Numb – #AtoZChallenge

Did you know that there are different kinds of numbness?

When most people think about being numb, they are thinking of anesthesia — the absence of any feeling. Most people are familiar with the term, relating it to the temporary anesthesia they have when they are having a medical procedure done. When the anesthetic wears off, their sensation returns. This is the kind of profound numbness often experienced by someone who is a paraplegic or quadriplegic, a loss of all sensation past the place that their spinal cord is injured. Some people with MS experience this kind of numbness in certain areas of their bodies. There is no damage to the tissue, but the nerves that transmit sensation to the brain are not doing their job due to being injured.

The other kinds of numbness are not the complete absence of sensation, but rather different states of altered sensation. Paresthesia and dysesthesia are the two most common in MS.

Paresthesia means “irregular sensation,” usually one that is annoying but not exactly painful. Most people have experienced that super-uncomfortable feeling of pins and needles that you feel when your foot is waking up after falling asleep. You really don’t want to walk on that foot until the sensation goes away! This sensation is really common in people with MS. Other manifestations of paresthesia are tingling, buzzing, or crawling sensations. Personally, I have the pins-and-needles feeling in my left foot all the time, but I also have intermittent buzzing. It feels as though a cell phone in “vibrate” mode has been implanted under the skin of my left leg and that I’m receiving calls that for some freaking reason are not going to voice mail. Bzzzzz. Bzzzzz. Bzzzzz. Bzzzzz. Thankfully, that imaginary phone doesn’t ring nonstop, but when it does start buzzing, it drives me crazy.

Dysesthesia means “abnormal sensation,” and can include feelings of burning, wetness, itching, or electric shock, when nothing has happened to cause or evoke those sensations. It can also refer to a sensation that just isn’t appropriate to the stimulus. For example, my left side does not feel sharpness properly from the waist down. I can feel it if you stick me with a pin, but it feels more like dull pressure than a sharp prick. On the other hand, that same area feels innocuous touch — like brushing up against something — inappropriately strongly, such that being lightly touched or even wearing clothing (or having covers on in bed) can be really uncomfortable and impossible to tune out. Needless to say, this can be problematic!

I’m very blessed to have had good results from taking Gabapentin for the paresthesia and dysesthesia I experience. It has turned the discomfort down to a dull roar. Unfortunately, I’ve had to increase the dose over the years. Back in 2009, I took 900 mg/day; now I take 3200 mg/day. I told Dr. Zarelli, my neurologist, that I was worried about having to take so much to get the same effect, but he assured me that it is by no means a particularly high dose, so I guess I have a while to go before I have to find some other treatment. (As long as that treatment doesn’t involve sleeping with no bedcovers or walking around naked, I’ll be fine.)

Pins” by Jayjay P / CC BY

Gabapentin – #AtoZChallenge

Gabapentin was originally developed as an anti-seizure medication for epilepsy, but was also found to help with neuropathy (nerve pain) and dysesthesia (altered sensations, pins-and-needles feeling, tingling). Thank goodness for that! There’s no way I’d be able to get through the day without it.

See, normally our bodies can screen out unimportant sensations of things like clothes or blankets or the brush of a purse against your side as you walk. I mean, it would be pretty weird if you put your clothes on and then felt them against your skin all day, like having to wear a shirt over a badly-sunburned back, wouldn’t it?

Yes; yes, it would.

I really have a problem with dysesthesia on my left side. I don’t feel pointy, sharp pain well enough, and I feel soft, glancing touch way too well. Without gabapentin, I wouldn’t be able to leave the house, because I wouldn’t be able to wear clothes without feeling like I was being slowly irritated to death. I wouldn’t be able to sleep in the same bed as my husband for fear of him accidentally brushing up against me. Walking would be particularly difficult, as my foot would freak out every time it hit the ground. Gabapentin has helped tremendously; it’s not perfect, but it turns the neuropathic pain from a 10 down to about a 4.

I just have to remember to take it on time; missing doses really does a number on me. I have a sectioned pill box and I’ve set alarm reminders on my phone, but still I mess up the timing, and I usually don’t know I’ve done it until I feel the nerve pain start to creep back in.