Can Fish Oil With Omega 3 Help With Neuropathy

Today's post from newswise.com (see link below) looks at the potential benefits of fish oil containing omega 3 fatty acids for people suffering from nerve damage. It has been found that the omega 3 fatty acids improved nerve health in terms of density and sensory signal transmission in rats. Now if these results can be successfully applied to humans then we have a cheap and relatively harmless, easily produced supplement which could really help neuropathy patients restore some normality to their nerve reactions. It's all still at the research stage but the science and potential seem solid. In the meantime, supplementing your diet with fish oil (plus omega 3) is not bad advice anyway unless your diet is already enriched with fish products.

Fish Oil May Help with Diabetic Neuropathy Released: 6-May-2015 4:05 PM EDT
Source Newsroom: American Physiological Society (APS)

Newswise — Bethesda, Md. (May 6, 2015)—Approximately 50 percent of patients with diabetes suffer from nerve damage, or neuropathy. No cure exists, and the most effective treatment, keeping blood sugar in control, only slows neuropathy. A new study in the Journal of Neurophysiology, however, introduces a new alternative, omega-3 fatty acids found in fish oil. The study shows that fish oil supplements can restore the condition of nerves damaged from diabetes in mice.

“Diabetic neuropathy is a very costly and debilitating complication of diabetes. It is the leading cause of foot ulcers and nontrauma-related amputations, and the impact of diabetic neuropathy on the patient and family are unmeasurable,” said Mark Yorek of the VA Medical Center in Iowa City, the study’s lead investigator. Fish oil is an attractive treatment approach because “supplements are considered very safe and could be easily translated into everyday care. Fish oil would be easy to take, like a vitamin, and should have few side effects when combined with other medications,” explained Yorek.

Previous studies of obesity and diabetes have reported better blood sugar handling, liver function and reduced inflammation with omega-3 fatty acids treatment. The health benefits were attributed to protective molecules produced from omega-3 fatty acids, including one type called resolvins. The research group had previously observed that diets enriched with omega-3 fatty acids from fish oil improved diabetic neuropathy in rats with Type 1 and Type 2 diabetes, and in this new study they examined why.

Researchers used a mouse model of diabetes to study the effect of fish oil. Diabetic mice were fed a high-fat diet and treated with daily injections of resolvin or given a high-fat diet in which half the fat came from fish oil. The results were compared to healthy, non-diabetic mice.

The researchers found that untreated diabetic mice had diminished sense of touch in their paws that corresponded to fewer nerves in the paw’s skin and slower transmission of signals along the nerves. The eyes of untreated diabetic mice also had fewer nerves. Though dietary fish oil and resolvin did not lower glucose levels closer to healthy range, they improved nerve health in terms of density and sensory signal transmission. The researchers also observed that resolvin stimulated nerve cells to grow.

“Even though a lot more work needs to be done, including clinical trials with human subjects, our animal studies suggest that fish oil can reverse some of the harmful effects of diabetes on the nerves. Our intent is to do more animal studies to demonstrate that fish oil treatment can reverse the harmful effects of diabetes on nerves even after a long period of poorly controlled diabetes. After completion of this work, we hope to begin studies with diabetic patients with neuropathy,” Yorek said.

The article “Effect of enriching the diet with menhaden oil or daily treatment with resolvin D1 on neuropathy in a mouse model of Type 2 diabetes” is published ahead-of-print in the Journal of Neurophysiology.

NOTE TO JOURNALISTS: To schedule an interview with a member of the research team, please contact Maggie Kuo at mkuo@the-aps.org or 301-634-7253.

About the American Physiological Society (APS)
Physiology is the study of how molecules, cells, tissues and organs function in health and disease. Established in 1887, the American Physiological Society (APS) was the first U.S. society in the biomedical sciences field. The Society represents more than 11,000 members and publishes 14 peer-reviewed journals with a worldwide readership.

http://www.newswise.com/articles/view/633928/

URINE TEST COULD HELP SPOT BLOOD CLOTS

A new study by researchers from California and Canada indicates a simple urine test can indicate the presence of venous thromboembolism, a blood clot that has broken free from its point of origin and which travels through the bloodstream, eventually lodging in a vein. The test evaluates the levels of fibrinopeptide B (FPB), a small peptide that's released when a thrombosis forms and which is removed from the body through urine

The results of the study will be presented at the American Thoracic Society's 2014 International Conference here.

Study lead author Timothy Fernandes, M.D., M.P.H., said the study was developed based on the results of a pilot trial that suggested that urine FPB levels could be used as a screening tool for venous thromboembolism in patients at risks for clots. "The urine FPB test offers advantages over other screening methods because it doesn't require blood to be drawn and it can provide more accurate results than the D-dimer test," Fernandes said.

The D-dimer test looks for blood evidence of a protein fragment called D-dimer that is present in the blood after a clot begins to break down. The FPB test has the potential for greater specificity because it can reflect ongoing clot activity, while D-dimer can only be measured once a clot has already become degraded.

"During our study, we validated the sensitivity, specificity and likelihood ratios for several diagnostic thresholds of urine FPB using stored urine samples from the Fernandes said.

The researchers used stored urine samples taken from 344 patients who participated in the Pulmonary Embolism Diagnosis Study (PEDS), a multicenter study of 1,417 patients considered likely to have an acute pulmonary embolism. For all urine samples, the researchers measured the FPB concentration and evaluated the sensitivity and specificity of the test at various cut-off points in relation to its ability to predict the presence of venous thromboembolism.

What they found was at concentrations of 2.5 ng/ml, urine FPB demonstrated sensitivity comparable to previously published values for plasma latex and whole blood D-dimer levels, but with greater specificity.

"The results of our study indicate that urine FPB tests may be a useful complement to current biomarkers such as D-dimer to measure for the presence and activity of venous thromboembolism," Dr. Fernandes said. "As an addition to other types of testing, FPB urine provides greater specificity and doesn't require a blood draw, which can be a major boon to patients."

The patent for the urine fibrinopeptide B test is held by the University of California Board of Regents. Dr. Fernandes and his co-authors plan on developing a urine dipstick test for FBP that could be quickly and widely applied.

Future studies are planned to assess urine fibrinopeptide B in other settings where D-dimer is used including use of urine fibrinopeptide after anticoagulation to determine the risk of recurrent venous thromboembolism.

Can Botox Help Neuropathy

Today's post from painresearchforum.org (see link below) looks at an issue that fascinates almost everyone from scientists to patients alike and that is whether Botox can help reduce neuropathic pain in humans. It was found that Botox can have a positive effect on people suffering from migraines but despite extensive research, the scientists can't establish why. However, extrapolating the science, it seems that Botox injected elsewhere in the body may have an equally beneficial effect on painful peripheral nerves - hence the hope that it can help people living with neuropathy. There have been whispers for years about Botox being a possible treatment but it has never translated to mainstream medical thinking. Now it looks as though it at least needs to be taken seriously as an option. You may need a dictionary of modern molecular biology to read this article (nothing more guaranteed to keep the public out of the picture than creating a whole new language!) but you will certainly get the gist of what's going on and opening the discussion with your doctor or neurologist may provide more information and tell you at what stage the whole investigation is at. Interesting!

