More about Myths!

Lets get back on topic, when it comes to “Myths” about peripheral neuropathy.

it’s amazing what people will try, before settling on a modality which works; such as neuromuscular therapy. We like to call them “Grandmas Remedies” in our office. Surprisingly, there is a bit of truth in many “home remedies;” but, there are a lot more “placebos” than most people care to admit.

The first and foremost “myth” that I hear, when a new patient comes into my office, is the fact that the patient has tried placing a bar of Ivory Soap in the foot of their bed, under the covers. Frankly, I can’t image how this one came about; as it is so strange. But, it is probably started as many of my patients have told me: “a friend of a friend tried it, and it works every time!” Well, it doesn’t work every time; in fact, I have never heard of anyone that it actually worked for!

My dad, as a suggestive child, was a prime example of taking a note of nonsense, and following through with it; “while I am gone, don’t shove beans up your nose,” she once told him, before going into town. When she came back, she found him sitting there on the floor… with a nose full of beans!  Most neuropathy patients fall into this ‘suggestive’ category as well. “If you want to bring feeling back to your feet… sleep wearing socks with a slice of purple onion in them.”  Some people will hear this, and in, what I think, is an act of desperation, go to bed with sliced onion in their socks. (Perhaps, this is where the Ivory Soap comes in… to help take the smell away.)  And, I have had a small amount of people say that they DID achieve some results doing this.  But, in actuality, this is just a placebo effect; people will be so desperate, that if they were told to shove beans up their nose for relief, a certain number of people would try!

Luckily, most “myth” remedies, aren’t as “desperate” as shoving  beans up ones nose; but people will try just about anything.  “Gin soaked white raisins,” is another “myth” I hear a lot about.  Whereas, one might enjoy these as a treat, or they would go great on a salad, they would do very little to relieve neuropathy remedies.  Of course, I have patients who argue with me, that “raisins have a lot of vitamins that can help neuropathy,” bit frankly, eating a few raisin would be like spitting on a fire to put it out! Variations of this use Vodka or even add dark chocolate to the mixture.  All, perhaps, good or good for you; but, really won’t do anything for a neuropathy.

How about this one: rub gasoline or motor oil into the feet to reduce pain, edema and burning.  Who in their right mind, would ever try such a thing… the desperate, that’s who!  In fact, when my own neuropathy was at its worse, I might have considered this (or beans up my nose).  Luckily, I was already treating neuropathy, when I developed it myself, so I knew better!

There are a lot more “myths” regarding neuropathy; and, over the coming months, we’ll discuss them more. We’ll even cover the ones which have a certain amount of truth involved in them!

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CAN A SERVICE DOG BE TRAINED TO SERVE TWO OR MORE PEOPLE?

Service dogs are defined by law as: “dogs that are individually trained to do work or perform tasks for people with disabilities.  Examples of such work or tasks include guiding people who are blind, alerting people who are deaf, pulling a wheelchair, alerting and protecting a person who is having a seizure, reminding a person with mental illness to take prescribed medications, *calming a person with Post Traumatic Stress Disorder (PTSD) during an anxiety attack, or performing other duties.”  *Unfortunately, there are still many agencies who don’t believe or follow this definition, as PTSD dogs come, more, under the heading of “Therapy” Dogs.  The law even makes it sound like it is impossible for a dog to serve more than one person; or, perhaps, it could even be illegal if they do!  Or, maybe, if they are serving more than one, particular person, they are “NOT” a true Service Dog.

