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Diabetes and Neuropathy

Neuropathy is a condition where nerves malfunction due to damage. As a podiatrist, I see many patients with this problem.

Although there are various causes for neuropathy, diabetes is the most common. It is believed that spiking blood sugar levels, abnormal blood fat levels and low insulin levels caused by diabetes can cause damage to the blood vessels that end up injuring the nerves.

Neuropathy and Diabetes Linked

It is estimated that over 50 percent of diabetics have some degree of neuropathy–that’s around 15 million people. This means about one in 20 Americans suffer from diabetic neuropathy–more than two times the number of people with Alzheimer’s, epilepsy, rheumatoid arthritis, HIV, Parkinson’s disease, and multiple sclerosis combined!

Nerve damage in the feet, legs, hands, or arms is known as peripheral neuropathy. This is one of the most common complications of diabetes. Symptoms of peripheral neuropathy may include a heavy feeling, numbness, tingling, weakness, burning, a cold feeling, hypersensitivity and even severe chronic pain. As neuropathy worsens, it can affect balance and the ability to walk, drive and sleep.

As a doctor, I was taught just like most others were, that there is no cure for neuropathy. We learned that the best we could hope for was to stop or slow down its progression. We were told that once nerve damage occurred, it could not be reversed.

An exciting new treatment may prove this prognosis to be wrong. Neurogenx has developed a treatment program where the nerves are electrically stimulated over a period of time, and the results appear promising. Four out of five people notice a significant improvement in their neuropathy symptoms. In some cases, people will feel their feet again, regain balance, get off their medications, sleep and even dance again. You learn more information about this treatment on the computer at www.neurogenx.com/anchorage. As a doctor, one of the most impressive aspects I’ve found about the Neurogenx Treatment comes from the medical tests they have done on patients. Punch biopsies of patients’ nerve tissue, taken before and after treatment, have found actual nerve regrowth.

Nearly all of my patients suffering from diabetic peripheral neuropathy take medications that help them live with and tolerate pain and other symptoms. While very helpful with coping, unfortunately, these medications do not solve, stop, or reverse the problem. Good diabetic control and exercise may help stop or slow down its progression, however. Hopefully, with the new advancements in this area, we will have effective ways of reversing the effects of neuropathy as well.

Dr. Rindlisbacher, commonly known as “Dr. Mark,” has been a podiatrist working in Anchorage for 24 years.

Does Neurogenx Really Work?

I hear this question daily, but I cannot answer it without telling you about a patient I treated about a year ago. DW came into the office complaining of pain, numbness and tingling in both of his feet and lower legs. Medically he had diabetes, high blood pressure, and migraine headaches. He was a long distance truck driver in the Midwest during the spring and summer months and would spend his winters here in Florida. He and his wife happened to be renovating their home here so he was very active.

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Hello from Neurogenx NerveCenter Suncoast!

Hello from Neurogenx Nerve Center Suncoast!

I am Carol Merrill, nurse practitioner and owner with my husband George, of the Suncoast Neurogenx office. I have been working with Neurogenx for more than 1 ½ years so I know how well this treatment works. When I was presented with the opportunity, I was excited to open my own clinic.

Now I will tell you a little bit about myself. With more than 40 years of medical experience, I have worked as a registered nurse and advanced registered nurse practitioner in Labor and Delivery, Neonatal Intensive Care Unit, as a supervisor in home health care and in women’s health care.
I married my best friend, George, in December 2016 and share a home and his 9 year old chocolate lab/ pit mix named Chloe. We like to spend our time away from work riding our motorcycles and doing motorcycle ministry work with our church.

I’m happy to be working with Neurogenx and want to share our care and knowledge with all who suffer with neuropathy. I invite you to write me directly at suncoast@neurogenx.com or can reach me at 727-300-5100.

Peripherial Neuropathy

Peripheral neuropathy refers to the medical condition that results when nerves that deliver messages to and from the brain and spinal cord and the rest of the body are damaged or diseased.

