Weight Bearing Exercise Can Be Dangerous For Neuropathy Patients

Today's post from huffingtonpost.com (see link below) looks at the problems that certain forms of exercise may bring the neuropathy patient who has lost most of the feeling in their feet. These problems are not to be underestimated but it's important to say here that the vast majority of neuropathy patients have some feeling in their feet, despite the numbness that can affect the toes and pads of the foot. These patients are unlikely to step on a nail and not feel something. That said, many people living with neuropathy feel very little and this can certainly lead to serious accidents. When this is the case, load-bearing exercises can be more dangerous than helpful. Nevertheless the article recommends exercise as being essential, as long as this is controlled and the feet are carefully and regularly monitored. The article is aimed at diabetic neuropathy patients but applies to all people living with neuropathy and foot problems.

Type 2 Diabetes and Peripheral Neuropathy: To Walk or Not to Walk?
 
Milt Bedingfield Posted: 05/11/2015 

It is now well known that engaging in light to moderate physical activity on a regular basis is of significant value for most people that have either Type 1 or Type 2 diabetes. In fact the American Diabetes Association recommends that people with diabetes should get a minimum of 150 minutes of light to moderate exercise per week including aerobic and resistance training.

What the ADA says...

It has also been recommended that people with peripheral diabetic neuropathy that have reduced or absent feeling in their feet should not engage in any form of weight bearing exercise activity. The American Diabetes Association recommends that people with diabetes-related peripheral neuropathy should limit the amount of weight-bearing physical activity they perform due to their increased risk of foot ulcers and amputation (1, 2). This is based on the fact that with peripheral neuropathy there is either a decreased ability or total inability in the feet to feel pain or discomfort.

As an example, standing barefoot on hot asphalt maybe in a parking lot in the middle of the summer would be very uncomfortable for someone with normal sensation in their feet, however go unnoticed for someone with peripheral neuropathy. Similarly, the person with peripheral neuropathy may develop a painful nickel-sized blister after walking too far or when wearing new shoes and not even feel it. Without daily inspection of the ankles and feet (which a lot of people do not do) this blister could go unnoticed for days resulting in a potentially infected, slow to heal, or non-healing wound. In the worst case this could lead to an amputation. All of this is the result of losing what is called the protective sensation in the feet.

In the absence of peripheral neuropathy whenever there is insult to the foot or feet such as a blister, a cut or scrape or stepping on a small piece of glass or nail, there would be pain which would cause you to notice the injury and hopefully treat the wound accordingly.

There are also painful stages of neuropathy that can precede lack of sensation which are characterized by frequent but intermittent pain in the feet throughout the day, having pain only in the evening while in bed to constant pain. This stage of neuropathy can result in changing the way you walk, that is your stride length, which part of your feet you strike the ground with first and ultimately what part of your feet support your body weight.

Because of everything I have just mentioned above this leads to the unfortunately recommendation that discourages walking for a great many people with diabetes.

To Walk or Not to Walk?

So where does that leave us? Exercise is arguably the best treatment there is, particularly in controlling Type 2 diabetes, and preventing diabetes related complications, such as peripheral neuropathy, however once you have peripheral neuropathy in your feet you should avoid doing any weight bearing exercise.

I have wrestled with the dilemma for years about how to guide my patients that would benefit immensely from starting to exercise or increasing their exercise however have various stages of neuropathy.

According to the Centers for Disease Control and Prevention, from 2000-2002, approximately 60 percent of lower-extremity amputations in the United States were diabetes-related, with the majority of those amputations being preceded by a foot ulcer (3). Almost all diabetic foot ulcers occur in those people that have lost feeling in their feet due to diabetic peripheral neuropathy (4, 5).

On the other hand poorly controlled blood glucose control contributes greatly to peripheral neuropathy.

Eight-year cardiovascular mortality is 34 percent lower among people with diabetes who walk two hours per week compared with non-walkers (6).

Feet First Randomized Controlled Trial

The Feet First Randomized Controlled Trial was designed to look at the effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy. The study, conducted over a 12-month period by Lemaster and colleagues, showed that participants in the Feet First intervention group achieved a modest increase in activity, with no increase in foot lesions, compared with those in the control group. The group also recommended additional research be conducted in this area to investigate the current guidelines and close supervision for patients with diabetes and peripheral neuropathy (7).

Tuttle and colleagues found that people with Type 2 diabetes and peripheral neuropathy experienced no negative consequences when performing moderate-intensity, weight-bearing exercise in their study (2).

Dr. Sheri Colberg reports in her article "Exercising with Peripheral Neuropathy" that recent descriptive studies suggest that patients with a lack of feeling in their feet who participate in daily weight-bearing activity are at decreased risk of foot ulceration compared with those who are less active (8, 9), especially if their daily routine is very similar with little variation from day to day regarding their physical activity (9, 10).

As a result of the above information, I am going to continue evaluating each of my class participants on a case by case basis, however, for those patients with peripheral neuropathy that I believe will be prudent in checking their feet and following the recommended foot care guidelines and stand to gain significant benefit from performing some weight bearing exercise, I will be more likely to recommend it to them.