However, the law, also, says that “Service animals are working animals, not pets!”  This can be a pretty ‘gray’ area; especially, when the Service Dog is more of a “Therapy or Comfort” dog.  Even in the above definition, regarding PTSD, many doctors, buildings, business owners, or so-called “Experts” can’t decide if the person with Post Traumatic Stress Syndrome is receiving, “Comfort, Therapy, Service or Companionship” from the animal!  To reiterate the law: “The work or task a dog has been trained to provide must be directly related to the person’s disability.  Dogs whose sole function is to provide comfort or emotional support do not qualify as service animals under the ADA.”  So, where does PTSD come in?  And, if a dog is trained to aid PTSD, are they ONLY allowed to treat/comfort ONLY their owner?  The law doesn’t say if the Service Dog ONLY has to be for one person or not; but, it sounds like it can’t!  But then, what about people like myself; who has, not only, a personal Service Dog, but the same dog being an “Office Service Dog”… who helps patients who come in? She is, also, a “Therapy” and “Comfort” dog for certain patients! The law (and people pushing the issue) makes it sound like a dog can do “one thing only;” and, I have had certain restaurants argue the fact with me!  But, with an Office Service Dog, this, certainly, cannot be the case.  One can argue that “Yes,” this is MY dog, but how do I tell or teach the dog not to treat, comfort or care for someone who is in need of her services?

Let’s start off with a little story.  Recently, I had someone come into my office for foot treatment; but, during that time a passing car ‘backfired’ and that patient began to have an anxiety attack and cry; as they have severe PTSD from serving in both Afghanistan and Iraq.  My own, personal, Service Dog, Hershey, is trained to detect dangerous blood sugar levels.  However, she also is trained to be a “Therapy Dog;” not that I need it so much, but I wanted her trained for my patients.

Noticing this man crying, (and just sensing, that he had high levels of anxiey) she came out from under my desk (where she likes to stay out of the way) and went over to this person to provided “support/service” by offering them love, sympathy and “someone/something” to hold until their anxiety had reduced to a manageable level.  Below, is a photo, similar, to what happened.  But, as with most dogs, Hershey’s behavior, when it comes to seeing someone upset, is more instinctive than trained.

 Picture2

Of course, my patient needs, perhaps, medications, talk therapy, support groups and/or other therapies to help deal with this disorder.  But, when a dog comes up and ’empathically’ helps someone (in the case, a total stranger) in distress, I call that “SERVICE!” And, a good Service Dog, will instinctively know when to help someone!  I don’t see any more difference between my dog helping to calm down an emotionally distraught person than I do her helping someone up out of a chair, of which she was trained, or to lead someone to the bathroom!  Again, “OK,” yes, she is MY Service dog; but, she is, also, the “OFFICE” Service Dog as well; meaning, that if someone needs help she can provide, she offers it!  She is not fitting the “Letter of the Law,” by helping only one person; and some, unfortunately, would take exception to that!

Fortunately or unfortunately, nobody has ever explained the difference between being a Service, Comfort, Therapy or even Pet, to Hershey!  She just sees if someone has a problem – either by recognizing it through training, such as with Low Blood Sugar, or being naturally sympathetic; and thus, naturally, going to help them.

Here is another example – I wrote about on Facebook sometime back; we were in a very public situation (petstore) for some additional training in walking on/off leash.  The trainer was teaching Hershey better skills, when the two of them were approached by a woman.  She stated “how cute” Hershey was in her purple Service vest and asked if she could pet her?  The trainer told her “No,” as Hershey was “working and part of her training was not to be petted or distracted while working.”  The woman understood, but Hershey seem determined she meet the woman. (And, Hershey is not the most social animal when meeting strangers on the street).  I gave permission for the woman to meet Hershey, and surprisingly, Hershey went to great lengths to put her face in the woman’s face… sniffing.  The woman said, “she must be able to smell what I ate for lunch.”  “Or,” the trainer said, “she has been trained to detect low blood sugar.” The woman stated, “Well, I am diabetic!”  The trainer replied, “Perhaps, you should go check your blood sugar, then;” which the woman, quickly, left to do!

Was Hershey being MY “Service Dog?”  Not by some business standards, because she didn’t ONLY detect MY blood sugar!  Was she a “Comfort Dog?”  She made the woman feel better, by her knowing that she might have a blood sugar problem which needed to be addressed.  Did she offer “Therapy?” Well, no… but, sort of?  Or, was she being a “Pet;” as she was not undergoing Service Dog Training at the time, but general behavior training?  Ask ten different people what happened, and they will give you ten different answers!

