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Old 10-18-2007, 10:59 PM #1
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Default Just came back from Neuropathy meeting!!!

Wow, what an interesting meeting. About 20 of us, and there was a professional man there video taping the whole meeting. He told me he was doing this for the neuropathy association and they were doing a dvd series.

The speaker was a Dr. Cary (from Cornell). She was there to give a speech on neuropathy and the various causes and how pain happens. I learned about pre-frontal cortexes and thalmuses.

We were allowed to ask questions, so of course the first thing that entered my mind was right after she explained that pain sensations are processed by the thalmus and go into the pre frontal cortex (I think I got that terminology right).

I raised my hand and I asked. Everything has to go through the thalmus first right?? and she said 'right?" So naturally I said "So get rid of the thalmus". She laughed and said "if you did not have a thalmus you'd be dead". So I said "well, that ended that question". She laughed and said "no, it's not a stupid question, because there is research being done on stimulating the thalmus and what we've found out so far is that when we stimulate certain portions of the thalmus, another part of the brain, right next to this part of the brain, well it takes over and feels pain. She explained how nerves mis-fire, and all the various kinds of neuropathies.

There were people there with CIDP, there was an english gentlemen with Celiac Disease. Many people asked questions on chemotherapy induced neuropathy. Alan asked about trigger point injections and she explained that in cases of neuropathies, the doctors can't pinpoint the exact nerves, that's why they won't give Alan trigger point injections.

People there had undergone plasmapherisis and their insurance won't cover it anymore. Many people there had IVIG every two weeks.

But the main thing the doctor spoke about was meditation and bio-feedback. She said "there is no miracle cure for neuropathy ont he horizon, so you have to use pain management and she said "Now don't laugh, but transcendental meditation works, you just find yourself a mantra......and I said "oh, you mean OM, MANE PADNE OM, and she just looked at me and said "oh yes, that's the one, that's a good one, how do you know about that" and I told her I took a meditation class over 30 years ago, and I never forgot the chant that we all said in class. She explained that we can change our brain, that we have control over our pain, and our brains.

All in all, it was a most interesting group meeting.

Our friend Doug (the one who sends me the scary emails that have Linda Blair from the exorcist jumping out at me in these emails), well, he gave up his bowling night to come and join us . We met him 6 or so years ago at our first neuropathy meeting in NYC. That was a big meeting with over 250 people in attendance. They dont' do those meetings anymore. Now they do it at the CBS building in NYC and maybe 20 people show up. I can't believe that there aren't more than that number.

So everybody asked questions about lyrica (theyall gained weight on it), they wanted to know if new meds were being developed, and the doctor just said "right now, there is no miracle cure for neuropathy, because too many things can casuse it. But she did say that before you go to the doctor, write down your whole medical history and family background, that doctors appreciate this.

So there you have it. We had some good laughs, we all supported each other and I promised to wring Doug's neck if he ever sends me another scary e-mail.

Next meeting should be on November 15.

I had hoped that some of you guys who live in NY would have shown up. That would have been so nice. Maybe next time???

Oh, and this is the best part. At 8 p.m. when it was all over and we all left the building, there were fire trucks, police cars and no one was allowed down the street. It seems a man hole cover blew up right near our block in NYC.

The traffic was horrendous.

Oh well, that's NYC for ya!!!!

Take care,

Melody
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Old 10-19-2007, 06:03 AM #2
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Default I will make one of those meetings at one point or another, Mel--

--if only to ask how we can get more input into the Neuropathy Association, which I've often criticized for being very slow to advocate for this condition as compared with organizations for MS, Altzheimer's, Parkinson's, etc. (as many here have read, LOL).

I've noticed that many people from the Association, and many of the meeting attendees, seem blissfully unaware of other places, such as this one, that have ammassed considerable databases and expertise on the topic. The Association seems to almost jealously guard what it sees as its purview. I think that needs to be opened up a little. (It would be fun if Liza Jane and Joe and I went down with you, I think.)
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Old 10-19-2007, 06:22 AM #3
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Lightbulb so you learned

about the pain loop that centrally mediates pain in the brain. And in some people creates an overdrive situation, to augment/increase pain?

The seminar I went to, did NOT recommend trigger point injections, since the majority of the pain, is central, not local.

We were told that the drug companies are working very hard and have things in the pipeline that are coming soon, for this. In fact the fibro specialist said this was the next "frontier" in pain management.

Did your lecturer say that most of the pain in PN is central? Our lectures were on headache, and fibro. But RSD and IBS were included in the fibro part.

