Polyneuropathy : Be clairaudient: Early warning signs and symptoms
The principle applies: the sooner the condition is detected, the better the chances of relief and healing. And this is known to be true of all diseases. Therefore, self-observation is very important if the body sends different signals than before in certain situations. Which these can be and how important the attentive in-your-self listening is, is illustrated in this chapter.
Why polyneuropathy is often only recognized at a later stage
We usually react quickly to sudden pain, whether it is discomfort in the spine, severe nausea, or toothache, and seek help from a doctor quickly. We behave differently in the case of nerve pain, which only in rarer cases manifests itself abruptly through strong insensations. The gradual increase in symptoms means that those affected often only seek medical help after years. Sometimes symptoms that ultimately turn out to be polyneuropathy are only mentioned in passing in the medical conversation. Usually this initially consulted doctor is also not a specialist in neurology, but often the family doctor, an orthopedist or a vascular specialist. So often the patient is examined primarily in terms of other diseases that may be present in addition to that. Since most polyneuropathies have a slow course, often lasting years, sometimes decades, valuable time can pass before a referral to a neurologist is made.
4.1 How patients describe the symptoms themselves
My clear recommendation to those affected is therefore: listen more closely to your own body and observe sensations or pains that you did not have in the past. As an aid to orientation, I list below, as precisely as possible, those typical complaints that patients themselves repeatedly describe to me
This is how patients describe disturbances in their sensory perceptions
Sensory symptoms are described in a particularly wide variety of ways:
“Now and then a certain numbness in the feet. One does perceive the touch, but it feels as if it comes from one’s own foot and is felt for some time after contact.”
” Tingling sensations, as if thousands of ants were running through the foot or leg.”
“Drawing pains in toes and in the ball of the foot, especially at night.”
” Feet feel cold, although they are described as sufficiently warm when checked by someone else. And vice versa: the feet are perceived as uncomfortably hot, when in fact they are cold or have a normal temperature.”
“The feet have become so hypersensitive that walking barefoot hurts. Even comfortable shoes lately create a painful pressure.”
“After walking for a long time, the feet feel numb in the front.”
“When lying in bed for a long time, the feet start to burn more and more, which is extremely uncomfortable and makes you unable to continue sleeping. Even the mere touch of the bedspread triggers painful sensations of heat or stinging.”
This is how patients describe their movement problems
Motor symptoms can also manifest themselves in very different ways:
“In the feet, calves or thighs, very painful muscle cramps occur more and more often.”
“Hikes are almost no longer possible, because the control of the legs is limited.”
“Exercises that used to cause no problems in gymnastics classes are now simply not possible because the muscles are so weak.”
“The toes can no longer be spread properly.”
“When walking, the forefoot can no longer be lifted properly, which is why the gait looks so strange.”
” The fingers or foot can no longer be moved properly.”
“Getting up from the chair becomes increasingly difficult.”
“Buttoning the shirt or pants becomes more and more difficult, because there is no longer a proper feeling in the hands.”
4.2 How the complaints can still manifest themselves
Attention: frequent stumbling can be a warning signal!
The various types and different distributions of the sensory disturbances can be followed relatively soon by changes in gait: One no longer perceives the ground as before and notices a certain instability when walking, especially in the dark. Walking on narrow paths, which places greater demands on balance, can also be difficult. Some patients often only realize why they stumble so often or get their feet “stuck” after they have been diagnosed.
For special forms of polyneuropathy (z.B. Guillain-Barre syndrome), however, it is typical that the disease starts with striking symptoms right at the beginning. Movement restrictions can start suddenly without specific early warning signals and can also deteriorate rapidly, sometimes to the point of being unable to walk
The feeling of temporarily losing the ground under their feet
In addition to the various forms of gait disorders, some patients also experience symptoms that seem to have nothing at all to do with polyneuropathy. One example is vertigo, especially staggering vertigo: Affected persons have the feeling of temporarily losing the ground under their feet or they perceive their surroundings as “staggering”.
Patients usually do not like to talk about some vegetative symptoms of polyneuropathy or they do not associate the complaints with it at all. Not always, but relatively often these disturbances, which are very unpleasant for the person concerned, are unfortunately also due to this disease.