Once again, the law says; “A service animal is a dog or other animal, that is individually trained to do work or perform tasks for a person with a disability.”   It doesn’t say “Person’s or People.”  I have diabetes.  Am I disabled?  No… just diabetic?  Then, why do I need a dog to help me detect low blood sugar BEFORE I am ready to pass out and go into a diabetic coma?  And, exactly “how” do I teach Hershey to “ignore” any and all detections of Low Blood Sugar, except mine?  If she is in my office, and performs this task on a patient, is she performing a Service to me or that person with the Low Blood Sugar?  This area is becoming more and more “gray!”

Let’s look at one more example and YOU make the determination (or, at least find the gray area)!  Another patient of mine has a granddaughter with severe autism.  She is 5 years old and has never spoken a word.  She recently met Hershey, while sitting on the floor, holding her “baby doll.”  I introduced her to the little girl and her grandmother, while saying “This is MY baby!” (You see, Hershey is more than just a work associate, and  she is more than just MY Service Dog… she is a member of the family!  Pet?  OK!) The little girl, smiled, at Hershey, and said “Baby!”  It was her first word!  Her thrilled mother, pointed to Hershey’s eyes, and said “Eyes?”  And the little girl repeated the word, “Eyes!”  The little girl saw something in Hershey, that brought out enough attention to say her first words!  Had this been just someone’s pet?  Who knows?  Perhaps, it would have had the same outcome; although, the little girls grandmother has a small dog that the little girl appears terrified of.  Was it Hershey’s training to be sympathetic? Again, who knows? Did Hershey see someone who needed her attention?  I, at least, like to think so!  So, what type of dog was Hershey?  She wasn’t “working” for me at that moment!  And, again, she didn’t fit the “Letter of the Law!”

I should think this little girl will be getting her own Service/Comfort/Therapy/Pet… soon! 

Service animals can take the form of ANYTHING; companion to someone with Asperger’s,  a shoulder to cry on to someone with Depression, a Therapist to help relieve stress and anxiety, a helper or guide for the sightless, ears for the hearing impaired, something to offer protection, someone to sleep with or even just a friend or companion to the lonely and someone to love! And, they don’t have to do it for just one person! 

Even if it is something as simple as having a guest or patient ask to use our bathroom, Hershey is providing A Service for them, just by leading them to the appropriate door… and she doesn’t have to be their own, personally trained, Service Animal!

Perhaps, it is time to “update” the law to define function better, and to help the general public understand it better!

Do We Need to Eat Vitamins and Minerals?

Let’s be really ‘basic’ with this particular post, as the subject matter can be so vast…

Simply put, our bodies cannot produce all of the nutrients and minerals that we need; nor, can it process all the nutrients needed from eating most foods, anymore. Without these nutrients, our bodies can start developing ‘issues’ which can be misinterpreted a number of different ways; very often, even antiquated issues (disorders such as Scurvy) can arise and be misdiagnosed… as doctors simply are not aware of new nutritional deficiencies or recognize antiquated ones anymore. Of course, doctors ALWAYS have a medication to treat most of these disorders; which, (some of which, anyway), could be effectively treated with the proper type of nutrition!

Why nutritional issues in this day and age? It can be for a number of reasons; but, one main reason is, we simply do not eat as well as we used to, say, 100 years ago. Plus, with the ‘Fast Food’ we now have to eat, many times, the nutrients are processed right out it!  “Processed Food;” who hasn’t heard of that? Couple processed foods with GMO’s, chemicals, artificial colors, flavorings, preservatives, hormones, and etc., and there, often, isn’t any nutrition left for the body to absorb.

Lets break this post down to just a few, choice, vitamins and add a simple patient example.  First, lets start off with something common to most people… Oranges and Orange Juice.

