Diabetic Neuropathy And Nerve Damage
Nerve Damage From Diabetic Neuropathy
Diabetic neuropathy comes from chronic high blood glucose and is normally a frustrating and debilitating complication that can lead to painful neuropathy symptoms that may be hard to diagnose. Some patients that have enjoyed some relief by controlling their blood sugar, exercising or keeping their weight under check, as well as some who have sought treatment from NSI Integrative Wellness Center in Clearwater, Fl. For the very best diabetic neuropathy treatment in Florida, call Dr. Edgerton and his staff for a free consultation here in Florida at our two locations:
|NSI Integrative Neuropathy Wellness Center Florida||NSI Integrative Wellness Center Florida|
|29901 U.S. Highway 19||5311 Spring Hill Dr.|
|Clearwater, Fl 33761||Spring Hill, Fl 34606|
80% IMPROVEMENT IN DIABETIC NEUROPATHY PAIN!
A lot of people normally complain about numbness or pain on their feet, though this is not the only symptom known for diabetic nerve pain. There are different symptoms that can be associated with neuropathy, depending on the regions where it is localized.
The following are symptoms which are commonly associated with neuropathy:
- Trouble emptying the bladder, and as a result constant infection
- Vomiting, nausea, diarrhea, bloating, and constipation
- Dizziness, fainting or low blood pressure when you change posture
- Trouble lifting the foot, ulceration on the feet or deformities on the feet
- Problems in getting or sustaining an erection
In the US pharmacy (including Florida), there are neuropathy treatment medications that can help relieve these symptoms in some individuals, though in most cases, finding a means to prevention is better than treating symptoms.
“Hemoglobin A1C readings must be kept lower than 7.0%. Any level predominantly at, closer to or higher than 8% can cause complications, even neuropathy,” says John Hare, MD, Medical Director of Joslin Diabetes Center’s Affiliated Center’s program.
On the brighter side though, the Diabetes Control and Complications Trial has revealed that keeping blood sugar in a healthy range lowers the risk of damage to the nerves by more than 50%. Besides, keeping diabetes in check will also make your work easier in limiting damage as a result of neuropathy if it develops.
Speak to our physicians at NSI Intergrative Wellness about the symptoms that you are experiencing with your neuropathy. Things might be tough, and you may have some questions, so the following are some answers that might be helpful:
Categories of neuropathy
There are three main types of neuropathy: sensory, autonomic and motor:
Sensory neuropathy: Normally referred to as peripheral neuropathy, or simply neuropathy) centers around the nerves relaying information to the brain about sensations from different parts of the body. Such could be sensations of heat or coldness, texture, pain and so forth. It is by far the most prevalent type of diabetic neuropathy.
Autonomic neuropathy: Targets the nerves controlling involuntary activity in the system, like in the stomach, intestine, bladder or the heart.
Motor neuropathy: on the other hand targets nerves which carry signals to muscles, thereby enabling you to move your fingers or walk, and is very rare with diabetes.
Sensory neuropathy brings about numbness, pain or tingling in the extremities and in the long run you will not be able to experience heat, cold, and other sensations where affected. Autonomic neuropathy in men causes impotence, neuropathy of the bladder, bloating in the stomach or diabetic diarrhea. Motor neuropathy on the other hand will result in weaker muscles.
You can have either symmetric or asymmetric neuropathy (affecting both sides or one side of your body). Mononeuropathy is a situation where only one type of nerve is affected, and polyneuropathy where so many are affected.
Depending on the part of the body affected, the following can also be used, requiring the corresponding neuropathy treatment:
Distal neuropathy: sensory neuropathy affecting the hands and/or feet. It is normally symmetric and occasionally asymmetric and is the most prevalent type of neuropathy.
Femoral neuropathy: very painful sensory neuropathy centered around your thigh muscles, and can be asymmetric or symmetric.
Diabetic amyotrophy: motor neuropathy centered on your thigh nerves, and results in weakness together with or in place of some pain. It can be symmetric or asymmetric.
Gastroparesis: autonomic neuropathy targeting the stomach, in the process making it impossible to empty normally. The symptoms are similar to ulcers, hence malnutrition and hypoglycemic episodes can occur because the food will not be absorbed normally. Later on you can develop high blood glucose.
Diabetic diarrhea: autonomic neuropathy which causes erratic functions in the small intestine. As a result you will pass unformed stool. Since the nerves that support the sphincter muscles are affected, you can pass stool without warning/control, hence fecal incontinence. If the stool stays longer in the large intestines, constipation is also a possibility.
Bladder neuropathy: a situation where the nerves in the bladder cannot respond well to the pressure when it fills up with urine and cannot allow it to empty properly either. Urine that remains in the bladder will infect the urinary tract. Common symptoms are pain when urinating, fever and pain in the lower back, together with clouded urine.
