Posted By: Brendan Hanavan Nerve Damage - 08-29-2012 12:29 PM
Finished my second bout of chemo at the end of June after 18 weeks.Got through it - just.Had all the predicted side effects and was hospitalised 3 times for various reasons,but I'm still here.
Towards the end of my chemo my peripheral neuropathy began to appear.The soles of my feet started to become numb and gradually I noticed a lack of sensation in my fingertips.This has slowly developed and now I have poor sensation and general lack of any strength in my fingers and hands in addition to general numbness in my feet.
The act of standing up from a seated position is a little difficult and I wonder if this is muscular or more nerve damage.
Just wondered if anyone has any insight into whether these side-effects are 'generally' temporary,will develop further or become permanent.
Posted By: saxicola Re: Nerve Damage - 08-29-2012 09:51 PM
Hi Brendan, I just want to say hello and welcome back. Well done on getting through your chemo. I see from your earlier posts that you have had a really tough time. I am suffering from peripheral neuropathy too, but I don't think it is anything as bad as yours. I have numbness in my toes and finger tips. It started a couple of months after my treatment finished. Now 5 months later it is still there but doen't annoy me as much. Not sure if this is because it is reducing or because I am getting used to it.

Best wishes for a good recovery. Sally
Posted By: Cheryld Re: Nerve Damage - 08-30-2012 02:54 PM
Not sure if trying to increase circulation would help but it might - try acupuncture -to try and return blood flow to the areas - nerves do regenerate slowly and not always entirely but look to see what you can do to help. congrats on the getting through chemo. Hugs
Posted By: LeftyS7 Re: Nerve Damage - 11-14-2012 01:38 AM
I,too, have numbness on the bottom of my feet from chemo and wondered how long it will last. My Oncologist says he's pretty sure that it will eventually go away but I wanted to hear from others as to their experiences. I'm disappointed that there hasn't been more response to the original post.

Edit: I found another, similar, post with responses of three and six years without being resolved.
Posted By: LeftyS7 Re: Nerve Damage - 11-14-2012 04:45 PM
Hasn't anyone on this board actually recovered from neuropathy?
Posted By: saxicola Re: Nerve Damage - 11-14-2012 11:11 PM
Well 2.5 months on from my post above in August, I do think things have improved. My finger tips are just about back to normal and my toes are definitely less numb and irritating. So I am hopeful this will continue to improve and disappear at some point, but it will take time. i will try to remember to update on this in the future. Sally.
Posted By: Doug G Re: Nerve Damage - 11-18-2012 02:07 AM
My fingertips and toes started to feel a little numb and tingly 4 months after treatment. Now nearly eight months post treatment I still have it. I have gotten used to it for the most part. From what I've read Cisplatin is the reason because of all the platinum that's in it. My MO gave me a Rx if the pain gets worse but haven't found the need. He also suggested taking a multi B vitamin.
Posted By: CubanKeith Re: Nerve Damage - 11-20-2012 03:40 AM
Once again this site proves the best source of info to explian and direct you through this odd journey. I have had this strange pins and needles thing going on in my toes, a least I now know where it has come from. 12 weeks of Cisplatin. Hoping that it does not get more pronounced. the dryness in my left ear annoys me, but I am begining to eat real food and I am feeling that I am finally heading in the right direction. It is obvious that this treatment can produce a lot of friendly collateral damage but I am thankful for this sites hints and tips and sharing and witnessing the courage of many of the members.
Posted By: Brendan Hanavan Re: Nerve Damage - 11-20-2012 10:59 AM
Saw a neurologist re. this problem 2 weeks ago. I thought she would just go through the motions and fob me off with a quick chat and sympathy (I really do need to be less cynical).
However, I had a full,thorough examination and what to me seemed a tight analytical approach to my symptoms. I was prescribed daily Pregabalin tablets to ease my condition.
At the moment I feel as though my neuropathy may have peaked (5 months after ending chemo).
I no longer have the acute pain/discomfort in my shoulder joint,the sense of numbness in my fingers,hands and feet doesn't appear to be spreading further,I'm sleeping well and I no longer have the 'electric shock' type sensation in my arms and hands when I extend them outwards.
The neurologist told me that my condition may ease a little, but it will never completely disappear. It's not perfect,but I can manage and I can live with that.
Posted By: Cheryld Re: Nerve Damage - 11-20-2012 05:08 PM
this is true... nerves do tend to regenerate somewhat but will never be 100% they are very touchy and don't like people messing with them... ;o) so glad you are feeling better. I had one bout of tingling in my palms during chemo. Post treatment I had the weirdest sensation, when I would bend my neck forward... it was like a lightening bolt shooting down my spine to the back of my legs... I looked it up, it's called L'hermette's sign (or something like that) it is said to go away within two years... and is neurological and brought on by being nuked... It's gone now. If it lasts more than two years then it's permanent but that's almost unheard of... So nerves... as I said.. very touchy fellows.

