I developed a weakness for alcohol while in the Army, however, and that led to drinking to excess on occasion, something that came to a head when I was in my early 30s. I attended my first AA meeting at 34 and, except for a couple of brief periods of "falling off the wagon" over the years, I've since been free of alcohol and been very conscious of diet, excercise and the habits that support good health.

About three years ago, at age 46, I became a member of the Mountain Club of Maryland and took up hiking and backpacking as a pastime. In December 2000, I had the time of my life when I hiked 50 miles in the Grand Canyon with two companions from the mountain club. Upon completing that hike, I began training for a 40-mile, one-day hike that would take me from one end of Maryland to the other along the Appalachian Trail. Peripheral neuropathy reared its ugly head before I could complete my training.

It began one morning when I noticed a dull throb in my lower back and some numbness and tingling in the tips of my feet. I concluded that I injured my back somehow from one of my training hikes or working out in the gym, so I made an appointment to see the doctor. A few days later I was in the doctor's office getting an x-ray of my spinal column, and by that time my back throbbed and my feet had gone completely numb. I was sure I had pinched a nerve in my back.

The doctor didn't see anything in the x-ray, so he sent me to a neurosurgeon. By this time, about two weeks after my feet had first gone numb, the feeling of numbness and tingling had spread upward to my shins. My shins tingled and ached like my back. I was putting ice on my back every evening after work, still thinking I had some kind of back injury.

The neurosurgeon ordered an MRI, a procedure I found unpleasant and expensive, and this showed nothing out of the ordinary. A week later he sent me to another doctor who conducted an electromyogram (EMG), an even more unpleasant test that involved pokes with needles and electrical jolts. I asked the doctor who did this test for results, but he just said to "wait and see."

Within the next month, while waiting for this test result and to see the neurosurgeon again, the tingling and numbness in my feet and shins spread upward all the way to my waist and became very unpleasant. My legs felt as if they were buzzing with electricity and my feet began to be hypersensitive. If I bumped my toe against something, it hurt a lot more than it usually would. I began to get really worried about what was going on. I occasionally would walk vigorously around the block in my neighborhood to try and quiet the buzzing nerves in my legs, or at least make them go numb and stop bothering me so much. I sometimes woke up and did this in the middle of the night.

I finally saw the neurosurgeon again, who had the EMG report in hand, and he said it showed "electrodiagnostic evidence of a generalized sensorimoter peripheral neuropathy." It was quite a mouthful to me, and I had never heard of PN before. The doctor gave me a textbook explanation, adding that, "This is a very early stage," as if that were some sort of consolation. I was in kind of a daze and didn't listen very well. I went home and looked up information about PN on the Internet. What I read about it scared the hell out of me.

Over the next month or two, the PN began to creep up past my waist and show the first hints of tingling in my torso, back, arms and face. It was progressing rapidly, and there seemed to be nothing the doctors could do to halt its advance. At the advice of the neurosurgeon, I went to see a local neurologist, who conducted a number of tests to determine if I had lupus, had MS or some other "demyelinating disease," was HIV positive, was diabetic, had Lyme disese, B12 deficiency, etc.

Then the pain began. I started to feel really strange sensations all over, very hard to describe, and at about the same time the tingling in my feet started turning into burning and aching. I complained to my neurologist about this, but he said he "didn't believe" in pain medication and ordered Neurontin. It didn't seem to help at all. I lost my nerve and started drinking to control the pain. That was a BIG mistake. A couple of weeks of that put me in the hospital, where I dried out and have stayed that way.

I have since seen two more neurologists, and undergone two additional MRIs to rule out MS or some similar disease. I have had additional blood tests and a second EMG. A neurologist at Johns Hopkins Hospital ordered a skin-punch biopsy, a procedure that involved taking three chunks of skin out of my leg for examination under an electron microscope. That revealed small-fiber sensory nerve damage.

I've also developed tinnitus, probably as a result of pain medications to deal with the PN, and that can really be an annoyance, especially at night when I'm trying to sleep. I have to listen to "white noise" sometimes so the ear ringing doesn't keep me awake (if the PN pain doesn't).

At this writing, it has been nine months since I first noticed the numbness in my feet. The PN has spread pretty much throughout my body, it seems, and I am in pain almost all of the time. I take about 2800mg of Neurontin and 200mg of Ultram a day, and that helps a lot, but it never quite gets rid of the pain -- just makes it more manageable. Sometimes I ache all over, as if I have arthritis throughout my body, and sometimes I burn. It seems worst in my feet and face. My legs and back burn and ache sometimes. Something is always burning, aching or both.

One neurologist thinks my PN was the result of alcoholism, but I had been dry for a number of years when it hit me, and it has progressed in the absence of my drinking. It is also noteworthy that my mother has peripheral neuropathy -- idiopathic it seems -- and has suffered from it for about five years. There is some common denominator there, but I'm not sure what.

I can only hope that it is leveling off and won't get much worse. It has greatly affected my life, and I find life quite difficult to enjoy at times. The pain can be depressing, and I can't do many of the things I used to do because of it. But I'm not giving up. I like the idea that we can "win over PN." I'm trying, but I'm still relatively new to this.

Michael Cast
Edgewood, Maryland
E-mail Michael:
netcastr@home.com