Hd related pain?

So in October of 06 I was told to get to the hospital after some bloodwork for feeling sick, joyous, renal failure! After being in bed for most of a few days in the hospital, I noticed some pain starting to come on in my legs… me thinking this was just to much lying around, I decided to wander around lots (oh how the nurses hated me)…

Up to this date, and trying numerous drugs (celebrex, lyrica, tylenol, etc etc) nothing much has helped (except one, which was stoped due to it doing a number on my stomach!) … the worst is the foot pain! if i push inwards on the back of my heel, not so bad, push down, and you could drop me to the floor if i were standing… (sometimes it just likes to throb with pain in this area)… or if i sit for an hour lets say, and get up, i have to walk like i’m an 80yr old w/o a walker! (no offence, but i’m only 36! =( … i’m really at my wits end, and wondered if anyone has had a similar situation or can offer any advice… i hate the med route, tried stretching for some odd days over 2 weeks which did nothing in the least… it seems once i’m up and about, it gets easier and less painful… except for the feet…

i did see a specialist and arthritis was ruled out, but not much advice was given other then stretch…

I was hoping PD might cure this, now my cath inside needs to be moved due to extreme pain on drain so thats been haulted for awhile… =| nothing but fun eh… anyone have any thoughts?

The only thing I could think to say here, is that there is SOME pain during drain of PD fluid anyway. For some it’s worse than others. Extreme pain, I haven’t heard of, but I do get the dreaded drain pain!

A podiatrist is the specialist that knows the most about conditions of the foot, including the heel. You might want to make an appointment to have your foot/heel pain diagnosed and treated. Here’s information about possible causes of heel pain:

So far as pain when doing PD, you’d probably get more response if you post questions related to PD to the bulletin board we set up for PD patients.

Some things to look at:

Are you saying you started dialysis in 06’? What type of specialist did you see? How are your labs regarding bone disease (pth/phos./cal.)? Ever had a bone density test?

You might have a combination of problems. The heel pad can also atrophy from an injury or from heredity. Then with kidney disease/dialysis you may have muscle wasting from the disease itself and from being less active which could be affecting your heels. Add to that bone disease from oversupressing the pth (adynamic bone disease- low bone turnover as many as 60% of dialysis patients have this) with vit. D analogs (zemplar, hectorol). And then there is osteoporisis. I am not clear on what causes what, but dialysis patients wind up with these conditions if everything is not balanced properly and many patients develop a “duck walk” when they first get up from a seated or lying position until they can walk it out.

And neuropathy Jane, don’t forget neuropathy.

The thing with neuropathy is that it is basically a short circuit - the nerve sends an incorrect, unjustified message to the brain. Neuropathy can manifest as a wide range of sensations. Mine makes it feel like my feet are hot or like the pins & needles feeling that I use to associate with them “falling asleep”.

For some reason the mixed up signal is always a bad feeling, you’d think that one of these times it’d feel like the feet were receiving a hot oil massage.

I also get sharp heel pain sometimes - usually first thing in the morning or after sitting - but it passes, diminishes with each step.

Oh yes, neuropathy is the biggie. Another one I have heard of that I forgot to include is Vitamin B 1 (thiamine) deficiency. I have read where a patient said she was diagnosed with beri beri as thiamine is dialyzed out during dialysis. By taking Vit.B 1 supplements, her feet problem of neuropathy-like symptoms cleared up in a week! The question I’d like answered is- who is qualified to diagnose feet problems? I read where one person said that podiatrists are not credible- better to see an orthopedic surgeon. But then I also read where someone said they saw an orthopedic surgeon and he didn’t know anything much about dialysis related bone problems. Bone/feet problems are very common in dialysis patients-most patients I have observed in all the units I have been in have trouble walking. Other than the patient who said her feet cleared up with Vit.B 1, I’ve not heard of any solid answers on dialysis patients and bone disease. My nephs have had no answers. The question I would like answered is, is it possible to manage bone disease with meds/surgery or not?

My neuropathy is getting worse all of the time. I’ve had it for the last 2 1/2 - 3 years. It started gradually about a year after I began dialysis. My feet are numb most of the time and foten feel ice cold around my toes and the balls of my feet. I have been taking neurontin in increasing dosages. I saw a podiatrist about one month ago and he recommended that I try Lyrica, which realy hasn’t helped – at least at the dosage he started me at. He also wanted me to see a neurologist who specializes in neuropathy. The earliest appointment I could get is June 19th. I’m going to get a CT Scan of my lumbar to see if there might be a problem in that region that could be contributing to the problem. Although I’m convinced it’s renal related. Normally neuropathy is related to diabetes – obviously a common malady for CKD patients, but in my case my A1C is quite normal.

I recently read a B-12 in addition to B-1 defienciency might also contribute – that checked out normal last week. Also read about and going to try additional supplements including biotin, choline and inositol. My nephrodoc has no problem with adding any to my regimen.

Rich Berkowitz

NxStage 2/06
In-center 3/03

I’ve always heard this and that about this subject, but have not been able to put together any solid answers. I would think Bill has the availability of top docs through NW Kidney Centers, yet he doesn’t seem to have any solutions. And Rich you sound like you have been agressive in trying to find out what the problem is in order to find solutions. I know with other problems I’ve had as a result of kidney disease or my txs, there were solutions to be found when I researched and dug deep enough. So, I certainly hope this one is solvable, too.

With Rich, it is interesting that you do not have diabetes yet developed the feet problems so quickly, just one yr after starting dialysis. I have read that neurologists treat neuropathy. Does anyone know, are they the main docs that treat neuropathy-why neurologists? And Rich, when you were tested for Vit B1 and 12 deficiency, can you explain what specifically the test was? Where did you read that biotin, choline and inositol are possibly deficient and what specific brand did your neph OK since even vitamins/minerals have fillers that might not be good for a dialysis patient…what doses are you taking?

Also, for all those who are having these feet problems, how are your labs re bone disease? Do you feel there is a direct connection to this problem and bone health or not?