Often, when I lecture, I mention Valencia Oranges as an example. Not all brands, mind you, but enough substantial brands to make a ‘generic’ heading here.  At one time, Valencia Oranges were the healthiest, sweetest, most tasty Orange one could purchase – especially, in juice form; but these days, they hardly resemble the Orange our parents grandparents grew up on – nor, is the juice we find in the stores the same.  More and more newer crops/trees, have been genetically altered (for various reasons) – and many juices, have already be altered and put on the market.

As most of the natural nutrients have been used up or taken out of the ground, artificial fertilizers are added; couple that, with artificial pesticides. If that wasn’t bad enough to take nutrients out of the ground and the fruit, some companies actually pick the fruit in an ‘unripened’ condition. This is to help it last longer while going to market. Once the fruit has reached its processing destination, it is often ‘fumigated’ to artificially ripen it. In other words, the fruit (oranges) have not, naturally, formed/grown the normal nutrients that our parents and grandparents found in them!

So, to make matters worse, some people, like my own family, seldom eat fresh oranges; but choose to drink orange juice. What do we see on the label? “Calcium (as well as other ingredients and chemicals) Added!”  Fresh fruit never needed to have any added ingredients! But, when it comes to ‘Orange Juice,’ it often doesn’t stop there!

After the oranges are squeezed, their juice is put into holding tanks, for upwards of a year! During this time, oxygen is removed from it.  Why? To help keep it from spoiling; but, this ‘liquid,’ is far from what we would call ‘Orange Juice’ in both appearance and taste!

When juice is stripped of all of its oxygen, it is also stripped of its flavor chemicals. The processors, will then use ‘outside flavor and fragrance companies’ to engineer flavor and aroma to put back to the juice and give it the appearance of ‘Freshness!’ Very often, these engineered flavors are not listed as ingredients on the label because they are derived from orange essence and oil – in much the same way perfume is made. Unfortunately, these so-called ‘natural’ flavor essences, hardly resemble what might be found on a tree!  Many of these flavorings contain high amounts of ethyl butyrate; a chemical in the fragrance of fresh squeezed orange juice.  Processors have found that Americans, especially, like enjoy this flavor. However, they will take this same, processed juice, and fabricate a different flavor essence, for other parts of the world to fit their taste… and it all says “Fresh Squeezed” on many of the cartons or bottles!

Interesting enough, these engineered flavors are not required to be even mentioned on the Orange Juice label by the FDA. Go figure!

Now, if one is looking for Vitamin C from the Orange or Orange Juice to supplement their nutrients… they are pretty much out of luck! Vitamin C in supplemental form must be taken; as the human body simply cannot ingest enough so-called ‘natural’ Orange Juice to make much of a difference. Then, surprisingly, for some strange reason, kids start developing scurvy as they did a couple hundred years ago! Or, in the case of Vitamin D… Rickets!  These disorders were supposed to have been ‘wiped out’ decades ago!

The same is to be said from other food stuffs (and, don’t get me started on meats!).  Unless one is going to purchase ‘truly Organic’ fruits and vegetables, many of the nutrients have been removed or simply not allowed to develop in the plant. I, especially, find this with patients with Peripheral Neuropathy.

Here is an example; last year, I had a patent come into my office whom stated that she “had not been able to wear shoes in 3.5 years;” as her feet were so swollen and hurt so badly. Against her Neurologists advice, she came to me as a “last resort.”  After performing an extensive Intake and examination, I asked the patient “How do you eat? Do you keep natural for the most part? Do you eat organic?”  She responded the way most doctors like to hear: she ate, “almost, all natural and organic!” This was something of a tip off to me, as ‘where’ she indicated she purchased her organic spinach and other ‘leafy greens,’ for example, I knew was right across the street from a farm which didn’t have organic vegetables. I explained to her, that her “Organic” food, was only as organic as the ground, water and wind would allow; and that “pesticides and artificial fertilizers” were, most likely, ‘blowing’ across the road and/or carried in the wind from across the street when the other farm was sprayed by crop duster.  In addition, “Chico water” and a lot of particulates and pollutants in it (which some in authority would deny… but, even its level of Prozac is high!) also added to the problem. Plus, did she “know for sure” that this spinach or other vegetables were not a GMO products?  She didn’t know, but just presumed that since she was paying TOP DOLLAR for her spinach, it was “top of the line!”