References:

1. Singh, N., D. G. Armstrong, and B. A. Lipsky: Preventing foot ulcers in patients with diabetes. JAMA 293 (2):217-228, 2005

2. Tuttle, L. J., M. K. Hastings, and M. J. Mueller: A moderate-intensity weight-bearing exercise program for a person with Type 2 diabetes and peripheral neuropathy. Phys Ther 92 (1):133-141, 2012

3. Centers for Disease Control and Prevention. History of foot ulcer among persons with diabetes -- United States, 2000-2002. MMWR. 2003;52:1098-1102. Medline

4. Pham H, Armstrong DG, Harvey C, et al. Screening techniques to identify people at high risk for diabetic foot ulceration: a prospective multicenter trial. Diabetes Care. 2000;23:606-611.

5. Reiber GE, Smith DG, Wallace C, et al. Effect of therapeutic footwear on foot reulceration in patients with diabetes: a randomized controlled trial. JAMA. 2002;287:2552-2558. CrossRefMedline

6. Gregg EW, Gerzoff RB, Caspersen CJ, et al. Relationship of walking to mortality among US adults with diabetes. Arch Intern Med. 2003;163:1440-1447. CrossRefMedline

7. Lemaster, J. W., M. J. Mueller, G. E. Reiber, D. R. Mehr, R. W. Madsen, and V. S. Conn: Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: feet first randomized controlled trial. Phys Ther 88 (11):1385-1398, 2008

8. Richerson, S., and K. Rosendale: Does tai chi improve plantar sensory ability? A pilot study. Diabetes Tech Ther 9(3):276-286, 2007

9. Ko, S. U., S. Stenholm, C. W. Chia, E. M. Simonsick, and L. Ferrucci: Gait pattern alterations in older adults associated with type 2 diabetes in the absence of peripheral neuropathy--results from the Baltimore Longitudinal Study of Aging. Gait Posture 34 (4):548-552, 2011

10. Kanade, R. V., R. W. van Deursen, K. Harding, and P. Price: Walking performance in people with diabetic neuropathy: benefits and threats. Diabetologia 49 (8):1747-1754, 2006

http://www.huffingtonpost.com/milt-bedingfield/post_9394_b_7188266.html

How Friends And Family Can Help Pain Sufferers

Today's post from paincommunity.org (see link below) looks at another aspect of care-giving when it comes to people living with relentless pain. This time it gives tips for family and friends and presents them from the point of view of the sufferer him- or herself. Many people with chronic pain feel misunderstood, disbelieved, unappreciated, ignored even and this is a plea for a little more understanding from those around them. of course, nobody pretends that people in pain are easy to live with but sometimes family and friends are at a loss as to how to help. This article suggests a few ideas.

What Can I Do? Tips for the Families and Friends
Posted by Janice Reynolds | January 14, 2014

The presence of persistent (aka chronic) pain is often “the elephant in the room”. For those of us who have persistent pain, daily living can be a challenge. Though we may not “look” like there is a problem, there is. For some, our pain is well controlled and for others it isn’t. For all of us, pain dictates how we spend our day as well as how we do things. It is very fatiguing even at the best. These are some thoughts and suggestions I wish to pass on to our family and friends. This is a response to the well-meaning comment: “What can I do?” This simple question can be overwhelming.

Tips That Can Make a Difference:
 
1. Don’t avoid me. Be the friend or loved one you have always been. Please visit. Find out or call first to be sure it is a good time for company.

2. Let’s talk together about it. Try not offer advice unless asked. You might start off by asking if I feel like talking about it at that moment or later.

3. Pain isolates; cry with me; laugh with me; let me know my feelings and needs are all right. Be patient and caring. Acknowledge my pain. Validate my feelings good and bad; loss, hope, sadness, anger, acceptance.

4. Remember persistent pain doesn’t mean the same level of pain is present all the time. Even if I have a good pain plan there are times my pain can elevate and spiral out of control. If you notice non-verbal cues, like a change in my mood, becoming very still or more restless or the inability to tolerate noise or light, encourage me to use the familiar techniques I depend on to lessen my pain; this could include taking recommended medications.

5. Don’t be afraid to touch me. Ask first if you have doubts; holding my hand lightly may be okay where squeezing it isn’t.

6. Learn the difference between physical dependence and addiction; I may depend on pain medication but may not have a problem with the misuse or abuse if it. These are very different situations.

7. If there is something you don’t understand, let me know so I can better explain it. Never be judgmental. Do not be afraid to be honest with me either.

8. Help me make a grocery list, if needed. Either offer to go with me or even shop for me.

9. Offer to watch my children or pay for a reliable babysitter for a while so I can have a little alone time with my spouse or by myself. They can probably use a break from me as well.

10. Cook or bring over a meal on occasion. Preparing something for the freezer for a time when I am having a bad day would be a life saver.

11. If you find I have fallen behind with cleaning, gently offer to help—dust, vacuum, wash dishes or clothes.

I know there are others. What would help you the most? Please pass this along to the families and friends of people you know who live with pain (including yourself); maybe we will get the elephant out of the room or at least halfway out the door.

http://paincommunity.org/what-can-i-do-tips-for-the-families-and-friends/

Personal Story Of How Autonomic Neuropathy Can Strike

Today's post from masslive.com (see link below) has no personal link to HIV but shows how devastating a random virus can be when it attacks the nervous system. The case in point here, contracted an unidentified virus which caused her autonomic nervous system (all those involuntary functions we take for granted, like digestion, breathing, blood pressure etc) to fail on several fronts. The general term for this sort of nerve damage is dysautonomia. It sounds like a disease in itself but is actually an umbrella term for this sort of condition, in the same way that neuropathy is a general term for nerve damage.This story shows how alarming it can be, especially when there's no way of knowing how far the disease will progress and what the prognosis will be.

