"Tight" feet and laser therapy

Hello @ajh5285, there are other members talking about laser therapy for neuropathy in a few other discussions that you might want to view here:

– Laser Therapy for Neuropathy: https://connect.mayoclinic.org/discussion/neuropathy-1/
– Has anyone used MLS Laser therapy or Calmare Therapy? https://connect.mayoclinic.org/discussion/question-about-therapies/

Have your feet gotten any better?

Thanks for your reply.
I still haven't dug through all the posts on the discussion links, but should do so.
My feet are gradually getting more normal sensation. Perhaps I'm just lucky.
I've also wondered about a couple of things I've been doing that might have helped. I'm especially interested in the question of small fiber neuropathy since I've had 3 different forms in my lifetime.
(1) A mononeuropathy which until recently was still present (this was the first spot to go numb as I started to develop Guillain-Barré syndrome (hospitalized for over a month - a long & distressing tale full of mistakes that I won't bore you with, but it took away 11 months of my life).
Perhaps it has finally run its course or one or more of the strategies lately have worked. Recently based on discussions here & elsewhere I've attempted to get some exercise every day (usually walking which inevitably involves climbing up hill, since our house is situated on the side of a hill with at least 3 different ways to walk that all involve hill climbing (note that hill climbing, in my experience, does nothing to help with stair climbing which I have been less successful in finding an easy way to do more than go up about a step of at most a few inches); the other recent strategy I've adopted is TRE/intermittent fasting. Still trying to sort out the best apportionment of proteins vs healthy fats vs carbohydrates...
(2) A polyneuropathy affecting my toes and that limited how far I was able to jog-trot as I exercised during recovery from (1); this finally disappeared years later after I started regular deep tissue massage (based on the Paul St John dermatome approach).
(3) "Chemo feet" &/or venous insufficiency following a course of gemcitabine-abraxane for inoperable pancreatic adenocarcinoma with lung mets. I regard my treatment by my first oncologist as malpractice since this is a very common complication of the therapy she prescribed, and can be alleviated, even prevented, by certain strategies if used at the time of receiving chemo.
Unfortunately I did not find this out until one of the nurses (a former colleague) informed me that "Chemo Brain" was real, and I overheard a discussion about using a bag of frozen peas to prevent it. I have since discovered that simply cooling my feet helps tremendously, to the extent that I'm still sleeping with my feet uncovered.
I've also been wearing sandals that have a massaging nobby surface built into the surface that comes in contact with the soles of my feet. The rationale is said to be something like helping your feet to "wake up."

Interesting and helpful info above! I'm still digging into this as my CIPN (Chemotherapy-Induced Peripheral Neuropathy) gets worse on Gemcitabine + Abraxane + Cisplatin (the latter two being known causes of CIPN).

There was another thread here recently ( https://connect.mayoclinic.org/discussion/seeking-a-second-opinion-1/?pg=3#comment-898695 ), in which @frygirl777 cited his very definite objection to icing while Oxaliplatin (which causes cold sensitivity as well as CIPN) was part of the cocktail.

I stumbled across this article https://letswinpc.org/disease-management/ice-prevent-neuropathy/ a few days ago, in which Dr. Allyson Ocean uses some guarded language (would, could, might, may) when it comes to icing during chemo in general (no specific mention of Oxaliplatin), but she does end with a definitive "certainly no harm in trying!”

I can't tell if it's helping me or not. I suppose I could do an experiment with ice on one foot (experimental variable) and no ice on the other (control) and see where that gets me...