Some of the symptoms include cloudy urine, painful urination, low back pain and fever.
Postural hypotension refers to autonomic neuropathy which brings about low pressure in the blood if you stand. In this case, your pulse will not accommodate the fluctuation in blood pressure, and as a result you will feel dizzy or faint.
Charcot joint is normally referred to as neuropathic arthropathy and happens when the bones in the feet fracture, leading to misalignment. This causes disfigurement because there are no nerves to properly stimulate the feet, and as a result the muscles are not able to support your feet appropriately. The more you struggle to walk, it also gets worse. You are at a greater risk if you have neuropathy or have already lost sensation on your feet.
Unilateral foot drop will happen in the event that you are unable to pick up your feet as a result of nerve damage through blood vessel disease or compression. Autonomic or sensory neuropathy brings about impotence, as does blood vessel disease.
Peripheral neuropathy is normally used to refer to diseases that damage the nerves just outside the brain and the spinal cord. Diabetes might be the common cause of neuropathy, but it is not usually the only cause. Nutritional deficiencies (B-12 and folate), chemical exposures, pressure on nerves, or medication especially in chemotherapy or treating AIDS can also bring about neuropathy.
There are several theories on how neuropathy occurs in diabetes patients. Generally, diabetic neuropathy is believed to result from chronic nerve damage through high blood glucose. This can happen in so many ways.
Just like electric wires are insulated, nerves are insulated by Schwann cells. In one theory, too much sugar in the system interacts with aldose reductase, the enzymes in the Schwann cells. This interaction transforms the sugar to sorbitol, drawing more water to the Schwann cells and forcing them to swell. The swelling will pinch the nerves, causing more damage and pain in the end. If this does not stop, the Schwann cells and the nerves eventually die away.
Another possibility is that intracellular metabolites get depleted and as a result nerves get damaged. There are so many theories that have been advanced so far, including one that suggests that the pathway for protein kinase C, currently under study by George King, MD are induced by high blood glucose, and result in several complications, including neuropathy.
Several studies have however revealed that reduction in the flow of blood to the nerves can also bring about diabetic nerve disease. Different studies in the United States (in Florida as well), are currently going on with this regard, to improve the flow of blood to the nerves. Examination is underway for PKC inhibitors and antioxidants. These drugs have already shown promising results in animals, and there are clinical trials to be rolled out soon enough.
Diagnosis for neuropathy
For a good neuropathy treatment plan, you might want to speak to your physician, since most people do not really know what causes neuropathy. For a lot of men, inability to have or sustain an erection is the first sign of trouble. Infection in the urinary tract is also something that you need to take seriously, while other clues include constant diarrhea and constipation, and most importantly ulcer symptoms.
Early signs of neuropathy can be detected through ankle and knee jerk reflex tests. These can reveal a situation where the nerves do not respond as they should normally, or a slight alteration in blood pressure if you sit from a reclining posture. To curb further problems, you will need more blood glucose.
Different tests such as electromyography and nerve conduction studies together with special observation can help rule out the possibility of other sources of the discomfort and in the process determine neuropathy. A bone scan or an X-ray will come in handy with respect to diagnosing Charcot foot fracture.
Neuropathy Treatment Florida
No miracle neuropathy treatment is available so far, though there are other helpful mechanisms in place. Sadly, replacing or healing damaged nerves is impossible.
If you have neuropathy, you need to make sure that your blood sugar levels are maintained at a proper level, exercise often, and watch your weight. This is important in keeping your blood glucose closer to the normal limit and minimize damage to the nerves.
In such a situation, patients are more than willing to try their hands on any kind of pain reliever, including non-narcotics. However, make sure that you stay away from the stronger narcotics. They will only lead you into addiction.
On the same note, the following are highly recommended; acetaminophen (Tylenol®), aspirin and ibuprofen (Motrin® Advil®, etc.). Pain medicines should be taken regularly throughout the day, instead of waiting for the pain to get out of hand. This is because if you keep waiting, the medication will not effectively handle the pain.
Creams with capsaicin have also been recommended by some physicians in Florida and the US; an extract of the hot capsicum pepper and then you rub it on the affected part of the skin. In some cases the creams block pain signals, though this is never the case for all the affected parties. From time to time, some people might actually experience side effects like irritation on the skin and eyes.
Before you try any of these products, always make sure that you speak to your physician, and follow the instructions to the latter.
You can however get capsaicin, approved by the FDA for pain over-the-counter in brand names such as ArthriCare® and Zostrix®.
There are a number of antidepressants that also work just fine, such as Amitriptyline (Elavil®), desipramine (Norpramin®) or imipramine (Tofranil®), which are members of the tricyclic antidepressant category of drugs. They are not normally prescribed for depression, although having persistent pain for months can be depressing, according to Dr. Gibbons.
