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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 25. This is the beginning of the thread.
Posted by Squiggles on February 14, 2002, at 20:39:09
Hi,
I've had this for over a year now, coinciding with
Klonopin withdrawal, but cannot surely say it is
caused by the K w/d; got an EMG with negative on carpal tunnel;
not sure *what* it is caused by - seems a bit lighter
now that I am reinstating clonazepam -- too early
to tell. I also take Synthroid and lithium - anyone
else have a similar history of symmetrical peripheral
neuropathy on the hands and wrists (glove neuropathy).
It feels like there is fluid under the skin, and at its worse
it used to be electric. When it first happened it was acute.
ThanksSquiggles
Posted by spike4848 on February 14, 2002, at 21:22:56
In reply to Carpal tunnel (aka peripheral neuropathy), posted by Squiggles on February 14, 2002, at 20:39:09
Hey There,
So I assume you symptoms are in both hands when you say "symmetric neuropathy", which narrows down the diagnosis a bit. When we think of polyneuropathies, certain diseases come to mind such as diabetes, hepatitis, alcoholism, vitamin deficies, hypothyroidism and amyloid. Some drugs as well like MAOI's. Rarely, an ascending neuropathy called guillain-barre can first start in the hands and feet. Some other rare birds are sarcoidosis, lyme and HIV.
If the pain is also shoulder and neck, it is probably nerve impingment from spinal cord.
How long have you had it?
Does ibuprofen help?
Does ice help?
What makes the syptoms worse?
Any neck or back pain?Spike
Posted by Squiggles on February 14, 2002, at 22:11:50
In reply to Peripheral Neuropathy 101 » Squiggles, posted by spike4848 on February 14, 2002, at 21:22:56
> Hey There,
>Thanks for the quick reply Spike,
> So I assume you symptoms are in both hands when you say "symmetric neuropathy", which narrows down the diagnosis a bit. When we think of polyneuropathies, certain diseases come to mind such as diabetes, hepatitis, alcoholism, vitamin deficies, hypothyroidism and amyloid. Some drugs as well like MAOI's. Rarely, an ascending neuropathy called guillain-barre can first start in the hands and feet. Some other rare birds are sarcoidosis, lyme and HIV.
>Yes, both hands and wrists - identical; had to wear
braces when it first started - wonder if Canola oil had
something to do with it.
> If the pain is also shoulder and neck, it is probably nerve impingment from spinal cord.
>There is no pain - however I have noticed a reduced
mobility in my lower back spine - i cannot bend
to the same degree anymore - something may have
happened - my doctor says i should lose weight;
but i am not THAT fat.> How long have you had it?
close to a year and a half - withdrawal from K coinciding;
> Does ibuprofen help?
can't take NSAIDS because i take lithium - there is
no pain;
> Does ice help?it did when hands were immobile;
> What makes the syptoms worse?the meds i take fluctuate the symptoms;
walking or exercise i think;> Any neck or back pain?
no - just the degree of mobility in lower back tail;
txSquiggles
Posted by Bob on February 14, 2002, at 23:59:12
In reply to Carpal tunnel (aka peripheral neuropathy), posted by Squiggles on February 14, 2002, at 20:39:09
Ever since I withdrew from Topomax and went on Klonopin, I have had problems with intermittently cold hands, which is sometimes to the point of being uncomfortable. Does this sound anything like your problem?
You say you don't have any pain, so what exactly is the problem?
Posted by Squiggles on February 15, 2002, at 1:17:46
In reply to Re: Carpal tunnel (aka peripheral neuropathy) » Squiggles, posted by Bob on February 14, 2002, at 23:59:12
> Ever since I withdrew from Topomax and went on Klonopin, I have had problems with intermittently cold hands, which is sometimes to the point of being uncomfortable. Does this sound anything like your problem?
>
> You say you don't have any pain, so what exactly is the problem?Not cold Bob; more like the hands are full of
water - like gloves blown up; however when it
first started it was sudden, and if i recall close
to eating a salad with Canola oil (in which case
it may be Enosophilic fasciitis [sp], but most
likely it is withdrawal from K, or as one doc.
thought hypothyroidism and the breasts getting
larger; when it first happened i had to wear
splints for a month - they were totally without
sensation; strange stuff.Squiggles
Posted by ST on February 15, 2002, at 6:12:14
In reply to Peripheral Neuropathy 101 » Squiggles, posted by spike4848 on February 14, 2002, at 21:22:56
Hi,
I have had almost crippling carpal tunnel syndrome at times. (I do massage therapy - sometimes I give WAY too many massages) What helps is acupuncture. After two sessions, it's usually gone! Often it's covered by insurance. Other massage therapists I know who suffer from CT get acupuncture and it keeps them working and free from pain.
