Brief Answer:
Have you had laboratory analysis?

Detailed Answer:
Good evening XXXX. My name is Dr. Dariush Saghafi. I am a neurologist in XXXXXXX OH and I would like to give you a few ideas to help you improve your condition of neuropathy.

I see that you are 86 years old and say that you have been diagnosed with neuropathy but you don't feel your doctor is able to offer assistance. Have you had any type of a workup for your neuropathy? There are a number of potential causes of neuropathy that should be checked in case there are positive results. For example, a standard laboratory workup that I always use on my patients would include the following blood tests:

1. Free T4
2. Total T4
3. TSH
4. Vit. B12
5. Folate
6. Vitamin D, D2, D3
7. BUN/Creatinine
8. Hemoglobin A1C
9. ANA, ESR, CRP

The above tests represent those which are most likely to result in a reversible causes for your symptoms. Please find out if your physician did any or all of these tests.

Therefore, in order to stop it or slow it down we have to know what's causing it to begin with. I would love to say that after doing all the tests we will have a terrific chance at knowing what is causing your symptoms but the truth is, only about 15-20% of all cases can be connected to a specific cause.

Medication is often unsatisfactory and itself could cause more symptoms than benefits and so we need to be careful when recommending drugs especially since your age adds some level of complications to using certain medications which could be recommended for idiopathic neuropathy. On the other hand if your symptoms are truly uncomfortable, painful, or in some other way intrusive on your life then, I would recommend a trial of increasing your gabapentin (depending upon your kidney function) if you are not suffering with side effects.

If the above information has provided some level of assistance to you then, I would appreciate greatly your written feedback and a STAR RATING at your earliest convenience. Also, if there are no more questions or comments on this thread then, I would ask that you CLOSE THE QUERY.

All the best.

This consult required 25 minutes physician specific input, research, and documentation of final draft for envoy.

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Brief Answer:
List of tests above remains valid

Detailed Answer:
Good afternoon XXXX

Thank you for that additional information. Your description of the complications from the heparin are very unfortunate. There would be, however, no correlation between that incident and the neuropathy you describe from your feet/legs to the level of the knees.

The fact that you have a symmetric affectation of both limbs and it appears that the disorder has gone from the farthest points south so to speak and crept its way up over the years to where it is today, is proof of that statement. The last list that I placed for you above remains full of the most essential tests necessary to discover the cause of this entity.

Having said that, unfortunately, 50% of cases or higher of neuropathy remain elusive in terms of cause. I hope that yours, however, is found in one of the tests I mentioned.

Once again, if the information I've provided is of value to you I'd greatly appreciate your written feedback indicating such and if there are no further questions or comments your CLOSING THE QUERY will guarantee that the network will apply credit properly for this case.

I will also give you the following information if you ever would like to do a webcam based consultation with me. Look me up at the following location:

www.healthtap.com/drsaghafi

I am online from Wed-Sat from 3a-6a EASTERN STANDARD TIME (New York City time) and would be happy to do a live webcam discussion if you ever feel the urge.

Meanwhile, cheers to you and I hope you get better soon.

This query required 13 minutes of physician directed time for review, research, and documentation of final draft for envoy.

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