DEAR DR. DONOHUE: I have neuropathy in my feet, and it hurts real bad. It burns and stings. I went to the doctors’ clinic. They did not know what to do for it. I hope you can help me. — S.R.

ANSWER: “Neuropathy” simply means “nerve disorder.” Some nerves are motor nerves, ones that bring messages from the brain so we can move about and use our arms and hands. Other nerves are sensory nerves. They bring to the brain all our sensations — heat, cold, the touch of a hand and painful feelings. A third nerve group takes care of involuntary functions like breathing and heart beating. Those are the autonomic nerves. All three kinds of nerves can be involved with neuropathy. Your neuropathy comes from a disruption of sensory nerves.

What causes neuropathy? Vitamin B-12 deficiency, copper deficiency, liver disease, lupus and many inherited illnesses are some of the causes. By far, the leading cause is diabetes. If a cause can be found, treatment involves eliminating it. The sad truth is that frequently, a cause cannot be found.

Even in the circumstance where a definite cause cannot be unearthed, treatments do exist. Amitriptyline, Neurontin, Lyrica and Cymbalta are oral medicines that have helped many with sensory neuropathy. A Lidoderm patch, an adhesive patch placed over the painful area, often controls neuropathic pain. Capsaicin cream is another product applied to the skin where the pain is felt. It, too, has minimized pain for many.

Get in touch with The Neuropathy Association at its toll-free number, 888-PN-FACTS or on the Internet at www.neuropathy.org. You’ll find the association a good friend that can keep you abreast of new developments and supply you with information on the latest treatments for this common affliction.

DEAR DR. DONOHUE: I have a 15-year-old grandson who was diagnosed with PANDAS two years ago. A year ago, he saw a doctor, who treated him with two IVs of a steroid (I think). The infusions took four to six hours and were given a day apart. They were ineffective. Is there other treatment available? He is getting no therapy. He did have several obsessive-compulsive problems. — B.C.

ANSWER: PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disease Associated with Streptococcus. That’s the strep bacterium, the cause of strep throat, among many other infections. The theory is that strep infection or infections worsen childhood tics or childhood obsessive-compulsive disorder. Tics are hard-to-repress movements like facial grimaces, shoulder-shrugging and even greater attention-getting movements like jumping. Obsessive-compulsive disorder consists of a recurrent, anxiety-producing thought (the obsession) that preoccupies the child’s mind and brings with it uncomfortable feelings. To suppress the obsession, the child performs a patterned response, like constant hand-washing, touching objects or eternally aligning the fringes of a rug exactly. Those rituals are the compulsion. They provide relief from the anxiety of the obsession.

To minimize the effect of PANDAS on these illnesses, some doctors give these children infusions of gamma globulin. I presume that’s what your grandson got. Affected children should continue with a therapist for their underlying disorder — tics or OCD — and continue the medicine prescribed for its treatment.

DEAR DR. DONOHUE: How much does exercise fit into weight loss? It’s my impression that you have to perform hours upon hours before any weight loss takes place. — D.J.

ANSWER: Ever hear of the BMR, the basal metabolic rate? It’s the calories we burn at rest. Close to 70 percent of everyone’s daily calorie burning comes from the BMR. Only the remaining 30 percent come from activities that involve exercise, including those things that are loosely considered the daily activities of life — moving from one chair to another.

Even so, exercise does take off weight. For significant weight loss, it has to last a considerable amount of time. However, exercise does increase muscle growth and decrease stored fat. Muscles, therefore, boost the BMR, so you can count that calorie burning as a benefit of exercise.

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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