Good luck,
Sarah
Posted by Bob on February 15, 2002, at 11:51:00
In reply to Re: Carpal tunnel (aka peripheral neuropathy), posted by Squiggles on February 15, 2002, at 1:17:46
> > Ever since I withdrew from Topomax and went on Klonopin, I have had problems with intermittently cold hands, which is sometimes to the point of being uncomfortable. Does this sound anything like your problem?
> >
> > You say you don't have any pain, so what exactly is the problem?
>
> Not cold Bob; more like the hands are full of
> water - like gloves blown up; however when it
> first started it was sudden, and if i recall close
> to eating a salad with Canola oil (in which case
> it may be Enosophilic fasciitis [sp], but most
> likely it is withdrawal from K, or as one doc.
> thought hypothyroidism and the breasts getting
> larger; when it first happened i had to wear
> splints for a month - they were totally without
> sensation; strange stuff.
>
> SquigglesThat is terrible. I hope it is getting better little by little at least! Do any of your docs think that the withdrawal from the Klonopin would leave a lasting effect like that (not that they could actually know for sure)?
Posted by Squiggles on February 15, 2002, at 16:10:15
In reply to Acupuncture, posted by ST on February 15, 2002, at 6:12:14
> Hi,
>
> I have had almost crippling carpal tunnel syndrome at times. (I do massage therapy - sometimes I give WAY too many massages) What helps is acupuncture. After two sessions, it's usually gone! Often it's covered by insurance. Other massage therapists I know who suffer from CT get acupuncture and it keeps them working and free from pain.
>
> Good luck,
> SarahThank you for the suggestion Sarah. I have
never tried alternative therapies; perhaps if
it persists and i can find no remedy, i'll give
that a shot - i think there are acupuncturists
in my neighbourhood.Squiggles
Posted by spike4848 on February 15, 2002, at 19:28:55
In reply to Re: Peripheral Neuropathy 101, posted by Squiggles on February 14, 2002, at 22:11:50
Well a cervical spine xray will tell you if your symptoms are from nerve impingement from the spine. But if the nerve conduction studies were normal, then impingement is highly unlikely. Neuropathy all together is unlikely if the nerve conduction studies were normal. So you have me stumped.
I think JohnX2 is having some problems with hand twitching coinciding with tapering off klonopin. It is possible that tapering off an anticonvulsant like klonopin could make the sensory nerves more active ..... we call that hyperasthesia. But that is just a guess.
Sorry
Spike
Posted by Squiggles on February 15, 2002, at 20:15:20
In reply to Things that make you go hummmm! » Squiggles, posted by spike4848 on February 15, 2002, at 19:28:55
> Well a cervical spine xray will tell you if your symptoms are from nerve impingement from the spine. But if the nerve conduction studies were normal, then impingement is highly unlikely. Neuropathy all together is unlikely if the nerve conduction studies were normal. So you have me stumped.
>
> I think JohnX2 is having some problems with hand twitching coinciding with tapering off klonopin. It is possible that tapering off an anticonvulsant like klonopin could make the sensory nerves more active ..... we call that hyperasthesia. But that is just a guess.
>
> Sorry
>
> Spike
I thought I posted this - sorry;
OK let me be brief because my peripheral
neuropathy is not your peripheral neuropathy :-)Rule out (by doctors' tests)
- diabetes (water deprivation test)
- carpal tunnel (stick electrode pins in hands/wrists)
- EMG - ???some doubt - the upper spine shows
an ambiguous erosion somethingmagigger
- lithium level
- thyroid (TSH) - another doctor thought it might be;My guesses:
1. Klonopin withdrawal (because i had myoclonic
seizures the year before upon withdrawing - this
dx'd by doctor - that may have left residual dammage;2. Water/lead poisoning (because it was so acute and
after drinking water)3. Lithium toxicity
4. Thyroid low
5. Virus (I had something like meningitis or
rhinal infection) very sick for two days;6. Candida (used a yeast fighter which made
me very sick like anaphylactic shock7. Mechanical spinal thing from computer work;