As I see so many odd disorders, with there being over 100 different forms of neuropathy, Intake and exam made me suspect Dry, Beri Beri (a thiamine deficiency) as the root cause of her neuropathy. She could, hardly, believe that, as it is such an antiquated disorder. I reminded her that I don’t diagnose, but it would be in her best interest if she saw her doctor and asked him about it. Of course, he dismissed the idea entirely, as she “ate so well and natural!”  

Be as that as it may, I sent her to a lab, as her doctor wouldn’t do it, to have her vitamin levels checked. Just as expected, she was deficient in just about everything; Vitamin D and the full range of B vitamins; but, especially, B1 (thiamine). My suspicions confirmed, she had Dry, Beri Beri.

I started her on high doses of B1 and other vitamins/minerals as well as neuromuscular stimulation for her symptoms. Within only three weeks, although she still had a lot of burning in her feet, her edema had totally reversed and her neuropathy almost disappeared. She was back in shoes.  Of course, upon returning to her doctor to show him her results in only three weeks, he stated the usual that my patients hear: “Well, sometimes with people your age, miracles happen!”

We have, only, dealt with a couple of vitamins here; but one can imagine how important other vitamins can be to issues such as sight, digestion, memory, heart health, immune system levels and more! Simply put, if our bodies don’t get the nutrition we need from our food, we are going to have to get it from someplace else… such as vitamin and mineral supplements!

Understanding The Differences Between Hemp and Cannabis in Health and Treatment.

This post isn’t about “Medical Marijuana,” it’s about Hemp; in seed, lotion or oil form!

Hemp has a certain, “misinformed” quality about it!  First, if it isn’t “Medical Marijuana,” what is it? Although Hemp and Marijuana are both names for the Cannabis plant, they serve many different purposes. Although, most people think of ‘smoking’ Hemp in the form of Marijuana, actual ‘Hemp’ (and/or Hemp Root, as it is more commonly known) has been used for hundreds of years in making wax, soap, rope, sails, clothing, hats, resin, fuel, cosmetics, plastics, and military grade fabric; as well as countless other items. It used to be so common, even the Decoration of Independence and the Bill of Rights were written on Hemp paper.

In our offices, we use Hemp Root for two purposes (besides, the Hemp Hat that I often wear in the summertime). Whereas, I don’t believe in ‘recreational smoking’ of pot any more than I recommend recreational drinking of alcohol, I do believe Hemp (Hemp Heart/Seeds) can be a health supplement and a good source of Omega 3, 6, and 9; which is vital to nutrition… especially, to those with Peripheral Neuropathy or Depression. In fact, Hemp Hearts and B vitamins together work very well to help ‘treat’ both disorders, naturally!

I’m not going to take the time to go into all the ‘mumble, jumble’ of the difference between Cannabis/Marijuana and Hemp/Root, chemically; but to distill things down, Hemp has most or all of THC, that Marijuana has, removed; meaning, “one cannot get high, just from consuming Hemp or wearing a Hemp Hat” (as I was once accused/warned of, by ‘caring’ friends and family)! When one consumes Hemp in the form of ‘seeds/powder’ or “Hemp Hearts,” they are supplementing their diet with the ‘Natural Omega’s that the body doesn’t normally get through traditional nutrition and/or supplements.

