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Hello, everybody. I'm brand new here but I've had DM for about 5 or so years and neuropathy for as long as I've been diagnosed. In fact it was the burning and numbness that brought me into the doctor's office and we went from there to a diagnosis of DM Type 2.
My main concern right now is that my neuropathy is increasing in severity. I'm not on any medications for it just my regular diabetes meds (metformin and glipizide) and some others for other conditions.
This week I went to see a podiatrist for the first time. He does nerve decompression surgery for diabetic neuropathy/compressive neuropathy. He's all gung-ho to do the surgery on me. I'm rather anti-gung ho. Are there others in this community who have had the surgery done? I'd really appreciate hearing from you.
I'm also going to speak to my physician about changing anti-depressant medication to Cymbalta. How does that work for folks who've taken it?
I know everybody has individual responses to different therapies. I'm just kind of feeling like I'm entering a giant forrest without a guide.
Thank you!

P.S. I rode in the Twin Cities Tour de Cure last Saturday for the first time. It was GREAT!

I cross posted this at the Neuropathy Group site.

Tags: Cymbalta, neuropathy, surgery

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I have Diabetic Neuropathy; so far just in my feet. The burning, tingling (sometimes feels like hundreds of needles) and numbness get pretty unbearable at times. I have been told that nerve decompression surgery may be an option and that maybe I need (vitamin) B12 shots. This is something I am scheduled to visit a neurologist about.
Not being excited about surgery, I did some research on the subject and came across a nutrient supplement that is supposed to calm the affects of neuropathy. The nutrient supplement is available at Walgreens, and is called Alpha Lipoic Acid. The recommended dosage according to the doctor whose research I read, is 300mg to 600mg a day.
I have been taking 600mg of Alpha Lipoic Acid a day for over one month. I am getting some relief. After the first two days of taking this, I started noticing relief. It is not as much as I would like, however, I do feel the Alpha Lipoic Acid is giving me relief from the neuropathy (it is no longer at the pretty unbearable at times level which I mentioned above).
I am comtemplating increasing the dosage, but I am going to think on it for a while. Other things I do is elevate my feet a few times a day, and soak them in luke warm water with just a bit of liquid ivory soap for 15 to 20 minutes (then rinse with plain water) before bed.
Trying the Alpha Lipoic Acid for a while before deciding to do surgery might be worth while. If you do, I would be interested in your results.
Thank you so much for the advice. Somebody told me about ALA (R-ALA) several years back and it didn't stick in my memory cells.
I'd avoid surgery also, if possible. Some neuropathies do heal with better BG control. It doesn't happen quickly depending on the severity, but it can happen.

You can try R-ALA (alpha lipoic acid), an OTC amino acid supplement. The R form is the most effective. ALA repairs the myelin sheath of nerves. It can also lower BG.

If you're not getting good results on oral diabetic meds, talk to an endo about insulin. More T2s are using insulin.
Hi. You say the R form of ALA is the most effective. How can I tell if ALA is an R form, and where would I purchase it.
It will say R-ALA on the label. I don't think places like Walgreens would carry this. It's more expensive. I order supplements from Swanson's on-line. They have good prices. Here's a link to the R-ALA brands they carry.
Thanks! I will check that out.
I've got this "thing" about taking insulin. I've seen a discussion posted about it on this website. It hasn't been recommended to me as yet but I'm trying to be more open about it and preparing myself for the possibility.
I'm going to try the ALA (R-ALA) and see what happens. Also will try and get the blood glucose in better control, too. Ah, portion control, you do elude me so.
You're not alone as a T2 being hesitant about insulin. If you can get your A1c down & have better control without it, that's the way to go to. We have several T2 members doing beautifully using just diet & exercise. Most important thing to get BG down by whatever means.

Hope R-ALA helps!
Please do yourself a BIG favor, and do not rush into surgery. I have had peripheral neuropathy (PN) for about six or so years. I had a very severe case, so severe that I could not crawl into my own bed and had to check into the ER. I had been rx'd neurontin when my PN was first dx'd, but that med did nothing for me, and I ended up in the ER. The ER doc switched me to Cymbalta, and that med has given me my life back. I've been on it for six years now. I have absolutely no pain and go about my life just fine. Please exercise your non-invasive treatment options first. Surgery is a big step, and it really ticks me off when I hear about doctors who try to shoehorn patients into expensive, invasive medical procedures that may very well not be unnecessary.

To illustrate this last point, I also have a benign brain tumor, an acoustic neuroma (AR) (vestibular schwannoma). I have known about it for about eight years. My AR is relatively large, about 2.0 cm measured across in any direction, the size of a large marble. The procedure to remove an AR runs about $70K, and the procedure to treat it with radiosurgery (cyberknife, gammaknife, etc.) runs about the same. The neurosurgeons were eager to remove my AR, and the ENTs who work with radiosurgery were eager to zap it. Both camps championed their particular procedure and poo-pooed the other. I came to realize that they were not interested me. They were interested in a huge payday. There are many. many former AR patients who fully regret going forward with skullbase surgery or radiosurgery. Their post-procedure quality of life has not improved, but on the contrary, has declined severely.

Against medical advice, I decided to wait and get a second MRI a year later to see if my AR was growing. An independent radiologist compared the two MRIs and told me that there was no growth. I had another MRI the next year with the same result: no growth. I get an MRI annually, and have had six so far, and all have shown no growth. I still have my marble in my head, and it feels great! I don't have to deal with post-surgery complications such as facial paralysis, dry eye, loss of balance, etc. Many of those who were talked into treatment have those issues to deal with for the rest of their lives. The doctors collected their money and have moved on.

I know I have painted a cynical picture here, but that is the reality. At the end of the day you have to advocate for yourself because you are the one who is going to have to live with your decision. Choice of treatment is a personal decision, and I respect that. However, you have an obligation to yourself to do your homework and be as informed as possible before choosing a path. Here's hoping you find a course of treatment that works for you.
I'm glad you still have all your marbles. ;-) Thank you for sharing your history with me. It's so good to hear from other diabetics out here in the real world.
I did feel "shoehorned" and that's why I decided I needed more than one voice in my decision making process.
Thank you.
You're welcome. :-)
i work for a chiropractor who is a specialist in spinal decompression etc- he has a 93% success rate with non invasive/non surgical/ not rx treatments. back surgery has 20-30% success rate. we actually get a lot of patients with failed back surgery pain.we deal with nerve pain also. all that to say, there are usually other options and i cant encourage you enough to explore/weigh all the options!




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