Monson Mom raises awareness of autonomic nervous system disorder
By Kathryn Roy | Special to The Republican on July 16, 2014

Emily Hespeth, a 16-year-old Monson resident, contracted a virus that has caused her autonomic nervous system to malfunction, and interferes with ability to eat.

MONSON -- Sixteen-year-old Emily Hedspeth was a healthy girl, just starting her sophomore year at Monson High School, when she began to show symptoms of an infection. That infection, which hit in September 2012, later resulted in a diagnosis of dysautonomia, an umbrella term for conditions that cause the body's autonomic nervous system to malfunction. The system controls such functions as heart rate, blood pressure and digestion.

Today, Hedspeth needs a feeding tube and struggles with various health problems. Her mother, Mary Hedspeth, is working to raise awareness about dysautonomia,.and its various forms. Emily suffers from Postural Orthostatic Tachycardia Syndrome (POTS), which causes an abnormal heart rate upon standing. There is currently no known cure for dysautonomia.

Hedspeth said doctors were baffled initially because it all started with what appeared to be an everyday virus.

“She had a fever, body aches, a headache, nausea, a sore throat, and she was very lethargic,” Hedspeth said.

More common ailments such as mononucleosis were ruled out. Although doctors never determined specifically which virus Emily contracted, they later determined that it had damaged her autonomic nervous system, her mother said.

“As a consequence of this, Emily also has gastroparesis, in which the nerves in charge of the stomach don’t work,” Hedspeth said. “She has a hard time eating and even maintaining her weight.”

Emily has a feeding tube coming out of one nostril, and she has had a temporary gastric stimulator out of the other nostril. She traveled to Louisville, Kentucky to have a permanent gastric stimulator put in in late June by the doctor who invented the device, to help her stomach function properly. Hedspeth compares it to a cardiac pacemaker, but for the stomach. It's too early to tell how the device will impact her quality of life.

But Hedspeth said Emily has suffered for a long time.

“Whatever she eats, she gets nauseous,” Hedspeth said. “She takes two bites of something and she’s full. She has terrible bloating. Sometimes her belly is so just so bloated, she looks pregnant.”

Hedspeth said her daughter has seen numerous doctors.

“Plenty of them thought she was anorexic,” she said. “Sometimes the doctors don’t listen to you, but I didn’t give up till somebody did.”

POTS causes Emily’s heart rate to change rapidly.

“Lying down, it’s 50 (beats per minute),” Hedspeth said. “When she sits up, it’s 80, and when she stands it’s between 120 and 130. She gets very dizzy and she almost passes out.”

Emily’s condition has forced her to miss out on school and other activities. She attempted to attend two classes at school this year.

“She had to go for Spanish,” her mother said. “She tried to do Spanish and English. She made it to Spanish, but every day is a battle for the poor kid.”

Emily is currently being treated by physicians at Massachusetts General Hospital, who are involved in a dysautonomia research study. She said researchers at Vanderbilt University are also studying the condition, and recently discovered that those affected by it have an unique aspect to their blood.

“Dysautonomia International (an advocacy group) is trying to raise awareness and money to help fund the next part of the research, so they can come up with a blood test which could be run by any pediatrician in the country,” Hedspeth said. “A lot of doctors don’t even know what (dysautonomia) is.”

Hedspeth said for now, it’s all about managing Emily’s symptoms. It’s not clear what the long-term prognosis is.

“They don’t really know how bad it’s going to get,” she said. “I don’t really want to think about it.”

For more information on dysautonomia, visit http://www.dysautonomiainternational.org./welcome.php

http://www.masslive.com/living/index.ssf/2014/07/monson_mom_raises_awareness_of_autonomic_nervous_system_disorder.html#incart_pop_thishour

Erectile Disfunction Can Be A Neuropathic Problem

Today's post from uk-med.co.uk (see link below) talks about erectile disfunction, the elephant in the room for many men living with neuropathy. Women can have problems in this area too, especially concerning dryness but this article concentrates on men. For once it is a study which looks at the problem from another angle, in that it looked at men with impotence and found that many of them also suffered from neuropathic problems. Usually, ED is seen as a possible side effect of neuropathy but it can also be said that neuropathy is a co-problem with erectile disfunction. Many people don't need studies to know that ED can be a depressing problem to add to the symptoms of neuropathy but dicussing it with your doctor may lead to satisfactory modern treatments improving the situation.

Smoking doesn't help guys!

 Neuropathic Pain Connection With Erectile Dysfunction

       
A recent research paper written by Dr Consuelo Valles-Antuna at the University Central de Asturias in Spain, has found a connection between nerve impairment in the peripheral nervous system and its effect on erectile dysfunction.

 They studied 90 patients that displayed acute signs of peripheral neuropathy and the added problem of erectile dysfunction, needing intensive therapy. Current drug treatments for erectile dysfunction include Viagra and Cialis.