Hemp Hearts taste great and can be put in cereal, smoothies or even (as I do) put in recipes like Meat Loaf –  used as a substitute for crackers or bread crumbs.  I have even been known to ‘salt and toast’ them as a snack. Having a slight nutty taste, similar to a sunflower seeds or pine nuts, Hemp Hearts contain, roughly, 10 grams of plant proteins per serving; and, certainly contain more protein and less carbohydrates than the same serving of Flaxseed (which, ones body has to convert to an Omega). They can be purchased online in bulk (as we used to purchase for our office from Canada); and/or many health food stores will have Hemp Hearts/Seeds in ‘pre-packeded’ bags or boxes. One special note, if purchasing from a health food store, who keep their Hemp Hearts in large drums, they do tend to go rancid over time. So, if you are ‘spooning out’ Hemp Hearts from the bottom of a large drum, they could be rancid if they have a strong smell to them. Hemp Hearts should be keep cool and dry in a sealed bottle or bag. I keep mine in a ‘Tupperware™’ container.

But, what else do we use Hemp for in our office? We use it in lotion or therapy cream form to help moisturize and heal dry, cracked skin; especially, the skin of diabetics. Often, as well, some of our diabetic patients will have ulcers on their feet; again, we use a Hemp therapy cream to, not only, heal the ulcer and moisturize, but to aid with pain relief; as many lotions and salves will have enough Hemp and other herbs in them to aid with laceration or ulceration pain… not to mention, ‘healing’ qualities as well. We use it, often ourselves in my family, for bee stings and insect bites!

Whereas, we don’t endorse many products, we will recommend to our patients interested, that they purchase three different types of Hemp products; which we have, personally, tried ourselves and/or use in our office (unless a product is proven to us, we simply don’t use or recommend it!).

The first Hemp product we were ever introduced to, was Dr. Bronner’s Soap products; available in a number of different types. This company, which we have had many discussions about products with its founder, has many types and kinds of products to choose from. It can be purchased in some stores; but more varieties can be found more online. Their web address is: https://www.drbronner.com/DBMS/category/LIQUIDSOAP.html; and, is certainly worth a look.

Second, is HempZ Lotion™. Again, available all over the internet and in some stores, HempZ Lotion™ is a fine example of Pure Hemp Seed Oil mixed with extracts. We keep a bottle out on our treatment table for patients to ‘help themselves’ to after neuromuscular stimulation. Many patients use it on their dry legs and arms. A little bit, can go a long way!

The third product we were introduced to, is made local to us; and that is, Hemp-EaZe™.  Like other Hemp lotions, Hemp-EaZe™ doesn’t contain any THC or other chemicals or toxins; so, there is nothing to worry about. It does contain, depending upon the product, several ‘natural’ ingredients/essential herbs; such as lavender, sacred sage, honey, bees wax, comfrey root and more which can aid a number of issues. This is why, it has pain relieving as well as healing properties. (A complete list of ingredients can be seen on their website at http://hemp-eaze.com/9-essential-herbs-2/) This product, in its many forms, can be found for purchase in many stores; or even offices, such as our own.

We use both the Hemp-EaZe™ Therapy Cream as well as the Lotion in our office for treatment along with whatever modality we are using on the patient; and, on our geriatric patients, with thin/sensitive skin, we even use their gentle “Baby and Me” salve!  Our patients help themselves to it for everything from bug bites, to heat rash, to bruising to poison oak! We find it to be a “well rounded” therapy cream for our office (meaning, we don’t have to purchase multiple therapy creams or products to treat multiple issues).

And, being that we are certified to work on dogs as well as people, we often use the Hemp-EaZe™ brand of ‘Pet Aid’ to help our canine patients with edema, bruising, insect bites and rash.

What about ingesting Hemp Oil? The “jury” is still out regarding Hemp Oil; but research indicates that it can be useful in treating a number of issues… from Diabetes to Cancer, in a positive way. Can we recommend Hemp Oil?  Almost!  I would still like to see some research reports on it; but, there are plenty of “positive” reports from all over the world on the internet, as to results people have achieved through use of Hemp or Cannabis Oil. Would I ever use it myself?  Perhaps. Right now, using this oil is a choice everyone must make on their own; currently, making or consuming is illegal in many parts of the country… but, at one time, so was vitamin B-17 (in the form of raw apricot pits) in the treatment of Cancer; but now, it is available in many health food stores, and over the internet through sources like Amazon.com.