8. Carpal tunnel.
I don't which - awaiting the results of reinstatement
of Klonopin dose to see if that is in any way
conclusive.Hope you guys are med students or else this
post will be equivalent to 2 Ks, 6 Vs and 4 Xs.tx
Squiggles
Posted by Squiggles on February 18, 2002, at 15:06:51
In reply to Re: Things that make you go hummmm!, posted by Squiggles on February 15, 2002, at 20:15:20
Hi,
as a follow-up to this, i just got back from
my doctor who found the TSH a bit high (5.960)-
that means hypothyroidic, and that may explain
a number of weird phenomena including carpal
tunnel and the big boobs - tomorrow I go from
0.112 Synthroid to 0.125 - wish me luck - I hope
I don't get speedy.that would answer the peripheral neuropathy thing
anyway;Squiggles
Posted by Bob on February 18, 2002, at 16:05:15
In reply to Re: Things that make you go hummmm!(carpal tunnel), posted by Squiggles on February 18, 2002, at 15:06:51
> Hi,
>
> as a follow-up to this, i just got back from
> my doctor who found the TSH a bit high (5.960)-
> that means hypothyroidic, and that may explain
> a number of weird phenomena including carpal
> tunnel and the big boobs - tomorrow I go from
> 0.112 Synthroid to 0.125 - wish me luck - I hope
> I don't get speedy.
>
> that would answer the peripheral neuropathy thing
> anyway;
>
> SquigglesHypothyroidism causes big boobs?
Posted by spike4848 on February 18, 2002, at 16:15:46
In reply to Re: Things that make you go hummmm!(carpal tunnel), posted by Squiggles on February 18, 2002, at 15:06:51
> Hi,
>
> as a follow-up to this, i just got back from
> my doctor who found the TSH a bit high (5.960)-
> that means hypothyroidic, and that may explain
> a number of weird phenomena including carpal
> tunnel and the big boobs - tomorrow I go from
> 0.112 Synthroid to 0.125 - wish me luck - I hope
> I don't get speedy.
>
> that would answer the peripheral neuropathy thing
> anyway;
>
> SquigglesGood to hear. The neuropathy may take awhile to resolve, even after your TSH normalizes. The nerves have to heal.
Your Friend,
Spike
Posted by Squiggles on February 18, 2002, at 17:09:30
In reply to Re: Things that make you go hummmm!(carpal tunnel) » Squiggles, posted by Bob on February 18, 2002, at 16:05:15
Bob,
that's pure conjecture - they just became big
over a year - maybe it's a weight thing; but
it certainly is sudden and feels like water -
infact my whole body feels like a water bed LOL
-- please excuse me if i am crude -- i look
forward to more refined moments; seriously, though
i do fear a raise in Synthroid as I had a very
bad experience in the past (thought that raise
was much higher).Squiggles
Posted by Bob on February 18, 2002, at 17:35:08
In reply to Re: Things that make you go hummmm!(carpal tunnel), posted by Squiggles on February 18, 2002, at 17:09:30
> Bob,
>
> that's pure conjecture - they just became big
> over a year - maybe it's a weight thing; but
> it certainly is sudden and feels like water -
> infact my whole body feels like a water bed LOL
> -- please excuse me if i am crude -- i look
> forward to more refined moments; seriously, though
> i do fear a raise in Synthroid as I had a very
> bad experience in the past (thought that raise
> was much higher).
>
> Squiggles
If you are truly hypothyroid, why would a raise in synthroid be bad? What bad reaction did you have in the past?
Posted by Squiggles on February 18, 2002, at 17:46:09
In reply to Re: Things that make you go hummmm!(carpal tunnel) » Squiggles, posted by Bob on February 18, 2002, at 17:35:08
I had become hypothyroidic (MEA CULPA) because
I had stopped taking Synthroid for almost a year;
this I did because I was speeding, insomniac,
and had diarrhea - I thought the drug was the cause;
so when my doctor got me and put me on replacement
(actually it was an intern) the dose was way too
high (the numbers got mixed up between what it
was a year before, and what was necessary now);So I got something like a heart attacks only many
times, panic, sweats, voracious appetite, heat,
etc. all the hyperthyroid symptoms - which indeed
I must have had. It was very frightening, and
i am grateful to my doc. who put me at euthyroid
level in 6 months - depsite my stupidity.But i was very ill - ER calls, etc.
