Small Fiber Neuropathy Symptoms Diagnosis and Treatment
Small fiber neuropathy is really an interestingcondition because it consists typically of just burning, numbness, pain of the feet,sometimes the hands later on without necessarily having any abnormalities on your EMG or nerveconduction study. So what I tell patients and actually residents or students who trainunder us is that a normal nerve conduction study does not exclude a neuropathy. And wewill confirm this by doing additional testing, specifically the nervous the the examinationat the bedside asking patients about their symptoms, for example, loss of sensation tocool or or hot temperatures, loss of pain sensation and also doing skin biopsies wherewe look at nerve densities in the skin both
from the calf and the thigh as well as doinga special test that looks at sweat function both in your foot in in the legs as well asthe feet to gauge the level of small fiber nerve damage. Small fiber neuropathy typicallywill progress unless the underlying cause is identified and reversed. Diabetes of coursebeing the most common cause is always screened for. But once the more common causes are excludedand the focus becomes on excluding any underlying secondary disease process but also controllingpain because if patients' symptoms of pain are generally controlled they tend to do prettywell and really have no other major functional deficits. I've really become interested overthe years is how interconnected neurology
and rheumatology are and one thing I oftendo on patients who have unexplained small fiber even autonomic neuropathy is have themsee rheumatology or get evaluated for connective tissue disorders like lupus or Sjogren's orsarcoid and sometimes even if we are not directly involved in treating the patients, this canbe the first sign of an underlying connective tissue disorder that can then be brought tothe attention of rheumatology and addressed from their standpoint.
Treating Neuropathy and Nerve Pain in the Feet
Let me start with I'm a diabetic. I developedneuropathy, which basically you lose all sensation in the feet, but it's over a period of time.It was very painful. I would have sensations in my feet like I was standing on fire, walkingon glass. Last October it got so bad that I couldn't sleep at night. Then I met Bullard, because he's just a great physician. I wouldn't think twice, I'd recommendhim to anybody. Very compassionate, very thorough, I can't say enough about Bullard. He'sjust a great physician and I don't know if there's anything he couldn't do hecould probably move mountains if he wanted to!Glen, probably one of the biggest questions
people are asking you is what'd we do, what'shappened. Of course, you had a tremendous improvement in your pain and the tinglingand the numbness. Easiest explanation is, to tell everybody, that this big nerve here,which is on the inside part of your left foot, was getting strangled. There was a noose aroundit. What we did is we went in and loosened the noose, and that allows that nerve to beginto function and work like it's supposed to.Now, the sensation is coming back, it's something that's going to take time butI can feel more. My quality of life has greatly improved since I had the procedure done by Bullard. There's no other physician
that I would recommend.Glen, in the next couple weeks, what we're going to do is make sure that the swellingis improving, hopefully begin to transition you out of your compression socks, becauseI know it's kind of hot right now, and then look at making sure that your shoe gear andthings like that are where they're supposed to be, fitting you well, protecting your feetand stuff. Ok? Very good. Thank you, I appreciate it, havea good weekend! You do the same. Alright, see ya.
Michael C on Wife KennaDysautonomiaHeadachesMSAHormones
(Music) Hi, my name is Michael. My wife Kennahas been a patient here with Jaudy for about five or six months now, and it's really been a long journey, tosay the least, and I know, being the support for her, and speaking for other husbands and family members who have loved ones who are going through difficulty and pain and suffering,
you know, to go to different s overthe years, as we have, and to walk away and really never have any answers, and not know what's wrong with your loved one. It'spretty tough. Its a feeling of being helpless, andalmost a desperate situation, but I have to say that through a series of events we found Jaudy through friends that recommended us here, and from the very beginning, we were very much welcomed, and Tina was very helpful and friendly and kind to us, and so, I guess I could say unless I
had seen this entire process myself, Iwouldn't have understood it, but being here from the very beginning, I have to say that that when we came for Kenna's first consultation, we brought with us about fifteen years of blood work and brain scans and reports and all sorts of things, and the who did an examination, and we came back a few days later afterhe took the weekend to go over everything, and it was a pretty long examination, two or three hours, and I have to say, I have never had anybody take
all those reports and everything, and very articulately explain from the very beginning, up until now, and even pointing out onpast blood work, here's what was happening here, here's what was going on here. It got worse from here to here, and then all the reasons for everythingin between, so, to me that was kind of the beginning of the quot;aha,quot; like, wow, this may justvery well work, and to get answers for it too, I mean to look at your wife and to see her
losing hope and being in despair, is ahorrible thing, and you can't do anything about it, but always know there's more hope, we always kept telling each other there's more options, we'll keep trying, we won't give up, and so, to come here and get theseexplanations and have the explanations continue from visit to visit, and to find someone like Jaudythat knows exactly what's going on, has answered every single question thatwe've had,
and explained it using the technical term, and then the term that we canunderstand, I've never met a physician like that before. So you know, to be here today, and to seemy wife going from being bedridden and not functioning really at all, to where she can function now, and there's hope, and there's definitely not only light at into the tunnel, but it's gettingbrighter and brighter each day, so for that I'm very grateful,