Knowing what I do about Hemp for medical issues, and how we cook, consume and treat with it, I would have to consider Hemp Oil if I were in need and knew where I could safely and legally purchase it!  And, perhaps, everyone should check out Hemp products for their own health and use as well.  It’s natural!

Making a Mirror Box

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Using a mirror to ‘fool’ the brain into seeing a missing limb can certainly aid with reducing phantom pain. Sometimes, electrodes are placed on the ‘good’ leg as well so the brain senses ‘electrical sensation.’ In some cases, another electrode is placed on the ‘stump’ of the other leg. In very basic, non-technical terms, this is to ‘help train’ the brain and the nerves to accept ‘where’ the pain sensors are now located.

In the case of a stroke patient, however, there is no missing limb.  Again, the brain needs to be ‘rewired,’ so to speak, to allow both feeling and function to return into the non-functional limb.

Of course, this works just as well with the upper body limbs; missing or non-functional, as seen above. With or without electrodes placed on either or both arms/hands, the mirror reflects the functional limb; and the brain ‘thinks’ it sees the affected arm in the mirror. This works quite well when exercise is added. Often, the good hand will go through exercise, while the non functional limb is hidden from view inside a box. To the brain, apparently, the mirror shows both limbs undergoing exercise; and, surprisingly, sometime times the non-functioning hand will start to ‘mimic’ what is seen in the mirror. Not full function, mind you, to begin with; but often the fingers will move and the tendons and muscles in the hand, wrist and arm will begin to flex. Again, in layman’s terms, this is an example of the brain repairing (or more likely, ‘rewiring’) itself to make the arm and hand functional once more.

The beauty of using mirrors or Mirror Boxes is, one doesn’t have to just have therapy in the doctor’s office or clinic. The motivated patient, can do exercise every day at home; perhaps, not with neuromuscular stimulation, but with exercise.

Mirror boxes can be made any side to accommodate feet, legs or arm/hands. And, depending upon the nature of the disability, one may be able to simply place a mirror between limbs. Or, if making a box, one can sit in a chair, put their foot in and do exercise. But remember, one does not have to be sitting to do this. Refer back to the photo on the last blog… one can simply lay on a bed or sofa with a full or half length mirror between the legs as well.

For hands, it is much easier. Here are the directions for making your own Mirror Box for hand use. However, just a plain cardboard box will work just as well and is fast to make. Not fancy… but it works!

This first, is more of a pyramid, so to speak. Three pieces of 12″ x 12″ wood, cardboard or cork-board is required, as is a ‘sticky’ duct tape and a 12″x 12″ mirror.

donut (2)Make a box or three sided triangle as shown in the photo. Attach sides. (Mirror is reflecting material from wall) Make sure to use extra sticky tape, if using just cardboard or Cork Board.

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Place the mirror on one side and use double stick tape or ‘glue’ to hold it in place, as the photo at the top of this page shows. The box is ready to use. It’s that quick and easy.  Of course, one can purchase ready made boxes to use, or can make as ‘fancy’ or expensive a box as one wants. This box, cost only $15 to make.

But, it can be done even more quickly and easily, as show in the following pictures:

hershey-3box mirrorA plate easel can be used, to hold a mirror, as can the bottom of a cardboard box or even just ‘taping’ a mirror to a box or container. Anything which can, safely, uphold a mirror, can be used. In our office, if our mirror boxes are in use, and we need another, we will quickly tape a 12″ x 12″ mirror to a handled equipment box to be easily carried from one room to another.

The key to using a Mirror Box is ‘blocking’ the view of the affected limb from the eyes/brain; while ‘fooling’ the brain into seeing a ‘healthy, working’ limb. 

