Questions to Ask and Treatment Options

Posted by dbchip @dbchip, 1 day ago

I recently moved this past summer and have my first appointment with my new Neurologist at Duke in January. Diagnosed 3 years ago with (CIAP) Chronic Idiopathic Axonal Polyneuropathy. My pain levels have gotten pretty consistent over the past 4-5 months.
Over the past 3 years I have tried the following with no luck:
Gabapentin
Duloxetine
Alpha Lipoic Acid-R
Lidocaine Cream
Pregabalin (still taking)
Acetyl L-Carnitine (still taking)
I did have success with the Pregabalin for about 4 months, but then it stop working.

Anyone have any suggestions on what I should ask when I go to my appointment as far as treatment? They my run the labs again and do another EMG-NCS, but I doubt they will find anything new.

Interested in more discussions like this? Go to the Neuropathy Support Group.

@dbchip

My Neuropathy was diagnosed on a EMG-NCS I had 3 years ago. Symptoms include: foot pain (numbness, tingling, aching burning) and bodywide muscle twitching

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Is the EMG painful?

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@dbchip

I have seriously considered doing this. Just hesitant on the investment and if it will work.

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Yes, it is a bit of an investment as you don't get immediate results. My health plan covered a good portion of it.

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@topsz

I have numbness in my toes and have not been diagnosed. Which Dr should I see? The numbers want gradual, one day it was just there! It’s a miserable feeling.

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Neurologist

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@topsz

Is the EMG painful?

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No but the NCS is

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@topsz

How was your neuropathy discovered? Testing? What were your symptoms?

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Mine was sort of self-diagnosed. Left side chest pain with sensitivity to touch. Numbness and tingling in lower legs and feet. Also a terrible itch all over which got worse overnight. Was taking GabaPentin at the time, but it was useless. While recovering from lumbar surgery, the hospitalist switched me over to PreGabalin which helped immensely. My pain doc was apprhensive about PreGabalin and would have recommended Cymbalta. He did offer Baclofen, but I couldn't tolerate it and the PreGabalin at the same time.

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@bajjerfan

Mine was sort of self-diagnosed. Left side chest pain with sensitivity to touch. Numbness and tingling in lower legs and feet. Also a terrible itch all over which got worse overnight. Was taking GabaPentin at the time, but it was useless. While recovering from lumbar surgery, the hospitalist switched me over to PreGabalin which helped immensely. My pain doc was apprhensive about PreGabalin and would have recommended Cymbalta. He did offer Baclofen, but I couldn't tolerate it and the PreGabalin at the same time.

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What tests did Drs perform? Is there a difference in symptoms between neuropathy and venous flow?

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@topsz

What tests did Drs perform? Is there a difference in symptoms between neuropathy and venous flow?

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A neurologist did some EMG type tests mostly because I have foot drop from nerve damage in my lower legs and feet. I can wiggle my left big toe, but not the right one where I have the foot drop. I did wear a AFO for about a year. She said the nerve damage was from being pre-diabetic. It doesn't seem to have gotten any worse. I also have CVI issues in my lower legs. I don't recall ever being given any type of "official" neuropathy diagnosis, but all I know is that the PreGabalin makes things a lot more bearable.

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In reply to @dbchip "Neurologist" + (show)
@dbchip

Neurologist

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Yes, a neurologist is the best starting point. I also have numbness and tingling in my feet. I have had the condition for 15 years. Recently, I have found my hands going numb and aching as I awake in the morning. The question I have is the malady with my hands related to my neuropathy in my feet. Perhaps it is just an extension of the development of my neuropathy, I have taken gabapentin and Cymbalta for many years for anxiety control, perhaps it has improved the neuropathy in my feet without me realizing that was an ancillary benefit.

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I also have lower left back pain with the numbness of toes. Anyone else experiencing this?

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