Primary neuropathy
Dr. Dalen, no one knows the cause of my neuropathy,” Gary said. I have burning pain in my feet, sometimes like fire, sometimes they feel heavy or like they are necrotic. I am not diabetic, will surgery work for me?”
”Gary, you don’t have diabetes and probably won’t get it; you fall into the majority of people’s cases. According to the American Neuropathy Association, there are many people in the United States who have neuropathy of unknown origin, or primary neuropathy, just like diabetic neuropathy. This is good news, Gary, and the answer is yes, my surgery is very effective for patients like you.”
I continued, “Gary, many types of neuropathy make the nerves susceptible to compression. In diabetic patients, sugar draws water into the nerve causing it to swell. The diabetic’s nerves thicken as a result, so they become compressed in anatomically narrow areas in the legs and arms. Although we may not be able to pinpoint the mechanism by which you develop the condition, this nerve compression does happen to you as well. Your skin biopsy shows that some of the fine nerve fibers associated with pain and temperature sensation are on the verge of necrosis. PSSD neurosensory testing shows that your thick nerve fibers associated with touch and pressure sensation will also be necrotic. You have a very common mixed fibrous neuropathy, not a fine nerve fiber lesion. So I’m going to examine your legs and feet to see if I can find the areas of nerve compression. Not all patients will have the same significant healing as Gary. Some patients will continue to have pain, or in rare cases, the pain may worsen due to nerve regeneration. Therefore, it is often necessary to repeat the PSSD test to demonstrate the presence of nerve regeneration.
Chemotherapy-associated neuropathy
”Dr. Dalen, I survived ovarian cancer and now I suffer from foot pain, so much so that I can’t walk more than a few steps.” Nancy describes her recent condition. She continued, “Dr. Dalen, it’s a miracle I’m on cisplatin. My tumor has been gone for 4 years, I beat it, but I have neuropathy and I can’t move very well! I loved skating and was a member of the skating patrol, but I could no longer skate when I lost my balance. I had to work on the testing of skating devices, but this job has been interrupted for 4 years due to my neuropathy, would your treatment for diabetic neuropathy work for me?”
”Yes, Nancy, there is hope.”
After studying diabetic neuropathy, I began to explore chemotherapy-associated neuropathy. I learned in diabetes research that certain problems with diabetes make patients’ nerves vulnerable to compression, and the same is true of chemotherapy drugs.
The normal nerves that innervate the hands and feet can also become compressed as they pass through narrow passages in the elbows and knees, wrists and ankles. Some of the drugs used in chemotherapy patients stay in the nerves, making them more susceptible to compression. Surgery can loosen these nerves, relieving pain and restoring sensation as well as coordination.
”Dr. Dalen, the doctors have helped me beat my cancer, I want you to help me beat my neuropathy and schedule surgery on my first leg!”
Stanley, a male patient who had lost sensation in his leg for two years, asked me, “Dr. Dalen, how does my nerve look?”
I replied, “Stanley, you are the first patient to have neuropathy due to thalidomide chemotherapy. This drug stopped the growth of your polymyosarcoma, but it also promoted painful neuropathy and limb paralysis. I have taken pictures of the lateral nerve of your knee, which is the common peroneal nerve. This nerve just crosses the location of the fibular bundle compression, which was born with it, but the chemotherapy made the nerve more sensitive to the pressure, so it produced the symptoms.”
Heavy metal poisoning
Eaten too much tuna meat? Then you may have mercury poisoning. Are you a lead plumber, welder or sand panner? Then you may have lead poisoning. And arsenic poisoning can give you neuropathy before it’s fatal.
Lead poisoning was the first neuropathy to be studied in the laboratory. Lead is known to cause disruption of the continuity of blood vessel walls, which allows fluid to leak out through them. When this happens in the blood vessels that accompany the nerves, the fluid enters the nerves causing swelling of the nerve cells. Thus, like diabetes, the nerves of patients with heavy metal poisoning swell, which makes it more likely that the nerves will be compressed in narrow ducts. Therefore, the Dalen triple neurolysis procedure is also effective in those patients with heavy metal poisoning who suffer from nerve compression.
These heavy metals, like calcium ions, are electron-bearing and positively charged, so they can also be absorbed and stored by bone tissue, slowly released into the bloodstream where they remain in stable concentrations, constantly causing symptoms.
A test called a heavy metal toxicity screen can detect the presence of heavy metals in the blood, and there are treatments available to filter out heavy metals from the blood, but the preferred treatment is “chelation therapy”.
Summary
The conventional medical view is that neuropathy is “progressive and irreversible,” meaning that if you have neuropathy, you will not get better. This is especially true for diabetic patients with neuropathy.
The good news is that my years of research have led me to conclude that many neuropathy patients have symptoms due to nerve compression in the upper and lower extremities, and this has been recognized by most doctors internationally. And the even better news is that nerve compression can be surgically eliminated and the resulting symptoms improved.
If you have symptoms related to nerve compression, then there is an 80% chance of pain relief and restoration of sensation through nerve decompression surgery. When these results occur, your balance will also improve and you will no longer be at risk for ulcers and amputations.