Botulinum Toxin Targets Mechanosensitive Nociceptors
Results provide hints about analgesic effects in migraine, other pain conditions
by Stephani Sutherland on 1 May 2014


Botulinum toxin type A (BoNT-A), a potentially deadly, muscle-paralyzing neurotoxin, has been famously repurposed to smooth out facial wrinkles, relax muscle spasms, and, recently, to treat headaches associated with chronic migraine. Despite intense ongoing study of BoNT-A for migraine and other pain conditions including osteoarthritis and peripheral neuropathy, researchers are still mostly mystified by the question of how the toxin stops pain. Two papers now show that BoNT-A selectively pacifies sensory neurons that detect mechanical pain in rodents and humans.

The first paper, published April 8 in Cephalagia, comes from Rami Burstein and colleagues at Harvard Medical School and Beth Israel Deaconess Hospital in Boston, Massachusetts, US, in collaboration with Allergan, Irvine, California, US (the maker of onabotulinum toxin A, marketed as BOTOX®). Burstein’s group found that BoNT-A specifically reduced neural responses to painful mechanical stimuli in both naïve and sensitized peripheral trigeminal nociceptors in rats.

“This study is the first to test BoNT-A effects on nociceptive neurons believed to mediate migraine headache,” wrote Andrew Russo in an editorial accompanying the research report (Russo, 2014). “As such, it takes us a step closer to understanding how this therapy may benefit migraine patients,” wrote Russo, a neuroscientist at the University of Iowa, Iowa City, US.

The headache component of migraine is thought to stem, at least in part, from activation of pain-sensing neurons of the trigeminovascular system, which innervate the meninges and its associated blood vessels surrounding the brain. To look at the effect of BoNT-A on those neurons, Burstein and collaborators made electrophysiological recordings from sensory neurons in the rat trigeminal ganglia while stimulating the exposed meninges with mechanical probes. Nearly half of small, unmyelinated C-fiber nociceptors became less sensitive to pain-inducing mechanical stimulation following application of BoNT-A, but the toxin did not affect cells’ responses to non-noxious mechanical stimuli.

Researchers believe that trigeminal neurons in migraine become sensitized the same way they do in other inflammatory conditions—via release of inflammatory molecules that amplify nociceptor signaling. To recapitulate that sensitization, the researchers doused the dura with a cocktail of inflammatory mediators. Spontaneous and mechanically evoked neuronal activity increased significantly following application of the cocktail; this hyperactivity was reduced back toward baseline levels after BoNT-A treatment. The toxin also worked prophylactically; pretreatment of the dura with BoNT-A prevented the increased spontaneous activity and sensitization to high-intensity stimulation in C-fibers, but again did not affect responses to non-noxious mechanical stimuli.

Together, the results indicate that BoNT-A specifically reduces high-threshold mechanical transduction in both naïve and sensitized C-fiber nociceptors. “It blocks one thing,” said Burstein, “the ability of the nerves to be activated by mechanical pain.”

That raised an anatomical question, said Burstein: “How can a drug that you inject in the scalp—outside the skull—interact with pain fibers inside the head?” Burstein’s group previously showed that trigeminal pain fibers extend nerve endings that exit the cranium through the sutures, tiny fissures between skull bones (Kosaras et al., 2009). To see whether the toxin targeted these extracranial pain fibers, the researchers applied BoNT-A outside the sutures. As with the dural application, extracranial BoNT-A did not change neurons’ spontaneous activity but assuaged their responses to strong extracranial mechanical stimuli. This suggests that BoNT-A could act, at least in part, directly on extracranial afferents.

But there may be other routes for the toxin to affect trigeminal pathways. In a recent PRF webinar, speaker Andrew Charles, University of California at Los Angeles, US, and panelists Russo, Robert Shapiro, and Gregory Dussor discussed the Burstein paper. Dussor, University of Texas at Dallas, US, said, “New studies show that BOTOX does not stay in the location where it is injected, but that it might actually move throughout the nervous system—even trans-synaptically.” So in addition to working at peripheral nerve endings found outside the skull, BoNT-A may also be transported back to the CNS and possibly to other neurons as well, he added. (See Dussor’s comment, below for further discussion.) Shapiro, University of Vermont, Burlington, US, also pointed out that BoNT-A’s enzymatic activity likely persists long after it has moved to new locales, perhaps cleaving protein targets along the way (see PRF related webinar discussion of BoNT-A starting at 1:16).

BoNT-A quiets human nociceptors, too

In a second paper, published February 18 in Annals of Neurology (Paterson et al., 2014), David Bennett at the University of Oxford, UK, and collaborators including co-first authors Kathryn Paterson at King’s College London and Stéphane Lolignier at University College London, UK, showed that BoNT-A could selectively and persistently block mechanical pain sensation in the skin of healthy human volunteers. In the study, 24 subjects received a weekly injection of BoNT-A in one leg and saline in the other. Quantitative sensory testing revealed that BoNT-A treatment blunted mechanical pain but left temperature and non-painful mechanical sensations intact. Subjects also reported less itch and pain in response to topical application of histamine and allyl isothiocynate (AITC; a pain-evoking chemical), respectively, in the BoNT-A-treated leg compared to control. Bennett’s findings indicate that BoNT-A selectively reduced mechanical pain sensitivity.

To determine if BoNT-A may target mechanical pain throughout the peripheral nervous system and in particular sensory neuron function, the group looked at the effects of the toxin on electrophysiological responses of cultured rat dorsal root ganglia neurons. BoNT-A did not change basal neuronal excitability, but fewer neurons displayed a slowly adapting, mechanically sensitive ion current in treated compared to control cultures. Other mechanically activated currents were unaffected, mirroring the team’s psychophysical findings in humans.

Both groups concluded that BoNT-A might affect an ion channel that transduces high-threshold mechanical stimuli in nociceptors. Together, Bennett told PRF in an email that the findings “provide a novel locus of action for this agent,” albeit a mysterious one. “We are still awaiting confirmation as to the molecular entity mediating noxious mechanosensation in mammals. Piezo proteins are important candidates, although the currents mediated by these channels are reported to be rapidly adapting (as opposed to the slowly adapting currents we were recording). This is a rapidly moving area, and we are eagerly awaiting the results of gene knockout studies to clarify this point,” Bennett added.

Bennett wrote, “We [and Burstein] both found that BoNT-A had a delayed effect in reducing the response to noxious mechanical stimuli.” Because of that delayed response—which took hours to develop in the rat and emerged over several weeks in the human study—the scientists concurred that BoNT-A probably does not immediately affect channel function, as some toxins do, but instead, they speculated that it may affect delivery of a mechanosensing protein or proteins to the cell membrane (for more, see comment below from Dussor).

That fits with botulinum toxin’s known mechanism of action, which is to interfere with fusion of synaptic vesicles with the plasma membrane, a key step in both neurotransmitter release and membrane protein trafficking. The idea also jibes with growing evidence for regulated subcellular translocation of TRP channels and other proteins as a driving force for nociceptor sensitization, and pain hypersensitivity.

“I think that is a real, attractive possibility,” said Russo during the PRF webinar, “and an area of cell biology that has been overlooked. There is a lot of room for botulinum toxin to act on cell mechanisms that would affect receptor localization, which would lead to plasticity and potentially cause chronic pain,” he suggested.

Many questions remain about the mechanism of action and selectivity of BoNT-A on mechanosensitive nociceptors. Paradoxically, the lethal toxin may give new life to studies on regulated protein trafficking in chronic pain and possibly offer a novel route to stopping some kinds of pain.

