With Neuropathy When Is The Glass More Than Half Full

Today's valuable post from healthline.com (see link below) is another of those irritating articles that give us no choice but to alter our lifestyles in order to improve our health. You hate to read them but you know they're true. In this case, it's about neuropathy caused by excessive drinking. Now I know, you're saying 'What's excessive drinking? My drinking's under control.' All I can say is, if you knew what the pain and discomfort from neuropathy felt like, you'd never touch another drop but the same goes for smoking, over-eating and all the rest of the habits that make life sometimes worthwhile - we know the pitfalls but do it anyway. the key to life is everything in moderation but when you've already gone too far and have a new disease for life, it's too late to just 'cut back' - you have to bite the bullet and stop. At least the article gives some tips as to how to do that but as you can imagine - they're pretty obvious. When you already have nerve damage from alcohol, there's no choice - you have to take steps to make your life more comfortable.

The After effects of Alcoholism: Alcoholic Neuropathy 
Written by Suzanne Allen and Elizabeth Boskey, PhD Medically Reviewed by Tyler Walker, MD on 11 February 2016

What is Alcoholic Neuropathy?

Alcohol can be toxic to nerve tissue. People who drink too much may start to feel pain and tingling in their limbs. This is known as alcoholic neuropathy. In people with alcoholic neuropathy, the peripheral nerves have been damaged by too much alcohol use. The peripheral nerves transmit signals between the body, the spinal cord, and the brain.

Thiamine, folate, niacin, vitamins B6 and B12, and vitamin E are all needed for proper nerve function. Drinking too much can alter levels of these nutrients and affect the spread of alcoholic neuropathy. Fortunately, abstaining from alcohol can help restore your nutritional health. This may improve your symptoms and help prevent further nerve damage. However, some alcohol-induced nerve damage is permanent.

Symptoms of Alcoholic Neuropathy

Alcoholic neuropathy can affect both movement and sensation. Symptoms range from slight discomfort to major disability. Although the condition is not life threatening, it can decrease your quality of life

Some areas of the body affected by alcoholic neuropathy include:

Arms and Legs
numbness
tingling and burning
prickly sensations
muscle spasms and cramps
muscle weakness and atrophy
loss of muscle functioning
movement disorders
incontinence
constipation
diarrhea
problems starting urination
feeling that the bladder hasn’t been emptied fully
sexual dysfunction
impotence
impaired speech
difficulty swallowing
heat intolerance, particularly following exercise
vomiting and nausea
dizziness or lightheadedness
Urinary and Bowel
Other

Call your doctor if you have neuropathy symptoms. Early diagnosis and treatment make it more likely that you will be able to recover.

Causes of Alcoholic Neuropathy

Your peripheral nerves help your body manage important sensory and motor functions including:
bowel and urinary elimination
walking
sexual arousal
arm and leg movement
speech

Alcoholic neuropathy is the result of damage to these nerves. The damage may be the direct result of long periods where you drank too much alcohol. Nutritional problems linked to alcohol use, such as vitamin deficiency, can also cause nerve damage.

Diagnosing Alcoholic Neuropathy
Your doctor will need to examine you to diagnose this condition. It is important to share any history of alcohol use with your doctor to get an accurate diagnosis. Your doctor will need to rule out other potential causes for your symptoms.

Tests, which may identify other potential causes of neuropathy, include:
nerve biopsy
nerve conduction tests
upper GI and small bowel series
neurological examination
electromyography
esophagogastroduodenoscopy (EGD)
kidney, thyroid, and liver function tests
complete blood count (CBC)

Blood tests can also look for vitamin deficiencies that are linked to both nerve health and alcohol use. Nutrients your doctor might test for include:
niacin
thiamine
folate
vitamins B6 and B12
biotin and pantothenic acid
vitamins E and A 

Treatment for Alcoholic Neuropathy

The most important thing you can do to treat this condition is to stop drinking. Treatment may first focus on problems with alcohol use. For some people, this may require inpatient rehab. Others may be able to stop drinking with outpatient therapy or social support.

Once alcohol use has been addressed, your doctor can focus on the neuropathy itself. Symptom management is important. Nerve damage can also make it difficult for you to carry out the functions of daily life. Nerve damage may even make injuries more likely.

Every person’s needs are different. Treatment for neuropathy may involve one, or many, different types of care. These include:
vitamin supplements to improve nerve health (folate, thiamine, niacin, and vitamins B6, B12, and E)
prescription pain relievers (tricyclic antidepressants and anticonvulsants)
medication for people with problems urinating
physical therapy to help with muscle atrophy
orthopedic appliances to stabilize extremities
safety gear, such as stabilizing footwear, to prevent injuries
special stockings for your legs to prevent dizziness 

Outlook of Alcoholic Neuropathy

Nerve damage from this condition is usually permanent. Your symptoms are likely to get worse if you don’t stop drinking. This could lead to disability, chronic pain, and damage to your arms and legs. However, if caught early enough, you can minimize the damage from alcoholic neuropathy. Avoiding alcohol and improving your diet can sometimes lead to a moderate to full recovery.

