Questions for my podiatrist

[cjsmith]

Questions for Dr. O tomorrow morning

I'm desperate for information, especially for a diagnosis and a
prognosis that I understand. My hope is dwindling. I have not been
as compliant with instructions as I thought I would be.

- Do we know the cause of this pain? Why do my nerves hurt when
someone else's do not? If we don't yet know the cause, how and
when will we find out?
Note: I have pain in places where I have not been diagnosed with
or treated for neuroma, eg medial side of second metatarsal head.

- Is there any hope that I will ever run again?

- Last visit the recommendations made seemed to be mainly attacking the
inflammation. If this is "nerve pain", why this strategy? How does
inflammation play into the picture?

- My pain has not been improved while on Voltaren, but if I skip a
pill by accident, the pain gets WORSE. Other inflammatory pain
(pelvic) also flares up if I miss a pill. I have also seen this
effect while I was taking naproxen sodium daily, about a month ago.
Is my body adjusting to the medication somehow? Are my body's
signals crossed in some way so as to make anti-inflammatory
medication less effective?

- I suspect a system-wide inflammation problem. Years of pelvic pain
is also linked to inflammation and has responded to anti-
inflammatories. How can I find out more about this possibility?

- What about physical therapy to correct twisted and unbalanced ways I
walk? (Myofascial Therapy Center in Los Gatos comes highly
recommended by a woman who was told she could never ride horses
again. She does. I am trying this.)

Comments

[redgrrl.livejournal.com]

Good luck, CJ -- I'm sorry to hear that you're still in pain! Thinking good thoughts for you...

[cjsmith.livejournal.com]

Thanks, Wen! Every time I get a little bit proactive I start getting more hopeful. My fingers are crossed for, at least, a good appointment tomorrow morning.

[quasigeostrophy.livejournal.com]

All good questions. Good luck!

[cjsmith.livejournal.com]

Thanks! Out the door in a minute or two.

[jtidwell.livejournal.com]

You're in my thoughts and prayers... good luck.

[cjsmith.livejournal.com]

Thank you. I appreciate it. I'm out the door in a moment to head over there!

[mactavish.livejournal.com]

Lists of questions are such a good idea. Good luck.

[cjsmith.livejournal.com]

Thanks! I love lists of questions and have used them well before stuff like surgery.

[rampling.livejournal.com]

Good job on the list of questions; that's such a help. I did that for my appt with my surgeon on Monday, and got the answers I needed. Nothing new, just filled in some details I really wanted to know.

[cjsmith.livejournal.com]

Excellent! :) Thanks for the luck -- I'm heading out now for my appointment.

[allanh.livejournal.com]

Several years ago, I had a nasty case of Bell's Palsy (facial paralysis) which was caused by an inflamed facial nerve that swelled up and cut off circulation to the nerve fibers that go through a little hole in the skull on their way to the brain. Before the Bell's kicked in, the pain in my face from even a featherlight touch was absolutely unbearable.

I can only imagine that kind of pain all over my feet, and wince in sympathy.

One of the most frustrating things for me was that none of the doctors could ever explain to me how my facial nerve became inflamed, or what causes such inflammation.

I've long suspected that in my case, the whole thing started with a minor oral herpes (chancre) herpes sore that sat directly on top of a nerve just inside my lip. Since the herpes virus "lives" in nerve sheaths between active attacks, I've always believed there was a link. I can't believe that a virus that retreats to spinal column nerve cells doesn't travel to other places in the body, and/or only affects one specific area (genitals, lips, etc.).

[cjsmith.livejournal.com]

Yeow! Mine's not that bad. It hurts when I walk, but featherlight touches are no problem at all. (I suppose foot nerves run deeper than face nerves. Evolution did one thing right.)

How did you sleep? Or wash? Man, that would've driven me nuts.

The connection you came up with makes loads of sense to me. The virus lives in nerve sheaths, you had a sore (full of active virus) right over a nerve -- it sure seems like a reasonable theory!

[allanh.livejournal.com]

How did I sleep? Badly.

How did I wash? Gingerly.

What really drove me nuts after the inflammation was over and the Bell's Palsy had manifested full-force was ... drinking. Anything. A box of drinking straws was my best friend for several months.

[cjsmith.livejournal.com]

Yeah, straws. Maybe those sports bottles with the squirt tops. All this just... resolved itself, on its own, after some months?

[allanh.livejournal.com]

Yep. That's the weird thing about Bell's Palsy. It goes away by itself.

How long does it take? It varies.

I asked my neurologist to be more specific. He said: it goes away when it goes away.

What causes it? We don't know.

What cures it? We don't know.

Are there any lifestyle factors? We don't know ... but a lot of cases seem to be stress-related.

The only treatment - and I hesitate to call it that - is to treat the nerve swelling with a course of oral steroids (don't tell Mark McGwire!). The idea of the steroids is to reduce the nerve sheath swelling, which will stop the nerves from cutting off their own blood supply, which will ... you get the idea.

This was about 4 years ago, not long after my dad died and while my former business was running itself into the ground. Yeah, I'd agree that it was probably stress-related. Once I finished shutting down the business a couple of years later, a number of odd medical problems I had just ... went away by themselves.