Squiggles
Posted by Bob on February 18, 2002, at 22:25:27
In reply to Re: Things that make you go hummmm!(carpal tunnel), posted by Squiggles on February 18, 2002, at 17:46:09
> I had become hypothyroidic (MEA CULPA) because
> I had stopped taking Synthroid for almost a year;
> this I did because I was speeding, insomniac,
> and had diarrhea - I thought the drug was the cause;
> so when my doctor got me and put me on replacement
> (actually it was an intern) the dose was way too
> high (the numbers got mixed up between what it
> was a year before, and what was necessary now);
>
> So I got something like a heart attacks only many
> times, panic, sweats, voracious appetite, heat,
> etc. all the hyperthyroid symptoms - which indeed
> I must have had. It was very frightening, and
> i am grateful to my doc. who put me at euthyroid
> level in 6 months - depsite my stupidity.
>
> But i was very ill - ER calls, etc.
>
> Squiggles==================================================
That sucks!!! I can't believe what the people on this board go through.
Posted by NikkiT2 on February 19, 2002, at 6:49:12
In reply to Things that make you go hummmm! » Squiggles, posted by spike4848 on February 15, 2002, at 19:28:55
I ahve Carpul Tunnel Syndrome (am awaiting an op in it) as well as Tenosynavitis and sporadic tendonitis..
I used to have weekly accupuncture and would reccomend it to anyone. it was great.. made me feel better in myself as well as my hand!!!nikki
Posted by Squiggles on February 19, 2002, at 11:57:44
In reply to Re: Things that make you go hummmm!(carpal tunnel) » Squiggles, posted by Bob on February 18, 2002, at 22:25:27
Today is the 1st day of my increase in
Synthroid dose from 0.112 to 0.125 - and
I am every so grateful my doctor told me that
if I felt uncomfortable or speedy to stop;Wow - my husband said don't worry it is such
a tiny amount you will not feel a thing; thyroxine
is powerful - 4 hrs after ingestion i had
heart palpitations, speediness, panic attack,
fear, and chest constriction.So, back to the pink dose for sure - if it's
high now i cannot imagine how high it would be
ina week; possibly that high measurement i got
(5.960 TSH) was a fluctuation;Anyway, this stuff is dynamite - harder than
cocaine I imagine.Squiggles
Posted by IsoM on February 19, 2002, at 12:15:58
In reply to Re: Things that make you go hummmm!(carpal tunnel), posted by Squiggles on February 19, 2002, at 11:57:44
Your reaction to increasing the dosage isn't a very common one. I can take 2 pills (88 mcg) & not notice anything different. Not that I do take 2, but forgetting a dose or taking extra, I'd never notice anything different. It needs to be a few days of change before anything registers for me.
I do have a friend though whose thyroid acted strangely. Her TSH levels would vary each time it was taken & she could tell each day how her gland was functioning by how she felt. She couldn't take Synthroid at all as one day the dose would be right & the next day too much.
Would switching to another form of thyroxine medication help at all? Your case sounds a lot like hers with the very unpleasant feelings you get from an increase. Sounds like you might need to see an endocrinologist again for another thorough check up of your thyroid.
Posted by Squiggles on February 19, 2002, at 12:33:44
In reply to Re: Dynamite Synthroid » Squiggles, posted by IsoM on February 19, 2002, at 12:15:58
I do seem sensitive to the dose. But the last
dose seemed perfect for me (0.112); it is also
likely that what was taken (it was 4:a.m. and i
was exhausted) showed an erroneous fluctuation;
My doc. has ordered more bloods this week to
get a more even picture; someone on the thyroid
boards even suggested i may be high..Chances are I am just right, but the carpal
tunnel can be explained by ..... are you ready
for Ockam's Razor - typing 16 hours a day for
the past 15 years or so LOL;well, we shall see, but as I said I am very
happy my doctor told me to stop if I get
uncomfortable and go back to the rose ones.tx
Squiggles
Posted by OldSchool on February 20, 2002, at 10:41:33
In reply to Acupuncture, posted by ST on February 15, 2002, at 6:12:14
Acupuncture is one of the few "alternative" treatments for depression I have any faith in. I tried acupuncture once for my depression, way back years ago when the meds totally were not working for me. I went to this guy who is an MD but who had formally studied acupuncture...he is a very unique MD in this area. He stuck all these small needles in me, including some in my scalp in the head region. Then he attached small electrodes with wires to the needles, particularly in the head area and fired super low doses of electicity into the needles. I couldnt feel the electricity, nor the needles. Maybe a little bit tingly feeling was about it.
