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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 17511
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Dr Love: I am having calmare scrambler treatment to possibly

Customer Question

Dr Love:
I am having calmare scrambler treatment to possibly stop pain in my extremities. The way scrambler works is that it places electrodes on the dermatones in non pain areas close to pain areas. This process in 93% of the cases successfully eliminates or substantially reduces the pain.
I recently had mris showing compressions and inpingments on my spinal cord and radiculopathies in cervical and lumbar. I also have been diagnosed with sfn. All of my extremities have been affected.
Where do you recommend the electrodes be placed given this information. I am thinkng that anywhere along the dermatones of the radiculopathies or spinal cord inpingements which would also pick up any pain caused by the sfn.
Please advise
Submitted: 1 month ago.
Category: Neurology
Expert:  Dr. D. Love replied 1 month ago.

I cannot recommend the location for placement of the electrodes since I cannot examine you. The doctor that is treating you with the scrambler would be the doctor to determine the location of the electrodes.

Plus, if you have to tell that doctor or clinic where to place the electrodes, then you should be seeing another doctor or clinic.

Customer: replied 1 month ago.
I am not asking you to tell me where to tell him to place them. The scrambler literature makes it clear that the DR placing the electrodes must have sufficient experience to properly place the electrodes or the euipment will not work. I am merely asking yu to discuss with me where might they go since all extremities are involved and you are aware of the history. So its more us surmissing rather than truly knowing where the electrodes will go
Expert:  Dr. D. Love replied 1 month ago.

First you ask "Where do you recommend the electrodes be placed"

Then you say "I am not asking you to tell me where to tell him to place them"

You specifically asked me to do the thing that you then said you were not asking me to do.

Customer: replied 1 month ago.
I was asking based on your knowledge of my case where you thought they should be placd. Not for purposes of me telling the Dr what to do, but more for simply discussing with me a possible place for placement since the electrodes have to be placed in a non oain area close to the papain area. So for instance the entire arm hurts, bi ceps tri ceps, forearm. I would think the closest non ain area might be somewher up higher on the arm or possibly the chest next to arm. I was simply asking your thoughts on where might the electrodes be plced given the pain is in all extremties
Expert:  Dr. D. Love replied 1 month ago.

As I said above, I cannot recommend the location for placement of the electrodes since I cannot examine you, regardless of the reason for wanting to know the location.

However, as a general rule, if neuropathic pain is affecting the entire extremity, then they probably are not going to place the electrodes in a location with no pain.

Customer: replied 1 month ago.
Well then let me ask a different question since because of circumstances you can not answer this question.What could cause small fiber neuropathy to progress into large fiber neuropathy. Why are nerves involved in small fiber while muscle is involved in large fiber. Is it muscle attached to nerves in large fiber.
Expert:  Dr. D. Love replied 1 month ago.

Since we do not know what causes idiopathic small fiber neuropathy, we cannot say what would cause it to progresses to large fiber neuropathy in some people.

It probably not related to the muscle, since there is no backwards communication from the muscle into the large motor fibers. It is more likely related to some factor that affects the severity of the process. For most people, the severity is such that it only affects the smaller fibers, but in the few people in which the underlying process is more severe, it may progress to also affect that larger fibers.

For other neuropathies, the severity of the underlying condition certainly increases the risk for progression. For example, in diabetic peripheral neuropathy, one of the common known causes of a small fiber neuripathy, the primary determinant of risk of progression into a large fiber neuropathy is how well (or poorly) the underlying diabetes is controlled. If we are able to get better control of the diabetes, then the likelihood of progression is lower. But in someone in whom there is poor control of the diabetes, the likelihood of progression is higher.

Once research is able to identify the underlying cause of what is currently considered idiopathic, then we can better say what factors may influence progression.

Customer: replied 1 month ago.
you are saying the cause and sevirity of the cause dermines wheher it an prgress. say if disulferim induced. Could that cause it to progress to large fiber even though i am no longer on disullferim.
Customer: replied 1 month ago.
Also I am concerned that Cleveland did not biopsy my arms. How can she know whether the small fiber has progressed to the arms if not tested. She stated only possibly that sfn was affecting arms. This leaves open the possibility that the radiculopathies caused the arm problems
Customer: replied 1 month ago.
She said since not a large fiber then the leg problem appeared to be a joint issue. Further, it was possible that the arms are affected by the sfn.
Expert:  Dr. D. Love replied 1 month ago.

Yes, it is probably the severity of the underlying cause and whatever factors may influence the underlying cause that determines whether it progresses.

You would need to ask her to explain her rationale for the diagnoses.

Customer: replied 1 month ago.
Hi
I asked a question of you and DR Phil tried to answer. I asked him to release the question to you
Expert:  Dr. D. Love replied 1 month ago.

I responded to the other question.

Please remember to provide a positive rating for this answer.

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