Neuropathy moving into hands - advice or tips please
 

I have Diabetic Peripheral Neuropathy bad in my lower legs and over the last couple months I have noticed it more and more in my hands. This is makign some things very frustrating. Turning pages when grading papers, reading books, picking up small things like coins or pills, dropping things, typing etc.

I know a bit of it is increased callous formation on my thumbs since I began using a wheelchair (gloved have been ordered) but it is also in my other fingers wich feel stiff and weak. Holding my hand open with my fingers outstretched takes effort, on bad days they are "clawing up" Last two fingers on each hand are weakest and least dextrous.

I know that this is something I will just have to work around, I am asking for tips for simple things to make daily tasks less frustrating.

Thanks for any help.

My hands are quite severely affected. Five years ago, tests revealed that I had lost 50% of my strength. I am not sure if there are any real good tips to coping with this. Occupational therapists can provide you with adaptive devices. I can't turn pages very well at all, nor use my pincher grasp. In addition, arthritis makes things very painful.

The biggest adaptation I have made is to allow a lot of extra time for things....you have to be patient with yourself.

Again, consult an OT and also, you can look online for adaptive devices.

have you asked your neuro about your hands? What does s/he say? My hands are permanently rolled up, but it's caused by my brain, not my neuropathy.

Also, if your hands are balling up you should wear night time splints to straighten them out so they don't loose the ablitily to unroll totally. I do alternate hands each night.

raglet

I think your progression is alarming and rather fast for diabetic neuropathy.

It might be a good idea to get another medical opinion.

Stress issues on your hands from using crutches would not impact the last two fingers as much as the first two and thumb.
Your issues with the last two follow a dermatome from the neck:
http://www.apparelyzed.com/dermatome.html

When I had my severe hand issues, from carpal tunnel due to my low thyroid, it was the thumb and middle fingers affected.
I used night splints to take the pressure off the carpal tunnel.
examples:
http://supports4less.com/bodyparts/wrist/index.htm
There are many types/price ranges.
I still use them occasionally now, if I overdo working with my hands. I also use the wrist braces that weight lifters use when digging in the dirt gardening. This keeps strain off the nerves in the wrist.

They are like these, only by ACE and flesh colored:
http://www.newgrip.com/wrist_brace.html

Do not wear them too tightly.

I am unclear from the chart what it is showing, but thanks for adivice, I do plan on bringing up the issues next time I see my neuro. Just keeping up with this whole thing has been a enough to drive me nuts. Fortunately people at work and the kids I teach are very supportive. Right now my hands seem to be cooperating, but then again I have had the day off and have not had to push my chair around or lean on my crutches.

I know they probably make things a little worse but I have definitely noticed a decline in strength and dexterity in the last couple of months. I should say i noticed a lack of sensation at least a year earlier but almost no change in it up until a few months ago that I noticed. That said I was pretty focused on getting relief from the pain in my feet and legs and up and around.

I may look into a nighttime splint to keep my hands straight. I tried using those little sticky rubber tips for turning pages today of a book I was reading but found that it was even more annoying since it made it so I couldnt feel the paper at all.

Before I see the OT at the clinic I may check with the OT at the school I teach at to see if she has some advice

Dermatome charts show the distribution of sensation (pain) along certain nerve pathways. When dealing with the spine, the feelings can be traced back to the source of the difficulty.

For example pain in the big toe may not reflect what is happening in the toe at all, but can be traced back to that area of the spine.

You can enlarge that chart by using the keystroke control + roller on your mouse.

The sort of night time resting splints that I am talking about are designed to maintain full finger extension, which splints that only support the wrist and thumb will not do.

Mine are made of aliminium which is very stiff but can be adjusted to fit the hand and arm, and covered with soft cushioning so they are very comfortable. They hold my fingers out in a fully extended position. I alternate which hand I wear them on as they totally imobilise the hand (can't even pull up the duvet with a hand wearing a resting splint). I have the regular working splints for the daytime to allow me to use my fingers.

I will try and find a link to show you what I mean. Do not allow your fingers to stay balled up all the time esle you will develop contractures.

The top splint in this link is very like mine (it is even the same colour). Notice how it extends the fingers out to prevent contractures. No clues why they say it is for geriatric use, people of all ages use them.

http://www.nextag.com/hand-splint/shop-html

hth
raglet

thanks for the info, the link you provided looks about like what I need.
Good news today, I recieved my new gloves for my wheelchair. They are fingerless but have an enclosed thumb and very thick padding on the palm.
Much better than the bicycle gloves I was using. Hopefully some of the callous formation on my thumbs will diminish and I might get some sensitivity back in the thumbs at least.

I also tried to make a hoist for my Wheelchair to get it into the back. It works but is almost more work than should be necessary. the access cab has a latch on the roof behind the driver seat. I had some rope cut and picked up rope hoist/locking mechanisms. They have a little too much friction to be effective, but it has pointed me in the right direction. I think a simple pulley will do the trick. It only needs to lift the chair about 2 feet and I need to be able to use it when sitting on the edge of the door before I transfer to the dirvers seat. It was relatively inexpensive, parts cost me about $8.

PN moving into hands
 

I have the same problen with the last two fingers on my right hand. I have been going to a rehab clinic, and working with a therapist on the problem. She uses a multiple lazer machine, along with electric stim, and multiple exercises to keep the fingers limber, and movable. It seems to have worked pretty well, (24 sessions). That is all that the insurance will allow.

In my case, the PN is the outgrowth of Waldenstroms cancer, and reacts to what the cancer is doing. Presently, my IgM is 6,440 (down from 7,900). As the IgM goes down, so goes the PN. The hematologist is using a combination of Rituxan,(860mg every 3 months) and Dexamethasone (10-4mg tablets every Friday), and Metanx daily. So far, the results have been less than I had hoped for. Seems the IgM has a mind of its own, and although it has receeded at times, it will suddenly spike up. and we have to start over again.

Now that the insurance has stopped the therapy, I only hope the cancer treatment drives the IgM down soon enough for the fingers to regain their abilities.

My bout with PN started with the feet, and so far, the only permanent damage that I can attribute to it is that "padded" sensation on the bottom of both feet. I am about finished with a problem we encountered last summer, which was "diabatic eruptions", (looked like huge blisters to me) which broke out on both heels. It has taken 6 months to heal those suckers. That was the pits. No shoes, only backless slippes the entire time. Try shopping at Wally World in your "fuzzies", and not draw attention.

Anyway, that's my story, and I"m stickin to it. LOL . Prayers, and good thoughts to all who suffer from PN, especially those with no known cause.