Peripheral nerves make up a complex network that connects the brain and spinal cord to the skin, muscles and internal organs. Damage to these nerves interrupts messages between the brain and other parts of the body. This disruption can impair muscle functions, prevent normal sensation in the arms and legs and cause pain.

Symptoms of Peripheral Neuropathy

Peripheral Neuropathy can make it difficult to perform everyday chore and tasks such as, putting a shirt on, bending over, walking short distances or hugging a loved one. The most common symptoms of Peripheral are:

  • tingling in the hands or feet
  • a feeling like you’re wearing a tight glove or sock
  • sharp, stabbing pains
  • numbness in the hands or feet
  • a weak, heavy feeling in the arms and legs, which sometimes may feel like your legs or arms lock in place
  • regularly dropping things from your hands
  • a buzzing or shocking sensation
  • thinning of the skin
  • burning sensations in your arms or feet
  • sore spots especially in the bottoms of your feet

These symptoms could indicate other conditions. Make sure to tell a doctor about all symptoms for proper diagnosis.

Treatment for Peripheral Neuropathy

What is the best treatment for Peripheral Neuropathy? The simple answer is whichever one works best for you. Neurogenx offers a one of a kind treatment for Peripheral Neuropathy. A non-surgical, non-narcotic treatment with a patented FDA-Cleared medical device that delivers results, successful in more than four out of five patients. If neuropathy treatment with medications, lasers or surgeries have not provided relief, find out more about about whether the Neurogenx Treatment might be right for you.

In support of National Peripheral Neuropathy Awareness Week in May, we are pleased to offer a FREE Peripheral Neuropathy & Balance Screening for people in the Greenville, NC area.  Please visit www.neurogenx.com/greenville or call 252-689-8400 and use code GRN-037.

 

Managing Chemo Induced Neuropathy

Steven Weinshel, MD, JD – Medical Co-Director Neurogenx NerveCenter of Sarasota
Board Certified in Neurological Surgery
Neurogenx Medical Advisor

Many patients receiving cancer treatment struggle with managing their chemo induced neuropathy.  Symptoms such as numbness, prickling, and increased skin sensitivity may be bothersome and some patients also experience severe pain, muscle weakness and other effects which may decrease quality of life.  If you have chemotherapy induced peripheral neuropathy (CIPN), here are some things you should know.

What is chemo induced neuropathy?

Certain types of chemotherapy medications are known to be “neurotoxic”.  While these medications are important in cancer treatment, over time they may damage the nerves and prevent them from functioning correctly.  Chemotherapy induced peripheral neuropathy occurs when sensory nerves in the extremities are damaged.

Symptoms of chemo induced neuropathy include abnormal sensations in the feet, legs or hands such as (prickling, burning or itching), loss of sensation in the feet and hands (numbness, cold sensation), and loss of motor function which may cause (clumsiness, loss of balance, frequently dropping things).  Some patients also experience severe pain which may be shooting or stabbing pains, extreme burning sensations, or cramping.

Chemo induced neuropathy is a common side effect of certain cancer medications.  Chemotherapy agents that are often associated with CIPN include: platinols (cisplatin, oxaliplatin, carboplatin), taxanes (paclitaxel, docetaxel) and vinca alkaloids (vincristine, vinorelbine).  Neuropathy may also be caused by other conditions including diabetes, shingles, and autoimmune disorders.

Managing chemo induced neuropathy

Treatment of neuropathy is aimed at relieving the symptoms or “palliative care”.  A combination of treatments may be tried to determine which works best for you.  These options may include:

  • Prescription medications such as antidepressants, opioid analgesics, sedatives, or anti-consultants.
  • Non-prescription analgesics or anti-inflammatories such as acetaminophen, ibuprofen and naproxen.
  • Topical treatments such as patches, creams and ointments used for muscle soreness and arthritis.
  • Nutritional support including a healthy diet high in B vitamins and antioxidants. Supplements may also be recommended.
  • Physical therapy or occupational to strengthen muscles, improve balance, and help with both large and fine motor coordination.
  • Massage therapy, acupuncture and relaxation techniques also help some patients.
  • Medical devices which use electrical stimulation on the skin to “distract” the nerves and reduce pain signals

