PN and Tamsulosin (Flomax)

Posted by Ray Kemble @ray666, Nov 16, 2023

Hello!

Because I've complained of not fully emptying my bladder, my PCP has just given me a script for tamsulosin (Flomax). She and I have discussed my concerns about adding this new medication, especially a medication that lists dizziness among its possible side effects.

Neurologically speaking, I have idiopathic large fiber PN. My chief symptoms are poor balance and a wobbly gait. Fortunately, I've no pain. The only medication I've been advised to try––although it requires a doctor's script, it is categorized as "medicinal food"––is EB-N5. I've been taking EB-N5 for more than 140 days with no ill effects. (I do periodic labs to monitor my B vitamin levels, especially my B-6.) Positive effect of the EB-N5? Other than reporting that my symptoms have remained stable, that's hard to say.

Back to the topic at hand: This morning, I took my first 0.4 mg dose of tamsulosin. I'll take another each morning ½-hour after breakfast, letting my PCP know if I experience any adverse side effects. I thought I'd post this topic here, wondering if any of you have used––or are currently using––tamsulosin along with managing your PN.

Wishing you all well!
Ray (@ray666)

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

@dbeshears1

Thanks so much John- I’ve never seen this before and it’s very interesting! I’ve been through a lot of PT and take a regular Tone & Balance class here, and one thing I’ve learned over my 7 years (or think I have) with this is that I have to know my body limits as it now takes me much longer to recover from over exertion, sometimes to the the tune of days or weeks. That’s hard for me, as I used to run long distance races and would expect to be sore for a day or two afterward, but now, if a therapist asks me to see how many times I can repeat sitting in a chair then standing in one minute, I know to tell them that it’s not an event I qualify for, as the damage will stay a long time, and it’s a better exercise for me to slowly stretch and strengthen things. I’m reminded of that today because I am having PT with a new therapist, in advance of foot surgery in 2 weeks (I’ve decided to move forward with the hammertoes correction…) Last week I tried to impress my new therapist by doing what he asked with the sitting & standing, and now we’ve stopped the therapy as we realize I’ve injured the knees I’ll need to walk with while in my surgical shoe, so we’re letting me rest & repair now until surgery.
On the genetic testing… since I just moved here, my new PCP just recommended that to me recently and made a referral to the genetics group. I have an appointment in January. It will be interesting if there are any findings like your article suggests is rarely found. Thanks again for sharing and making us more informed!!

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Interesting conversation to enjoy between you, @ray666 and @johnbishop . I too cannot handle even the teeniest overuse of my muscles. I also have learned to maintain a completely even keel with my emotions. Example: last week I had an early morning appointment (8:30, which now counts as early for me, as I have to treat my nervous system delicately for the first few hours of the day). It was for OT for vestibular therapy for this awful dizziness. I was starting to feel stressed when I got there, no shower ( too much morning activity), worried about having to drive dizzy (requires wearing sunglasses and keeping one eye closed), possibly having diarrhea there (totally unpredictable from autonomic neuropathy). When I learned that it was a PT appointment, not OT, which I can’t have because I already have PT for pain - well, I had a surge of anger and frustration. I argued with the receptionist. I had her repeat herself. I had her call the clinic manager. I perched on the edge of her desk because I needed to sit down. I held up the line of other patients. I tried not to burst out crying.
I felt myself sinking into a downward spiral, so I did what I have always enjoyed. After taking a Percocet and a Baclofen, I got out my mower and rake, and worked outside in the sun for an hour and a half.
Well, I had what I call a “ death night”, woke the next morning very groggy, dizzy and just sick. Ended up canceling all appointments as I struggled, suffered, and slept all day. Saturday was ruined as well. I went into an emotional tailspin.
In the midst of this, I messaged my neurologist, asking for a prescription to calm my nerves in these conditions, in essence create a zombie state, keep my nervous system from flaring. He agreed.
Add another drug to my huge list.
Anyway, just wanted to share my experience of slipping out of my safety zone and trying to be the person I used to be, by working outside in the sunshine!

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@johnbishop

If you want some easy to understand videos on the different neuropathies, checkout Dr. Matthew B. Jensen’s YouTube channel
https://youtube.com/@MatthewBJensen

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What a great site, John! Thank you for this.