Stephani Sutherland, PhD, is a neuroscientist, yogi, and freelance writer in Southern California, US.

http://painresearchforum.org/news/40155-botulinum-toxin-targets-mechanosensitive-nociceptors

Can Chiropractic Techniques Help With Neuropathic Problems

Today's post from diabetesnewsjournal.com (see link below) addresses the perennially thorny topic of whether chiropractitioners can be of help to neuropathy sufferers. It's fair to say that 9 out of 10 neurologists will dismiss this idea with a snigger but there are many cases of nerve damage patients being helped by chiropractic techniques but it may depend on the cause of the nerve damage and whether that can be helped directly. At least this article doesn't claim that chiropractic care can 'cure' neuropathy; it makes a claim for this sort of care to be an element in an overall strategy. If you see chiropractic clinics offering 'cures' for nerve damage, please ignore them and don't waste your money or run the risk of further damage. These clinics, or so-called medical practitioners can not provide a cure - there is no cure - end of argument. However if a chiropractioner offers his or her services as part of a wider treatment strategy, it may be worth discussing it with your home doctor or neurologist. Remember though, if you're paying for this treatment, you need to be convinced that it will help.

Chiropractic Care May Help Control Peripheral Neuropathy in Diabetics
March 17th, 2015 Leonor Mateus Ferreira 

While about 60% of patients who suffer from diabetes also develop peripheral neuropathy, a nerve condition that causes tingling, numbing and tickling in the extremities, the Raveling Chiropractic Center is implementing a new technique to treat the disease. According to the center, chiropractic care may offer several benefits to treat the disorder.

Chiropractor Paul Raveling administers chiropractic care at his center with patients who suffer from peripheral neuropathy to help with the management of pain as well by treating the underlying cause. In addition to pain and numbness, the condition can include a variety of other symptoms such as prickling and throbbing or a freezing sensation. In addition, it can also damage the brain’s capacity to communicate properly with regions of the body.

“Chiropractic care is an effective treatment for peripheral neuropathy because it targets the root cause for a patient’s pain symptoms; we do not simply rely on medication to numb this pain,” explained Raveling in a press release. “While chiropractic care is not a ‘cure’ for peripheral neuropathy, it is an important part of an effective treatment program.”

“Treatment programs that cover up the symptoms are ignoring the bigger problem. As a chiropractor, I follow a ‘whole body’ approach to treatment, which means we start by addressing the underlying trigger for a patient’s pain,” he continued, explaining that a diagnostic exam is conducted in order to identify the cause of the pain and understand which specialty of care is needed in addition to chiropractic care.

The chiropractor believes that early diagnosis and treatment may reduce the severity of the motor nerve and sensory nerve damage, as well as help patients with the management of the disease. In addition, Raveling noted that the pain symptoms associated with peripheral neuropathy indicate poor health conditions and need to be evaluated carefully.

Peripheral neuropathy is a condition often associated with diabetes, despite the fact it can also be caused by autoimmune disorders, tumors, nutritional imbalances or infections, and it can even be hereditary. The nerve disorder currently affects about 20 million people in the United States, according to the National Institute of Neurological Disorders and Stroke, and while the symptoms may seem unimportant, early diagnosis may prevent further complications.

“Everyone experiences peripheral neuropathy a little differently. For some individuals, the pain may come and go, while for others, the pain may be constant. As the condition worsens, individuals may experience coordination and balance loss, along with a freezing pain, muscle weakness or extreme sensitivity to touch. I urge anyone who may be experiencing these symptoms to seek immediate treatment,” added Raveling.

The University of Kansas and Irving-based company Reata Pharmaceuticals have also recently established a partnership to develop drug technologies discovered by a professor of medicinal chemistry Brian Blagg and professor of pharmacology and toxicology Rick Dobrowsky. These compounds, called “novologues,” are expected to become a treatment option for diabetic peripheral neuropathy as well.

http://diabetesnewsjournal.com/2015/03/17/chiropractic-care-may-help-control-peripheral-neuropathy-in-diabetics/

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/

Doctor Patient How To Better Help Yourself

Today's post from online.wsj.com (see link below) looks at how the health care industry is exploring new ways of getting patients more involved in their own care. It's maybe not surprising that in these days of universal cut-backs, that this sort of idea is gaining ground - it's more cost-effective. Patients are pretty fed up with being burdened with yet more responsibility for the sort of care they've always taken for granted but nevertheless, there are some good ideas here. This blog has always encouraged people living with neuropathy to take more responsibility for their lives with the disease. That can mean anything from making detailed lists of symptoms, dates etc before going to the doctor, to doing as much research as possible to create a partnership with the doctor, thus achieving the best possible care. Neuropathy is not a disease that plays by the book, so the more we know and understand, the better we can deal with it. Certainly worth a read to see if anything might strike you as a good idea for your own situation.

The Health-Care Industry Is Pushing Patients to Help Themselves
Providers are Using Tech Tools and Personalized Approaches to Get Patients More Engaged

By Laura Landro
C.J. Burton June 8, 2014 4:54 p.m. ET

It's the last mile in the race to fix health care—getting patients more involved.

Hospitals, doctors and public-health officials are pushing patients to keep track of their medical data, seek preventive care and stay on top of chronic conditions. They're measuring how motivated patients are to manage their own health and adopting a wide range of strategies to help them do better, a concept known as patient engagement.

The federal government, for instance, is promoting new initiatives to give millions of Americans access to their medical records online, so patients can use them to better manage their health. Providers, meanwhile, are mining those records to find patients who aren't compliant with their regimens or missing preventive care, and nudging them to take action. And new mobile applications help clinicians keep a closer eye on patients' progress in things like diet and exercise.

Driving this effort is a pressing shortage of doctors that leaves medical teams scrambling to provide the care patients need, even as more people develop chronic conditions like diabetes that need regular attention. Meanwhile, costs are soaring, and the choices patients face over insurance coverage are getting more complex and demand much more informed decisions.



Studies show that more-engaged patients have lower costs and better health outcomes. When more engaged with care, patients and families can help prevent drastic mistakes or oversights, such as identifying a wrong drug or dose they get from the pharmacy or notifying a doctor about a strange medication side effect, according to the National Patient Safety Foundation. But the vast majority of Americans, the nonprofit group warned in a recent report, "remain relatively uninformed and passive recipients of health care services and thus lack the confidence and skills needed to fully engage in their health care."

The More You Know

The Institute of Medicine, which cited patient engagement as key to an effective health-care system in a 2012 report, urged doctors to use technology to fill the gap.

One basic step is making sure people have easy access to their medical records online, so they can do things like check their data to make sure it's accurate and all their doctors have the same information. Some providers are offering after-visit summaries and providing patients with access to their doctor's notes about them.

Becoming familiar with one's own health records can help patients better understand their own condition and have more informed conversations with doctors, says Lygeia Ricciardi, director of the Office of Consumer eHealth in the federal office of the National Coordinator for Health Information Technology. And with the flood of new fitness and health apps, consumers can plug in data from their own medical record, such as generating a fitness regimen that takes into account a knee injury, weight and blood pressure. "Getting access to personal health information is the start of engaging patients to be full partners in their care," she says.

 

The federal information-technology program is promoting expansion of the Blue Button connector, a program that securely provides health records to patients online. Launched in 2010 as a link on the Veterans Health MyHealtheVet website, Blue Button lets veterans create a single file with all their personal health data. Last year, the VA significantly expanded the types of information available, including lab results, doctors' notes, problem lists and wellness reminders; more than 974,000 unique users have downloaded more than 6 million files.

