1. Welcome to the Foot Health Forum community where you can ask about foot problems and get help, as well as be up-to-date with the latest foot health information. Only registered members can ask a question, but you do not need to register to respond and give help. Please become part of the community (here) and check out the shop.

Peripheral Neuropathy

Discussion in 'Ask your questions here' started by graphicslady, Sep 27, 2008.

  1. graphicslady

    graphicslady New Member


    Members do not see these Ads. Sign Up.
    I am new to this site, and I'm sure this has been discussed many times before, but I am a diabetic and have extreme peripheral neuropathy, which at this time only affects my feet. The pain is agonizing and I have tried everything under the sun - Neurontin, Lyrica, Topamax, many pain medications, and the side effects are almost as bad as the pain. I would like any and all suggestions or help as to what else I can do to relieve the pain. I seriously don't want to wind up addicted to all kinds of pain medications. Has anyone tried Cymbalta?
     
  2. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    Diabetic neuropathy is a puzzling and often daunting condition which can potentially result in symptoms ranging from mild to severe derangement of sensation varying from insensitivity to aberrant sensations to pain of excruciating proportions. The degree to which such neuropathies can be mitigated, if at all, varies greatly, and what has worked well or not at all for one patient may, and often will have totally different results in another. So another's experience with any particular medication or type of therapy can rarely be relied upon as a measure as to how you might react to it. Yours is not at all an unusual story, but there is no magical or even uniformly best approach to the problem. The selection of a neurologist or pain management specialist who has had a great depth of experience with many such patients as yourself and who can work effectively in concert with your endocrinologist would be the most appropriate method of obtaining as optimum of a result as might be possible for you. Given the selection of an experienced and knowledgeable specialist, I don't really think that much can be gained by the solicitation of anecdotal experiences from others. It is frequently only a recipe for false hopes and most often, disappointment. But for those who are willing to take that roller coaster ride, I think it unlikely that I will dissuade them.
     
    Last edited: Sep 27, 2008
  3. graphicslady

    graphicslady New Member

    I appreciate your reply and agree with you wholeheartedly - BUT - and this is a big but for me and I'm sure for others. I've spent thousands of dollars going to specialists and thousands of dollars on medications - I simply cannot afford to go to anymore, especially when they will not tell you up front whether or not they have a new drug therapy, or any other therapy of any kind - before you give them your money. I know this sounds negative, but, believe me, at this point in time, my experience with this has become extremely negative. I've even had them take my money and then tell me that there is nothing that can be done. They have put me on everything there is on the market, I think, and every single one of them has had side effects that I simply can't tolerate, and the only one I haven't tried is Cymbalta. I guess I was just wanting to see if anyone had had a good and positive result from this medication before I spent even more money going back to my general physician and asking him for a prescription. I guess I feel a little desperate at this point because it seems that surely, in this day and time, there would be something available for this kind of pain that would not turn you into a drug addict, a fate which I am almost as concerned about as I am losing my feet, but not quite.
     
  4. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    As I had previously opined . . I am under no illusions that I can dissuade you from searching for the anecdotal experience of others who may or may not have the same problem as you, the same intensity of symptoms as yours, and the same tolerance for medication as do you. Moreover, all of the evaluation they will offer is totally individually subjective, and what seems to have been helpful or not helpful to them is no more relevant than a reading of the physician's package insert for the medication. I am unaware of any of these sorts of pharmaceuticals which are devoid of substantial side effects, some which present more severely in some person than others. I think that your comment that a doctor won't tell you whether he/she has had experience with a new medication without crossing his/her palm with silver is a mis-assessment of the motives. I think that more than likely the doctor is simply unable and unwilling to offer blind hope without first assessing the individual problem. I can assure you that any medication which persists on the market has been effective to SOME degree in at least SOME patients, and a new one, which show more promise than previously available products, very quickly makes the rounds. I understand that patients become very frustrated and desperate when faced with a severe illness or condition which has been refractory to successful treatment though much has been tried. But I can more or less assure you that any competent doctor knows what is available and is going to try every reasonable approach to solving your problem. The fact is that the treatment of diabetic neuropathy is very problematic, and it is the lucky patient who responds as well as he or she might like to therapeutic measures. Desperation often elicits the taking of inappropriate risks, and I am sure that the many doctors whom you have engaged are just as anxious to offer you effective treatment as you are in receiving it. But testimonials from patients who might have simply been fortunate enough to be the ones to find success, even with medications which have failed in you, is not generally a productive approach. Again, I know that this won't stop you, but it is more than likely that you are grasping at straws.
     