Preventing Alcoholic Neuropathy

You can avoid alcoholic neuropathy by:
avoiding excessive drinking of alcohol
not drinking alcohol if you have symptoms of alcoholic neuropathy
seeking help if you are having trouble avoiding alcohol
eating a healthy and balanced diet
taking vitamin supplements if you have deficiencies (always talk to your doctor before taking supplements)

http://www.healthline.com/health/alcoholism/alcoholic-neuropathy#Overview1

People With HIV Deal With Their Nerve Pain Better Than Most

Today's post from relief.news (see link below) talks about how people living with HIV have lived with the disease and the pain that often goes with it - sometimes better and with more resilience than people without HIV in their lives. Up to 40% of people living with HIV suffer from neuropathy. Nobody's has got to the bottom of why this happens. It's assumed to be a side effect of long-term HIV medication, or the virus itself attacking the immune system, or a combination of both with other factors thrown in. Considering the stigma that is still attached to HIV, it makes a pleasant change to read an article that shows that HIV patients can actually live with the pain far better than the rest of the population faced with the same pain levels. An interesting article...worth a read.

The Role of Resilience and Physical Activity in HIV-Related Pain By Relief Staff December 13, 2016

How is HIV-related pain different from other types of chronic pain?

People living with HIV experience pain similar to people with other chronic conditions. For example, people with HIV can have similar nerve pain in the feet and legs as diabetics. The significance of our study is that HIV-positive patients react to their pain differently.

Many people with moderate to severe chronic pain find it difficult to move around. But we found that, in contrast, HIV-positive people who had chronic pain were still active.

There were two parts to our study: we measured activity and resilience (or a person’s ability to cope with adversity). We wanted to see if HIV-positive people with pain moved less than those without pain and if resilience affected how much they moved. We also wanted to know if resilience affected how much pain they felt.

We measured activity by getting participants to wear movement detectors over two weeks. It helped us understand how much patients with chronic pain moved and how much time they spent being active each day. The overarching finding was that activity levels did not drop as pain increased.

In previous studies, women who suffered from rheumatoid arthritis spent large parts of each day not moving. And similarly, women who experienced really bad period pain moved much less when they were menstruating.

But people living with HIV and chronic pain did not stop their usual activities, despite the pain they experienced.

To measure resilience we used a questionnaire developed by pain researchers in the U.S. Researchers from Europe have used this questionnaire to assess resilience in patients experiencing chronic spinal pain. They found that people who were more resilient coped better with chronic pain and were more active.

Our assumption was that the more resilient patients were, the more active they would be. This assumption proved to be incorrect. Resilience made no difference to activity levels. We also assumed that resilience would lead to participants experiencing less pain. But that wasn’t the case either. Patients who were more resilient did not have less pain.

What type of pain do people living with HIV experience? How common is it?

One in every two people with HIV experience pain. This includes headaches, chest pain, back pain or frequently peripheral nerve pain in their feet and hands.

The pain can be moderate to severe and can be caused by the immune system’s response to the virus or can co-occur with it. The pain does not tend to go away when patients go onto antiretroviral drugs. Some drugs have been shown to inadvertently induce pain. While the pain can be short-lived, it can also become chronic.

So what factors did play a role in activity levels and why?

There were two reasons why HIV-positive people with pain may have continued to be active: financial stresses and stigma.

We found that younger participants, unemployed participants and those that worried most about getting food were the ones who were more active. It seems they relegated their pain to a lower priority.

Our study also showed that stigma often stopped people from talking about their pain and may have motivated them to keep active.

We asked the participants with pain who they spoke to about their pain. Nearly half of the patients had not told their closest friends and some had not disclosed this to their family. They said they feared that talking about their pain might reveal their HIV status.

Why are these findings important and what’s next?

The HIV-positive patients who were more resilient were more satisifed with their health.

HIV-related pain is really difficult to treat. Improving resilience, for example, with psychological treatments, may be one way of improving patients’ satisfaction with their health even if their pain stays the same.

With other kinds of chronic pain, people who keep active do better. But sometimes, pushing through pain can actually make pain intensity and disability worse. In this study we looked at how pain affects activity in HIV. Now we need to look at how activity affects pain.

We know that for patients with other kinds of pain, social support is really important to help them cope. HIV-positive patients may go without social support if they conceal their pain. We need to understand how they cope instead.

The impact of HIV stigma on pain also needs to be investigated.