Pathological sweating, frequent diarrhea, but also constipation can be indications
On the one hand, this includes pathologically altered sweating. This can manifest itself as both increased and decreased perspiration or as patchy sweating with a sometimes very dry feeling on the skin.
Constant diarrhea and weight loss indicate that food is being transported through the digestive tract too quickly. Conversely, regular difficulty swallowing, bloating, flatulence and constipation may also be due to polyneuropathy.
Diabetes can also damage the nerves in the genital area.
Polyneuropathy is also frequently manifested by impairment of our sexual organs. For example, first-time erectile dysfunction or sensory disturbances (too little or too painful sensation) during sexual intercourse may be symptoms of (diabetic) polyneuropathy. Men with diabetes are twice as likely to suffer from erectile dysfunction as non-diabetics. However, nerve damage can also be due to circulatory problems, psychological causes or side effects of medication, which is why detailed examinations are essential.
In diabetic women, nerve damage in the genital area can cause diminished or absent sexual desire and absent or painful orgasm. While the majority of affected men can be helped with the treatment options available today, there is unfortunately no effective drug therapy available for women yet.
The more openly you describe your complaints, the better the doctor can help you
The complaints observed by the patient and described to the doctor are of utmost importance for the further course of the examinations and consequently for the correct diagnosis. The more detailed and open the patient’s description of all his complaints, the more targeted the further measures that the doctor can take.
Important to know, since at first glance it does not appear to be related: a clearly reduced sensation of pain often occurs simultaneously with sensations that are not caused externally, such as tingling, stinging, burning sensations, etc.”. at. The dangerous consequence: the entry of splinters or small shards, the formation of blisters by constricting shoes or ingrowing toenails are not noticed, because affected people do not feel the small injuries. This often leads to poorly healing, chronic wounds that, in the worst case, will not close.
Attentive relatives are sometimes the first to notice symptoms
Relatives are also challenged to develop an eye for the symptoms of polyneuropathy. For example, eye muscle paralysis and fluctuations in attention (vigilance) usually suggest vitamin B deficiency in chronic alcoholism. Inflamed skin and diarrhea can indicate a so-called pellagra polyneuropathy, which is due to a vitamin B2 deficiency. An increasingly frequent, unsteady gait should also be a reason for the person concerned to visit a doctor.
The following patient example shows how differently polyneuropathies can start and how helpful a quick diagnosis is for the further course of the disease.
Patient example 8
A 37-year-old man, who had been completely healthy until then, notices a rapidly increasing pain in the right forefoot within an hour. First of all, he attributes this to an incorrect sitting position. The pain, however, does not go away and the patient takes 2 tablets of a conventional painkiller in the evening.
The next day, the patient notices that he has slight difficulty walking and has to lift his right leg a little more deliberately. The gait disorder and the pain increase during the day, so that the patient finally goes to the emergency room of a hospital in the evening. There, the weakness is determined and an MRI of the lumbar spine is performed. Since this is inconspicuous, the patient is recommended further outpatient neurological control examinations.
The following day, the symptoms are worse and the patient is admitted to a neurology department. At the time of the examination, he already has an almost complete paralysis of the toe and forefoot elevation on the right as well as a reduction in sensation on the right forefoot. The blood test shows increased inflammation values and subsequent examinations reveal a so-called “vasculitis”, an inflammation of the vessels supplying the nerves. During the examination phase, the patient experiences the same complaints in the region of the 4th lumbar vertebra. and 5. Fingers of the left hand one. Once the diagnosis is confirmed, the patient is given a strong anti-inflammatory therapy and then long-term drug treatment. The symptoms slowly recede and within 6 months the patient is symptom-free again.
Polyneuropathies can also take an extremely rapid course in some, rarer cases. In such situations it is of utmost importance to be examined immediately and specifically by experienced physicians.
Although in rarer cases it can happen very quickly, the majority of all forms of polyneuropathy take a very slow course, often extending over many years. Even if symptoms such as sensory disturbances, tingling or cramps in the legs or a slight unsteadiness of gait only occur at longer intervals, their cause should be clarified soon. Because they indicate that something in the body is not working quite as it should. Heavy sweating or impotence disorders can also be signs of a polyneuropathy. The more open and trusting you are with your doctor, the quicker he will come to the correct diagnosis and be able to help you very well. Therefore, please do not ignore the first signs!