The Centers for Medicare and Medicaid Services is now using a Blue Button connector to make health-claims data available to Medicare beneficiaries, as are the Defense Department and Indian Health Service. Payers including Aetna Inc. and Humana Inc. offer a Blue Button link that lets members download personal health records into a single file, and retail pharmacy chains are in various stages of using Blue Button to let customers download prescription histories. Combined, Ms. Ricciardi estimates Blue Button participants reach about 170 million Americans.

But many consumers aren't aware they can download records, or understand how they can be helpful, says Kyra Bobinet, co-instructor for a Patient Engagement and Design course at Stanford University's medical school. Dr. Bobinet, who also has a consulting firm, engagedIN, helped improve the design of the Blue Button website to make it more user-friendly and helped with the messages for a consumer-awareness campaign about Blue Button to be launched this fall. The effort includes ads that say, "Ever forgotten a tiny detail? What if your life depended on it?"

Providers have incentives to help patients pay more attention to their medical records. To qualify for federal funding to help them replace paper files with electronic records, doctors must meet requirements to show "meaningful use" of the technology—including engaging patients and families in decision making and providing them with their health records and clinical summaries they can view, download and share with other doctors. The meaningful-use requirements also specify a percentage of patients must actually use the information, which gives doctors a reason to encourage them to do so.

"If your doctor says, 'Hey, have a look at your records,' you are more likely to actually do it," Ms. Ricciardi says.

Tailoring the Information

Beyond letting patients see their medical records, health-care providers are making efforts to give them specially tailored information and tools that help them change their behavior.

"Personalization is a key factor in engaging patients in their health and keeping them motivated to maintain healthy behaviors," says Joseph Kvedar, director of the Center for Connected Health at Boston-based Partners Health Care System Inc., which includes Brigham and Women's Hospital and Massachusetts General Hospital, both affiliated with Harvard Medical School.

The center last year launched a website, Wellocracy, to help people wade through the flood of health trackers and mobile apps on the consumer market, to figure out which technology best suits their personality, motivation and health goals. The center also is working on a number of programs that use technology to help patients manage chronic conditions and maintain wellness.

Blood Pressure Connect allows patients to measure their blood pressure from home, using a cuff with a Bluetooth radio and a device that captures the signal and sends it into a secure data repository. Providers can then review the data. In a 2012 study of 219 patients, all were able to decrease blood pressure significantly despite wide variation in age and type of medications.

"People who are disengaged in their health are the toughest group to manage and indeed account for a disproportionate share of health-care costs," says Dr. Kvedar. "Our eventual goal is to get their attention and then use our personalized messaging apps and tools to keep them engaged."

The center's researchers are evaluating other programs, including movement-tracking videogames to help in rehabilitation after orthopedic surgery and highly personalized text messaging based on sophisticated software algorithms to help smokers kick the habit. For example, users can send an inbound text like the word "crave" and the system will return information that helps them deal with their hunger for a smoke. Another text-messaging-based program being studied helps improve activity levels in patients with diabetes.

At Mass General's Charlestown HealthCare Center, primary-care physician Rajani LaRocca provided a fitness tracker for a group of patients aged 59 to 70 with diabetes last year who met weekly for six weeks to walk and get counseling on how to live a healthier lifestyle. While wearing trackers, the patients increased activity, Dr. LaRocca says. Some lost a significant amount of weight and kept it off, and more than half still use the tracker.

Even though Dr. LaRocca went the extra mile, walking with patients herself some days, "as doctors we are only with our patients for a short amount of time, while they have to keep up these behaviors every day," she says. "If we can get people engaged and energized and empowered, things are only going to get better."

Laura Jennings Cranford, 72, participated in the program, and says it has helped her with a continuing struggle to lose weight and keep up exercise. Data from the tracker was uploaded to her medical record, where she could view it online. "Once you start seeing the numbers, you begin to think you can do more by taking an extra walk around the block," she says. "It really got me moving."

Walking Them Through

Another way to keep patients engaged is personalized information and advice. More than a decade ago, Healthwise Inc., a nonprofit in Boise, Idaho, pioneered the idea of doctors writing "information prescriptions" in the form of a video, brochure or interactive decision tool to help patients better deal with a health problem. Chief Executive Don Kemper says new technology has helped make it easier "to get each patient just the information they need, at the time they need it and in a way they will trust and use it."

About 15% of practicing physicians in the U.S. now deliver information prescriptions created by Healthwise through their electronic medical record, including links that connect patients to an online health encyclopedia to learn more about their own health issues.

For example, doctors who are too busy to go over medication issues with patients in detail can prescribe an online program called "Beta-Blockers to Prevent Another Heart Attack," which helps patients understand how the drugs work and why it is important to keep taking them. Healthwise also is piloting the use of automated phone calls with interactive voice-response technology that prompts patients to answer questions such as whether they are having a problem after a hospital discharge, so staff can intervene.

To help make educational programs for diabetics more fun, Healthwise created Oscar, a character that walks people though various scenarios they may run into while trying to manage the condition—such as being at a picnic and being offered a sugary dessert by an aunt they don't want to offend. Participants post comments online discussing choices Oscar might have made.

Patients are also sent daily text messages or emails, and are required to review a health video or article and share what they learned from it, as well as report on the progress they are making with a goal for the week.

Jo Diamond participated in a Healthwise study testing the approach in the Dallas area last year. Diagnosed with diabetes 17 years earlier, she says she lived in denial of it for a decade, gaining weight and changing doctors every few years, often dealing with spiking blood-sugar levels and depression. Through her job at a package courier service, she signed on for the study, enjoying the online discussion about Oscar's options and the ability to communicate with other patients.

"It helped me to really take note of where I am in the diabetic stage and what I need to do to improve myself," she says.

Ms. Landro is an assistant managing editor for The Wall Street Journal in New York and writes the Informed Patient column. She can be reached at laura.landro@wsj.com.

http://online.wsj.com/articles/the-health-care-industry-is-pushing-patients-to-help-themselves-1402065145

How To Help Problems With Standing If You Have Neuropathy

Today's short post from paincommunity.org (see link below) gives some practical tips for people who find standing for long periods of time both uncomfortable and painful (almost all neuropathy sufferers). In this case the advice applies to the kitchen. Worth a quick read.

TPC Comfort Cookin’ – Stand Your Ground: Comfortably
Posted by Janice Reynolds | February 11, 2014

Do you find that standing for any length of time can be difficult? Does that keep you from spending time in the kitchen cooking your favorite meals? I find that when your feet or hands hurt, your overall pain may worsen.

Tip #1: Look at what is under your feet.
One thing that can help is strategically placing a thick area rug in the kitchen. I highly recommend that it has a no skid backing and that the edges that do not roll up (which I have in my work area) or better yet–a gel mat. These can be found in stores or online by names such as “comfort “mat, “anti-fatigue” mat and “wellness” mats. They are widely available, in a variety of sizes as well as price ranges from low-cost to expensive. User reviews indicate that they have been helpful for back pain, a variety of foot problems, joint problems, and fatigue. I know when my rug has been taken up for cleaning that I notice the difference immediately.
Tip #2: Look at what is under your bum.
For those longer periods of time (like doing prep work) when it is really difficult to stand, a bar chair/stool (preferably with a study back) is wonderful. Just be sure, for you, it is easy to sit on, easy to get up on or down from and if it swivels that it does not move too freely that you miss your mark and down on the floor you go

http://paincommunity.org/tpc-comfort-cookin-stand-ground-comfortably/

Athletes Can Help With Pain Management

Today's post from eurekalert.org (see link below) looks at why it seems that athletes have a higher pain threshold than the general population and asks the question whether specific forms of exercise can reduce the need for pain-controlling drugs. Neuropathy patients have difficulty with most forms of exercise, so any new developments will need to be targeted towards the capabilities of people with chronic nerve pain. Studies will need to be carried out by people with a thorough knowledge of how neuropathy works but maybe electronic fitness equipment can be modified to stimulate the right muscles, nerves and organs.