Editor’s Note: Antonia Wadley, PhD, is a postdoctoral fellow in the School of Physiology, Faculty of Health Sciences, at the University of the Witwatersrand in South Africa. Wadley is originally a physiotherapist from the UK but now researches HIV-related pain. Wadley and colleagues published a recent study on the role of resilience and activity in HIV-related pain. The interview below, where Wadley describes her recent work, was originally published in The Conversation Africa, and is reprinted here with Wadley’s permission. Also see a related YouTube video on the study here.
 
http://relief.news/the-role-of-resilience-and-activity-in-hiv-related-pain/

Is Your Nerve Pain Worse Than Mine

Today's post from neuropathyjournal.org (see link below) talks about why some people seem to do better with chronic pain than others. It's an age-old subject: women for instance have long claimed that they can bear pain much better than men (probably rooted in the pains of child birth) but there's no indisputable evidence to show this is true. When it comes to neuropathy, everybody's pain is different because everybody has an individual form or strength of neuropathy which determines how much pain, or other symptoms they have to live with, so of course, some bear it better than others because it's literally less or more painful. Nevertheless, neuropathy emerges as one of those conditions that can push people beyond the 10 on the pain scale and despite this, can lead to stigma and accusations of exaggeration. It's also one of those diseases that can come and go which confuses onlookers looking for consistency to measure their reactions against. For that reason it's a rotten disease because outwardly people with neuropathy can look as healthy as the next person. It takes patience on both sides to understand what someone is going through. People go on and on about pain thresholds but with neuropathy, everybody's pain threshold is unique to themselves - it makes it difficult for both patient and doctor to appreciate the other's point of view. This article covers the subject in an objective manner - worth a read.

Why Some Cope Better with Chronic Pain
By LtCol Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS0 

NOTE: The science in this article is based upon a review of, “The Brain” by Carl Zimmer, Award Winning Biology writer, June 2011 issue of DISCOVER Magazine. It is highly recommended that you read this great article.

There are no medical tools, stethoscopes or thermometers, to measure or determine objectively if a neuropathy patient has chronic pain.

While measurable, observable, objectivity is the hallmark of modern science, to many times what drives treatment, testing and payment approvals by medical insurance is the observable. The neuropathy patient lives in a world of subjective symptoms until measurable damage is done to the axon (nerve) or the covering to the nerve (myelin).

Neuropathic pain can occur for years or even decades before there is measurable damage to the peripheral nerves. (Read One Man’s Journey with Neuropathy). The reality as recently confirmed by the medical experts in the Journal of the Peripheral Nervous System – such measurable nerve damage can take years to happen. Meanwhile the neuropathy patient suffers alone from some unknown underlying pain from a disease or condition, too often dismissed by doctors.

Patients are trying their best to cope with the problems moving limbs in a motor neuropathy or the chronic pain that accompanies many sensory or disturbance to many internal systems as in autonomic neuropathies and sometimes all three. It is easy for the doctors no having the necessary tools for diagnosis and faced with the demands of objective information, to dismiss the patient or diagnose with the diagnosis of somatization.

Now you may have heard the brag. “I have better pain tolerance than you!” Or, “You must have little tolerance for pain.” Or worse, “You have a low tolerance for pain and I deal better with pain than you do.”

The implications are that there is something wrong with you and something superior about them. Such comments hurt and all too often afflict more psychological pain on top of the physical pain and damage that is being done to the brain by chronic pain.

The truth is there is something right with you, but it is not what these braggers think or imply with such unhelpful insensitive comments.

True, the experience of pain is personal and complex. Each of us for a variety of reasons experience pain differently.

Yet science knows that the person with “tightly linked neurons” experience more pain. So you can always say that you are more tightly wrapped, but this will probably go over their heads.

There are physical and psychological reasons why each of us reacts differently to pain and pain medications. This is why partnering with the doctor to find what works for you is so important. (Read Partnering with the Doctor).

That being said, there is something right with you as research of the brain reveals high levels of the enzyme AC1 increases chronic pain.

To any patient living with chronic pain, you do not need to explain what neuroscientist researchers now know about chronic (lasts more than 60 days) pain and how over time, under treated pain actually causes concrete psychological changes in the brain. We now know that patients actually begin to lose gray matter and some of us do not have a lot of it to give away!

Yet the exciting promise behind this discovery of enzyme AC1 is the related testing of NB001 in animals, a compound which attaches itself to AC1 preventing the “neuronal activity that makes chronic pain possible.”

The results are so promising that human trials are planned in the near future.

Whether this compound will continue to show promise in the more complex world of humans remains to be seen, but the road to “where chronic pain lives” has been unveiled.

The promise that science will eventually find a solution for the many patients suffering with chronic neuropathic pain, pain that is beyond the understanding of anyone except the patient experiencing such pain, has moved ever closer.

This is why we must support neuropathy research and more training in the clinical diagnosis and treatment of all neuropathies.

https://neuropathyjournal.org/why-some-cope-better-with-chronic-pain/