DEAR DR. DONOHUE: I have peripheral neuropathy. It came as a side effect of the chemotherapy I got for ovarian cancer. It has me struggling with numbness and pain in my feet, ankles and lower legs. I couldn’t take Neurontin, so I use Lidoderm patches on my skin. I also have poor balance. Do you know a program that could help? – A.R.

ANSWER: I can introduce you to The Neuropathy Association, which provides people with valuable information and the latest treatments. It makes them feel less alone in suffering with this common affliction, since most of the public is unaware of it. Its number is 1-800-247-6968, and its Web site is www.neuropathy.org. You and all neuropathy patients would be well-served by contacting the association.

Neuropathy is nerve damage, and “peripheral” refers to nerves in the legs and arms. Other nerves can also be involved, like the ones controlling blood pressure and sweating. The damage comes from diverse causes: diabetes, vitamin B-12 deficiency, industrial chemicals like mercury, infections such as shingles, and many medicines, especially those for cancer treatment. For some, however, no cause is ever found. It just happens.

The nerve damage can lead to numbness, constant pain or extreme sensitivity to a stimulus, even one as innocuous as a mild touch that would not disturb a person with normal nerve function.

Balance is often a problem for people with neuropathy, and it can destroy hand, arm and leg dexterity. Physical therapists can help people cope with this aspect of the illness.

Pain control is the primary interest of many neuropathy patients. Neurontin is a popular medicine that helps many. The skin patch you mention is somewhat like Novocain, deadening painful sensations. Gabapentin is another popular medicine. Nerve blocks have given some patients pain relief. And strong pain relievers like oxycodone might have to be prescribed.

DEAR DR. DONOHUE: Approximately three months ago I had a strange pain on the left side of my stomach. It went away in two weeks, but I have had diarrhea for two months since. All this started after a trip to the Caribbean. We stayed at a five-star hotel and have frequently gone there without any problems. I have seen two gastroenterologists, and they feel I picked up a parasite. I have been on Flagyl and Alinia. I have also had a colonoscopy, which was normal, as well as a normal biopsy.

I have gone from between six and eight bowel movements a day to two or three, but it is still diarrhea. I have heard horror stories about parasite infections lasting years. Why is my situation so stubborn?

Do you agree with the parasite theory? – F.D.

ANSWER: Flagyl is an excellent medicine for one parasite, the one-celled ameba that flourishes in many places in the tropics and which is a cause of diarrhea. Alinia should take care of two other common, diarrhea-causing one-celled organisms – cryptosporidium and giardia. They have a worldwide distribution, and they can be caught right at home in North America.

Your diarrhea frequency is decreasing – a good sign. Perhaps you are at the tail end of your infection, and things will right themselves entirely in another week or so.

On the other hand, if diarrhea persists, you need a careful examination of a stool specimen for parasites and for their eggs. The number of parasites in the world is truly staggering, and you might have one that doesn’t respond to the medicines you took. If you do have such a parasite, it will still be in your stool, and it can usually be seen upon microscopic examination.

You have had a colonoscopy and a biopsy, both of which are normal. That rules out many causes of diarrhea. However, don’t abandon your gastroenterologists. They will have to start fresh if things don’t turn around promptly.



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.