Dear Elizm
Yours was a wonderful post! Thanks for all your hard work.
I am a physician, diagnosed with idiopathic small fiber peripheral neuropathy about 18 months ago, although, in retrospect, I had the symptoms for some time before the diagnosis. I have had the million dollar work/up at my local university, including a skin biopsy, which was positive.
Interestingly, my diagnosis of PN coincided pretty closely with the sudden diagnosis of other problems, including abdominal B-cell lymphoma, prostate cancer, and a weird one (oncocytoma of the kidneys). All of them, other than the PN, are very slow growing, and so far, have had no effect on my life. It's very hard not to think that one or all of my other diagnoses have something to do with the PN, but so far all my docs, including neurologists, oncologists, internists, urologists, etc. can't make a connection.
The PN, on the other hand, has had a dramatic negative influence on my life, although, as is common, everyone tells me I look healthy. It's like a bad joke. My symptoms are primarily severe burning when wearing shoes and socks, and freezing when going barefoot. In the last few months, it has been effecting my legs, so that pants and bed sheets are uncomfortable.
I have tried all the usual treatments. The only thing I can say helps for certain is warm weather! Interestingly, even when the sun is just out, I feel much better. To me, this indicates a psychological component. The other thing that may be helping is Duloxetine, I just started it 6 weeks ago, which is sometimes how long it takes to work, and now that the weather has turned warm, it's hard to know which one (if either) is responsible.
Elizm, I really admire the detailed and ordered approach to your post. In particular, I appreciate your references to articles in PubMed, which, of course, I use frequently myself. Are you a medical professional?
At any rate, should I relapse (which wouldn't be a surprise; as we all know, PN is a moving target), I intend to try at least some of your remedies.
Thanks again!