    Last edited: Sep 27, 2008
  5. Unregistered

    Unregistered Guest

    I'm trying to help my 85 yr old father w/severe diabetic peripheral neuropathy. All the while over many years he's been treated by a GP never referred to a specialist. He can hardly walk or stand. I gained 2 things in reading this post how I can help him is urging him to see a neurologist and/or pain dr. which neither of us new. It's not unreasonable to ask if a drug has been effective for someone because after all it takes a dr to prescribe it in the first place and a dr isn't simply going to do that based on someone reading about it on the internet. Maybe a GP who doesn't refer to specialists is not up on all the recent treatments for every condition. I'm not sure if he's tried cymbalta but will ask. So thanks for the info.
     
  6. graphicslady

    graphicslady New Member

    Hi, Foot Doc. Sorry - I didn't mean that every single doctor I've been too had monetary motivations - they absolutely haven't, and, of course, most of them have tried to help me - of course they have. But pretty much to no avail. Since I know I'm not gonna gain your approval for asking this question, may I take a chance on getting lectured (and I'm smiling) by asking if YOU can tell me anything about Cymbalta? :confused: I know, I know...it may or may not help me.
     
  7. FootDoc

    FootDoc New Member

    DISCLAIMER:
    THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***********************************************************
    Keep in mind that as a doctor of podiatric medicine, my practice is limited by the laws of the State in which I practice, but, in any case, although I can act professionally to treat the aspects of a disease which affects those areas of the body which I am licensed to treat, I am not licensed to treat an underlying systemic condition simply because it might have some of its manifestations in the feet. As an example, I treat the foot manifestations of diabetes, but I do not treat diabetes. Now, I know that some podiatrists and other medical professionals possessing limited liscenses, such as dentists, might sometimes exceed the law and their licensure boundaries, but I do not.

    I certainly have patients under my care who are under the care of doctors of medicine for both diabetes and complications thereof, such as peripheral vascular disease and diabetic neuropathy, and some of those patients have taken, among other medications, Cymbalta. In addition, I studied pharmacy prior to my becoming a podiatrist and I hold a license as a pharmacist. So I have a potentially greater basic understand of pharmaceuticals than even some prescribers. That being said, I do not have intimate first-hand prescribing knowledge of Cymbalta other than an understanding of its use, its potentials and its drawbacks.

    Cymbalta is basically and anti-depressive medication of the serotonin reuptake inhibitor variety. It is not the first or the only such medication to find secondary use in the treatment of peripheral neuropathy. It was intitially used for this purpose as what is termed "off label," when, as in the case of many medications, it was experimentally found of benefit for other than its intended use. Eventually the FDA officially approved its use for diabetic neuropathy. It's effect is said to be independent from its mood-altering effects. As with all medications for the treatment of diabetic neuropathy, its benefits vary from patient to patient, but there is adequate evidence that it benefits some patients. The most common side effects include nausea, dryness of the mouth, insomnia, dizzyness, constipation diarrhea and vomiting, but, as with all medication, there is a much longer list of potential side effects.

    I still maintain that the use of this or any medication should be left to the decision of an adequately trained specialist.

    I hope that you find this information helpful.
     