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I'm not sure I've ever heard an official definition for "chemo foot" but I do notice some swelling of my feet after jogging or long walks, and it's worse right after an infusion than for the same exercise 1-2 weeks later. One RN told me that was an example of chemo foot... caused by an inflammatory response to the neuropathy, perhaps aggravated by bad running & walking technique while not being able to feel the soles of your feet. 🙁

You should be able to find information using the search term . Cleveland Clinic has an informative page. where the condition is included in the secondary category, and chemotherapy is listed as one of the causes.
https://my.clevelandclinic.org/health/diseases/22752-erythromelalgia
As usual, "your mileage" [regarding symptoms] may vary.
I tend to just call the condition "chemo feet" since that's my primary problem.
Other more commonly-encountered effects of "chemo" may be referred to as < o hands> and < o brain [fog]>

The saddest part of this commonly encountered Adverse Effect is that the knowledge about the signs, symptoms, and ways to ameliorate or even prevent it does not seem to have risen to the level of the physician staff in many institutions [including my own university hospital, which, perhaps, not coincidentally, is not a center of excellence in my current state of residence (WI)].

For some reason, it's seems to be harder to find recommendations for exercise, even though there is evidence online (M C C, I think) and a few journal articles, that exercise is beneficial in several ways.

A succinct summary regarding Exercise reads
"Exercising: Choose gentle activities that get you moving without significantly raising your temperature. These include swimming, yoga and Tai Chi."

Oh, yes, one more comment about your swelling after jogging -- somewhere I have encountered the recommendation that it is also important to wear footwear that provides adequate cushioning against "percussive effects." Sorry, my "chemo brain" (aka my leaky bucket brain) fails to tell me where I saw this comment.

Sorry, I see that somehow a key word was dropped from my first message, although the proper name for the condition was included in the url.

The search term that should work is "erythromelalgia."

P S - I'm clueless as to why when I entered "chemo." it is showing up above sometimes as just "o."

Perhaps it's best to spell everything out completely ?!?

I was told by my oncologist that with Oxaliplatin, since it causes cold sensitivity, icing could cause permanent damage to your nerves. This is why I chose not to continue doing it after the first round. He instead reduced my Oxaliplatin dose by 20% and going into my 8th round, I have zero neuropathy. My suggestion would be requesting that your dose be reduced over taking the risk of risking permanent nerve damage.

I had worsening of neuropathy after oxaliplatin was stopped due to an allergic reaction. I was having mid symptoms. I stopped May 2, 2023. I believe that the neuropathy has finally stabilized. I am not having pain but my ability to use my fingers is reduced and my balance has been affected. Probably the dose could have been reduced but I was not that bothered by the symptoms. I knew that people with BRCA mutations specifically tend to respond to platinum drugs so I wanted to take the full dose.

"I had worsening of neuropathy after oxaliplatin was stopped due to an allergic reaction."

That is a commonly known reaction. My neurologist (and literature) refer to it as "coasting."

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I found a summary of the POLAR study on icing and compression to treat Chemotherapy-Induced Peripheral Neuropathy here:
https://www.breastcancer.org/research-news/hand-cooling-compression-nearly-halve-risk-of-neuropathy-from-chemotherapy
It was specific to breast cancer patients on taxane meds (Taxol, Abraxane), but found benefit in both icing and (independently) compression.

As I thought more about the advice from @frygirl777 's oncologist about NOT icing with oxaliplatin, the more it made sense.

If you were in a dark room for hours, and gradually let your eyes adjust to become hypersensitive to the absence of light, and then had someone take a flash photo in front of your face... so for a (possibly bad medical analogy), it might be similar to letting your nerves get into a hyper-cold-sensitive state on oxaliplatin, then blasting them with ice. In both cases, overloading a sensor that has been adjusted to its highest gain settings.

For the specific case of oxaliplatin, compression might be a good alternative. I'm not experiencing the same level of cold sensitivity I did on Folfirinox. Mild, but nowhere close.

Cold was really painful after my chemo. My food was uncomfortable to eat if it was not at room temperature. Taking food out of the fridge was painful. I got cramping in my face with the cold. The cold sensitivity has improved significantly and I am comfortable with eating food out of the fridge although room temperature seems better to me. The neuropathy affects my ability to use my fingers and my balance is off but fortunately I am not having pain. I was only having very mild symptoms at the end of chemo. I am not sure if there was anything which would have prevented the worsening after chemo stopped. Exercise is helping me to manage with my symptoms.