Patients that volunteered for the research had an average age of 54 years, 10% under 40 years and 2% were over 70. No interconnection with the IIEF-5 (International Index of Erectile Function) summary was found in the older test subjects, by way of making them more susceptible, if anything the younger participants had lower IIEF-5 scores. Breakdown of other medical backgrounds was; 30% cardiovascular disease, 16% neurogenic conditions, 16% diabetes, 7% mental health and 11% no risk factors.

Those presenting with worse cases of peripheral neuropathy also had very low IIEF-5 results. Neurophysiological investigations supported evidence that 69% had neurological pathology and 8% of these had myelopathy, which affects the spinal cord. Over a third had polyneuropathy, with small percentages were exhibiting small fibre and pudendal neuropathy, which causes problems in the pelvic area.

 Dr Valles-Antuna believes that this is a unique study, that covers the full spectrum of peripheral nerve fibre conditions in a non-selected group presenting with erectile dysfunction. Using the information gathered from the sufferers, combined with neurophysiological tests has shown that peripheral neuropathy is prevalent amongst men with impotence. With reference to this information, it is advised that medical practitioners’ should perform neurophysiological examinations on erectile dysfunction patients and establish that the pelvic area has been screened effectively.

http://www.uk-med.co.uk/Health/Neuropathic-Pain-Connection-With-Erectile-Dysfunction

Acid Reflux Drugs Can Play Havoc With Your Nervous System

Today's post from naidw.org (see link below) looks once again at a subject that crops up quite frequently on the neuropathy message boards and that's the negative influence of commonly-used, acid-reflux drugs including:
Rabeprazole (Aciphex) Esomeprazole (Nexium) Lansoprazole  Prevacid)
Omeprazole (Prilosec, Zegerid) Pantoprazole (Protonix) exlansoprazole (Dexilant) on our nervous systems. It becomes especially relevant if you've been prescribed these drugs to protect your stomach from excessive acid production by other drugs, for other conditions (HIV combinations are a good example). It's surprising how many people are also prescribed these drugs and end up staying on them for years, long after the original need has passed. The consequences can be very serious indeed! Apart from the potential damage to your nervous system; if your stomach's natural acid production is suppressed, it means that certain drugs will never be allowed to work because the acid needed to break them down, is terminally suppressed by the acid-reflux medication. Reading this article will provide you with all the information you need and should help you decide if you need to have a serious discussion with your doctor or not. The less acid-reflux drugs, the better - certainly for your neuropathy problems.

Acid Reflux Drugs May Cause Dementia and Neuropathy
Thursday, 18 February 2016

Has your memory been slipping lately? Have you experienced unexplained pain, weakness, numbness or tingling in your arms of legs? Have you also been taking an acid reflux drug like Nexium, Prevacid or Prilosec for a couple years? If so, then you may be the latest victim of the pharmaceutical industry’s medical model of healthcare.

After that first paragraph, you may have expected to see an attorney’s phone number to call and join a class action lawsuit! Well, I am sure that it won’t be long before that actually happens. New research, published Monday in The Journal of the American Medical Association (JAMA), showed that certain acid reflux drugs are “significantly associated” with vitamin B12 deficiency. In turn, vitamin B12 deficiency causes serious health consequences including anemia, osteoporosis, depression, memory loss, dementia, neuropathy and cardiovascular disease.

If you have acid reflux, you need to understand what is causing it. Find the cause and correct the cause. Simply popping pills to block the natural production of stomach acid has proven to only cause even more serious health conditions. Read on to learn how to restore your health without these dangerous drugs!

Acid Reflux Drugs Linked to Vitamin B12 Deficiency

Acid reflux drugs, like Nexium, have long been known to cause some very serious side effects. Among them are problems such as anemia, heart problems, hypertension, osteoporosis and further digestive problems including irritable bowel syndrome (IBS). In fact, drugs used to treat acid reflux do not treat the condition itself but only the symptoms. They are not designed to correct the cause of the problem. As a result, the problem continues to worsen over the years. Drug treatment is continued and the drug side effects continue to worsen as well.

This new research(1) sheds further light on this problem. It showed that people taking certain acid reflux drugs are far more likely to suffer from vitamin B12 deficiency. The study implicated proton pump inhibitors (PPIs) – Nexium, Prevacid and Prilosec – and histamine 2 receptor antagonists (H2RAs) – Pepcid, Tagamet and Zantac. Proton pump inhibitors proved to be the worst.

Unfortunately, the study’s senior author, Dr. Douglas Corley, stated(2) that patient’s should not stop taking the drugs but should get their B12 levels checked. If your levels are deficient, then presumably, you should treat that as another symptom as well. All the while, the underlying causes are left unaddressed. Vitamin B12 deficiency cannot be corrected unless the cause of the deficiency is addressed. In this case, the cause may be your acid reflux pill.

Left uncorrected, this leads to fatigue, anemia, irritable bowel syndrome, increased risk of bone fracture, hypertension, dementia, depression and neuropathy. It is dangerous, costly, and simply ridiculous to continue treating symptoms of any condition rather than addressing the cause. Wouldn’t it be much better to find what is causing the acid reflux and correct the cause? 

Why Do You Have Stomach Acid?

Stomach acid has been unjustly vilified as the cause of acid reflux and GERD. In a similar fashion,cholesterol was incorrectly pegged as the cause of deadly heart disease. Just as pharmaceutically lowering cholesterol increases the heart attack death rate, blocking stomach acid with drugs only makes the problem of reflux and GERD even worse!