Anyway, after he turned on the juice he had me lay there on the table for about thirty minutes relaxing. Then he came in and took the needles out and honestly I did feel quite different. I felt more upbeat...a little bit wired. I felt activated for three days afterwards. It did work. He told me that putting these needles into my scalp and firing the electricity into them was like a acupuncture version of ECT LOL.
The bad thing was these acunpuncture sessions were like $75 a pop and you need to get them like three times a week for it to really take effect good. My insurance didnt pay for it so I stopped going after the first session. He told me most of his patients are getting acupuncture for chronic pain. I have no doubt that acupuncture has some uses in treating depression after my experience. Particularly if the doctor fires small amounts of electricity into the needles...felt good.
Id like to know how the Chinese treat major depression in People's Republic of China. I bet they have some interesting and unique treatments that involve acupuncture.
Old School
Posted by Squiggles on February 20, 2002, at 11:37:59
In reply to Re: Acupuncture can work for depression too, posted by OldSchool on February 20, 2002, at 10:41:33
He "turned on the juice"? I thought they
just poked you with fine needles - no penetration,
no electricity. It sounds like Chinese
ECT - do they know how it works - is there a theory
or a model; sorry, I am very sceptical and
old-fashioned about personal electrical appliances.Squiggles
Posted by sid on February 20, 2002, at 19:14:52
In reply to Re: Acupuncture can work for depression too, posted by Squiggles on February 20, 2002, at 11:37:59
I had acupunture treatments against major depression and it helped greatly. Nobody knows how acupuncture works yet, it is just observed that it works. Some scientific studies have been done and acupuncture could produce a remission rate that was similar to the ones obtained from using ADs. It's been proven to be effective otherwise as well.
It doesn't have to be on the head, and it doesn't have to include electricity to heal depression. Electric treatments, as described by OldSchool, are often used against pain; it dumbs the pain somehow. I had acu-electric treatments for back pain in the past.
My acupunture treatment for depression did not involve electricity however. It involved leaving the needles in the first week only, then, once a week, different poking series (poking the needle in with presure and taking it out immediatly) and moxa heating my skin. Moxa is a dried herb - it's rendered humid with some water and rolled into a little ball. Then it's stuck to the skin and it's lit. When it feels hot on the skin, you say so and it is removed. It's thermal treatment, basically, on different "meridians" (spots on the body that can be used for acupuncture treatments).
Acupunture treatments differ between individuals for the same illness. An acupuncturist asks you about everything: diet, digestion, vision, any symptoms at all, blood pressire, sleep patterns, life habits, allergies, etc... Then given ALL that, they decide on the treatment.
Plus, acupuncturists have different backgrounds and inclinations - some never use moxa, some never use electricity, some use heating lamps on areas where there are needles, some never poke with the needles, etc...
My treatment was once a week for 7 weeks, then every other week, for a month, then every month, then every change of season (4 times a year). It is important for the treatment not to be too long or too often because you can get somewhat addicted. It worked very well for me and helped me so much - it was the first thing that gave me hope I'd be well again some day.
Unfortunately, some acupuncturists are good and others not so much! I moved since then and never found another acupuncturist that was as good as the one I consulted for my major depression. Since I recently realized still had dysthymia, I decided to try meds (Effexor XR for now). Had I had the same acupuncturist still, I'm not sure I would have needed the med. Oh well.
Posted by ST on February 21, 2002, at 18:19:21
In reply to Re: Acupuncture can work for depression too, posted by sid on February 20, 2002, at 19:14:52
Acupuncture really is amazing. I do massage therapy at an acupuncurist's office and I see the change in people.
I used to have severe asthma and had tried ALL the Western medicine remedies. Nothing worked; I had bronchitis every month and was sick half the time. It was getting in the way of school and I was miserable. I finally went to an acupuncurist. Within a month, I had no more asthma attacks. After a few more months, I stopped getting sick all the time. I stopped having breathing problems and was able to start singing again. (I'm a singer) For 7 years I was symptom free. I didn't do any kind of "maintenance" which is recommended. I should have gone back once or twice a year probably, but didn't always do that. When I was in NYC I worked in a hideously smoky bar. The asthma and bronchitis came back, but stopped again once I resumed acupuncture treatments. Amazing stuff.
This is the end of the thread.
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