The medication will block your pain, and this is why you have to take them at night when the pain is intense, to help tone down the pain and help them sleep. It’s all psychological. When you think about the pain too much, you will experience it, but when you keep your mind focused on something else, you will not feel the pain. This is how the antidepressants work, allowing you feel less pain. It will also help with insomnia and depression from the neuropathy.
You must be patient with antidepressants, for up to a month for them to become effective. Apart from that you may experience a dry mouth, but this should not be a big problem
Some other useful drugs include anti-convulsants like phenytoin (Dilantin®), carbamazepine (Tegretol®) or gabapentin (Neurontin®), mexiletine (Mexitil®). You can also use metaxalone (Skelaxin®) for muscle pain. Sadly, most of these drugs have side effects especially in the older patients.
It is fine to inquire on the use of nutritional supplements or vitamins for pain relief. This however only works when vitamin deficiency is the cause of your neuropathy, or the vitamins will just be passed out through urine, very bright yellow urine, though the neuropathy treatment will not harm you.
Besides that however, nothing is conclusive about the rest of the nutritional supplements and treatments. Be careful because vitamins that cannot be passed out through urine can be toxic, so try not to take too much of vitamin supplements to ease your pain.
There are other successful alternatives like acupuncture, meditation and biofeedback, and this is also encouraging, as long as it works well for you. However, just try not to do it because someone else is.
There was a time back in the 19890s when aldose reductase inhibitors hit the market in all the US and Florida also, causing a frenzy. Sadly, none of these drugs have been effective, and their side effects to date are still a concern. Because of this reason, none of them have seen the light of the market yet, though a lot of research is still going on through some companies to figure out their effectiveness in dealing with neuropathy, says Dr. Gibson
Treatment for gastroparesis
In the case of gastroparesis, where the stomach does not empty properly, our physicians can prescribe metoclopramide (Reglan®). This helps the stomach push food through the digestive system. Sucralfate (Carafate®) can also be used together with this to get rid of additional acid that might be in the stomach, says Dr. Gibbons
Treatment for bladder neuropathy
If you are going through bladder neuropathy where the bladder doesn’t empty completely, bethanechol (Urecholine®) can work for you. Bethanechol is a urine propellant which keeps the bladder clear. Most of the patients in this situation will often develop frequent urinary tract infections. For this reason, we may prescribe prescribe chronic antibiotic therapy to minimize the bacterial level in your bladder and urinary tract.
Treatment for impotence
Male impotence occurs from damage to the blood vessels (versus psychological causes or due to medications such as anti-depressants or blood pressure medication) and this can be treated with drugs that are injected to induce an erection before sex or inserted into the end of the penis. Alternatively, we can also use vacuum devices that induce an erection or surgical prosthesis.
Drugs like Cialis, Levitra®, and Viagra® can also be used, though you have to consult your physician before using these drugs. Those who suffer from diabetes have a higher risk of heart and blood vessel disease. Using these drugs can induce sexual activity in individuals that are struggling with heart disease (diagnosed or undiagnosed). For this reason, make sure that you only get to use them upon the recommendation and approval of a physician.
Remember that using these drugs together with nitroglycerine tablets (a treatment for acute heart problems such as angina or heart attack) can be fatal. Besides that there are unsubstantiated claims that using these drugs can affect the retinal circulation, besides the common side effects.
Treatment for postural hypotension
Particular blood pressure medication can be prescribed to patients that are struggling with postural hypotension or alternatively they can also use support stockings so that blood does not pool in their legs. If you have diabetes and high blood pressure, a good blend of lowering pressure mechanisms and medicine can stop your pressure from going so low immediately when you sit up, and you would need specific adjustments to realign this procedure effectively.
Treating Charcot damage
To prevent Charcot damage do not put any weight on the foot as it is healing. The foot will be under cast for a while to limit damage. After that you will have special shoes, and you might also need surgery to restore your feet to their normal shape.
Avoiding further problems
The biggest problem with neuropathy is the fact that over time, the nerves that are affected end up dying and you lose complete sensation in the area. Make sure that you monitor the affected area every other day for cuts or any problem that you do not feel.
You should have your shoes in mint condition to prevent pebbles or anything causing you harm without you realizing it. If you are affected, try to stay away from electric blankets, heating pads and so forth because you might end up setting yourself ablaze without knowing or feeling it. Hot baths should also be taken with care, so that you do not scald your legs.
Does the pain ever end?
Sadly there is no good answer to this question. However, if you can get your blood sugar level in check, you can manage to ease the pain. In the event that this is impossible, using Tylenol at intervals every few hours and antidepressants in the evening, coupled with exercise can help you manage the pain.
It can take close to two years for the pain to turn into numbness, and this happens only when the nerve cells have been badly damaged. In the meantime, our aim is to make sure that we find viable ways of helping you manage the pain effectively, and keep the discomfort at bay, living a normal life irrespective of the challenges associated with this painful situation.
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