Mirror Box Therapy

Many people seen surprised to find, that someone with a missing limb might have peripheral neuropathy; I don’t know why… they are like anyone else and can suffer from the same maladies, such as neuropathy, diabetes or other issues. In fact, diabetes may even be the reason they are missing the limb in the first place! In the same sense, if one, previously, has peripheral neuropathy, ‘losing a limb’ doesn’t necessarily mean that one ‘loses’ the neuropathy in that leg too! Many times, the patient suffers from, what the layperson probably HAS heard of…, “phantom pain.”

Diabetics are especially susceptible to phantom pain when they lose a limb; as the brain ‘remembers’ the pain it once had, but doesn’t really realize that the limb might be missing. So some people may feel discomfort in the leg even though it is not there. Even simple things like ‘itching’ can be felt in the missing area; surprisingly, often, if someone ‘itches’ in the air near the where the itch would have been, the itching sensation can often be relieved. “ Psychosomatic?” Perhaps!

But, when one has peripheral neuropathy, it is a somewhat different matter. Most neuropathies occur in both feet; so when a foot or leg is missing, the ‘neuropathy,’ often, is still there. Sometimes, we can just put an electrode on the ‘stump’ and that takes care of the problem with some neuromuscular stimulation. But other times, we need to go to extreme measures and ‘fool’ the brain, so to speak.

I keep a full length mirror on my office hallway wall for a reason; it’s not that I want to check my or my patients hair or clothing, I am, merely, storing the mirror on the wall, out of the way. Why, you might ask? When an amputee patient with neuropathy comes in, I take the mirror off the wall and place it between the patients full leg, and what is left of the missing leg. (If the leg is missing from the hip, then I’ll have someone hold the mirror in place.) The patient ‘leans’ a bit toward the full leg and looks in the mirror. Of course, what they see is a ‘reverse’ image of their leg… (in other words, two legs!) the same, as if they were looking down at both legs, if one wasn’t missing.

mirror

For whatever reason, the brain sees this reflection and associates it with the missing leg; so, again, if one had a ‘pain’ on the missing leg, the brain could be ‘fooled’ into relieving that pain! Confusing? How, exactly does this work? First, as previously mentioned, the brain is fooled by the reflection; but then, we fool it even more by attempting to remove the other symptoms in the phantom leg the way we do with a normal leg. We can use massage therapy on the opposite foot, acupuncture or even neuromuscular stimulation. In other words, if we were to put an electrode on the full leg, chances are, the patient would ‘feel it’ in the missing leg as well; and the symptoms are relieved. In extreme cases, we will place an electrode on the ‘stump’ of the missing leg as well… in an effort to ‘retrain’ the muscles and nerves to feel actual sensations and to ‘forget’ the phantom pain.

This can be done just as easily with missing hands/arms, as it can with the feet; and, best of all, one doesn’t have to be a physical therapist or neuropathist to do it at home. Yes, therapy is best left to the professionals… but, if one can’t receive the therapy they need, ‘home therapy’ is the next best thing; and, one really doesn’t have to be an expert to achieve some impressive results. Full length mirrors can be purchased cheaply in many stores or thrift stores for $20 or less! And/or one can make a ‘Mirror Box’ at home to use for themselves or with a family member almost as easily. Of course, there are many different models available on the internet for purchase too! Placing the affected limb into the box, simple stimulation/sensation is added in the form of massage, or heat and cold, or pin prick. Anything, to make the brain feel like there is ‘sensation’ when it sees it in the mirror.

The next question I, generally, get asked it: “Well, if this works with missing limbs, what about non-functional limbs… like from stroke or accident?” The same treatment holds true. Mirror Boxes can be purchased or made for foot/leg use as well or simply go back to a wall mirror. Reflection and stimulation of the functional hand or foot, will fool the brain and help to ‘reroute’ the nerves which may have been damaged through stroke or accident. Even exercise, such as squeezing a ball with the functional hand, will cause nerves and muscles in the affected limb to respond.

Does this work for everyone? Certainly not; but it works for many more than expected!

 

My next Blog, will go into more detail as to “Making a Mirror Box” and the treatment for non-functional limbs.