You have acid in your stomach for a reason. The cells that line your stomach produce it. In fact, your stomach is specifically designed with a layer of cells that protect it from the otherwise damaging effects of the acid. This stomach acid is required by your body for:


proper digestion of food, especially carbohydrates


Absorption of nutrients (such as vitamin B12)


Killing harmful bacteria and limiting bacterial overgrowth

Without this acid in your stomach, you cannot properly digest carbohydrates or effectively absorb certain nutrients. Blocking this acid production also allows for overgrowth of bacteria and opens the door for H. pylori infections. Simply having the stomach acid is not the problem. In fact, most people suffering from acid reflux actually have too little stomach acid rather than too much.
What Causes Acid Reflux and GERD?

The problem is when the acid leaks (refluxes) into the esophagus. Your esophagus does not have the protective lining that your stomach has. When stomach acid gets into the esophagus, the burning pain of acid reflux results.

Your body has a very strong valve – called the Lower Esophageal Sphincter (LES) – between the stomach and esophagus that is designed to prevent the reflux of acid. The cause of the acid reflux is adysfunctioning LES muscle which allows the acid to reflux into the esophagus.

It is not a problem of having too much acid. Again, most cases of acid reflux actually occur with low levels of stomach acid. The acid is just in the wrong place. Lowering acid levels or blocking its production does not fix the problem with the LES. As a result, the acid reflux continues and you are prescribed acid blocking drugs for the rest of your life.

So, the real question is what is causing the dysfunction with the LES muscle and how can your correct this cause of acid reflux?

Correcting the Cause of Acid Reflux

Your Nerve System and Chiropractic Care. The LES is an autonomic muscle. That means that it is automatically controlled by your autonomic nervous system. Stress on the nerves that control this muscle can cause it to malfunction. Additionally, production and secretion of stomach acid is controlled by your nerve system. Ensuring proper nerve system function is the first step to healing acid reflux and GERD naturally. Chiropractic physicians are trained to find and correct nerve interference such as this. As a result, many people experience significant relief simply from including regular chiropractic care in their wellness lifestyle.


Eliminating Drug Effects. It is also important to consider other prescription drugs that you are taking that may be causing the problem. Common culprits include steroid drugs, NSAIDs (such as Advil and Aleve), and aspirin. These drugs are commonly prescribed for various pain syndromes. However, there are many natural, safe, and more effective methods for correcting these conditions as well.


Excessive Carbohydrates. Consuming excessive carbohydrates – especially simple carbs like sugars, breads, pastas, pastries, etc. – create an inflammatory environment in your body. This can prevent normal production of stomach acid and allow bacterial overgrowth. This leads to gas production and increased intra-abdominal pressure. As a result the LES muscle becomes inhibited and acid reflux occurs. Simply switching to a low carbohydrate, anti-inflammatory dietnaturally corrects this cause of acid reflux.

Balancing Bacteria. Low stomach acid allows for bacterial overgrowth and disrupts the balance of healthy gut bacteria. Consuming foods rich in probiotics (healthy bacteria), such as raw fermented foods, restores this balance. Taking a probiotic supplement may be necessary as well. Restoring the normal, healthy bacteria in your gut helps to correct many digestive disorders, including acid reflux.

Natural Remedies for Acid Reflux

Using these methods addresses the actual cause of acid reflux and GERD and allows your body to heal itself naturally. While you are healing, you may need to use some natural remedies as well to help with the symptoms. As mentioned earlier, the problem is most often a result of not enough stomach acid production in order to digest food, absorb nutrients and kill harmful bacteria.

Bitter herbs can be used to increase production of stomach acid. These include herbs such as barberry bark, caraway, dandelion, fennel, ginger, goldenseal root, peppermint, and wormwood. They are typically taken in very small doses and made in a tincture of water. Consult an well-trained herbalist for best results.

While you are reconditioning your body to produce the proper amount of stomach acid, you may benefit from natural digestive enzyme supplements as well. Without proper levels of stomach acid, the pH is too high to stimulate the release of these enzymes naturally. These supplements can help provide your body with the support it needs to break down carbohydrates and proteins more effectively.
As with all health conditions, dangerous drugs are not the only option. It may seem easy to simply pop a pill and ignore the problem. However, your body and your long-term health will ultimately suffer the consequences. You can live a radiant and vibrantly healthy life! Simple lifestyle changes make a huge difference in your vitality and they will help you heal acid reflux naturally!