    Last edited: Sep 27, 2008
  8. graphicslady

    graphicslady New Member

    Yes, I do find it useful - my son is also a pharmacist, bless his heart and my pocketbook - and is the one who told me to ask my primary physician about Topamax and Cymbalta, so I did, and he gave me a prescription for Topamax, which made me so ill I thought I might have to go to the emergency room after three days on that vile medicine. Neurontin made me turn around in circles (literally) and I gained 15 pounds two months. Lyrica made me unable to walk in a straight line or think straight, and I gained 12 pounds in 7 days, so now I'm fat on top of being in horrendous pain! I guess that's why I'm a little reluctant to even try anything new, but I must, so I think I will try Cymbalta (or I will ask my physician for a prescription). Thank you so much for engaging in this conversation with me today - it helps to know there are still doctors out there who truly do care about their patients, because, whether you want to believe it or not, there are many many physicians practicing today who are more than happy to take your money knowing full well there is nothing new they can offer. Unfortunately, I researched it a little late too and now know that this is more than likely going to be the case anyway. Thank you again!
     
  9. graphicslady

    graphicslady New Member

    Oh - I forgot - I caught that little remark about dentists! :D
     
  10. FootDoc

    FootDoc New Member

    I'm afraid I don't understand what you mean. I only referred to dentists to give another example of a medical partitioner who, as in the case of podiatrists, possess a limited license. In most States, MD's and DO's can legally treat any part of the body by any means, whether they are qualified to do so or not. That's not to say that they cannot face professional sanctions and subject themselves to malpractice actions by doing so, but they are within their LEGAL rights to do so. Those with limited medical licenses, such as podiatrists and dentists are legally prohibited from treating any area and by methods not defined by their State's Practice Act for that profession. My inclusion of dentists as another example of potentially illegal extenders of their boundaries of practice had no other intent.
     
  11. graphicslady

    graphicslady New Member

    Foot Doc, I'm assuming this is your own personal website that I happened to stumble on. I'm just a normal everyday person looking for some kind of help. I certainly didn't mean to offend your professional integrity. Just having a bit of fun. I'll unjoin now. Thanks so much for your help.
     
  12. Admin

    Admin Administrator Staff Member

    Its not; He just generously gives his/her time to help out.
     
  13. FootDoc

    FootDoc New Member

    I was neither offended, nor do I understand why my reply might have made you think I was. I just had, and still have no idea what you inferred in my mention of dentists.
     
  14. Unregistered

    Unregistered Guest

    Oh come on Admin!!!!!!
     
  15. FootDoc

    FootDoc New Member

    I stumbled across this forum maybe 4 years ago. As far as I am aware, it is base in Australia, but the actual owners have been difficult to uncover. When I first got here, it was very much like many other such forums, where there was a combination of medical contributors who were giving mostly shoot-from-the-hip opinions, diagnoses and treatment recommendation of the type which they wouldn't (or I HOPE wouldn't) consider doing in their offices with their own patients an a plethora of lay folks, who came, sometimes as voyeurs and sometimes simply for their own entertainment and "virtual" social interaction, and who would address each others complaints, based only on their often one-time experiences, with what they believed to be similar problems as the poster, and offered rather definitive recommendations, often in the well-meaning but misguided belief that they were being helpful, but which acvice, if followed, was often a potential recipe for disaster. Medicine is NOT a spectator sport, and should neither be treated as such or thought of as entertainment.

    I am a practitioner of more than 3 decades experience. I am Board Certified in foot and ankle surgery and have longed served and continue to serve as the Chief of Podiatry at a major teaching hospital in the U.S. I am the senior member a a multi-doctor, hospital-based practice, and, as such, I now see only a limited number of specially-selected patients and act otherwise as a consultant to the day to day practice and have administrative and teaching responsibilities at the hospital. This leaves me the time to often do as I wish, and what I wish more than anything else to do in my professional capacity is to share the information which I have gleaned over many years of study and practice with both my professional peers, new professionals and the public. That is why I can maintain such a presence on this and a couple of other forums under different names. I don't use my real name because I want neither the credit nor the responsibility for offering my opinions. They are to be taken "as is," and my DISCLAIMER makes it very clear that my goal is to offer general information to the public which should not be taken as a definitive answer to the problems of individual questioners, but might be helpful to them in understand their foot problems and aid in their discussion with their own private doctors.

