Neuropathy Uncategorized

Patient’s Guide to Diabetic Neuropathy

Neuropathy is a broad medical term for nerve damage. Neuropathy is quite common due to type 1 as well as type 2 diabetes. Did you know that it is estimated that more than 26 percent of people with diabetes — type 2 actually have evidence of damage to their nerves at the time that they are diagnosed with diabetes. A type of neuropathy, called polyneuropathy, is the one of most common type of neuropathy that occurs in patients that suffer from diabetes. There are many other types of neuropathy and often terms like diabetic neuropathy and polyneuropathy are large categories of illness and a more specific diagnosis can eventually be found. Neuropathy often affects people without diabetes as well.

There are many signs and symptoms of neuropathy usually the earliest signs are loss of sensation often with burning sensation in a stocking or glove distribution. Catching neuropathy caused by diabetes and treating the neuropathy early will often lead to better quality of life and even reversal of symptoms.

There are many treatments for diabetic neuropathy unfortunatley they are not widely publicized and includes a three step process:

1. Identifying the extent of the damage to the nerves this will allow us to target therapy

2. Stop the nerve pain — as long as your life (and sleep cycle) is disrupted by nerve pain healing will be delayed (most common issue seen with patients who have neuropathy)

3. Heal the nerves — Replace deficiencies that are associated with neuropathy, increase circulation, and use advanced regenerative treatments (often referred to as stem cells) to heal nerves have been damaged by demyelination.

Pain in the foot from neuropathy. Symptoms of peripheral neuropathy. Most common symptoms of neuropathy is numbness in the fingertips and foot. New neuropathy treatments.

If you are suffering from neuropathy pain and would like to receive help please contact our office by clicking here.


Medications that Cause Neuropathy

Patients are often unaware that many common medications can cause neuropathy.  Medications known to cause neuropathy from “toxic effect”:

  • Most chemotherapeutic drugs
  • Antibiotics (eg, dapsone, fluoroquinolones, isoniazid, metronidazole, nitrofurantoin)
  • Antiretrovirals (eg, didanosine, stavudine) 
  • Amiodarone 
  • Colchicine 
  • Disulfiram 
  • Phenytoin 
  • Pyridoxine
  • Tumor necrosis factor inhibitors (eg, infliximab)

There are many ways to treat the toxic buildup that occurs from such medications. The first step is to migrate to a different medication and discontinue the original medication. The next steps vary depending on the medication but typically can involve infusions medications that restore liver function. For heavy metal there are iv infusions that will bind to the heavy metals and help your body eliminate them.

Adam Sewell MD

How to Win Back Your Health

I have been fortunate to have been able to treat thousands of patients in my career.  Looking back at my experiences of having a front row seat to watch and help so many people overcome their health challenges has been a real blessing.   I found three characteristics that are common among patients that have overcome health challenges.

  1. Positive Attitude (Focusing on Positive)

Probably the first and most misunderstood characteristic: Positive attitude.  This idea is commonly misunderstood to be unrealistic.  This is not the case. This is the most common characteristic I have seen in patients who have overcome almost any illness. The patients will acknowledge negative issues and results but they never dwell on the negative.  There is a large body of research from Carol Dweck, PhD on the importance of a “growth mindset” in the areas of education and learning.  Ms. Dweck set out to find why some children were able to learn faster than their peers.  What she found was that the children that were considered “gifted” and learned faster had one thing in common, they all had a certain set of beliefs.  These beliefs she called the “growth mindset.”  These beliefs were most evident when the children came across obstacles.  For example, when the student failed to solve a problem correctly those students with the growth mindset would almost immediately attempt to solve the problem again.  Often when faced with an incorrect answer they would say statements such as “it’s okay I will love to figure out this problem” and “I love challenges”.  The growth mindset students would also be forward thinking and anticipate success with beliefs such as “ I am going to really love it when I get this problem correct” and “I can figure this out, I love challenges”  This set of beliefs was the only thing that separated the “gifted” students from the average students.  How can you apply the “growth mindset” to your life? How will looking at the world through the growth mindset lens change your thoughts and therefore your actions?