References for this Article:

(1) Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B12 Deficiencyhttp://jama.jamanetwork.com/article.aspx?articleid=1788456

(2) Stomach acid drugs may increase vitamin deficiency riskhttp://www.reuters.com/article/2013/12/10/us-stomach-acid-drugs-vitamin-d-idUSBRE9B914Y20131210?feedType=RSS&feedName=healthNews

https://naidw.org/blog/members-myblogs/acid-reflux-drugs-may-cause-dementia-and-neuropathy

Sleep Deprivation Can Lead To More Pain And Weakness

Today's post from brainlessblogger.blogspot.nl (see link below) looks at the effects of impaired sleep patterns on fibromyalgia patients. Fibromyalgia is also a neurological condition closely linked to other forms of neuropathy and many neuropathy patients are well aware that their problems getting quality sleep have an on-going effect on the rest of their lives. The article looks at studies that suggest that short-term sleep deprivation can lead to an increase in adrenalin production and the patient actually feeling better ('running on adrenalin'). However, long-term sleep impairment does lead to an increase in pain due to fatigue and a build up of over-worked neural activity. Neuropathy patients are often kept awake, or wakened, by the pain or tingling itself, leading to a vicious circle of symptoms that reduce the quality of life considerably. The conclusion is that good sleep is essential - no surprise there but if lack of quality sleep is a problem for you, it's worthwhile getting expert advice to achieve as much undisturbed sleep as is possible in your case.

sleep duration and fibromyalgia pain intensity
Tuesday, January 12, 2016

Insomnia, sleep disorders and impaired sleep have always been considered significant factors in regards to fibromyalgia syndrome and even explored as a cause to the syndrome. It is during deep sleep that people produce significant amounts of growth hormone which repair and maintain muscles. Therefore lack of deep sleep and interrupted sleep, which are predominate features with FM, have long been considered factors in pain intensity along with lack of overall time sleeping. Lack of sleep, therefore, must relate to pain levels. A recent study in the Journal of Pain, 2012, suggests this is not necessarily the case.


The Study


74 people with FM were asked to be a part of the University of Florida study and were observed over a 14 day time period. Given the small test group and time frame of the study we have to take these results with a grain of salt. In the study set up FM patients had a sleep diary where they would record how their sleep went and they also were to rate their pain levels every evening.

"For this study, a research team from the University of Florida hypothesized that decreased total sleep time would predict higher clinical pain in a sample of patients with fibromyalgia…Results of the analysis showed that four sleep measures evaluated in the study failed to significantly predict clinical pain. The authors noted that the effects of impaired sleep, such as fatigue and inactivity, may play more significant roles in clinical pain than measures of sleep duration or insomnia. Sciencedaily.com"

Why the results are surprising

These results are surprising because we would expect the opposite. Historically other studies have shown disruptive sleep patterns in people with chronic pain conditions will produce increased pain. Lack of sleep is in fact a factor that can produce pain in healthy people as well. Given the majority of FM patients have disrupted sleep one would expect the results to show decreased duration of sleep would increase pain the next day.

Why we cannot draw firm conclusions

The study is only of 74 people so this is not a large study and we cannot draw any conclusions from one small study. Secondly, the duration of the study itself was short, only over a span of two weeks, which given the nature of chronic pain and sleep disorders is hardly significant. A few days of less sleep can get someone, who regularly gets disrupted sleep, into a sleep deprivation state running on adrenaline. For the short term this will actually make them function fairly well on a pain basis. They will be in 'fight or flight' mode and not feel as much pain, or at least, not right away. However, accumulated sleep deprivation will cause the pain to build up such that we often see with FM the morning muscle pain being severe in the morning and becoming less severe as the day goes on. Ironically, also with short, disrupted sleep someone with FM may feel very alert in the morning because they have not actually gotten much sleep. They do not feel the pain from being in one position for a long period of time so there is no muscle aches from that. The lack of sleep, initially, makes them feel alert, energized and with no morning stiffness and pain. Whereas, longer durations of sleep are often still of poor quality leaving someone with FM still feeling groggy. They will often wake up with morning stiffness and pain from laying in one position for too long if they have managed to be asleep for any length of time. It is not necessarily duration that is a factor but quality. Therefore, it is not necessarily the case that decreasing the total sleep time would increase the pain the next day with someone with FM. Ten hours of poor quality sleep where the person woke up frequently and spent very little time in deep sleep cannot be compared to five solid good hours of sleep. Ten hours of poor quality sleep may leave the person feeling groggy, stiff and sore, while the five hours of restorative sleep may leave them feeling alert and well rested.

Nevertheless, FM patients suffer from poor quality sleep and, at times, other sleep disorders such as restless leg syndrome (RLS) or sleep apnea. Whether the duration of their sleep affects intensity or not certainly lack of sleep affects fatigue, mood and likely even overall health. It is vital with FM to try and maintain healthy sleep habits and a regular sleep cycle. Quality of sleep is just as important as quantity of sleep.

http://brainlessblogger.blogspot.com/2016/01/sleep-duration-and-fibromyalgia-pain.html

Can a high CD4 cell count cause neuropathic pain

Today's post from EATG: the European Aids Treatment Group, (see link below)is based on a study of 1,539 HIV-patients by the University of California. It reveals much of what most of us already know but interestingly also, the fact that a high CD4 cell count (which we all use as a measure of immune system health) can be a possible cause of neuropathic pain. Not really what we want to hear when we're spending every waking minute trying to boost that very cell count. The article suggests that it may be a consideration when deciding whether to start anti retroviral treatment in the first place. Considering that the current thinking is that it's better all round, to start as soon as possible, the dilemma is obvious. On the other hand, there's not really much of a choice is there? The medication which halts viral development is more or less essential and for some people, the pain may be an unwelcome but necessary by-product.

Debilitating HIV-associated sensory neuropathy remains common
20/05/2010

Debilitating sensory neuropathy remains prevalent in HIV-infected patients, despite a general decline of neurological complications with use of combination antiretroviral therapy.