Safety interventions

Your chemo induced peripheral neuropathy symptoms may increase your risk of injury.  Motor difficulties may increase your chance of a fall and numbness in the feet or hands may prevent you from noticing an injury once it occurs.   To help you prevent injury, you should:

  • Take care of your feet. Clean them daily and wear slippers or shoes both indoors and outside.
  • Make sure to check your shoes for irritants like small pebbles before you put them on.
  • Ensure that halls and walkways are well-lit and free of clutter and tripping hazards like rugs.
  • Install grab bars and non-skid surfaces in the bathing area
  • Make sure that your water heater is not too hot. If possible, adjust it to 110F or below.

Unfortunately, in most cases, once symptoms begin to occur, chemo induced neuropathy is irreversible and may continue to worsen.  If your chemo induced neuropathy symptoms are severe enough, a reduction or change in your chemotherapy may help.  You and your doctor must weigh the risks and benefits of your chemo regimen and work together to determine how well you are managing your chemo induced neuropathy.

Sources:
Chemocare http://chemocare.com/chemotherapy/side-effects/numbness-tingling.aspx
Dana Farber Cancer Institute http://www.dana-farber.org/Health-Library/Tips-for-Managing-Neuropathy.aspx

 

The Basics of Peripheral Neuropathy

The Basics of Peripheral Neuropathy

By Mark Shelly, DPM
Medical Director

Neurogenx NerveCenter of Encino

What is Peripheral Neuropathy?

Peripheral neuropathy (P.N.) is a medical diagnosis that describes damage to nerves and nerve endings, usually in the extremities, such as the feet and hands. P.N. can occur at any age and currently 20 million Americans suffer with the medical condition.

Peripheral neuropathy can result from many different things. The most common causes are:

  • Diabetes
  • Prescription Drugs – most commonly those involved with chemotherapy and HIV treatment
  • Toxins – including pesticides and solvents
  • Cancer
  • Alcohol
  • Chronic kidney disease
  • Chronic liver disease
  • Autoimmune disorders – such as Rheumatoid Arthritis, Lupus and Sjogrens
  • Trauma
  • Heredity
  • Nearly 30% of P.N. patients are described as idiopathic, which means the cause of neuropathy is unknown.

 

Older woman in pain

Symptoms of Peripheral Neuropathy

Peripheral neuropathy is a progressive problem, which means that it frequently starts with symptoms that are only moderately noticeable, but the symptoms gradually increase and get worse over time. The symptoms can include:

  • Tingling and numbness – especially in the hands or feet
  • Pins and needles sensations
  • Hypersensitivity
  • Burning, stabbing or shooting pain
  • Numbness in the feet or hands
  • A heavy feeling
  • The feeling of wearing tight socks or gloves
  • Or, as many patients have described to me – vague feeling of “something different” or “something stuck on my foot”
  • Cramping
  • Weakness

How is Peripheral Neuropathy Diagnosed?

Diagnosis neuropathy begins with a complete physical exam and usually includes:

  • Neurological assessment
  • Nerve biopsy/skin biopsy to observe the number of nerve endings
  • Electro-diagnostic tests such as a “nerve conduction velocity test” to evaluate how the nerves are functioning

Watch this space for future posts about available treatments as well as discussions of specific types of neuropathy.

Also, I would love to meet you at the 2017 Take Back Your Health Conference – coming up on April 8 & 9, 2017: www.takebackyourhealthconference.com

As part of the activities for this event, I also invite you to register to win a FREE TREATMENT COURSE: www.neurogenx.com/encino-giveaway

 

Neuropathy Of The Feet Success Story

The Spring edition of the Pinellas Health Care News a special article about Neurogenx patient George Potprocky, a career firefighter who retired to Florida. George had suffered for some time with a burning needle sensation in his feet that progressed to numbness.

“Once, I lost a nail and didn’t realize I lost it because I couldn’t feel it,” George recalls. “It was also hard for me to walk any distance. I’m part of a team that works on a racecar, and every time we’d go to the track, the other guys would walk up to the line. I’d take the scooter because I couldn’t walk that far. I finally said, I’ve got to do something about this.”

