Neuropathy Awareness Week on May, 2024: why has my heart rate been significantly higher than usual lately?

Neuropathy Awareness Week 2024. Neuropathy: Neuropathy, Peripheral Neuropathy, CIDP National Neuropathy Awareness

There are many possible causes of a rapid heartbeat, including:

exercise, heavy lifting or other activity that requires exertion, fear, pain, anxiety, stress, anger, or nervousness, fever, dehydration. This may be caused by too little intake of fluids, loss of blood, diarrhea, vomiting, or medications such as diuretics, sometimes called "water pills." low blood pressure, also called hypotension, hyperthyroidism, which is a level of thyroid hormone in the body that is too high, congestive heart failure, a condition in which the heart cannot pump blood effectively, irregular heartbeats, known as arrhythmias, such as atrial fibrillation or ventricular tachycardia. These may be caused by salt imbalances, heart attack, and other conditions, low red blood cell count known as anemia, medications or drugs. Albuterol, which is commonly used to treat asthma, as well as some over the counter and prescription decongestants can cause rapid heartbeat. Cocaine abuse and alcohol withdrawal are other causes of rapid heartbeat, excessive caffeine intake, some herbal therapies such as ephedra, also called ma huang , infections. These may include such as a serious blood infection called sepsis and pneumonia, nerve damage, known as peripheral neuropathy, that affects the nerves attached to the heart. This is often due to diabetes, a condition that results in a high level of blood sugar, low oxygen in the blood, also called hypoxia. There can be many causes for this. Examples include asthma and emphysema. Other causes are possible. Sometimes, no cause can be found.

A rapid heartbeat is defined as a heart rate that is faster than normal. The heart normally beats fewer than 100 times per minute in adults. In children, the heart can beat slightly faster than 100 times per minute and still be considered normal.

At rest, a person's heart rate usually stays within a standard range. This range is usually 50 to 100 times per minute in adults and slightly faster in children. With increased physical activity, stress, or other conditions, however, the heart rate may increase above the normal level.

A person with a rapid heartbeat may have no symptoms at all. When symptoms do occur, they may include: • palpitations, or an unusual awareness of the heartbeat • excessive sweating • fatigue or weakness • shortness of breath • chest pain • lightheadedness or dizziness • fainting • symptoms related to the cause of the rapid heart rate

If you have arthritis.....?

I have a degenerative disorder where my body is producing a protein that is attacking my bones and joints thereby creating an arthritic condition throughout my body.

As a result I will soon begin to have my knees and hips replaced and have as much repair done on my joints done as possible.

It might be understood as being very uncomfortable and makes it difficult to get a good night's sleep (I have not slept more than four hours in a night in more then four years...).

As a Buddhist, I do not take any medication that might cloud my awareness unless the pain is extreme. I use mediation to deal with the discomfort.

I also do weight resistant exercises three days a week, cardio/aerobic work daily and study Aikido all of which seems to help mentally if not physically.

As much as possible I maintain a vegetarian diet.

As I have also been diagnosed with having multiple myeloma and neuropathy, my discomfort in this present manifestation or lifetime will not last too long for which I am grateful.

If you are now developing arthristis, I hope that it goes well for you and that your attending physicians are able to assist you in the same.

namaste

i am looking for a specialist who knows anything about gravatational leg ulcers and how to treat them?

Leg ulcers

What are leg ulcers?

Leg ulcers skin loss on the leg or foot due to any cause. They occur in association with a range of disease processes, most commonly with blood circulation diseases. Leg ulcers may be acute or chronic. Acute ulcers are sometimes defined as those that follow the normal phases of healing; they are expected to show signs of healing in less than 4 weeks and include traumatic and postoperative wounds. Chronic ulcers are those that persist for longer than 4 weeks and are often of complex poorly understood origin.

Ulcers may be provoked by injury or pressure such as from a plaster cast or ill-fitting ski boot. They may also be caused by bacterial infection, especially impetigo, ecthyma and cellulitis and less often tuberculosis or leprosy.