This finding is from a study in which the researchers tested 1,539 HIV-infected individuals for clinical signs of neuropathy and neuropathic pain.

"We were surprised by the high prevalence," lead author Dr. Ronald Ellis of the University of California, San Diego, told Reuters Health by e-mail.

"Painful neuropathy frequently persists and requires ongoing management," even when antiretroviral therapy has reduced viral load and restored immune function, he said.

In the May Archives of Neurology, Dr. Ellis and colleagues report that 881 patients (57.2%) had HIV-associated sensory neuropathy, and 335 of those 881 (38.0%) had neuropathic pain.

"Neuropathic pain was significantly associated with disability in daily activities, unemployment, and reduced quality of life," the investigators say.

Patients currently taking combination antiretroviral therapy had an adjusted odds ratio of 1.60 for clinical signs of sensory neuropathy, compared to past users or never users of antiretroviral combinations.

Age (aOR 2.13), past use of stavudine, didanosine, or zalcitabine (aOR 1.95), and lower CD4 nadir (aOR 1.16) were also associated with sensory neuropathy.

Paradoxically, neuropathic pain was associated with a higher CD4 nadir, as well as with past use of stavudine, didanosine, or zalcitabine.

In an editorial, Drs. Dennis Kolson and Francisco Gonzalez-Scarano, both of the University of Pennsylvania in Philadelphia, said the "association between neuropathic pain and a higher CD4 nadir suggests that a functional immune system may contribute to the induction of pain." They also suggest considering the risk of neuropathy - and the disability that results -- when deciding whether to start antiretroviral therapy.

Regarding potential for peripheral nerve regeneration and recovery, Dr. Ellis told Reuters Health, "It may be that treatments can be designed to enhance regeneration. Alternatively, we may find that earlier HAART therapy using agents without neurotoxicity can protect individuals from developing neuropathy in the first place."

By Dave Levitan
Medscape Today

http://eatg.org/eatg/Global-HIV-News/Treatment/Debilitating-HIV-associated-sensory-neuropathy-remains-common

Mercury Can Cause Nerve Damage Vid

Today's post from docotrrainey.com (see link below) is an interesting one, including a video, about the potential for mercury causing neuropathy. Now you may not immediately think that you're in any danger of absorbing mercury into your system but dental fillings, chemical wastes, pesticides and even vaccines can introduce mercury into your body. Amongst other toxic effects, mercury can attack your nervous system and cause significant nerve damage. There are ways to neutralize any mercury in your system, by eating foods rich in sulfur (see list in the article). An interesting read but remember you have to look at everything you read in perspective and look at your own personal circumstances to see if there's a risk.
 

Mercury Toxicity – Beware! It can deteriorate your neurons. 

According to the Environmental Protection Agency (EPA), Mercury can destroy your digestive system, cause mood swings, irritability, muscle weakness, skin rashes, memory loss, central nervous system damage, and the list goes on. This list does not list all the damage that Mercury can cause to the body, but it gives you a brief overview and can be viewed here: http://www.epa.gov/hg/effects.htm

Please view this week’s video about Mercury. If you are unable to view the video, the text can be viewed below in its entirety. When you are done, be sure to watch the video from Calgary University by clicking here http://www.youtube.com/watch?v=BtFsy0rQsak . This video is the coolest in cutting edge medical technology. 

 


Transcript:
Hello, I’m Dr. Ian Rainey with your weekly health tip. This week we are going to talk about Mercury, not to be confused with the planet. Mercury is an element. In fact, it is one of the most toxic substances on Earth and it has many negative effects on the body. Because of this, it has become what many call the great mimicker of many health conditions. It can damage the immune system and the reproductive system. It can also inhibit neurological and cardiovascular health. This video will provide information about the sources of mercury exposure, potential health effects, how to eliminate Mercury and ways to reduce your exposure to mercury.

Sources of mercury include: dental amalgam fillings, hazardous waste, vaccines, pesticides, shellfish, and coal burning power plants

Here are some the things you should know about mercury toxicity.

Mercury is known to denervate nerve fibers. This works in a similar fashion to the way the multiple sclerosis. Essentially, it makes it so the nerves cannot do their job.

Mercury can leak into the blood brain barrier. Not many things can. That is what makes it so toxic and difficult to remove. Once this happens the nerves lose their ability to conduct information and create visual responses.

Mercury can cause depression. It does this by binding to the hormones that make you happy, such as serotonin.

Mercury can cause hearing loss.

Mercury can change your emotions. It does this by decreasing norepinephrine and dopamine activity. This will make you lose excitement and joy for life.

Mercury can cause peripheral neuropathy autoimmunity, recurring sinus problems, prostate issues and gum infection.

Mercury is also at the root of many undiagnosed patients who have chronic fatigue and fibromyalgia. One of the most common ways that a patient presents with Mercury toxicity is with a terrible burning sensation and pain that seems to migrate to different areas.

All of these symptoms resemble nerve damage. But the medical community looks for nerve damage with things like EMG’s, nerve conduction tests and MRI’s. You are never going to find any mercury toxicity with these tests.

As a result, out of confusion and an inability to find the solution, health professionals begin diagnosing things like erythromelalgia, fibromyalgia, idiopathic pain syndrome and neurosis.

