Keeping me awake at night

Graphic: Human nervous system via Wikipedia
Human ner­vous system

I’ve known that I had periph­eral neu­ropa­thy since early 2010 when I checked in with a podi­a­trist about other issues. I saw my per­sonal doc­tor and he took a full bat­tery of blood tests to deter­mine if there was any­thing obvi­ous. The results ruled out any of the “bad things” (dia­betes, HIV/​AIDS, etc.). He did detect a vit­a­min D defi­ciency so he had me tak­ing mega dosages of vit­a­min D. Because the sup­ple­ment would not have imme­di­ate effect, I did not get back to him right away and then for­got about the problem.

How­ever, this year, I’ve noted a wors­en­ing of the symp­toms (pin pricks and numb­ness on my feet, espe­cially the left foot) to the point that it was keep­ing me from falling to sleep. Symp­toms seemed to flare up about 1:00 or 2:00 am. My home med­i­cine con­sisted of Aleve, restora­tive poses on my mat, using a ten­nis ball to stretch the sole of my foot, and apply­ing ice to the foot. I tried to do some of these things before going to bed. Results were incon­sis­tent, and I would usu­ally dose off when I was com­pletely exhausted. Some­times, I could pull myself together to go to work. Dur­ing the day, I would not notice the pin pricks because my shoes and socks applied a uni­form pres­sure that tended to lessen my sensitivity.

Since my father’s death in Jan­u­ary and accel­er­ated by my mother’s death in April, I’ve been liv­ing off reserves (don’t ask me to explain; I’m search­ing for a con­cept that doesn’t sound too “New Age-​​ish”). I attended yoga class in fits and starts, I did not make to the gym either, and each new begin­ning seemed to start from a more degraded sta­tus. Because I had to pri­or­i­tize my time and energy to take of my job respon­si­bil­i­ties and the set­tling of my par­ents’ estate, I have not been tak­ing care of myself as well as I should.

This sum­mer, I could feel that things were catch­ing up with me: just run together a string of nights with just 4-​​5 hours sleep each, and anyone’s per­for­mance suf­fers; and pain med­ica­tion and sleep­ing pills did not seem to have an effect. I finally went to my doc­tor again and we did another round of blood work, which revealed that I was in oth­er­wise good health.

The next step was to see a neu­rol­o­gist, who con­firmed the orig­i­nal diag­no­sis — the con­di­tion of idio­pathic periph­eral neu­ropa­thy — the “idio­pathic” means that the doc­tors don’t know what the cause is, and the “periph­eral” means that the con­di­tion is out­side the cen­tral ner­vous sys­tem (brain and spinal cord). The neu­rol­o­gist did not find any impair­ment (grip, bal­ance, coor­di­na­tion, etc.) aside from the pain, and because I can remem­ber the pin prick sen­sa­tion as far back as 12 years, it’s not some­thing of recent onset. He then ordered up an elec­tromyo­g­ra­phy and nerve con­duc­tion test — basi­cally elec­tro­cut­ing my feet, legs and arms for two hours and mea­sur­ing the speed of the periph­eral nerves. The results showed that the nerve cir­cuits in my feet and legs had a degraded capac­ity, but no clear cause was iden­ti­fied.  I was given a pre­scrip­tion of Gabapentin (a generic drug to treat epilepsy, but also effec­tive for neu­ro­pathic pain) and told to ramp up the dosage until it relieved my pain.

Con­clu­sion: After a three-​​week blitz, West­ern med­i­cine has deter­mined that what­ever the cause, the only option is to treat the symp­toms by help­ing me man­age the pain and to mon­i­tor my con­di­tion to see if it got worse. I could prob­a­bly con­sult some more spe­cial­ists or look for some obscure dis­ease (does Dr. House receive patients from DC?). I’ve con­sulted with my acupunc­tur­ist and he said that he could help with the pain and, per­haps, slow the neu­ropa­thy, but did not hold out much hope for revers­ing it. I am going to have to take own­er­ship of my pain and body, and learn to man­age both, which is a trial-​​and-​​error process.