Neuropathic Two Step

Phantom Appeasement. That’s pretty much what we might call a medication that was effective in damping the discomfort of peripheral neuropathy. Most analgesic medications limit the signals which pass through certain channels. Pain paths, they’re called. Signals pass along specific routes from the area of affectation to the brain and the drugs effectively interfere with the passage of those signals, usually blocking pain receptors. Neuropathy is such a difficult pathology because there are no pain paths involved. The pain is the result of short circuits within the nervous system. They are similar in nature to phantom pain experienced by amputees, who suffer pain in limbs that no longer exist.

Medications like Nerontin (Gabepentin) are effective in a small number of people and they work by dampening, or slowing, certain nervous system functions. But it, and drugs like it, are generally targeted and there is no way to ensure that the areas suffering neuropathic discomfort will be included in the damped portion of the brain or nervous system.  While most people figure that the malfunction of neuropathy occurs in the head, the brain is actually a distributed organ with elements in the cranium and throughout the spine. This is why some people with Multiple Myeloma experience neuropathy even when they have not had chemotherapy. It’s rare, but at times deterioration of the spine  affects elements of the nervous system outside the skull. But usually neuropathy results from the destruction of cells involved in the nervous system in general. As a result, any medication to subdue the phantom pain of neuropathy will have to be similarly phantom in nature. A bullet that strikes its target regardless of the direction it’s fired.

Some people can get an appearance of relief through opiates, and even aspirin can have some positive effect. Again, it depends on the person. But in cases of narcotic and non-narcotic analgesics, the effect derived is through a general dulling of the senses generally. But the case can be made, at least for narcotics, that the discomfort isn’t reduced, the patient simply doesn’t care about it quite as much. However, any improvement in neuropathic symptoms is negligible at best.

I am dubious personally when it comes to supplements. However I readily admit that some nutritional and medicinal supplements appear to have some benefit. However, like the benefits of Gabepentin, opiates, or aspirin, the spread of people benefitting is a small percentage of the total. When it comes to peripheral neuropathy, there is no magic bullet, no single or combination therapy that can be depended on to provide neuropathic relief.

What I know of peripheral neuropathy is that giving the brain something else to focus on and react to is a way to alleviate, at least temporarily, the symptoms of peripheral neuropathy. Soaking feet in warm massage baths or enjoying foot and lower leg massage can bring almost a flood of welcome relief. It’s true that the positive effects are transient, and that the symptoms will return. But the actions can reduce or eliminate the discomforts for a temporary period, and when it comes to the exquisite agony that peripheral neuropathy can manifest, any relief is welcome.  Taking steps like not wearing shoes, instead resorting to slipper socks a size too large can reduce the external irritants that provoke neropathic symptoms. The same is true of setting pillows to each side of the feet in bend, making a tent which keeps the pressure of the blankets and sheets from pressing down on the feet can make a huge difference in comfort levels. Combining this approach and enhancing sleep time with Ambien or Temazepam or Benadryl can help sleep come and remain for a greater period than one would otherwise experience.  Taking warm baths and showers can also be a plus, flooding the body with pleasant sensations that overwhelm the negatives is also a proven way to achieve at least temporary relief. Like I said, any relief is welcome, especially the more profound the neuropathic symptoms.

A recent addition to the tools against illness and treatment side effects are specialty pain clinics and specialists. Different from the typical pain clinics, they specialize in combating the disabling symptoms of neuropathy. They will work with a victims, moving through the various medications, supplements and physical therapies which ave proven effective for some, tailoring a best approach for sufferers. True, some are hacks, front people for miracle cures. But many are dedicated and empathic people who only want to alleviate the suffering of others. Whether a victims approaches their discomfort on their own, through their oncology team, or with a specialist in neuropathic pain, there are ways to at least make it more tolerable for many who suffer from neurpathy’s special torture. But it’s a battle.