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@julbpat

Interesting conversation to enjoy between you, @ray666 and @johnbishop . I too cannot handle even the teeniest overuse of my muscles. I also have learned to maintain a completely even keel with my emotions. Example: last week I had an early morning appointment (8:30, which now counts as early for me, as I have to treat my nervous system delicately for the first few hours of the day). It was for OT for vestibular therapy for this awful dizziness. I was starting to feel stressed when I got there, no shower ( too much morning activity), worried about having to drive dizzy (requires wearing sunglasses and keeping one eye closed), possibly having diarrhea there (totally unpredictable from autonomic neuropathy). When I learned that it was a PT appointment, not OT, which I can’t have because I already have PT for pain - well, I had a surge of anger and frustration. I argued with the receptionist. I had her repeat herself. I had her call the clinic manager. I perched on the edge of her desk because I needed to sit down. I held up the line of other patients. I tried not to burst out crying.
I felt myself sinking into a downward spiral, so I did what I have always enjoyed. After taking a Percocet and a Baclofen, I got out my mower and rake, and worked outside in the sun for an hour and a half.
Well, I had what I call a “ death night”, woke the next morning very groggy, dizzy and just sick. Ended up canceling all appointments as I struggled, suffered, and slept all day. Saturday was ruined as well. I went into an emotional tailspin.
In the midst of this, I messaged my neurologist, asking for a prescription to calm my nerves in these conditions, in essence create a zombie state, keep my nervous system from flaring. He agreed.
Add another drug to my huge list.
Anyway, just wanted to share my experience of slipping out of my safety zone and trying to be the person I used to be, by working outside in the sunshine!

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Good morning, julbpat (@julbpat)

I'll have to keep this short as I'll shortly receive a tele-med call from my doc. I want to be sure I have all my notes together. Reading your post, I'm reminded of one of my greatest frustrations: my PN's inconsistencies. My PN's "basic load" of poor balance and wobbly gait is always there. Still, then I have these "worse" episodes (usually lasting two to two and a half hours) during which my "normally" poor balance is even poorer and my "normally" wobbly gait is even wobblier. I used to attribute these so-called "worse" episodes to the hours following a half hour's at-home PT or early evening when the fading daylight can play tricks on my proprioception. But then I'll have one of these worse episodes when it's unrelated to exercise or twilight … so I just don't know. 'Tis a mystery!

Cheers!
Ray (@ray666)

REPLY
@julbpat

Interesting conversation to enjoy between you, @ray666 and @johnbishop . I too cannot handle even the teeniest overuse of my muscles. I also have learned to maintain a completely even keel with my emotions. Example: last week I had an early morning appointment (8:30, which now counts as early for me, as I have to treat my nervous system delicately for the first few hours of the day). It was for OT for vestibular therapy for this awful dizziness. I was starting to feel stressed when I got there, no shower ( too much morning activity), worried about having to drive dizzy (requires wearing sunglasses and keeping one eye closed), possibly having diarrhea there (totally unpredictable from autonomic neuropathy). When I learned that it was a PT appointment, not OT, which I can’t have because I already have PT for pain - well, I had a surge of anger and frustration. I argued with the receptionist. I had her repeat herself. I had her call the clinic manager. I perched on the edge of her desk because I needed to sit down. I held up the line of other patients. I tried not to burst out crying.
I felt myself sinking into a downward spiral, so I did what I have always enjoyed. After taking a Percocet and a Baclofen, I got out my mower and rake, and worked outside in the sun for an hour and a half.
Well, I had what I call a “ death night”, woke the next morning very groggy, dizzy and just sick. Ended up canceling all appointments as I struggled, suffered, and slept all day. Saturday was ruined as well. I went into an emotional tailspin.
In the midst of this, I messaged my neurologist, asking for a prescription to calm my nerves in these conditions, in essence create a zombie state, keep my nervous system from flaring. He agreed.
Add another drug to my huge list.
Anyway, just wanted to share my experience of slipping out of my safety zone and trying to be the person I used to be, by working outside in the sunshine!

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I feel for you!!! I always struggled when I went to PT and something a little different was bothering, or I thought my hands/fingers were needing some special attention. I have always had fantastic therapists, but felt a little dejected when they’d say “That’s OT, not PT” and that I should get my doctor to send in a referral for an OT. Over time I came to realize the difference and how they do indeed specialize, but I sure wished I could get 2 in 1 sometimes to save me a trip and exhaustion. Keep up the fun work on your yard work passion - but in moderation! Keep the positive vibes 😊

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@dbeshears1

Well - after all I wrote, I STILL got my doctor's final Label for my affliction wrong - I forgot the word IDIOPATHIC! So my "final" diagnosis from him was actually "Severe IDIOPATHIC Axonal Sensorimotor Peripheral Neuropathy" (I knew when I wrote it before it seemed to be missing some syllables. This is exactly why it helps to refer to our written notes. Good luck tomorrow!!

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Good morning, Debbie

These terms! Idiopathic. Axonal. Large Fiber. Small Fiber. Sensorimotor. Peripheral Neuropathy. Polyneuropathy. I'm reminded of those tiny magnetic strips, each strip labeled with a different English word, that we'd attach to the refrigerator door, and then arrange and re-arrange, again and again, each time trying to make a readable English sentence. Do you remember those? That's how I often feel when I'm trying to tell someone about my PN, like I'm re-arranging magnetic strips on my refrigerator door. 😀

Ray

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@dbeshears1

Well - after all I wrote, I STILL got my doctor's final Label for my affliction wrong - I forgot the word IDIOPATHIC! So my "final" diagnosis from him was actually "Severe IDIOPATHIC Axonal Sensorimotor Peripheral Neuropathy" (I knew when I wrote it before it seemed to be missing some syllables. This is exactly why it helps to refer to our written notes. Good luck tomorrow!!