 

Higher pain tolerance in athletes may hold clues for pain
management
Public release date: 17-May-2012

Regular exercise may help, according to new study in Pain

Philadelphia, PA, May 17, 2012 – Stories of athletes bravely "playing through the pain" are relatively common and support the widespread belief that they experience pain differently than non-athletes. Yet, the scientific data on pain perception in athletes has been inconsistent, and sometimes contradictory. Investigators from the University of Heidelberg have conducted a meta-analysis of available research and find that in fact, athletes can indeed tolerate a higher level of pain than normally active people. However, pain threshold, the minimum intensity at which a stimulus is perceived as painful, did not differ in athletes and normal controls. Their findings are published in the June issue of Pain®.

"Our analysis reveals that pain perception differs in athletes compared to normally active controls," says lead investigator Jonas Tesarz, MD. "Studies in athletes offer the opportunity for an evaluation of the physical and psychological effects of regular activity on pain perception, which might foster the development of effective types of exercise for relief in pain patients."
Researchers reviewed fifteen studies that evaluated experimentally induced pain threshold or tolerance in athletes compared to normally active controls. 568 athletes and 331 normally active controls were included. Eight of the studies were conducted in the USA, two in Canada, one in Australia, and four were conducted in Europe. The studies, which included both men and women, evaluated endurance sports, game sports, and strength sports. Twelve studies reported on pain tolerance, and nine studies examined pain threshold.
Athletes were found to have consistently higher pain tolerance in comparison to normally active adults. The magnitude of pain that athletes could withstand varied depending upon the type of sport in which they participate. For example, endurance athletes had a moderate tolerance for pain and their scores were fairly uniform. Athletes involved in game sports had a higher tolerance for pain than other athletes, but the results varied widely, suggesting that endurance athletes are more alike in their physical and psychological profiles, while athletes involved in game sports are more diverse.

The finding that regular exercise is clearly associated with higher pain tolerance, but pain thresholds are affected more ambiguously, likely has clinical implications, according to Dr. Tesarz. "Numerous studies of the effect of physical exercise in pain patients demonstrate a consistent impact on quality of life and functioning without an improvement in pain scores. It may be advisable in exercise treatment for pain patients to focus on the development of their pain-coping skills that would affect tolerance, rather than the direct alleviation of pain threshold," he notes.

"Further research is needed to clarify the exact relationship between physical activity and modifications in pain perception, and to identify the involved psychological factors and neurobiological processes. However, the observation that pain perception is modifiable by physical activity provides promise for the use of non-invasive methods with few side effects for patients with chronic pain conditions," concludes Dr. Tesarz.

http://www.eurekalert.org/pub_releases/2012-05/ehs-hpt051512.php

Neuropathy A Help Source For Beginners

Today's post from neurocentre.com (see link below) is a quick guide to neuropathy and a pointer to the British Neuropathy Trust (http://neurocentre.com/Neuropathy/) as a source of help. Most countries have their own neuropathy sites to help people new to the disease but this one, like the American Neuropathy Association, is international and people there will be able to answer most of your questions. Always useful to have this sort of resource at hand.

Welcome to the Neuropathy Trust
Posted on April 10, 2013

What is Peripheral Neuropathy?


If you have been told that you have peripheral neuropathy (PN) and / or neuropathic pain (NeP) the chances are that you will be pleased to to have found this web site. Many people in your situation feel confused and a little afraid. Uncertainty over the future course of your illness, along with pain, may feature highly as cause for concern. Being told that you have a condition which you may never have even heard of before can also lower your self confidence. It may surprise you to know that you are not on your own, far from it. Some authorities have estimated that at least up to 8% of the population may be affected by PN. That equates to approximately 4.7 million people in the UK alone.

Our first message to you is “don’t worry”; you are not on your own. The Neuropathy Trust began in 1998 with one individual who, like yourself, believed that he was just one of a few people affected. Learning more about these common conditions and their likely effects on yourself and others is one way to begin the process of regaining your confidence. It may become a turning point in your own life, as it has been for so many other people.

So, what exactly is Peripheral Neuropathy (PN)?

Peripheral Neuropathy [pron. - new-rop-athy] is a generic phrase denoting functional disturbances and/or pathological changes in the peripheral nervous system.

If the involvement is in one nerve it is commonly referred to as mononeuropathy, in several nerves, mononeuritis multiplex and if diffuse and bilateral, polyneuropathy.

Peripheral Neuropathy is not a specific disease but rather a manifestation of many conditions that cause damage to the peripheral nerves. There are believed to be in excess of one hundred different causes of peripheral neuropathy.

Many of our subscribers are affected by what is known as a cryptogenic or idiopathic neuropathy, which simply means that they have been diagnosed as having a peripheral neuropathy but the underlying cause has yet to be determined. We also have an ever-increasing number of subscribers who are affected by neuropathies of known origin, such as diabetes mellitus, HIV, nutritional deficiency, and as a result of the neurotoxic effects of certain prescribed treatments and therapies.

The symptoms of peripheral neuropathy often affect the arms and legs. Common characteristics, depending on the type of neuropathy may include muscle weakness, chronic neuropathic pain (including – numbness, sensory disturbance, pins & needles, burning sensations etc.), and paralysis.

Additional complications reported by a significant number of our subscribers include amongst others; fatigue, memory retention deficit, mood swings, swallowing difficulty, acid reflux/generalised stomach complaints, and ataxia. Ataxia is a term used to describe a general lack of co-ordination, position sense and manual dexterity.

The symptoms of Peripheral Neuropathy often vary from person to person and can affect people to a lesser or greater degree. However, in some cases, the symptoms may tend to necessitate a change in lifestyle which not only can affect the person directly, but also may possibly have a knock on effect on the family.

One of the hardest things about coming to terms with peripheral neuropathy is not necessarily the disabling effect that it can cause. It is quite natural to experience –

Feelings of isolation – because the chance of meeting other people with a similar condition may appear remote.

Feelings of frustration – because you quite naturally want to know what is happening to your body. These feelings can be exacerbated if no definitive diagnosis has been reached.

Peripheral Neuropathy affects people in different ways. It is quite natural to think that you are on your own and you may find it difficult to explain to others what it feels like.

The Neuropathy Trust. Registered Charity Number 1146892. Registered as a limited company in England and Wales 7632041

http://neurocentre.com/Neuropathy/2013/04/

Electrical Spinal Cord Stimulation to help HIV related Neuropathy

Today's post comprises two articles from aidsmeds.com (see link below) and spine-health.com (see link below) which concern a story that is gathering pace and appearing all over the Net. It gives hope to HIV patients with neuropathy, that there may be a way of controlling their pain after all other options have failed. Electrical stimulation is in itself, not a new idea for helping with nerve damage but this treatment could potentially significantly improve people's lives with neuropathy. Hopefully we'll hear more very soon but meanwhile it may be worth mentioning to your HIV specialist or neurologist.