“After starting the Neurogenx treatments, I got more feeling back,” continued George. “Now, I can feel the floor when I walk; before, I couldn’t. My wife used to tell me my feet were cold, but I didn’t know they were cold. I can feel that now. I’ve already gotten back at least eighty percent of the feeling in my feet, and it keeps getting better.”

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Chemo Induced Neuropathy – Peripheral Neuropathy Caused by Chemotherapy

Chemo induced neuropathy can be a side effect of certain cancer treatment medications.  Chemotherapy induced peripheral neuropathy (CIPN) occurs when the sensory nerves of the feet, legs and arms are damaged by certain chemotherapy agents given to treat cancer.  CIPN is not as well-known as other chemo side effects but it can be debilitating.

What is chemo induced neuropathy?

Peripheral nerves normally work to detect and send signals about touch, temperature and movement from distant areas of the body such as the hands and feet.  Certain types of medication used to treat a variety of cancer may damage these nerves and result in chemo induced neuropathy.  If the nerves are damaged, they may no longer function correctly.   In some cases, nerve signals may become too frequent, may be “confused” or they may stop happening at all.

Chemo induced neuropathy is a common side effect for certain types of chemotherapy but it is not as well-known as others like hair loss and nausea.  Symptoms of chemo induced neuropathy include abnormal sensations, loss of sensation and motor symptoms.

  • Abnormal sensations – You may develop abnormal sensations in the feet, hands and other parts of the body. Sensations may include prickling or “pins and needles”, shooting or stabbing pains, unexplained itchiness and sudden or unusual extra-sensitivity.
  • Loss of sensation – You may lose some or all sensation in the hands, feet or other areas. This may appear as numbness, feeling of coldness when the skin is warm, or an inability to sense temperature.  If you cannot feel your skin, you may not notice an injury and should take care to avoid risks.
  • Motor symptoms – You may notice a loss of motor function when your body cannot sense its own movement or your muscles are not receiving the right signals. This may cause clumsiness, loss of balance, and decreased reflexes.  You may also notice that you frequently drop or cannot hold on to some items.

In some case, pain caused by chemotherapy induced peripheral nausea can be severe and may limit your ability to participate in day-to-day activities.  The stress of living with chemo induced neuropathy may also contribute to depression and emotional difficulties.

In addition to peripheral neuropathy symptoms, some patients also develop body-wide symptoms which can be serious.  Other symptoms of chemo induced neuropathy may include constipation, difficulty with urination, trouble swallowing and blood pressure changes.  Any of these symptoms should be reported to your doctor right away.

Medications

There are many kinds of oncology drugs, all of which have side effects.  Some of these medications are known to be “neurotoxic” and more likely to cause chemotherapy induced peripheral neuropathy than others.  Oncology medications most commonly associated with CIPN include:

  • Platinum-types – carboplatin, cisplatin, oxaliplatin
  • Vinca alkaloids – vincristine, vinblastine. vinorelbine
  • Taxanes – paclitaxel, docetaxel
  • Cytarabine
  • Ifosfamide

It may be difficult to tell if symptoms are chemo induced neuropathy or have been caused by your cancer or treatments like radiation.  Symptoms of neuropathy may also be caused by other conditions like diabetes, poor circulation, shingles, autoimmune disorders and other disorders.

Determining that your symptoms are caused by chemo induced neuropathy will be important in knowing how to treat your condition.

Sources:
American Cancer Society  https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/peripheral-neuropathy/symptoms-of-cipn.html
Cancer Network  http://www.cancernetwork.com/oncology-journal/chemotherapy-induced-peripheral-neuropathy

10 Symptoms of Neuropathy

Symptoms of neuropathy occur when a set of nerves become damaged or stop working correctly.  The most common type is called “peripheral neuropathy” which occurs when sensory nerves coming from areas like the hands and feet malfunction. Rather than sending appropriate information about touch, temperature and motion, the nerves may begin sending confusing signals or they may stop working altogether.  Symptoms of peripheral neuropathy may begin suddenly or may develop over time.