For autoimmune patients, I think the presentation is more peripheral. Like with MS. Did your lecturer break this down, between the peripheral and central issues? People without the autoimmune markers, may have a more fibro type presentation, perhaps?
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Old 10-19-2007, 06:58 AM #4
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Melody,

I TOTALLY agree with what was said about the brain in the meeting. My own Neurologist has recently changed my small fiber PN diagnosis to Central Pain Syndrome. And boy, does it ever make so much more sense to me. She basically said without going into great detail that the severe pain I experienced from the spinal disorders left an "imprint" on my brain. So, I have the central sensitization or whatever label someone wants to put on it. Basically, I have a hypersensitive CNS. And this is why most meds will not work for me or just barely take the edge off. Anyway, painonline.org explains it best. And I think this is why Klonopin helps me so much and the only med that ever has. It is just quieting my CNS. Also, along with my Neurologist and during the past two years I have had two other docs mention I must have a "CNS problem"!
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Old 10-19-2007, 08:52 AM #5
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Hi All:

One of the bigger points that the doctor said was that she explained the different way we perceive pain. She used this example:

"Let's say you are having a conversation with your friend and your face is in the direction of your friend and you are having an intense conversation with your friend. And all of a sudden, your right hand wanders and touches something hot. Your brain does not pause and say "oh I feel something burning, let me take away my hand". Your take away your hand instinctively. She explained that the brain does multi-tasking in this perspective.

She did go into the central nervous system, and she spoke of small fiber neuropathies (she never mentioned large fibers). She explained that the number one cause that most doctors immediately think of is Diabetes. Then she said "but we now know that there are many many causes of neuropathies. There are auto immune markers in certain people". She began talking in MEDICALESE and I looked around and many people, well, they didn't get it. I didn't get a lot either, but I managed to comprehend more than I ever could thanks to my coming on these boards.

Oh, one more important thing. I brought up the topic that many doctors do not take people with neuropathy seriously. They say to them "it's all in your heads, deal with it". She said "unfortunately doctors are not trained in neuropathy". And I said "why on earth not?" And she said "well, many doctors never come across a case. Some doctors say they never heard of neuropathy, they say "what is neuropathy?"

That's when I said "that's baloney, because diabetes has been around for centuries and we ALL know that neuropathy is a side effect of uncontrolled blood sugar, so how can doctors not be aware of the seriousness of neuropathy pain??"

Then after a while, after everyone had asked their questions, (remember we are being videotaped), I politely asked the following question:

"If a new patient came to you and said he was diagnosed for 15 years with Idiopathic Peripheral Polyneuropathy, and oh, by the way, his mother died from Guillian Barre Syndrome", would you just say "Oh, it's not connected"???

She looked at me and said "well, obviously, I am specializing in the field of Peripheral Neuropathy, so I don't pooh pooh anything. I would look into that, of course I would". I then said "well, for 15 or so years, my husband went to countless doctors, neurologists and this kind of specialist and that kind of specialist, and absolutely everyone of them, as soon as I said "his mother had Guillian Barre Syndrome, do you think there might be a connection?". Absolutely every one of them said "No, there's no connection"

This doctor then said "well, I can't speak for what other doctors have told you, but I would definitely have looked into the connection. I then told her "finally someone ordered a spinal tap and they found protein and he is now on IVIG." She then went on to explain that for some people IVIG works miracles and for others, it does nothing. For some people Plasmapheresis works wonders (Doug had undergone plasmpheresis 6 years ago, until his insurance cut him off). They even put a port in him at the time.

Then she said "there are medicines that will work on some people but the side effects are horrible, we are trying to do more research into neuropathy but doctors really don't know that much about it. It's an ongoing learning process. One of the people at the table said "we have to be our own advocate, doctors need our input, they just don't get it".

Oh, I told many people at the table about these forums. I had mentioned them the previous time I was there. I don't know if they visit, or lurk or whatever. But some of these people have pain and many just have numbness.

Oh, and this is important. We spoke about CIDP and GBS. The doctor said "we usually don't say CIDP anymore, we say AIDP. Then she explained it's now being referred to as Acquired inflammatory demylinating polyneuropathy.

She further said "when you get it immediately and it hits you and then it goes away, it's Guillian Barre. When you get it and it's prolonged for year, we call it CIDP, (NOW AIDP).

Then I said to her "I'm going to tell you what I'm taking and you will probably laugh at me (I was about to mention the Methyl B-12), and she said "I would never laugh at anything, I am always open to various ways people get help with their PN)> I explained about my taking Methyl B-12 and what it did for my burning. I said "it didn't help my husband, but it saved my life". This was exactly what she said "I would only make sure that you are not taking all this in a B-complex, like for example are you taking many b-complexes in one day"?? I assured her that no, just the Methyl B-12. She said "oh, that's good, but be wary of B-6, too much is toxic (everybody was writing all this down). She said "we have found out that B-6 can make neuropathy worse". So be careful what supplements you are taking. Don't take more than 50 mcgs of B-6 a day. She said "the other B vitamins are just fine" (Hey, finally found a doctor who didn't put down most of the B-vitamins.)

