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Old 08-03-2007, 09:34 PM #1
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Cool Smirk What do you veteran PN ers think of......

...decompression surgery for neuropathy. I was reading up on decompression surgery being performed at Univ of Fl. The surgeon states there is a 90 percent success rate , it is quite similar to Carpel tunnel surgery except of course it is performed on the tibial nerve. I figured someone on our board may have researched the pros and cons. I am seriously considering this option to relieve the symptoms in my feet....... .....Tom
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Old 08-03-2007, 10:40 PM #2
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Default Good question...

I've had the CT surgery. Last Oct they did the right hand and 3 weeks later the left. It was a lifesaver for me. 100% improvement. I no longer have any symptoms of CT syndrome and believe me, before the surgery I was in agony. That might be why I didn't really notice the problems with my feet. They were drowned out by the pain in my hands and arms. I had pain all the way through my shoulder in my right arm, the funny bone nerve is what it felt like. Since the surgery...nothing. No numbness, no tingling. I can sleep with my hands in any position I choose. I can do things I couldn't do before the surgery because it triggered pain and other symptoms in my hands. If the decompression surgery is anything like this I'd go for it.

I have talked with people that have had the CT surgery that didn't have nearly the good results I've had. I believe most of that is because for many people the surgery is done after there's already permanent damage done to the nerves. If the damage is permanent then the surgery is done mostly to prevent further damage and it does offer a certain level of pain relief. I had no permanent nerve damage prior to the surgery which is a miracle as the CT symptoms began around 20 years prior to my surgery.

That's another question for me...could my PN symptoms be from a compression issue? With the CT symptoms beginning from no real cause such as repetitive motion injury is it possible this is a physiological problem for me? So far there's no real reason for me to have PN. No injury, no chemical exposure, no auto-immune disorders. I also have a daughter that's only 22 and is beginning to experience CT symptoms. Same story, no cause to point to. So I have to wonder if this could be an inherited problem? If it is it would seem decompression surgery might be an answer.

I'll be interested to hear, as you are, if anyone else has knowledge of the surgery. And if it looks good I may talk to my doctor about it.

Barbara
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Old 08-03-2007, 11:46 PM #3
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A couple of years ago I researched tarsal tunnel surgery, as an orthopedist had recommended it for me. What I found at that time was that the success rate for that surgery was poor. And there is always the risk that surgery will cause scar tissue that might create a problem of its own. If you are considering it, Tom, I would research it very well, and maybe even get a second opinion. Just carefully consider the risks of anesthesia, risks of infection or scar tissue, et al before jumping into it. It's so tempting to want a "fix". Maybe this is the best thing for you, but be careful.
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Old 08-04-2007, 06:29 AM #4
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Default My speculation--

--is that such surgeries are indicated, and have the best results, for those whose neuropathy can most definitely be traced to compressive issues, without any other attendant causes. As such, they are analagous to spinal laminectomies/foraminotomies which are designed to get mechanical pressure off of nerve roots (this causes the form of neuropathy referred to as radiculopathy).

But--and this is an important caveat--many neuropathic symptoms may be due to the so-called "double-crush" phenomenon. This involves nerve damage from two different etiologies, and often at two different points along the nerve. Either one alone may not cause symptoms, but together . . .for instance, nerves somewhat damaged by impaired glucose tolerance may not cause noticeable symptoms until they are also compressed in the carpal tunnel area, at the elbow, at the tarsal tunnel, in the thigh area--there are many areas in which a nerve trunk may be impinged, and this damage adds to that from something else, and symptoms erupt. People with neurological damage from diabetes, vasculitis, gluten sensitivity are known to be very prone to compressive neural effects that add to the symptoms, and likely a lot of "idiopathic" people are as well.

In such cases, the surgery might provide symptomatic relief for a time in that it removes one of the contributing "offenders". But I would think that anyone who is a candidate for these surgeries owes it to themselves to get a very thorough work-up for other causes of neuropathy first, to see if there is a more systemic problem that needs to be addressed.