Chronic leg ulceration affects about 1% of the middle-aged and elderly population. It most commonly occurs after a minor injury in association with:

Chronic venous insufficiency (45-80%)

Chronic arterial insufficiency (5-20%)

Diabetes (15-25%)

Chronic leg ulcers may also be due to skin cancer, which may be diagnosed by a skin biopsy of the edge of a suspicious lesion. There are also many less common causes of ulcers including systemic diseases such as systemic sclerosis, vasculitis and various skin conditions especially pyoderma gangrenosum.

What causes leg ulcers?

Venous insufficiency refers to improper functioning of the one-way valves in the veins. Veins drain blood from the feet and lower legs uphill to the heart. Two mechanisms assist this uphill flow, the calf muscle pump which pushes blood towards the heart during exercise, and the one-way valves which prevent the flow of blood back downhill. Faulty valves and impaired calf pumping action result in pooling of blood around the lower part of the leg to just below the ankle. The increased venous pressure causes fibrin deposits around the capillaries, which then act as a barrier to the flow of oxygen and nutrients to muscle and skin tissue. The death of tissue cells leads to the ulceration.

Arterial insufficiency refers to poor blood circulation to the lower leg and foot and is most often due to atherosclerosis. In atherosclerosis the arteries become narrowed from deposits of fatty substances in the arterial vessel walls, often due to high levels of circulating cholesterol and aggravated by smoking and high blood pressure (hypertension). The arteries fail to deliver oxygen and nutrients to the leg and foot resulting in tissue breakdown.

Diabetic ulcers are caused by the combination of arterial blockage and nerve damage. Although diabetic ulcers may occur on other parts of the body they are more common on the foot. The nerve damage or sensory neuropathy reduces awareness of pressure, heat or injury. Rubbing and pressure on the foot goes unnoticed and causes damage to the skin and subsequent ‘neuropathic’ ulceration.

Who is at risk of leg ulcers?

Certain conditions have been linked with the development of venous and arterial leg ulcers.

Venous ulcers Arterial ulcers

Varicose veins

History of leg swelling

History of blood clots, e.g. deep vein thrombosis (DVT)

Sitting or standing for long periods

High blood pressure

Multiple pregnancies

Previous surgery

Fractures or injuries

Obesity

Increasing age and immobility

Diabetes

Smoking

High blood fat/cholesterol

High blood pressure

Renal failure

Obesity

Rheumatoid arthritis

Clotting and circulation disorders

History of heart disease, cerebrovascular disease or peripheral vascular disease

Diabetic ulcers are more likely if diabetes is not well controlled by diet and/or medication. Ulcers are also more likely if there is poor care of the feet, badly fitting shoes and continued smoking.

What are the signs and symptoms of leg ulcers?

The features of venous and arterial ulcers differ somewhat.

Characteristics of venous ulcers:

Located below the knee, most often on the inner part of the ankles.

Relatively painless unless infected.

Associated with aching, swollen lower legs that feel more comfortable when elevated.

Surrounded by mottled brown or black staining and/or dry, itchy and reddened skin (gravitational or venous eczema).

Venous ulcers

Characteristics of arterial ulcers:

Usually found on the feet, heels or toes.

Frequently painful, particularly at night in bed or when the legs are at rest and elevated. This pain is relieved when the legs are lowered with feet on the floor as gravity causes more blood to flow into the legs.

The borders of the ulcer appear as though they have been ‘punched out’.

Associated with cold white or bluish, shiny feet.

There may be cramp-like pains in the legs when walking, known as intermittent claudication, as the leg muscles do not receive enough oxygenated blood to function properly. Rest will relieve this pain.

Diabetic ulcer

Neuropathic ulcer

(Spina bifida)

Traumatic ulcers (paraplegic)

Diabetic ulcers have similar characteristics to arterial ulcers but are more notably located over pressure points such as heels, tips of toes, between toes or anywhere the bones may protrude and rub against bedsheets, socks or shoes. In response to pressure, the skin increases in thickness (callus) but with a minor injury breaks down and ulcerates.

Infected ulcers characteristically have yellow surface crust or green/yellow pus and they may smell unpleasant. There may be surrounding tender redness, warmth and swelling (cellulitis).

What is the treatment for leg ulcers?

Where possible, treatment aims to reverse the factors that have caused the ulcer. As ulcers are often the result of both arterial and venous disease, careful assessment is needed first.