10 common symptoms of neuropathy include:

  1. Tingling or prickling sensations – Portions of your feet, legs or hands may have a “pins and needles” sensation.
  2. Burning or itching sensation – Patches or larger areas of your skin may feel as if they are “on fire” or itch severely.
  3. Numbness – Your toes or fingers, soles of feet or palms or larger areas may go “numb”.
  4. Feeling of coldness – Your feet, legs or hands may feel like they are cold even if the actual skin temperature is normal
  5. Unnoticed injuries – if an injury occurs or develops on the foot or other affected area, a lack of sensation may prevent you from noticing. Injuries that are not treated may become more severe.
  6. Extreme sensitivity – Areas of your skin may become oddly sensitive to even the slightest touch. This is known as “paresthesia”.
  7. Shooting pains – You may experience shooting pains in the affected area or nearby. These pains may “come and go” and may range from mild to severe.
  8. Loss of balance – Because your nerves are not sending the right signals, it may be difficult for your body to tell “where” it is in space, resulting in loss of balance.
  9. Abnormal gait – When sensory nerves are not functioning, coordination is much more difficult and the “gait” or normal walking pattern may become unsteady or irregular.
  10. Difficulty sleeping – Because of your other symptoms of neuropathy, you may have difficulty sleeping. Pain, tingling, or other sensations may make it hard to fall asleep or may wake ypu up during the night.

Symptoms of neuropathy may begin suddenly or may develop over time.  Certain symptoms may also appear to get better, only to begin again in the same or a different area.  You should be aware that neuropathy may also affect your emotional well-being and should discuss all of your neuropathy symptoms with your doctor.

Sources:
Medicine Net Today http://www.medicalnewstoday.com/articles/147963.php?page=2
NIH https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Peripheral-Neuropathy-Fact-Sheet#3208_3

Neuropathy Treatment That Works: Neurogenx NerveCenter of La Mesa in the News!

Dr. Bahreman – La Mesa, CA

Surgery-phobes (and you’re probably one of them), take heart. If you suffer from neuropathic symptoms or neuromuscular pain, you’ve got the option of a non-invasive treatment that proponents say is 87 percent effective.

“The concept is called electro-signal therapy or electromedical therapy,” says Dr. Amir Hassan Bahreman, Medical Director at the Neurogenx NerveCenter of La Mesa, part of a nationwide specialty healthcare network that has been open since October. The FDA-approved and patented Neurogenx™ Treatment employs high-frequency electronic signals that penetrate muscular tissue where pain and discomfort persist. According to the Neurogenx™ website, “The treatment creates changes at the body’s cellular level that reduce swelling, remove excess fluids and waste products, alter Ph levels and increase cellular metabolism.”

“Inflammation of the nerve is the major reason for nerve damage,” explains Bahreman, who is the only board-certified neurologist in San Diego County who offers this treatment as an alternative to narcotics or invasive surgery.

“With this technology, the (developers of Neurogenx™ Treatment) were able to prove that the inflammation can be reduced.” The ideal candidate for this treatment, he says, is a person suffering from peripheral nerve damage. It has also been successful for patients with diabetes, fibromyalgia and even vitamin deficiency. Treatment is not a one-time-only proposition. “You have to be committed to the program for it to be effective,” Bahreman stresses. That program generally entails 40-minute sessions twice a week for three months, all of it on an outpatient basis.

“The treatment success rate is very high,” says Bahreman, who has more than 14 years of experience in neurology and whose regular practice in the office is called the Neurological and Pain Institute. “We have seen day and night differences in many patients following treatment.”

Since some patients may be new to electromedical treatment or perhaps even wary about it, Bahreman offers complimentary consultations to each prospective new patient. Because patients come into the office so often during the treatment program, “they know us by name and ask us what’s going on in our lives, and we do the same,” says Eileen Craker, Bahreman’s physician liaison. “We want to create close, caring relationships with our patients.”

Author:
David L. Coddon
La Jolla Light Staff Writer

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