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-   -   Nociceptive Pain (https://www.neurotalk.org/peripheral-neuropathy/203237-nociceptive-pain.html)

mrsD 04-13-2014 12:18 PM

Keep in mind... there is NO 100% accurate diagnostic test for most things. So reading about the psoriatic arthritis, is just a typical description for most problems. Many people with rheumatoid arthritis, never test positive for Rh factor.

Lupus patients may have periods of normal ANA tests. Those are just 2 examples.

Dr. Smith 04-13-2014 12:24 PM

Quote:

Originally Posted by IH8PN (Post 1063084)
Anybody with similar symptoms find relief from any medication in particular?

Not really. Acetaminophen takes the edge off if/when I'm just sitting around. I take amitriptyline at night (as needed), but I'm not really sure if/that it alleviates the pain (it doesn't do much/anything if I don't go straight to sleep) or just knocks me out. Massage feels good, but doesn't really make anything go away. I can't take NSAIDs; I wish that I could.

I don't know about cannabinoids, as they're not yet legal where I am.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430692/

Mild exercise seems to help a little—getting the blood/circulation moving, but too much/too intense exacerbates things.

Doc

IH8PN 04-13-2014 01:18 PM

Quote:

Originally Posted by Dr. Smith (Post 1063227)
I would caution not to go too far the other way, either—don't "put on a show". Doctors are pretty good at reading people, and if they suspect deception/exaggeration, you could also get labelled (in the extreme) malingering, "drug-seeking", "Münchausen Syndrome", somatic symptom disorder, etc.

patient exaggerating symptoms

IMO, your appearance should reflect how you actually feel—no more—no less.

Doc


I began seeing a psychiatrist not long after the onset of my pain. I made it pretty clear that I had never had an issue with depression before and was only depressed because of my pain and decreased quality of life. I told her if the pain ever went away she would never see me again. Its a good walk from my car to her office so I brought crutches last time. I wonder what she thought of that.

Also I went in flip flops to my first neuro appointment in 50 degree weather and made it clear I couldn't tolerate shoes or socks. I've never asked for pain medication other than gabapentin. I'm not sure how long I can hold out with the pain before I start making suggestions.

Kitt 04-13-2014 01:21 PM

In my case
 
any doctor I see has only "heard" about CMT. They have had like 10 minutes on the subject. So unless I see a neurologist who knows CMT, which I have, the other doctors have no clue. Even the orthotist and the podiatrist have seen only two others and we are all different. They seem surprised since they cannot put us three (don't know the others) into one category. That's how much they really know.

IH8PN 04-13-2014 01:42 PM

Quote:

Originally Posted by mrsD (Post 1063188)

I'd refrain from using the word nociception with your doctor.
They tend to label people in the records as hypochondriacal when medical terms like this are used in conversation.

Thanks, I try and refrain from sounding like a "know it all"

I do work in the medical field so I tend to use medical terminology when appropriate, and my doctors are aware of my profession so I hope they don't think I'm trying speak "over my head"

I've also done a lot of research and learned so much here on this board about my condition, so I feel like walking a fine line when speaking with my doctors and letting them in on how much I know.

So when they go in to their "neuropathy talk" and I know what they are going to say before the words come out of their mouth, most of the time I just sit there and nod my head and act like I'm learning something new.

One thing that is frustrating is, if I now know that "achy pain" isn't something helped my TCA's and Antieleptics, shouldn't the neurologist know this? If I know of dozens of tests for neuropathy causes shouldn't the doctors? I'm still learning to dance with the doctors to get proper treatment, but it's a process.

IH8PN 04-13-2014 02:18 PM

Quote:

Originally Posted by mrsD (Post 1063188)
Your presentation includes a rapid onset? After a vaccine?
Psoriatic arthritis is an autoimmune type condition and those tend to appear suddenly when there is an immune trigger.
Autoimmune conditions tend to run in families, with certain genetic tendencies to be reactive with the immune system.

Is it common for arthritis and PN to go hand and hand? My right foot hit me hard with aching, burning, and sensitivity all within 24 hours and all in the absence of injury or illness that I'm aware of. Seems that there has to be a logical explanation, I just haven't found it yet.

mrsD 04-13-2014 02:43 PM

Fast=
1) autoimmune attack (including arthritis and tendonitis)
2) poisons (sudden high doses heavy metals) or pesticides/herbicides
3) gout (uric acid or pseudogout with calcium crystals)
4) vaccine injury (but these are autoimmune in symptoms)

In my experience PN itself, is slower in onset.
Secondary causes like diabetes, hypothyroid, are slower onset.

There are about 100 causes of neuropathies.

Kitt 04-13-2014 03:50 PM

Quote:

Originally Posted by IH8PN (Post 1063249)
Thanks, I try and refrain from sounding like a "know it all"

I do work in the medical field so I tend to use medical terminology when appropriate, and my doctors are aware of my profession so I hope they don't think I'm trying speak "over my head"

I've also done a lot of research and learned so much here on this board about my condition, so I feel like walking a fine line when speaking with my doctors and letting them in on how much I know.

So when they go in to their "neuropathy talk" and I know what they are going to say before the words come out of their mouth, most of the time I just sit there and nod my head and act like I'm learning something new.

One thing that is frustrating is, if I now know that "achy pain" isn't something helped my TCA's and Antieleptics, shouldn't the neurologist know this? If I know of dozens of tests for neuropathy causes shouldn't the doctors? I'm still learning to dance with the doctors to get proper treatment, but it's a process.

I worked as a health claims adjuster a number of years ago so I knew a lot about different conditions. And also, as far as CMT, I've done reputable research on that since snail mail. Many, many years and it has been in my family forever.

zygopetalum 04-13-2014 06:59 PM

I get that achy pain in my legs and ankles too, I don't know what it is either. It seems to me like the sural nerve is irritated but I feel it in my muscle too as a 'nervy' kind of pain. A lot of mine seems to be med side effect from COPD meds.

judi

Dr. Smith 04-13-2014 07:01 PM

Quote:

Originally Posted by IH8PN (Post 1063243)
Its a good walk from my car to her office so I brought crutches last time. I wonder what she thought of that.

Also I went in flip flops to my first neuro appointment in 50 degree weather and made it clear I couldn't tolerate shoes or socks.

You're not alone. I've been taking notice of other peoples' footwear (or lack thereof) in public, and canes/crutches/sticks, and I think I'm starting to be able to identify other PNers. If you regularly/semi-regularly bring crutches with you and wear flip-flops whenever you go out, I wouldn't worry about it. I've been wearing slippers and using a cane for a few years now. Once a doctor asked me if I needed the cane, and I told him, "Only if I don't want to fall down." End of discussion. No one has ever asked about the slippers, but one look at my edema-swollen feet should answer that.

Quote:

I've never asked for pain medication other than gabapentin. I'm not sure how long I can hold out with the pain before I start making suggestions.
Rather than making suggestions, some chronic pain wisdom is to ask for suggestions on how to deal with pain, and/or as MrsD suggests, focus on symptoms and the effect they are having on your day-to-day life.

I've used some technical terms with my doctors, but I've always told them upfront that I'm very proactive, and they find out very quickly that I'm not their "average" patient. I find that doctors are more open to my ideas when I'm open to/willing to try their ideas/suggestions. I ask questions and their opinions, but I don't try to Dx or Rx. If something is/isn't working, I'm not shy about giving feedback.

Doc


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