Last edited by glenntaj; 08-05-2007 at 06:26 AM.
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Old 08-04-2007, 04:19 PM #5
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Cool Smirk Thanks for your input......

it seems to be a controversial subject in the medical community. A number of practitioners are elated with the success patients have received in eliminating pain and even improving conductivity.However, the double or triple crush question does concern me. Some are even saying the procedure is a "cure". I think that is a stretch, but for me I would think the chances are good that I would benefit from the procedure, since I have been dealing with pn for only four months. I doubt that I would be oked for the procedure ,since a patient should be getting no relief from pain meds and the pn is definitely affecting their quality of life. But it is something to consider , perhaps if needed in the future. Well thanks again....Tom
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Old 08-04-2007, 07:07 PM #6
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I agree. Surgery, if necessary, can be a wonderful solution.

But, most doctors are very bad at diagnosing other neuropathies and their causes, and we have had too many people here after a surgery (with or without temporary relief) who ended up with more problems because unnecessary surgery was done.

You will do your homework carefully.

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Old 08-04-2007, 07:54 PM #7
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Default Please read

Dakota's genntas, and dear rose post's. I wish with all my heart i
hadn't done it. But make sure you are sure you have researched
it. Because when it comes down to it ,you will be making the choice,
yes think it through,i wish i had not been in such pain,i let it
make the decision for me. Good luck dear one. Sue
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Old 08-04-2007, 09:55 PM #8
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Default From all that I've read

on the subject, I find that most folks who aren't happy don't complain probably because in their paperwork they signed some sort of 'waiver' to speak out? I really in the 3+ years I've been actively reading/reasearching on the web much that says more than your own "Questions"....very little by way of answers and less in the last few years regarding real research.

I have known folks who have had CT surgery, and their odds were and resulted in the negative sides of the dice roll.

I had a direct cause/effect CT a few years prior to my overall PN onset, and believe me, IF you have a valid PN diagnosis, I doubt, seriously doubt that any Carpal Release surgery would ultimately help your pain...

Granted, the true key to all this FOR YOU TO DETERMINE, would be in your own putting together the info asked for and getting all your tests to 'PLUG INTO' the www.LizaJane.org worksheets...Seeing and being sure that some tests that could either eliminate or include asorbtion or a slew of other issues is often key to 'getting the whole picture' for YOU.

Doesn't mean flashing LJ's List in front of the docs...just means - YOU have got to ask questions about: What about X Test? Or A test? Why haven't you done these tests? That way, they think it's THEIR idea and aren't they brilliant...to which, YOU go 'thank you!'... It ultimately means, don't ever let a doc say "trust me, let me do the 'thinking'" - Remind them that YOU are the BODY attached to this PROBLEM/ISSUE/SYNDROME...whatever...let them know you are one thinking HUMAN being! You are NOT a vegetable? Soo, do what you have to get what needs to be done -well, DONE!? Hugs - j
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Old 08-04-2007, 11:02 PM #9
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Default Thanks j

You said that far better than little old ME!!! Sue Hey were we called OLD
PN????
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Old 08-04-2007, 11:23 PM #10
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Default Sue, as you well know...

OLD is a definition of age/ability and not MENTAL STATUS?
It is just that these 'insults' to our bodies well, 'AGE' us? more than we want or need. I now have the SKIN of one 20+ years my senior...to say I like it is not well, relatable here? Not to mention all that has been going on with my bones...
Key now tho is to focus on YOU and support YOU as best we can help.. if only in words, opinions and sharing.
YOU are now going thru double/triple boatloads of STUFF! Serious stuff.... and its' not fun going thru ONE thing -let alone many... Simple hugs and good things thru the multiple things and that....you will ultimately give us the whole tooff? I dont' want to appear prying myself, but I do know there are many, many other good hearts/minds who work and care here that could provide you with the varied insights that apply to you-YOU!...So you can decide what it is YOU need to DO for what all you have to do?

IF you need to keep it all private and PM -well do SO! I don't think I've ever ignored nor has anyone else ignored a PM and few if ever have ever let 'cats out of the bags'....Think on it this way: We all have That tee-shirt? It may be a different size or color, but we ALL wear it! I for one, am glad mine has had enuf washings that it doesn't itch! - j
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