An Algorithm for the Evaluation of PN (Neuropathies)
 

This was published in '98, but take a look and tell me what you think:
http://www.aafp.org/afp/980215ap/poncelet.html

Nothing's perfect, but that is one of the good ones some of us having been passing around for years.

Good on ya for posting it again!!

rose

I've seen it
 

Bob,
I think this is one that GlennT posted in the "stickies". I agree with Rose that it is one of the better ones.

Billye

Bob:

I went to the algorithm information.

It said this,"Nerves are composed of different types of axons. Large, myelinated axons include motor axons and the sensory axons responsible for vibration sense, proprioception and light touch. Small myelinated axons are composed of autonomic fibers and sensory axons and are responsible for light touch, pain and temperature. Small, unmyelinated axons are also sensory and subserve pain and temperature. Neuropathies involving primarily the latter two fiber types are called small-fiber neuropathies."

If you think I can understand most of that, forget it. So here's my question. I have diabetes and most recently, I burn, and then I freeze (only my feet). I don't have pins and needles. I only had the pins and needles (and burning) on the day the podiatrist used that vibrating tool on me. Never got the pins and needles again. I have burning and freezing of the feet),I can feel everything that touches any part of my feet (except for the tips of my toes, at least that's what my doctor at Cornell told me). I don't have any problem with sheets being on my feet, or socks or anything like that. I don't have any stabbing, or electric shocks. And the B-12 methyl seems to make the burning much less problematic.
So what do I have?? Small fiber, large fiber, axonal, large mylinating, demylinating, sensory, WHAT???? Your best guess!!!!!

Thanks, Melody

BOb
 

I can across that one some years back just crusing the net - and even gave a copy to one of my docs - who thought it was really good... I tried to see the author as a patient - but she's 400 miles north of me - so found help locally...

but yes, its a good article......

Predominately small fiber neuropathy with the unmyelinated axons being damaged to the greatest degree.

"Predominately small fiber neuropathy with the unmyelinated axons being damaged to the greatest degree."

Now break this down in words that a two year old can understand (aw, you know what I mean).

So far as I can understand it, I have small fiber neuropathy. That's about all I could understand. Oh, just so you know, the weather greatly affects the freezing. If the weather changes, (goes from nice warm day to a little bit brisk, my feet freeze). If it's a gorgeous warm day, so far I'm fine. I will never undersand why the weather outside affects me inside the house.

Thanks,
Melody

Melody, Joe is just saying that you display mainly small nerve damage because of your reaction to the heat and cold, the small nerves job is to interput the right temperature and send those signals to your brain, they can't when there damaged.
Myelinated nerve fibre wraps around the axon and becomes damaged and cannot send the proper signals to your brain, then its unmyelinated.
An axon is just the portion of a nerve cell that carries nerve impulses away from the cell body. A neuron typically has one axon that connects it with other neurons or with muscle or gland cells. Some axons can be real long, sometimes from the spinal cord down to a toe. Most axons of vertebrates are enclosed in a myelin sheath, which increases the speed of impulse transmission.
i hope this helps.
Brian :)

Okay, let's see if I have this correctly (or as far as my little own brain can understand)

I HAD myelinated nerves (that became damaged due to my diabetes). So my melinated nerves then became unmyelinated nerves.....and these unmyelinated nerves are wrapped around an axon and because they are damaged, everytime the weather changes, my brain is getting a wrong signal and freezes or burns (depending on whether it decides to freeze or burn).

Now I've been taking the methyl b-12 since the burning started. Probably a good week up to this morning. I notice the burning is much less severe.

So I gather it's a good thing I'm doing the methyl b-12. Can't be bad thing, right?

So if I keep my blood sugar around 100 to 112 (which ain't easy but I'm trying the best I can), then by keeping my blood sugar under good control, I have a better chance at not experiencing the freezing and the burning.

And by taking the Methyl b-12, well, over a period of time, I just might turn these unmyelinated nerve things into myelinated nerve things. So when they wrap around the axon, they might not send such mixed signals.


Did I get this right? and if not, correct whatever I said that was incorrect, okay?

And thanks much.


Jeez, I wish this was french class, it would have been SO MUCH EASIER than axons and myelination

Sounds like you are spot on to me, & yep your doing all the right things to heal those damaged small fibres, perhaps do a "Google image" search may explain it more so in a diagram of " unmyelinated nerves "
Brian :)