hugs... :o)
Posted By: KenEggman Re: Nerve Damage - 11-23-2012 02:43 AM
Yes this is one of the gifts that Cisplatin keeps giving, side- effects. My tingling and numbness is annoying. I too find my hands are pretty weak. Once in a while my foot drags. I am also very cold and must wear lots of layers. Hope it does go away some day. Ken
Posted By: saxicola Re: Nerve Damage - 11-23-2012 10:59 AM
Brendan, I'm so glad you are finding things a bit easier. Sally

Posted By: MarkInOregon Re: Nerve Damage - 11-24-2012 04:36 PM
I had numbness on the bottom of my feet post-treatment. Doc did the poke with a pen test and sort of wrote it off. Three years out and it has improved but I still feel it. And the hard to stand from sitting, I still have to pause when I stand. Between the chemo, rad, and surgery, it did a number on my already shaky (pun intended) sense of balance.
Posted By: PaulB Re: Nerve Damage - 11-24-2012 11:07 PM
I have severe neuropathy since 2009, and was even paralyzed from the waist down, and could not walk for 10 months. In severe cases, it can effect the organs. I have optic ischemic neuropathy too in my left eye causing complete blindness in it, and almost the other. The neuropathy is my major complaint, and still causes 24/7 pain, numbness, loss of feeling, sensation, movement, muscle loss in the toes, feet, calf and hamstring, and fingers too. I can't drive, stand long or walk that far..a block or two. There severity of neuropathy..chemo induced.. there are 20 different types neuropathy, depends on the type of chemo given, the amount given, duration, frequency, and underlying Medical conditions or other medications that may contribute to netve damage...diabetes, alcoholism...most neuropathiex are resolved after time, but some can be permament.

There is not much really to be done for it, and each person is different as far as some therapies, medications, and vitamins. I used some prescriptions, which I did not like them since they are basically antidepressants or antiseizure medications. Docors rell e I'm better off without. Others have success with vitamin b6, glutamine powder. Accupuncture, PT...to name a few.
Posted By: PaulB Re: Nerve Damage - 11-27-2012 12:24 AM
There is a nerve test, EMG, Electromyogram, that can test for nerve damage. I had it done, and it's like getting stuck with an electrical cattle prod 200 times lol. The results, I have nerve damage in my hands, legs and feet. Like I didn't know that.
Posted By: David2 Re: Nerve Damage - 11-27-2012 05:35 PM
This is all quite interesting - and disturbing - to read. The latter especially in your case, Paul.

I'm having another strange archipelago of symptoms/side effects... don't really know what to call them. Beginning about this past February my hands, specifically the thumb and first two fingers, went cold, numb and tingly. To make a long story short I've had the usual battery of tests - first those delightful nerve conduction studies that Paul speaks of, then an MRI of the cervical spine. Result: no nerve or spinal damage. For which of course I'm grateful.

Yet the problem persists. Most of the time if feels as if there are hundreds of tiny pinpricks in my hands and radiating up my arms, sometimes to the shoulders. The fingers are always cold, sort of the halfway feeling you get when you've come in from extreme cold and your hands are beginning to warm.

I should add that this isn't painful. But it's damn disturbing, and since both my neurologist and my regular MD have no answers for me, quite a puzzlement.

I am 3 1/2 years out from RT and I had no chemo but I did have a neck dissection. No idea what of any of this may have contributed to it. I also get lightheaded from time to time when I try to stand up. So maybe it's a circulation problem.

Sure is weird! Any thoughts appreciated.
Posted By: Bette Re: Nerve Damage - 11-27-2012 06:03 PM
Have you checked your glucose lately?
Posted By: Cheryld Re: Nerve Damage - 11-28-2012 04:35 PM
Yes... I was thinking the same thing... ;o) It could be related to diabetes or poor circulation. hopefully not... but do have it checked.
Posted By: PaulB Re: Nerve Damage - 11-29-2012 04:08 AM
David, I was going to say diabetes like mentioned, which I have, and have the same numb cold feeling in the legs you describe, like having frostbite. I also have anemia, which makes you feel cold too.