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Hi, Debbie

Well, I had my tele-med chat with my doctor. When I asked him about my condition's proper name, he suggested "idiopathic sensorimotor peripheral neuropathy," short and sweet. He said I could tack on "axonal" if I wanted to, and "poly-" vs. "peripheral"? That would be up to me; I could alternate terms but still say the same thing. As for "severe"? He backed away from calling my PN "severe," although it's certainly borderline and may be heading toward bona fide "severe;" only time will tell. For now, though, I'm going to call my PN "idiopathic sensorimotor peripheral neuropathy" or simply "ISPN" (especially when I'm pressed for time).

As Kurt Vonnegut might say: "So it goes … "

Merry Monday!
Ray

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@ray666 - Ray, - I'd use AISPN - I think the axonal is important and you have the identical dx that Mayo gave to me. I've had about 4 years to digest what I was told, and I know this is something you may have suspected but when you hear it confirmed, it's different. Like others with PN, no cure. But you can live with this and as you have said on this forum, be prepared to make adjustments. You will make adjustments and continue to meet our friends at the coffee shop. Keep moving, stay positive and learn what you can about your diagnosis. Knowledge how to live with this is important. Remember, there are a lot of things out there a lot worse. This is just another bump in the road. Ed

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@njed

@ray666 - Ray, - I'd use AISPN - I think the axonal is important and you have the identical dx that Mayo gave to me. I've had about 4 years to digest what I was told, and I know this is something you may have suspected but when you hear it confirmed, it's different. Like others with PN, no cure. But you can live with this and as you have said on this forum, be prepared to make adjustments. You will make adjustments and continue to meet our friends at the coffee shop. Keep moving, stay positive and learn what you can about your diagnosis. Knowledge how to live with this is important. Remember, there are a lot of things out there a lot worse. This is just another bump in the road. Ed

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Good morning, Ed (@njed)

I suppose I can add the “A” to “ISPN” without it totally demolishing my plans for the day. 😀 PN has taught me a lot about the need to remain flexible, be willing to make adjustments, and be ever-ready to deal with the unexpected. If it weren’t for wishing I hadn’t been saddled with PN to begin with, I could be persuaded to say the challenge of living this way is almost fun*––like being invited to sit in the captain’s chair and take over flying a Boeing 777. The complexities of managing PN (what doctors, what medications, what exercises, etc.) are––in my imagination––something like a first-time look at a Boeing 777’s instrument panel. 😀

*Before anyone takes me to task, I do NOT think of my PN as “fun." Far from it! It is most definitely UN-fun.

Ray (@ray666)

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Hello, all!

I'm the fellow who started this thread about PN and Tamsulosin. At the time, I'd only just been given the script by my PCP; I hadn't yet received the drug. I received the Tamsulosin six days ago and began the following day taking one cap per day, so I've now been taking Tamsulosin for four days. Why not five days? Well, that's why I'm posting again. I know that among Tamsulosin's side effects were possible dizziness and lightheadedness. My PCP had assured me that the odds of my being one of those vulnerable to the side effects were slim. But here's what happened. For three of the four days I had far more difficulty with my balance, more than what I consider my "normal" difficulty because of my PN. That made me suspicious. Last evening for the first time since receiving the Tamsulosin, I skipped the evening dose, and today for the first time since I began feeling the added wobbliness, I feel "normal" (in other words, I feel my by-now familiar––and manageable––PN wobbliness). I know my PCP told me it might take several days to get used to Tamsulosin. But now I'm wondering if there might be some substitute medication. I've left a message for my PCP, but I haven't heard back yet.

Ray (@ray666)

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@ray666

Hello, all!

I'm the fellow who started this thread about PN and Tamsulosin. At the time, I'd only just been given the script by my PCP; I hadn't yet received the drug. I received the Tamsulosin six days ago and began the following day taking one cap per day, so I've now been taking Tamsulosin for four days. Why not five days? Well, that's why I'm posting again. I know that among Tamsulosin's side effects were possible dizziness and lightheadedness. My PCP had assured me that the odds of my being one of those vulnerable to the side effects were slim. But here's what happened. For three of the four days I had far more difficulty with my balance, more than what I consider my "normal" difficulty because of my PN. That made me suspicious. Last evening for the first time since receiving the Tamsulosin, I skipped the evening dose, and today for the first time since I began feeling the added wobbliness, I feel "normal" (in other words, I feel my by-now familiar––and manageable––PN wobbliness). I know my PCP told me it might take several days to get used to Tamsulosin. But now I'm wondering if there might be some substitute medication. I've left a message for my PCP, but I haven't heard back yet.

Ray (@ray666)

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Hi Ray, You might want to discuss the UroLift or Holep procedures to see if they might be an option. I’ve thought about it but just haven’t taken the initiative to do it.

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