Spinal Cord Stimulation Shows Potential for Peripheral Neuropathy
February 7, 2012

Electrical stimulation of the spinal cord markedly reduced peripheral neuropathy (PN)–associated pain in a man living with HIV who didn’t respond to more conventional PN therapies, according to a February 5 presentation at the 6th World Congress of the World Institute of Pain in Miami and reported by Medscape.

Data involving another five patients enrolled in the study, being conducted by Kenneth Candido, MD, of the Advocate Illinois Masonic Medical Center in Chicago and his colleagues, are awaited, but the researchers are encouraged by the results they’ve seen thus far. “We believe that it is not only a new indication, but it offers relief for individuals who were previously left to the devices of primary care physicians who really only have at their disposal the ability to prescribe narcotic analgesics,” Candido said.

Treatment initially involved temporary placement of two leads, each containing eight electrodes, into a segment of the spine. Once the electric stimulation proved safe and effective, permanent electrodes were placed by the study investigators.

The study volunteer highlighted by Candido’s group at the Miami conference was a 50-year-old man who had been living with HIV for 20 years and had an eight-year history of “excruciating” neuropathic pain and burning sensations, notably on the soles of his feet. He had not responded to other available neuropathy treatments, such as narcotic and non-narcotic pain relievers, anti-seizure drugs and nerve blocks.

The results thus far have been encouraging, Candido told Medscape. “He has now had almost two years of reduction in his pain, from a constant level of about 8 out of 10 down to about 1 or 2 out of 10, and we’ve been able to wean him off his [narcotic pain relievers],” he said.

Spinal cord stimulation is a well-established technique currently indicated for the management of failed back surgery syndrome, complex regional pain syndrome, inoperable peripheral vascular disease, and refractory angina pectoris.

http://www.aidsmeds.com/articles/hiv_spinal_neuropathy_1667_21869.shtml

Spinal Cord Stimulation for Chronic Pain
By: Clifford A. Bernstein, MD

Approved by the FDA in 1989, spinal cord stimulation (SCS) has become a standard treatment for patients with chronic pain in their back and or limbs who have not found pain relief from other treatments. While the treatment does not work for everyone, most patients who qualify for neurostimulation therapy report a 50 to 70% reduction in overall pain, as well as an increased ability to participate in normal family and work activities. Many patients find that they can decrease or stop taking painkillers or other pain medications after undergoing spinal cord stimulation. Given these benefits, there has been ongoing investment and advances in spinal cord stimulation technology, and many individuals suffering from chronic pain find that neurostimulation positively impacts the quality of their lives.

Electrical Stimulation Blocks the Pain Signals

In general, neurostimulation works by applying an electrical current to the source of chronic pain. This creates a pleasant sensation that blocks the brain’s ability to sense the previously perceived pain. There are two related forms of electrical stimulation commonly used to treat chronic pain:

Spinal cord stimulation (SCS). In spinal cord stimulation, soft, thin wires with electrical leads on their tips are placed through a needle in the back near to the spinal column. The leads are placed through a needle inserted in the back (no incision is required). A small incision is then made and a tiny, programmable generator is placed in the upper buttock or abdomen (under the skin) which emits electrical currents to the spinal column.

•Peripheral Nerve Field Stimulation (PNFS). Very similar to spinal cord stimulation, peripheral nerve field stimulation involves placing the leads just under the skin in an area near to the nerves involved in pain.

In both approaches, the generator can be programmed in a way similar to using a remote control to adjust the television. The area or intensity of electrical stimulation can be changed, and the system can be turned on and off or adjusted as necessary to provide optimal pain relief. Although programming is initially done at the physician’s office, patients can learn how to control the stimulation on their own and adjust it to their pain levels.

Sources of Chronic Pain Treatable with Spinal Cord Stimulation

While spinal cord stimulation and peripheral nerve field stimulation can be used to treat chronic pain from multiple sources, it does not eliminate the source of chronic pain or treats the underlying cause of the pain. Instead, they interfere with the transmission of pain signals to the brain, so the brain does not recognize (or has only limited recognition) of the pain. Sources of chronic pain that spinal cord stimulation may be used to treat include:
•Failed back surgery syndrome: chronic pain after one or more back or neck surgeries to fails to alleviate persistent low back pain, leg pain (sciatica or lumbar radiculopathy) or arm pain (cervical radiculopathy).
•Reflex sympathetic dystrophy (complex regional pain syndrome): a progressive disease of the nervous system in which patients feel constant burning pain.
•Causalgia: chronic pain with a burning sensation caused by peripheral nerve injury.
•Arachnoiditis: painful inflammation and scarring of the meninges (protective layers) of the spinal nerves
•Peripheral Neuropathy: a constant burning pain of the legs caused by the most distant nerves dying off

It is important to note that the degree of pain relief experienced from spinal cord stimulation or peripheral nerve stimulation varies from person to person. As pain changes or improves, stimulation can be adjusted as necessary

http://www.spine-health.com/treatment/back-surgery/spinal-cord-stimulation-chronic-pain

Can A Gluten Free Diet Help With Your Neuropathy

Today's post from themodernlucy.blogspot.nl (see link below) is a personal account (with no link to HIV) by a woman with neuropathic problems. She found that adopting a gluten-free diet helped considerably. A gluten free diet is not easy and may not be for everyone but there are certainly considerable numbers of people who's condition has been improved by cutting out gluten. If going the whole hog is too difficult, then reducing your intake of meat and dairy foods may help anyway.

How Peripheral Neuropathy Has Changed My Life
Thursday, June 7, 2012

Since about 4 months after my surgery, I have had peripheral neuropathy off and on. It basically feels like tingling and numbness in all my extremities, numbness in my face, and tingling on my scalp. Most doctors that I saw shortly after my experience felt that it was all psychological, but as time went on, I felt better and better psychologically but still had this feeling. I also had severe digestive issues.

I was told the only way to stop my stomach pain was to have surgery again. And, I was told that nothing would stop the peripheral neuropathy but more and more drugs. I refused both courses.

Today I can say that a gluten-free diet has improved both of these issues. I have tested it now for about the 4th time, and every time I go off the gluten-free diet, my peripheral neuropathy and brain fog get worse, and by the 4th time, they become unmanageable (I could barely get through the day). When I maintain the diet, these issues become nonexistent. Also, on the diet, I have no stomach pain or digestive issues.

Why does gluten-free help? I have no idea. I could be a celiac, but there is really no way to know. I am not willing to eat gluten for long enough to have a biopsy to verify that diagnosis because I just feel so horrible when I eat it. I have always had stomach issues, so it is very possibly that I've always had an issue with gluten. It could be postmenopausal gluten intolerance which is also very common. I plan to take it up with my doctor on my yearly appointment.

The fact that I feel so much better without the gluten is really amazing. I never thought I could get here. I do believe everything happens for a reason, and maybe I needed to have that surgery to get to where I am today with my health.

Our whole family is trying to eat a more whole foods diet. I am working on a new meal plan. I posted earlier about how I had finished a meal plan. Well, that was before I realized how crucial being gluten-free is to my well being, and it was before we decided not to eat as much meat and dairy products. We are now trying out new recipes and working on a new meal plan. I will start posting recipes soon.

 http://themodernlucy.blogspot.nl/2012/06/how-peripheral-neuropathy-has-changed.html

MEDITATION CAN HELP REDUCE MIGRAINE PAIN

For those suffering from migraine attacks, daily meditation might be a good idea for instant relief.

During a small study, researchers assessed the safety, feasibility and effects of a standardised meditation and yoga intervention called mindfulness-based stress reduction (MBSR) in adults with migraines.