    Over the years, I have had a small number of distractors of whose purpose, other than to make trouble in coming here I question. Although in earlier years I engaged them with logic rather than simply returning the animosity they showed to me, now I simply ignore all but the dissatisfaction of the actual poster. There are always one or two trouble-makers who seem to live like cock roaches in the woodwork of this site and other sites such as this, who opportunistically come out of the shadows when they can jump on some other poster's quibble with me and those on other sites who gererously offer their help. These, I see as sad excuses for people who have nothing better than to bemoan and criticize the good attempts of others, while they just about NEVER offer anything productive themselves.

    I do not come here to give strokes to posters, or to be their close friends or to attempt to make them simply feel better or comisserate with them about having their foot problems. I come here to offer them information on which they might understand basic foot problems and what the choices of treatment might be. To that end, I insist on adequate and clear information before I will spend my time considering a meaningful response, and there are many folks who come here with highly unrealistic expectations, which they turn into animus when they are simply told that. Some then respond in a way to such disappointment as they would NEVER considered doing with their own doctors whom they are actually paying. It's far easier to get angry at someone who you cannot look in the eye. But I tend to overlook such ingrates and go on to the next one whom I might actually be able to help.

    So choose to believe the Admin or not, GraphicsLady, but this is NOT my site and I just come here for the reasons given above.

    Hope you find help with your neuropathy and that I have been of some assistance.
     
    Last edited: Sep 30, 2008
  16. Unregistered

    Unregistered Guest


    Ahem.....Can U run that past us again?
     
  17. Unregistered

    Unregistered Guest

    Hello GraphicsLady,

    I too suffer from peripheral neuropathy. My pain isn't as intense as you mentioned your is, but it does affect my quality of life. From what you say regarding medications, it seems like you have tried everything, without success.

    My recommendation, is to try acupuncture, and perhaps also Chinese herbs. Unlike standard
    Western medicine, Chinese medicine is based on the principle of balancing the bodily processes, to achieve optimum health. Acupuncture has long been used, to treat chronic pain conditions, including peripheral neuropathy, with success. It can also be used to treat your diabetes.

    The big pharmaceutical companies that push all of these medications, are only concerned with profits, and not curing the patient. These medications can be quite toxic, which is why you've experienced such awful side effects.

    You can look in your local Yellow Pages, to find good, licensed pratitioner of acupucture, and Chinese medicine. Many health insurance plans (perhaps yours), cover the cost of acupuncture treatments. Even you don't get it paid for by your health insurer, you'll wind up spending less money on it, than you do on conventional drug treatments.

    I wish you the very best of luck, and hope that you seriously consider acupuncture/Chinese
    medicine, to give the 0pain relief that you seek.

    Best regards,

    Sonya.
     
    Last edited by a moderator: Oct 5, 2015
  18. flyhal

    flyhal Guest


    I have read all the replies and no one said a thing of any help to the painful feet. I fully understand this problem. I am not diabetic but have damaged nerves in the soles of my feet that have progressed up into the calves of my legs. I have high arches and basic training in the military put excessive pressure on the nerve endings and I have suffered with this since the mid 50's. About 20 years ago, the pain became chronic and then moved upwards into my legs. Neurontin helped to stop the pain in the calves but has done nothing for the damage nerves in the feet. A doctor recently told me that for how long as I have had this pain, I should be use to it by now. This is not the answer I am seeking. There must be something to soothe the feet but to date have found none. Opiods, Tramadol, salves, etc. have not helped at all. Lidocane shots in the feet did not help either. I supposed that the feet could be numbed so I did not feel anything but this could be dangerous. I am now 75 with 55 years of dealing with this. Only recently did I find out that I have Small Fiber Neuropathy but knowing this does not help the pain. I seems that at this point in time, only death will rid the pain.

    Hal
     
Loading...

Share This Page