Neuropathies cause pain, weakness or both

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DEAR DR. DONOHUE: My right foot burns like it’s on fire. There’s nothing on the skin, and I can move my foot fine. My doctor gave me a cream to put on my foot, but it’s not doing anything. What do you think I have? – J.M.

ANSWER: I’d consider a neuropathy. Neuropathies are nerve disorders brought on by many different conditions – diabetes, heredity, Lyme disease, immune attacks, compression from adjacent structures, genes and vitamin deficiencies. The pain that follows a shingles outbreak is a neuropathy.

Since there are two kinds of nerves, there are two kinds of neuropathies. Motor nerves conduct impulses to muscles to get them to move. Sensory nerves deliver information from the skin and the body’s interior to the brain, alerting it to temperature change, touch, pain and a thousand other sensations. There is a third kind of nerve, one that combines both sensory function and motor function.

If motor nerves are the primary target of neuropathy, then muscle weakness is the consequence. People can have an unsteady walk, or they find it impossible to pick up a foot when taking a step. If a sensory nerve is involved, intractable pain is the consequence. If a nerve that is both motor and sensory is involved, then both weakness and pain arrive together.

You should ask your doctor for a referral to a neurologist, who can investigate nerve function with special equipment.

If you have a painful neuropathy, there are many medicines that can lessen the pain. Amitriptyline, Cymbalta, Neurontin, Lidoderm skin patches and Zostrix ointment are choices. Lyrica is a new product for diabetic neuropathy.

Other treatments are available for motor neuropathies.

The Neuropathy Association is standing by, ready to help all with neuropathies. Its toll-free number and Web site are 1-800-247-6968 and www.neuropathy.org.

DEAR DR. DONOHUE: My grandson, age 5, is believed to have Hirschsprung’s disease. The boy has always appeared healthy, but he must have had something going on that we (my husband and I) were not told. Can you give us an idea of what Hirschsprung’s entails and what we can expect for him? We are worried sick. – P.M.

ANSWER: Hirschsprung’s disease is a born-with condition where the nerves that control the action of the final segment of the colon have no plug-in outlets. That makes having a bowel movement difficult to impossible. Usually it’s discovered shortly after birth. Your grandson must have only a mild case of it.

He probably has had a constipation problem from infancy. The doctors have now raised the issue of this ailment. If the diagnosis proves correct and if his symptoms are of such magnitude to warrant surgery, removal of the affected segment of colon can rectify matters.

DEAR DR. DONOHUE: I spent six weeks in the hospital after a simple hernia operation that I was supposed to stay only overnight for. The incision came apart the night of the operation. Then my heart started beating rapidly and irregularly. They thought I had a clot in my lungs, and I was transferred to the intensive-care unit. One week there, and I got a mersa infection. No one has explained to me what that is. My family doesn’t understand it. Can you tell us what it is? – B.W.

ANSWER: MRSA (your “mersa”) is methicillin resistant staphylococcus aureus infection. You have heard of the staph germ, I’m sure. It’s a common cause of infection. In the early days of antibiotics, penicillin cured staph infections. The germ learned how to resist penicillin, so a new antibiotic, methicillin, was invented. That took care of matters for a few years, but now staph germs are beginning to outwit that antibiotic. Those are the MRSA germs. There are antibiotics for them, but these infections are often hard to cure and take a long time to treat.

You’re a victim of the overuse of antibiotics. Because antibiotics have been used for conditions that don’t require them, germs have learned how to evade them. That has ushered in the era of super germs. MRSA is one of those super germs.

DEAR DR. DONOHUE: For more than a year, my blood tests have indicated a low white blood cell count of 3,600. My doctors have not been really concerned about this. I do have concerns. I am active, exercise regularly and do not have any symptoms. What is your opinion? – E.L.

ANSWER: White blood cells fight infections and are involved in the body’s immune defenses. The normal count is 4,300 to 11,000. Your count is slightly below normal.

You don’t have any symptoms. You are active and feel well. Your count is most likely normal for you. Counts at your level still afford you more-than-adequate protection against infections.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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