Out of this confusion came an answer. We now are able to test for mercury toxicity in the body with a simple urine test. I do offer this test for patients who exhibit many of the signs of mercury toxicity.

So now you may be wondering what you can do to reduce the mercury load on your body. You should eat foods that are high in sulfur. This would include things like kale, horseradish, collards, cilantro, watercress, cabbage and broccoli. You should also include foods that have cysteine. This includes oats, chicken and red peppers because they contain metallothionein. Metallothionin is a natural chelator that will help eliminate mercury from the body. Even chlorophyll is a natural chelator! So don’t forget to eat your green veggies.

If you can’t seem to stomach all of these foods, there are special vitamins and supplements that combine the best of all natural chelators to help you eliminate the mercury in your body. Those are available at my office or at the Good Earth.

I want to thank Joe Buishas and and Dr. Ron Grisanti for providing material, as well as the University of Calgary for the video explaining how Mercury causes nerve damage to the brain. Please watch this extra video if you have the time. It is amazing to see how Mercury actually destroys your nervous system. http://www.youtube.com/watch?v=BtFsy0rQsak

http://www.doctorrainey.com/weekly-health-tip/mercury-toxicity-beware-deteriorate-neurons/

Can Doctors Feel Your Pain

Today's interesting post from healthland.time.com (Time: Health and Family, see link below) talks about whether doctors truly can empathize with their patient's pain. Many people living with neuropathy get the impression that their doctors are responding more from the text book to their symptoms, than from genuine sympathy and understanding and may even feel disbelieved, or that they are overreacting. This article shows that that may not be true at all and that doctors understand our pain better than we think.

Can Doctors Feel Their Patients’ Pain?
By Alexandra SifferlinJan. 30, 2013


A study shows physicians may care more than you think about their patients’ pain.In spite of studies showing that the relationship between a doctor and patient can influence healing, the interaction isn’t known for its expressions of outward empathy. But a new study takes a closer look at the biology of the exchange and found some revealing surprises.

Using brain scans, researchers from Massachusetts General Hospital (MGH) and the Program in Placebo Studies and Therapeutic Encounter (PiPS) at Beth Israel Deaconess Medical Center/Harvard Medical School showed that that when doctors believe they are treating patients, they can feel their pain and also empathize with their patients’ relief after the treatment.

In the study, published in the journal Molecular Psychiatry, 18 doctors simulated treating a patient while in a functional MRI (fMRI) scan. They used what they believed to be an electric pain-relieving device on two female actors pretending to be patients.

(MORE: White Coats, White Lies: How Honest Is Your Doctor?)

To convince the doctors that they were relieving the patients’ pain, the study authors gave each doctor a dose of “heat pain” to their forearms and then simply reduced the amount of heat when they touched them with the fake pain relieving device, therefore simulating treatment. While they were being tested, the researchers scanned the doctors’ brains to see which regions reacted to the heat pain stimulation.

Each doctor was then introduced to one of the patients, and performed a standard clinical examination. The doctor and patient then moved into a room with the scanner where the doctors were provided with a remote control that could activate the pain relief device. The room contained mirrors so the doctor could maintain eye contact with the patient, who was hooked up to both the heat pain stimulator and the pain relief device.

The doctors, who were in the fMRI machine, were then instructed to either treat the patient’s pain or press a control button that provided no relief. The doctors watched the facial reactions of their patients as they “felt” pain and when they felt relief. Throughout the experiment, the researchers image the brains of the physicians.

(MORE: Reality Strikes: A Doctor-In-Training Encounters Her First Patient)

The researchers focused on two parts of the brain connected to pain perception: the right ventrolateral prefrontal cortex (VLPFC) and the rostral anterior cingulate cortex (rACC). The VLPFC region is associated with pain relief and the rACC region is associated with reward. Both regions generally become more active when patients undergo placebo therapies, or think they are receiving benefit of some kind. The researchers found that these same areas were activated in the doctors’ brains when they thought they were providing effective treatment.

That’s in line with previous research on the placebo effect, which shows that belief in an effect can activate brain responses. The results are the first, however, to implicate the placebo effect in physicians who connect with their patients, and may provide new insight into the biology of caregiving. “This is a scientific-centric medical system. Unfortunately it is not as human-centered as we want it,” says senior author Ted Kaptchuk, associate professor of medicine at Harvard Medical School and director of the PiPS at Beth Israel Deaconess Medical Center in Boston. “One of the things we are seeing is that these intangibles that we call ‘the art of medicine’ are just as tangible and important as the tricks in the black bag.”

(MORE: Can Patients Handle the Truth? Getting Access to Doctors’ Notes)

The study is reassuring in that way, since it potentially provides a foundation on which physicians can build a more understanding relationship with their patients, which will ultimately make them better physicians.

It may even be possible, says Kaptchuk, to find a biological model for high quality care. He hopes to repeat the study and take simultaneous brain scans of both patients and their doctors. “We are actually in a position that at some point, maybe we can measure the provision of care between a physician and patient,” he says. “That will allow us to actually model and develop and actually educate optimal provision of care. This is a study that has potential in those directions. We see this an a really interesting first step. It certainly doesn’t answer all the questions, but it’s a first step that no one has ever taken before.” And one for which patients are grateful.

http://healthland.time.com/2013/01/30/can-doctors-feel-their-patients-pain/#ixzz2JTN7mz4r

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