Venous leg ulcers, in the absence of arterial disease, are usually treated with exercise, elevation at rest, and compression. Compression must not be used if there is significant arterial disease, as it will aggravate an inadequate blood supply. Varicose vein treatment may also help.

A vascular surgeon should assess patients with arterial leg ulcers as they may require surgery to relieve the narrowing of the arteries.

It is also very important to treat underlying diseases such as diabetes and to stop smoking.

Cleaning the wound

No matter what the cause of the ulcer, meticulous skin care, and cleansing of the wound are essential. The removal of surface contamination and dead tissue is known as debridement. Surgical debridement or medical debridement using wet and dry dressings and ointments may be used. Maggots and larval therapy are occasionally recommended. Debridement converts the chronic wound into an acute wound so that it can progress through the normal stages of healing.

Treating infection

Antibiotics are not necessary unless there is tissue infection. This is likely if the ulcer becomes more painful and/or the surrounding skin becomes red, hot or swollen (cellulitis). Cellulitis may also result in fever and sickness. It should be treated with oral antibiotics such as flucloxacillin – the choice will depend on the causative organism. Topical antibiotics are best avoided because their use may result in increased antibiotic resistance and allergy.

Wound dressings

There is a whole range of specialised dressings available to assist with the various stages of wound healing. These are classified as non-absorbent, absorbent, debriding, self-adhering and other. Consult an expert in wound healing to determine the most suitable; this will depend on the site and type of ulcer, personal preference and cost.

Dressings are usually occlusive as ulcers heal better in a moist environment. If the ulcer is clean and dry, occlusive dressings are usually changed weekly; more frequent changes are avoided as dressing changes remove healthy cells as well as debris. Contaminated or weeping wounds may require more frequent dressing changes, sometimes every few hours. Honey dressings can be helpful.

Accelerate wound healing

Wound healing requires adequate protein, iron, vitamin C and zinc. Supplements may be prescribed if they are deficient in the diet.

New products to aid wound healing are available but require further research to determine their effectiveness. These include:

Growth factors and cytokines

Hyperbaric oxygen to increase tissue oxygen tension

Skin graft substitutes

Connective tissue matrix

Expanded epidermis

Epidermal stem cells

V.A.C. (vacuum assisted closure) device

In some patients, the ulcers fail to heal by themselves and require plastic surgery. The procedure typically involves taking skin from elsewhere on the patient's body and placing it over the ulcer (skin grafting). Despite this procedure, it is not uncommon for the ulcer to recur.

Compression therapy

Compression therapy is an important part of the management of venous leg ulcers and chronic swelling of the lower leg. Compression therapy is achieved by using a stocking or bandage that is wrapped from the toes or foot to the area below the knee. This externally created pressure on the leg helps to heal the ulcer by increasing the calf muscle pump action and reduce swelling in the leg.

Several options are available to achieve compression:

Several layers of bandage (3 or 4-layer bandage compression system)

Shaped tubular bandage

Elastic graduated compression hosiery (stockings)

Unna boot (gauze bandage impregnated with zinc oxide)

Can leg ulcers be prevented?

To prevent leg ulcers and to promote healing of ulcers:

Be very careful not to injure your legs, particularly when pushing a supermarket trolley. Consider protective shin splints.

Walk and exercise for at least an hour a day to keep the calf muscle pump working properly.

Lose weight if you are overweight.

Stop smoking.

Check your feet and legs regularly. Look for cracks, sores or changes in colour. Moisturise after bathing.

Wear comfortable well-fitting shoes and socks. Avoid socks with a tight garter or cuff. Check the inside of shoes for small stones or rough patches before you put them on.

If you have to stand for more than a few minutes, try to vary your stance as much as possible.

When sitting, wriggle your toes, move your feet up and down and take frequent walks.

Avoid sitting with your legs crossed. Put your feet up on a padded stool to reduce swelling.

Avoid extremes of temperature such as hot baths or sitting close to a heater. Keep cold feet warm with socks and slippers.

Consult a chiropodist or podiatrist to remove callus or hard skin.

Wear support stockings (compression hosiery) if your doctor has advised these.