  1. Taking Responsibility.

When we give away responsibility we give away our power.  Nearly all patients that heal and recover completely have always taken their healthcare as their responsibility.  While they consult physicians and other healthcare professionals they take responsibility for getting better.  When recommended a treatment they read about it and prepared themselves.  Often I could tell the success of a treatment prior to the treatment because the patients would often be so focused on getting better.  The patients would often come to a new patient appointment with many informed questions and would take notes.  If there was an obstacle to their care such as an insurance company they would work on their end to handle it.  If there was a problem with scheduling they would figure it out.  What was very interesting is that by taking responsibility it would empower the patient and in many cases this would correlate with a faster rate of recovery.  How often do we accidentally give our power to someone else?  How can we take our power back by taking responsibility?

  1. Willing to Try

The final characteristic common to patients who were able to win back their health was a willingness to try.  All too often, when we face a challenge we can default to blame or a “why me” attitude and give up.  Those patients that overcome a health challenge have a willingness to try different treatments and therapies.  Not all therapies worked and many did not work right away.  It is the ability to persist and keep trying until the correct solution is discovered that makes the difference between failure and success.  What I found most about patients who overcame illness was that by taking initiative and being willing to try new treatments this would produce results.  When these results were analyzed it would provide information that would often lead to a solution.  Without the initial attempt and failure, we would have never had the information to find the solution.  The willingness to try was directly linked to the solution the patient was seeking.  How willing are you to try new things?  How willing are you to think “outside of the box”.  I think this quote by Tobias Wolfe says it well — “We are made to persist .. That’s how we find out who we are”


Patient’s Guide to Neuropathy

Neuropathy is probably one of the biggest misunderstood areas of medicine. Partially because neuropathy does not fall under one medical speciality and partially because the term neuropathy encompasses many different illnesses.  

I find that the easiest way to explain the types of neuropathy is to group the neuropathies by what is happening to the nerve:

Axonal Nerve Damage (Damage to the wire)

If you have a problem with the long part of the nerve that sends the information, kind of like having a problem with the telephone line it is called axonal neuropathy.  The reason it is called axonal is because the neuropathy is caused by the long part of the nerve known as an axon being damaged.  The best way to think about this is to think of wire where parts of the wire has been damaged.  Kind of like an old cellphone charger where you have to place the cord “just right” for it to charge your phone.  

The following illnesses cause “axonal neuropathy” (wire damage neuropathy)

  • Diabetes
  • Critical illness
  • Longstanding HIV infection
  • End-stage kidney disease (aka “Uremic polyneuropathy”)
  • Amyloidosis
  • Hypothyroidism
  • Vitamin deficiencies
  • Lyme disease
  • Toxic — due to alcohol, chemotherapy exposure, and most heavy metals

Demyelinating Nerve Damage (Damage to the insulation around the wire)

Other illnesses cause “demyelination” the best way to think of this form of nerve damage is like a wire where the insulation surrounding the wire has been damaged:

This type of nerve damage is usually caused by:

  • Autoimmune illnesses (for example Guillain-Barré syndrome*)
  • n-hexane exposure

Environmental (physical damage to the wire due to the environment)

The third type of nerve damage is environmental meaning the nerves were damaged by something in the environment.   Environmental factors can also impact nerve health in many ways. 

Environmental nerve damage has been caused by:

  • Vibration-induced nerve damage 
  • Prolonged cold exposure
  • Low oxygen supply 

Each of these types of neuropathy can be determined with some testing.  Once you determine what type of nerve injury you have there are many ways to go about fixing the problem.

First step is to control the pain — we will often use a small device that can generate an energy field around a nerve or a set of nerves while we treat the nerve.  Chronic pain isn’t a joke as anyone who suffers from it will tell you and getting out of pain is the first step to healing.  There are many reasons why but one of the most important is that if you are in chronic pain the pain causes release of flight or fight chemicals called catecholamines.  These are the chemicals that get released if you are suddenly startled or are in physical danger like before a fight.  These chemicals cause your heart to beat faster and shift blood flow away from organs that don’t need it and towards the muscle to get your body ready to either fight or take flight (run away). Being in this state will likely stop any healing process. 

So what do you do to stop the pain and then heal the nerve?

There is now technology that can turn off pain from nerves.  This technology is call a neural stimulator (not to be confused with tens units or shock like devices).  The neural stimulator generates an energy field around the nerve or group of nerves and can interrupt painful patterns.  It is kind of like a remote control for your pain.  It essentially allows you to turn off your pain and replace it with a pleasant sensation.  For most patients, once the pain is controlled then sleep cycles return to normal blood pressure often will level out and blood pressure medications are often decreased.  Once the body is in the state there are several ways to heal the damaged nerves which we will cover in our next post.