregoing information is for educational purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If an individual suspects the presence of a tick-borne illness, that individual should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases.
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--- LYME neuropathy diagnosed in 2009; considered "idiopathic" neuropathy 1996 - 2009
---s/p laminectomy and fusion L3/4/5 Feb 2006 for a synovial spinal cyst
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Old 03-15-2009, 04:12 PM #58
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Default An Algorithm for the Evaluation of Peripheral Neuropathy

An Algorithm for the Evaluation of Peripheral Neuropathy

http://www.aafp.org/afp/980215ap/poncelet.html

I think this one lists a good view of Peripheral Neuropathy!
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Old 05-15-2009, 06:39 PM #59
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Thank you for this thread, it's full of great information.
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Old 08-21-2009, 10:25 PM #60
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Default One doesn't often mention the 'C' word?

This is a good paper I came across again that does caution and outline the diagnostics......http://theoncologist.alphamedpress.o.../full/11/3/292
While seemingly scary? It really isn't? The two, neuropathies and cancers CAN occur separately. I am an example, and am still here? - j
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