Nineteen adults were assigned to two groups with 10 receiving the MBSR intervention and nine receiving standard medical care.

The participants attended eight weekly classes to learn MBSR techniques and were instructed to practice 45 minutes on their own at least five additional days per week.

“We found that MBSR participants had trends of fewer migraines that were less severe,” said Rebecca Erwin Wells, an assistant professor of neurology at Wake Forest Baptist Medical Centre in North Carolina.

Secondary effects included headaches that were shorter in duration and less disabling.

Participants had increases in mindfulness and self-efficacy – a sense of personal control over migraine pain.

“In addition, there were no adverse events and excellent adherence,” Wells reported.

Specifically, the MBSR participants had 1.4 fewer migraines per month that were less severe.

The participants’ headaches were significantly shorter as compared to the control group.

“MBSR is a safe and feasible therapy for adults with migraines. Although the sample size of this pilot study was small, secondary outcomes demonstrated this intervention had a beneficial effect on headache duration, disability, self-efficacy and mindfulness,” researchers concluded.

The paper was published online in the journal Headache.

Can Yoga Help With Nerve Pain

Today's post from livestrong.com (see link below) looks at the potential benefits of yoga for people living with neuropathy. To my mind, this may be literally 'stretching' a point when it comes to the relief of nerve pain (especially in the feet and legs). If you've ever tried yoga, you'll know that it requires a level of fitness that tests even the healthiest bodies and while its benefits are sworn by, neuropathy patients may not be prepared to go through yet more pain to achieve a non-guaranteed end-result. Where it may well help is with people who are at the beginning stages of peripheral neuropathy and who can do the exercises (however gentle) without too much physical strain but I do wonder how many long-term neuropathy patients will be willing to take the risk. It may also help with neuropathy conditions such as sciatica, where entrapment is probably involved. However, we all know that exercise is good (and even necessary) for neuropathy patients but subscribing to the theory of 'no pain, no gain' may just be a stretch too far. I'm very willing to be proved wrong here and success stories will be published.
 

Yoga for Peripheral Neuropathy
by ANDREA CESPEDES Last Updated: Dec 24, 2010

Tingling, numbness, sensitivity to touch and lack of coordination are all telltale signs that you may have damage to your peripheral nervous system, a condition known as peripheral neuropathy. Yoga is one of many therapies that may help strengthen the communication pathways between your nerves and your brain, alleviating symptoms and discouraging progression. 

A Peripheral Neuropathy Primer

Your peripheral nervous system consists of the sensors that transmit information between your brain and spinal cord and the rest of your body, including your skin, digits, arms and legs. Muscle weakness, abnormal sensitivity to temperature changes and, over time, paralysis, impaired digestion and disrupted endocrine function can develop.

Causes of peripheral neuropathy are varied. You might experience it as a result of a traumatic accident, such as a fall or car accident; repetitive stress, as is the case in carpal tunnel syndrome; or from metabolic and endocrine disorders, which includes diabetes. Cancer, certain infections, autoimmune disorders, nueromas and small vessel disorders may also be to blame.

Regardless of the cause of your nervous system compromise, you want to increase the communication between your spine, brain and nerves throughout your body. While your doctor must help you treat the underlying condition, yoga can assist in symptom management. 

Yoga's Potential

Research has revealed potential for treatment of neuropathy with yoga practice. A 2002 issue of the Indian Journal of Physiology and Pharmacology reported a study showing that, among 20 people with type 2 diabetes, yoga performed 30 to 40 minutes daily for 40 days improved nerve function and glycemic control (high glycemic levels aggravate neuropathy.)

A 2012 review of the research of the effects of yoga on nervous system disorders published in Annals of Indian Academy of Neurology confirmed yoga as a valid integrative and complementary therapy for conditions such as peripheral neuropathy. Remember that yoga ought to be combined with other treatments; it shouldn't be your only line of attack. Lifestyle modifications, medical interventions and electrical nerve stimulation are also important strategies.
 
Poses to Practice

The severity of your condition determines the type and intensity of yoga you'll practice to address peripheral neuropathy. Less-advanced cases may do well with a Hatha-style class that involves seated and standing postures, including Triangle pose, Camel and Bow pose.


More advanced neuropathy may require a gentler practice, but you can still benefit from meditation, gentle twists and supported backbends. Use a bolster or block for support in Bridge pose or reclining Hero, for example.

All of these poses are particularly beneficial in opening the front side of your body, increasing oxygenation of tissues and improving blood circulation to nerves.
The Benefits of Relaxation

A regular yoga practice teaches you to handle the stress of living with peripheral neuropathy. Meditation and deep breathing helps you learn how to live through distraction, even painful physical ones as can happen with nerve disorders. When you learn how to breathe and be present on the mat, you can more easily shift into a pattern of acceptance off the mat. Peripheral neuropathy can't be cured, only contained, so acceptance is essential.

The body-mind connection acquired through yoga also helps benefit you when trying to manage the symptoms of peripheral neuropathy. You'll have a better sense of how you react to specific poses and which ones are helpful and which are aggravating. This translates off the mat, so you have an idea of what activities you can push through, what may set off an episode and how you can manage symptoms of neuropathy when it occurs.

Read More: How to Relax the Nervous System Naturally

http://www.livestrong.com/article/342259-yoga-for-peripheral-neuropathy/

Chilli Patches Do They Help Or Not

Today's short post from neuropathydoctor.com (see link below) is written by Dr. Brandt R.Gibson, whose work has been featured on this blog before. Although it's from february 2012 and the story is not new, I'm publishing it in response to recent questions about both capsaicin cream and the capsaicin patches from NeurogesX. Do they work? Well, the American FDA says that the evidence is not sound enough to rate their approval, especially for people with HIV-related neuropathy but looking around the forums, it's clear that some people's (but by no means all) symptoms have been helped by using capsaicin (chilli pepper) derivatives, so as the doctor says; why deny yourself some relief if something genuinely helps! Watch out though; the cream must never get in your eyes or mouth, it can be very painful. Using thin, disposable, rubber gloves is advised. Similarly, the patches need to be administered by someone who knows what they're doing (a nurse or doctor) and although they can provide relief for some period of time, initially they will be painful. You should discuss this with your doctor before going ahead, in the knowledge that capsaicin will not 'cure' your neuropathy but may help to relieve the symptoms.

Chilli Pepper Patch May Not Work For HIV Neuropathy

by Brandt R. Gibson, DPM on 9 February 2012


A pain patch from NeurogesX Inc., made from chilli pepper has been questioned on efficacy by the FDA. This drug was designed for HIV patients with associated peripheral neuropathy. There is approximately 1.1 million people in the United States infected with HIV. Of these, approximately 1/3rd present with peripheral neuropathy either from the virus itself of the drugs utilized to treat it. According to the FDA, however, the efficacy was not shown yet in any of the studies, so it may not get approved until additional studies are done.

This is a big blow to the company, but a positive for HIV sufferers if the medication really has no efficacy. The problem I have with limiting access to drugs that may help is that peripheral neuropathy in other forms may benefit from this medication even when HIV associated neuropathy is not helped. Neuropathy varies with the causes and therefore varies with the treatment options. All neuropathy patients deserve a medication that can decrease or resolve the associated pain that can be very debilitating.

