Tuesday, September 8, 2009

peripheral neuropathy


Hi Everyone
Fallout day otherwise known as day 14. Have been back at work this week, the blood counts have improved a little this week, feeling pretty good, perhaps just tired.
I have posted some blogs mentioning the numbness in my feet and hands and I do not feel I have explained the problem medically yet.

The body has two parts to the nervous system, the central nervous system and the peripheral nervous system. The central nervous system is essentially the brain, and the peripheral system is essentially everything else. The peripheral system includes the sensory and motor nerves to the muscles. Sensory is touch and motor is involved with movement of muscles. The peripheral nervous system also includes the autonomic nervous system, which controls the  internal organs and glands.
Certain chemotherepeutic agents can cause damage to the peripheral nerves, which is called peripheral neuropathy.  The main ones that do this are Vincristine, Cisplatin, Paclitaxol, Etoposide and Tenoposide.  Those at greatest risk of developing peripheral neuropathy are diabetics, alcoholics, malnourished, and those who have had chemo before.
The symptoms are numbness, tingling, or burning of hands and or feet, numbness around mouth, constipation, loss of position sense (not knowing where a certain part of your body is with your eyes closed), cramping of hands or feet.  The constipation would be if the autonomic part of the peripheral system is affected.
The symptoms usually start after a chemo treatment and decrease prior to the next one.  Some people do not develop them until after the final treatment (like me).  The symptoms tend to peak in intensity at 3-5 months after the final treatment, and from there they diminish intensity, and often go away, but not always.
When the symptoms are severe with early treatments, the dosages of the chemo agents are often decreased for subsequent treatments.

I did a search of the literature and there are many agents being used in an attempt to prevent this, but to date, none have been shown to be of any benefit. It seems that most oncologists suggest vitamen B6 at a dose of 100 mg a day, and L Glutamine (which is an amino acid or a building block of proteins) of as much as 10 grams a day.  Personally, I have a call in to my doctor to see what he suggests.  I DO try to be a good patient. I am fairly certain that mine will just go away as I developed it so late, but I had wanted this blog to be informative, so have included more info.
There are a lot of potential treatments for this problem should it become chronic, and my suggestion here, is to seek help early rather than late, as these types of problems are often much easier to treat before someone has had them for months and months.

I have been working hard on my garden, ....?? perhaps to impress any one who comes to our party on Friday night. I have included a picture of what I am calling my fall garden. I have planted fall spinach, fall beets, my zuchinis have finally started to produce and my artichokes look like they are headed for a fall crop.

P and L
Janet Bates
jankenb @ gmail.com


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