DEAR DR. DONOHUE: Could you mention peripheral neuropathy in one of your articles? I have just been diagnosed with it, and it started in my legs. I do not have diabetes. Sometimes the pain is so bad that I want to scream out loud. Do you have any suggestions? – L.M.

The “peripheral” of peripheral neuropathy locates the trouble in the body’s arms or legs, its periphery. Neuropathy is nerve damage.

Some peripheral nerves bring sensation information – pain, heat, cold, touch – to the brain. These are sensory nerves. Others bring information from the brain to muscles telling them to move. These are motor nerves. And a third kind carries out both functions. Your neuropathy involves sensory nerves. Damage to them makes a person feel burning or sharp pain almost all the time.

The causes of peripheral neuropathy are many. It can follow on the heels of a viral infection. It can result from exposure to poisons like arsenic and lead. Diabetes is one of the main causes. It is seen as a secondary symptom in other illnesses such as rheumatoid arthritis and lupus. An immune system attack on nerves is another cause. Finally, there are many patients for whom no cause is found. In that case, it is called “idiopathic” – cause unknown.

When no cause can be identified, treatment for sensory neuropathy is pain-control treatment. If pain is mild, simple pain relievers – Tylenol, aspirin – can often control it. For more intense pain, gabapentin (a seizure-control drug) or amitriptyline (an antidepressant drug) can sometimes obliterate the pain. For severe pain, the judicious use of narcotics – morphine and oxycodone, for example – is a fairly dependable solution.

Physical activity, believe it or not, helps. So can TENS, a little device that delivers a gentle electric pulse that might deaden pain. Lidocaine skin patches are another possible control measure.

Neuropathy is a vast subject, and this answer does not do it justice. The Neuropathy Association – 1-212-692-0662 – can supply you with valuable information. The Web site is:

DEAR DR. DONOHUE: My mother is 85 and suffers from Alzheimer’s disease. Two weeks ago she had a seizure. Her doctor chose not to put her on medicine because he thought it might make her Alzheimer’s symptoms worse. What do you think of that? – J.R.

About one in 10 Alzheimer’s patients will have a seizure. It happens mostly in the later stages of this illness.

If your mother is in an environment where she is watched, if there are no signs of a correctable brain problem, such as a tumor, and if she has no recurrence of a seizure, then it is not a breach of good medicine to observe her without adding another medicine to her probably already long list of drugs. The doctor is right. Seizure medicine might worsen Alzheimer’s symptoms.

Alzheimer’s is a cruel disease that affects both patients and their families. Readers who would like more information about it can order the Alzheimer’s pamphlet by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Please clear up a dispute I have. I was told that when a doctor prescribes medication, one could ask the pharmacist for advice pertaining to the specific drug.

Recently, when I had a prescription filled, I called the pharmacist to ask him a question, and he told me I had to call my doctor, since he could refer to my history. This was only a general, plain vanilla question. I don’t feel it is necessary to call the doctor, since the druggist deals with this all day long. What is your opinion? – R.W.

Pharmacists are well-qualified to discuss a drug’s action, its purposes, how to take it and its side effects. Questions about illness should be directed to the doctor.

I don’t understand your pharmacist’s reluctance to answer a plain vanilla question. (I love that “vanilla” expression.)

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.

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