One small side note, Zostrix or Capsaicin creams are similarly made from red peppers and have been shown to be effective in peripheral neuropathy by overstimulating the nerves and creating a resolution of pain for a period of time. Although these treatments have not been shown to resolve neuropathy, they are valuable in the treatment of the pain in many individuals. If the drug made by NeurogesX Inc. were effective even in some respects it may be worth putting it on the market as an option.

Just my personal opinion…..

http://neuropathydoctor.com/http:/neuropathydoctor.com/chill-pepper-patch-may-not-work-for-hiv-neuropathy

How To Help Friends Understand Neuropathy Symptoms

Today's post from supportforchronicpain.com (see link below) may sound a little corny and/or contrived but it reflects one of the commonest problems that's brought by readers to this blog's attention concerning living with neuropathy and that is...other people's total misunderstanding of the situation. Nobody's at fault here - it's just a lack of knowledge as to how neuropathy works but what this letter does is carefully 'educate' the reader, without bitterness or rancour and as such may be extremely useful if people's reactions to your problem leave you speechless and frustrated. May be worth sending to assorted family and friends!

Letter to a friend

The ‘Letter to a friend’ has been circulating the internet for years, and is constantly being adjusted by those using it. I definitely believe that the letter deserves a spot on this website – rarely have I seen the things that you’d want to tell to your partner, family, friends and colleagues phrased in such an eloquent way:

Dear friend,

You know that I am a chronic pain patient. Having chronic pain means many things change, and many of them are invisible. Unlike having cancer or being hurt in an accident, most people do not understand even a little about chronic pain and its effects, and of those who think they know, many are actually misinformed. When the illness or pain is invisible to the naked eye, the consequences can be even more destructive.

Social relationships of chronic pain patients often suffer. Of course that’s not something I want to happen, as that makes my pain only harder to bear. I would like to use this letter to explain what suffering from chronic pain means to me.

Please understand that being sick doesn’t mean I’m not the same person I was before. I am forced to spend most of my day in considerable pain and exhaustion, and if you visit, I probably don’t seem like much fun to be with sometimes, but I’m still me, stuck inside this body. I still worry about work, my family, my friends, and most of the time, I’d still like to hear you talk about yours, too. Please tell me about the cool things you have done, or the problems you have. I still want to be a good friend to you, and I don’t want us to stop talking about everything we love to talk about.

Please understand the difference between “happy” and “healthy.” When you’ve got the flu, you probably feel miserable, but I’ve been sick for years. I can’t be miserable all the time. In fact, I work hard at not being miserable. So, if you’re talking to me and I sound happy, it means I’m happy. that’s all. It doesn’t mean that I’m not in a lot of pain, or that I’m not extremely tired, or that I’m getting better, or any of those things. Please don’t say, “Oh, you’re sounding better!” or “But you look so healthy!” I am merely coping. I am sounding happy and I am trying to look normal. If you want to comment on that, you’re welcome to do so.

Please understand that being able to stand up for ten minutes doesn’t necessarily mean that I can stand up for twenty minutes, or an hour. Just because I managed to stand up for thirty minutes yesterday doesn’t mean that I can do the same today. With a lot of diseases you’re either paralysed, or you can move. With this one, it gets more confusing every day. It can be a bit like a yo-yo. I never know how I am going to feel when I wake up the next day. In most cases, I don’t even know know on a minute to minute basis. That is one of the hardest and most frustrating components of chronic pain. Please repeat the above paragraph substituting “standing’ with “sitting”, “walking”, “thinking”, “concentrating”, “being sociable” and so on, it applies to everything. That’s what chronic pain does to you.

Please understand that chronic pain is variable. It’s quite possible (for many, it’s common) that one day I am able to walk to the park and back, while the next day I’ll have trouble getting to the next room. Please don’t attack me when I’m ill by saying, “But you did it before!” or “Oh, come on, I know you can do this!” If you want me to do something, then ask if I can. I still love to be invited for nice things, maybe even more than I used to. I will tell you whether I can go or not. In a similar vein, I may need to cancel a previous commitment at the last minute. If this happens, please do not take it personally. If you are able, please try to always remember how very lucky you are, to be physically able to do all of the things that you can do.

Please understand that “getting out and doing things” does not make me feel better, and can often even make me significantly worse.You don’t know what I go through or how I suffer in my own private time. Telling me that I need to exercise, or do some things to “get my mind off of it”, may frustrate me to tears, and it is incorrect. If I was capable of doing some things at any- or all of the time, don’t you think that I would? I am working with my doctors and I am doing all that I can. Another statement that hurts is, “You just need to push yourself more, try harder”. Obviously, chronic pain can affect the whole body, or it might target specific areas. Sometimes, participating in a single activity for a short or a long period of time can cause more damage and physical pain than you could ever imagine. Not to mention the recovery time, which can be intense. You can’t always read it on my face or in my body language. Also, chronic pain may cause secondary depression (wouldn’t you get depressed and down if you were hurting constantly for months or years at a time?). I do like when you encourage me to do my exercises or when you help me find new activities that I am able to do, and it would be wonderful if you compliment me when I manage to do them.

Please understand that if I say that I have to sit down, lie down, stay in bed, or take my medicines right now, that probably means that I do have to do it right now, It can’t be put off or forgotten just because I’m somewhere, or because I’m right in the middle of doing something. Chronic pain does not wait for anyone. If you want to suggest a cure to me, please don’t. It’s not because I don’t appreciate the thought, and it’s not because I don’t want to get better. Lord knows that I’d love to. In all likelihood, if you’ve heard of it or tried it, so have I. In some cases, I have been made sicker, not better. This can involve side effects or allergic reactions, as is the case with herbal remedies. It also includes failure, which in and of itself can make me feel even worse. If there were something that cured, or even helped people with my form of chronic pain, then we’d know about it. There is worldwide networking (both on and off the Internet) between people with chronic pain. If something worked, we would KNOW. It’s definitely not for lack of trying. If, after reading this, you still feel the need to suggest a cure, then so be it. I may take what you said and discuss it with my doctor.

Please understand that if I seem touchy, it’s probably because I am. It’s not how I try to be. As a matter of fact, I try very hard to be normal. I hope you will try to understand. I have been, and am still, going through a lot. Chronic pain is hard for you to understand unless you have had it. It wreaks havoc on the body and the mind. It is exhausting and exasperating. Almost all the time, I know that I am doing my best to cope with this, and live my life to the best of my ability. I ask you to bear with me, and accept me as I am. I know that you cannot literally understand my situation unless you have been in my shoes, but as much as is possible, I am asking you to try to be understanding in general. In many ways I depend on you, people who are not sick. I need you to visit me when I am too sick to go out. Sometimes I need you help me with the shopping, the cooking or the cleaning. I may need you to take me to the doctor, or to the store. You are my link to the “normalcy” of life. You can help me to keep in touch with the parts of life that I miss and fully intend to undertake again, just as soon as I am able. I know that you care about me, that you feel helpless because you cannot put an end to my pain. Please, don’t let this feeling of powerlessness come between us. I don’t need you to cure me, I need you as my friend!I know that I asked a lot from you, and I do thank you for listening. It really does mean a lot.
 
Love from me

This letter was originally written by Ricky Buchanan under the name of Bek Oberin around 1995. Ricky is an internet veteran, having started one of the first 25 blogs on the web. She lives in Australia with disability from chronic fatigue syndrome (CFS). The letter was first written to let people know what it is like to have CFS or Fibromyalgia and has been adapted for a lot of other chronic disorders.

http://www.supportforchronicpain.com/coping-with-chronic-pain/letter-to-a-friend/