I was finally definitively diagnosed with Small Fiber Polyneuropathy after the puzzle piece of Gastroparesis was added to my long list of disparate symptoms and my neurologist ordered an IENF Skin Biopsy.
My symptoms started three years before that after a day at Disneyland walking and standing for hours.
I could hardly walk to the car, and suffered level 7 BURNING, tingling, numbness, parenthesis’s, etc., that kept me from sleeping/dreaming for 3 years before I saw a podiatrist who diagnosed bilateral plantar fasciitis with bilateral Achilles Tendonitis. He tried cortisone injections which did nothing. Neither foot braces, resting feet, Lidocaine patches nor ice helped.
My PCP referred me to a neurologist who prescribed 300 mg Gabapentin which did nothing.
He titred up my Gabapentin to 300 mg Gab 3 x per day (900 mg total daily) PLUS Cymbalta (Duloxitine) 60 mg, and the burning went away!! He said the Gabapentin blocks the pain signals from my feet/lower legs, and the Duloxitine blocks the pain Receptors in my brain. Coincidentally, the pain receptors in the brain are in the same region that controls Depression. No wonder pain and depression go together, and that is why the Cymbalta (Duloxitine) plus Gabapentin works together to control symptoms for me. My pain has been controlled for over a year! I resisted the depression piece at first because I didn’t understand the pain/brain connection. When you need to control things, accepting "DEPRESSION" is hard.
I’ve recently been diagnosed with Central sleep apnea, and will have an in-lab sleep study.
Hopefully, this isn’t a progression of my autonomic symptoms.
Another weird symptom - when I gasp for air, my lower legs tingle! This has improved since starting AutoSet CPAP. Sleep lab results should be interesting.