Skin sensory sensitivity
Background: now 74 yo previously reasonably healthy with history of I B S managed by diet; diagnosed last year with inoperable pancreatic adenocarcinoma; now being treated with abraxane - gemcitabine, with complications of "chemo feet" and sometimes "chemo brain;" up to around cycle 7 with changes in dosing and timing to address a less than vigorous response by my "elderly" bone marrow
Current med is digestive aid Creon (ugh) for exocrine insufficiency Also Pepcid (famotidine) for indigestion when needed
Also continuing desire for warmth not helped by what seems like continuously overcast weather since the start of 2023, and living in an old COLD farmhouse in snow country.
I now also have what my oncologist has diagnosed as venous insufficiency affecting my left leg from the knee down, manifesting as swelling and some heat, although my toes tend to remain cool / cold to the touch, very much like my right foot. I also have the sensation that both feet feel "tight." Given our "rugged" (my oncologist being polite) living conditions, there have been only rare opportunities for walking outside; complicated by a search for appropriate footwear now mostly solved by OrthoFeet (I think, although it's early days yet)
The latest wrinkle is hypersensitivy, particularly involving my feet, the left much more so than the right
An example would be finding it practically unbearable to have the electric cord of my heated blanket lying across my toes
Have others experienced this phenomenon?
Have others discovered any effective treatments?
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I haven't experienced anything like this, and I have no medical knowledge, but I wanted to say that I'm sorry you're dealing with it. It sounds so painful! Do you have a palliative care MD? Palliative care doctors help you manage symptoms and side effects, and this certainly is one. I've read that there are some medications that can help with neuropathy (I don't know what they are). I would also talk to my oncologist about revising the chemo regimen, either permanently or for a little while, to see whether your body can recover.
Thanks for your reply.
I have for the moment adopted a wait-and-give-the-current-regimen-a-chance approach, since my current oncologist is very responsive to communications through MyChart. I have two more Chemo Infusions scheduled in the coming couple of weeks, after which he plans to repeat imaging studies, since the end-goal is still improvement or lack-of-progression of disease.
So far, he has not insisted on piling meds on top of each other - this is consistent with my wishes; he is also open to trying other approaches. An example is that instead of instantly prescribing gabapentin, he has recommended applying Dove Dry Skin Relief / Expert Repairing Balm to the area affected by venous stasis. (I am also doing some walking, mostly indoors lately since our weather continues to be mostly too inclement for outdoor walking).
I have learned so much from the experiences shared by other patients here and I've used that information to guide my own searches for whatever pertinent studies have been published.
This is my own approach to not throwing out what western medicine has to offer, and yet remaining open to other possibilities.
I have not yet asked for palliative care, since I feel that puts me in a defeatist position from the get-go, and I don't think that is good for my mental health. I am already leading a very isolated life where I have to make a real effort to persuade far-flung family and friends to come for visits and a hug or three.
Thank you for sharing your difficult story. I can't travel and my family can only visit rarely. Zoom, calls from friends, walks with friends when weather permits have helped to reduce social isolation. Palliative care is not just end of life care, it is geared up for improvement in quality of life. It might help you to talk to a person involved and ask about the services that are provided. My minister has served as chaplain for a palliative care team and I think it might have a lot to offer. You can always stop if it doesn't.
I do regret not having an established relationship with some non-denominational church or group. But there again living on a 73+ acre farm 5 miles from anywhere more "urban" and working the most demanding years (24/7 on call for weeks at a time) at the end of my career, prevented it even occurring to me to do so.
There always seems to be an "on the other hand" and in this case, I have a distant cousin who is a minister in the same state as mine, and I was already in renewed communication with him through his brother. He has shared some advice with me, at least part of which I practice just about every night.
I hear you re the palliative care. I don't want to give up either! Palliative care was explained to me as I listed above--it's designed to help manage symptoms and side effects. I was told that in my medical system, the palliative doc and the oncologist work as a team. The oncologist prescribes and manages the treatments; the palliative doc helps you deal with nerve damage, loss of appetite, weight loss, reduced mobility, or whatever develops during those treatments. I currently have very few symptoms, but I already have seen a palliative MD. So far, we've had a long initial consult, and he wrote a prescription to boost my appetite. This also gets me on his books for if/when I'll need more help later (for example, I'm told he's the one who'll write the pain management plan). It may be that your oncologist can do all of the palliative stuff for you, in which case that's great--one less MD to manage. (wink, wink!) Glad your online system allows you to keep in touch with your MD; that helps a lot.
I had similar symptoms of peripheral neuropathy when doing Folfirinox over 24 months. To deal with the discomfort, I was prescribed gabapentin (brand name neurontin). It is often used to treat diabetic neuropathy. Initially I was prescribed 300mg every eight hours. That was too much for my system and resulted in feeling drowsy and unable to function at a normal level. It was reduced to 200 mg every 8 hours and after taking it for one week, began to take effect and provide relief to the hypersensitivity in the tips of the toes. However after approximately 8 weeks on it, it was causing disturbing dreams and sleep. I stopped it and after the feet began exhibiting discomfort, went back on it. I had to keep pausing the drug when sleep was affected.
I then dropped the dose to 100 mg and took it every six hours instead of every eight. That seemed to be the sweet spot in controlling discomfort and not affecting sleep. Eventually my neuropathy resolved after many years and no longer required gabapentin.
Thanks for sharing your experience. Finding the sweet spot seems to be the equivalent of the search for the Holy Grail - just always a little bit out of reach.
I have just about concluded - at least as of today - that my whole body is hurting and so I shouldn't be surprised that fixing a little bit here, simply invites the protests coming from somewhere else to become more apparent!
i had shingles last year when i put a top my skin gets a reaction help any ideas