Ken, after holding off so long...3 years almost, I'm finally going to see a pain specialist tomorrow that I was referred to see by my RO team. Will probably prescribe Neurontin, and see what is new with treatments.
Posted By: Bette Re: Nerve Damage - 11-29-2012 04:17 AM
Something else I should have mentioned. The thyroid could be the culprit. It tends to make you cold especially in the extremities. Reggie was like that until they got his hypothyroidism under control.
Posted By: David2 Re: Nerve Damage - 11-29-2012 06:18 PM
Bette and Paul - good thoughts. I'm already on Synthroid and have my levels checked every 3 months. I suppose that could be affecting things but this has been going on for longer than that.

I also had some evidence of leukopenia - low white cell count - this was more than a year ago before these current symptoms became constant. At the time my doc sent me back to the MO who's also a hemotologist, but he didn't think there was any problem that warranted treatment.

The diabetes/glucose angle is another interesting one I hadn't considered - yikes. I have an annual physical coming up in January so I'll ask my doc about it.

Many thanks!
Posted By: Uptown Re: Nerve Damage - 12-03-2012 08:43 PM
Everyone will develop neuropathy and depending on your awareness of your own body it can be a big deal or just discomfort. The alternative is no treatment. Also be aware of LeHermitte's sign. When you bend your head down while walking down stairs you will feel as if a lightening bolt is shooting up your spine. This is supposed to resolve but as everyone points out you never know how long and drugs can help but you may go through a slew before you find one that helps. Mine is still there 9 yrs later. Excercise those muscles and get the blood flowing. Ask about HBO treatment early if you had surgery too but if it persists. Check vitamin B1 as nerve damage can result and be permanent from low B1. You cannot take pills for this as it is water solvable and you need injections until it is up as well as checking B12. Water is now your best friend. Finding anyone to address this is perhaps the single biggest post treatment problem we face. Permanent nerve damage will only get worse and waiting may result in permanent damage. Be well but be diligent.

Ed
Posted By: Brendan Hanavan Re: Nerve Damage - 12-05-2012 02:47 PM
Have just had a letter through inviting me for EMG/NCS 'Investigation' from the neurophysiology dept.It goes onto say it will be "a test on the nerves and muscles in your arms and/or legs."
Having read PaulB's post, I do wonder if I'll be volunteering for the tasered patient of the month award, with a standard result of 'yeah. . you've got nerve damage in your hands and feet , the door is over there,' as I stumble out of the unit emitting electricity like the Emperor from Star Wars.
Posted By: PaulB Re: Nerve Damage - 12-05-2012 05:45 PM
Lol. Good luck, and hopefully it's not that bad. I was given a prescription for Neurotin last week, and took it for two days, and stopped taking it since I was out of it, and felt high. I have a lower dose prescription I'm going to try. If its the same, I'll deal with the pain instead, which I probably will, and reason I stopped the meds three years ago. Going to see about physical therapy again, accupuncture is not covered by Medicare, I believe, and don't feel like paying out of pocket.
Posted By: Ed H Re: Nerve Damage - 12-06-2012 12:07 AM
Cisplatin is well known for causing varying degrees of peripheral neuropathy (nerve damage in the distant parts of extremities). It usually takes the form of anything from numbness to tingling to pins and needles to (sometimes) pain. Some liken it to the sensation you get when a limb that has been nearly frostbitten begins to warm up, or to the unpleasant sensations associated with a limb "falling asleep". As a group these altered sensations are called paresthesias.

Usually, peripheral neuropathy does not "go away". It may "lighten up", or gradually fade, or we may simply become more accustomed to it and notice it less. It can cause foot drop (tip of foot hangs lower to ground), it can make standing up more difficult (harder to stand when you can't feel the floor well!), and it can cause stumbling and even contribute to falls. I had peripheral neuropathy before treatment, and although I only had 1 and a half doses of cisplatin, it has worsened. Oddly, it did not worsen until about eight weeks after my last chemo. In my case it is one more annoyance, and distressing to a degree, but it is tolerable and manageable,

Another form of nerve damage that Cisplatin can cause is loss of high frequency hearing--that "sisssss..." of cymbals, the sound of leaves moving, the way water sounds in the shower are all affected. It can heighten sensitivity to some sounds while diminishing sensitivity to others. It is like the peripheral neuropathy, something that affects some more than others, some not at all. I developed high frequency hearing loss as well. It can also cause or worsen tinnitis, a ringing or whooshing sound caused by auditory nerve damage, which I also had (mild form) before treatment, and which the cisplatin worsened to a degree.

Unfortunately there is no know treatment for these neuro side effects, though there are some experimental approaches being study to help minimize their development in the future. There are support groups in many communities for people with peripheral neuropathy (there are many forms and many causes), and I recommend these; just as with this forum, they are a great way to learn about the problem, and to learn what others have found helpful for adjusting and living with these changes.