Wow, I learned lots of stuff at this meeting.

Oh, some of the people there said they had charlie horses and toe spasms all the time. These were the people with the CIDP. Alan does not get this.

These people said there is supposed to be a prescription quinine pill but that they can't get it any more but it helps with cramping.

The doctor said "just drink tonic water".

So I hope I have covered most everything I can remember.

You're lucky I remember anything any more. I'm almost 60. Oh my god!!! lol
And yes, Bob, and Liza Jane, you must come, if you can, to the November 15th meeting. I'll be sure and make sure of the date and post it on these boards.

Oh, another point the doctor brought up was depression and anxiety. She said "this is a vicious circle. I don't mean to pooh pooh your depression, your anxiety or your pain, but pain is made much worse by anxiety and depression, and if a patient came into my office and that patient had neuropathy and that patient told me she wasn't depressed, well, I would think there was something wrong with that patient, Of course you are depressed, you have pain, and pain makes the neuropathy worse. So it's a circle". "That's why I believe in bio-feedback and meditation, you all should try it for 30 minutes each morning, get yourself a mantra, it could be anything, let's say if you are catholic, it could be a religious saying, just keep saying it over and over, until you change your brain patterns".

This is exactly what she said. God, my brain puzzles must be working overtime, I'm remembering all this stuff. lol

melody
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Last edited by MelodyL; 10-19-2007 at 09:11 AM.
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Old 10-19-2007, 09:05 AM #6
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To: Mrs. D.

You asked if the lecturer spoke about PN pain being central??

Believe me, when she started talking about Pre-frontal cortexes and the Thalmus , etc. that's when I had to really struggle and comprehend what she was saying.

From what I observed, these 20 or so people at the meeting, wanted to know if there is a cure on the horizon. They couldn't care less about pre-frontal cortexes. These were people who used canes and walkers and moved very slowly. These were people who, when they went on neurontin, got so drowsy, they had to get off of it.

One guy had narcolepsy and he still drives. He is on neurontin and lyrica.

There was a really skinny lady there who had just gained 20 lbs in 2 weeks on lyrica. And she was skill skinny.

Can you imagine my doctor telling me "Melody, you need to go on Lyrica". I would give him such a look.

lol
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Old 10-19-2007, 09:52 AM #7
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Kathi as far as your neurologist changing your diagnosis to central pain syndrome, from small fiber PN, isnt your pain caused because of damage to your small nerve fibers? You may also have central pain syndrome but wouldnt you also have small fiber neuropathy? The two do not seem to me mutually exclusive to me. For instance, if you broke your tibia and this set off a central pain syndrome (rsd), you would still have the broken broken bone until it heals or if it heals and also would have central pain syndrome.
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Old 10-19-2007, 10:12 AM #8
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Quote:
Originally Posted by MelodyL View Post
\......Can you imagine my doctor telling me "Melody, you need to go on Lyrica". I would give him such a look.
If'n ya had ta.... you would.
It IS possible to successfully diet on Lyrica (or Neurontin) after weight gain.
It just takes determination and discipline.
(my grandmother called it 'shpielkas')
(shhh-peel-kass - Yiddish)

Mel.....ya got BOTH !
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Old 10-19-2007, 10:24 AM #9
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Joe,

Actually and according to painonline.org they are linked. What that particular website helped me the most with is how the nerves act or what is occuring when they are damaged. It makes more sense to me simply because every test I have ever had came back negative for anything...as in idiopathic and she even said it almost didn't show up. Anyway, her reasoning is pretty much what Melody is spelling out about the brain and such. In any case, this is probably why meds like Neurontin and Lyrica didn't do a thing for me. Neither did the supplements. But the benzos worked! Xanax was tried as a last resort, and that was the ticket. But I didn't want to take 3 a day so she switched me to Klonopin and it has helped. I am just saying that being a spinal disorders person what I have read on this other site makes much more sense to me. So, it is possible I have both...no need to really differentiate since it is all neuropathic pain anyway. But it does explain to me why most meds did not work.
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Old 10-19-2007, 10:32 AM #10
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Bob:

I've got BALLS!!!!

lol

P.S. You HAVE to come to the next neuropathy meeting. We'd all meet each other and learn stuff. And they serve nice coffee in carafes. Do you know people came into the meeting room (they had just come in from Minnesota and Colorado), they had nothing to do with the neuropathy meeting, they just wanted to look out of the window and see the view from the 33rd floor. in NYC. Well, I went over to the window and I had to step back. I was afraid to look down. jeezz...
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