My hearing changes have stabilized and seem to actually be improving somewhat; that isn't usually what happens, but I am hopeful that I may gain a degree of improvement. I hope that your paresthesias also gradually lighten and/or become less noticeable. I developed mine in my early 30's and although I am aware of them, they no longer enter my consciousness very often, and likely that is what will happen over time for the worsening that has occurred. Best wishes, and here's to hope that one day we will no longer have to be poisoned and/or burned just to survive cancer! In the meantime, I will pay that price to (hopefully) live to see my children finish school, get out on their own, marry, to meet my grandchildren, and to see many more sunsets.

Posted By: Ed H Re: Nerve Damage - 12-06-2012 12:11 AM
Addendum: some do find neurontin to be helpful, and others find vitamin supplements such as B-complex and niacin to be helpful (though niacin in larger doses can be dangerous). And although mainstream research tends not to support it, some find relief from complementary medicine techniques such as massage or acupuncture, whether through actual effect or placebo effect. Unless dangerous or breaking your budget, they may be worth a try.
Posted By: PaulB Re: Nerve Damage - 12-06-2012 02:31 AM
The hearing loss is from Cochlearotoxicity caused mainly by Cisplatin. There are many causes for Ototoxicity, mostly medication induced, and one is by Chemo, mostly from platinum based chemos like Cisplatin, and this �Cochlearototoxicity,� which can either be reversible, temporary or permanent, and is dose dependant, meaning it depends on the dosage of Cisplatin you received, and the medical community has found it occurs more often when Cisplatin is given in high doses, above 60mg, bi-weekly, instead of lower weekly doses. What happens is the Cisplatin is absorbed in the cochlear�s sound detecting hearing cells, and damages them being some chemos attack fasting acting cells like hairs, nails, nerves, etc. It is suggested that you tell your oncologist when in treatment if hearing loss or tinnitus occurs since they can regulate the dosage, stop it or change the medications, so not to make this adverse effect permanent.

There are 20 different types of neuropathies, and the one from chemo is "CIPN", Chemo Induced Perpheral Neuropathy. It is basically damage to the peripheral nervous system. The nervous system transmits information between the nervous system and rest of the body, particularly the hands and feet and too a lesser degree the bladder and bowel, including vision. Peripheral neuropathy can repair itself over time, but sometimes is permanent and with no real cures. This nerve damage is also a cause of chemo brain or fog. Some symptoms appear right away, during treatment, but some platinum based chemos have a delayed onset of symptoms from weeks, months or even years, so this should be considered and discussed before, during and after treatment, especially with pre-existing conditions like diabetes, alcoholism and other co-contributing factors.

Chemo drugs attack fast growing cells like cancer, hair, bone marrow, so explains the loss of hair and lowered blood levels, but nerve cells are effected the same way and are are more sensitive than other cells and can be damaged easily and can be the cause of chemo brain and peripheral neuropathy..After chemo exposure, the cells that are responsible for producing Myelin, a fatty substance, that insulates and protects nerve conducting fibers, can become damaged.

There are many other contributing factors that can make CIPN worse like other illness, lifestyle, nutrition, amount, duration and type of chemos. Some symptoms, and their effects for day to day activates vary. Sensory symptoms like numbness, tingling or burning sensation. Sensation to touching something cold or cold breezes cold or burning of hands, balance, trip or stumble when walking, unsteady feeling walking on uneven surfaces, need to hold onto handrail going up or down stairs, pain with fine hand and difficutly writing or typing on keyboard, decreased of vibrations and diminished or no reflexes, Some people have to wear socks, gloves, scarves, hat to minimize sensation and in some cases causes weakness, incontinence, constipation, muscle paralysis in the limbs and many others. I was unable to walk fore 10 months due to the severe neuropathy from 5 day Induction chemo of Taxotere, Cisplatin, and 5-FU, and had to relearn to walk.

As mentioned, there is there is no real cure, but some find relief with treatments benefit from vitamins, pain medications, physical therapy, acupuncture, changing lifestyle and reducing exposures to certain chemos, Cisplatin, taxotere and 5-FU, to name a few.

I thought you would appreciate more info I have about these conditions from personal experience, but does not mean they may occur.









Posted By: LeftyS7 Re: Nerve Damage - 01-10-2013 05:23 PM
Thanks, Paul, very helpful. I'm 19 weeks out of treatment and still have neuropathy on the soles of the balls of my feet. My Chemo Doc told me that he "thought" that it would go away by now but it hasn't, though it does seem to have improved. Good to hear straight talk.
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