Greetings, Dr. Roach Am I a guy doomed? I overcame a fight with testicular cancer when I was 25. The good news is that I’m doing well, forty-five years later, with two children and three grandchildren. I solely take gabapentin to alleviate peripheral neuropathy brought on by the chemotherapy medications I was given for my cancer. My feet developed neuropathy from one or more of these medications.
I took 800 mg three times a day as directed by a neurologist for almost 15 years. It has been 800 mg four times a day for the past 20 years as I’ve become older. People appear surprised that I’m still alive after taking so much gabapentin when I speak to them.
There have never been any known negative effects on me. According to what I’ve read, gabapentin use over time may raise the risk of dementia. Given the prolonged use of gabapentin, are there any particular conditions I should have tested for by my usual physician? — C.P.
ANSWER: Due to its sensitivity to both chemotherapy and radiation, testicular cancer is among the most treatable malignancies. However, years after a successful therapy, issues may arise with either of these techniques.
Chemotherapy based on platinum has long been a standard treatment for advanced testicular cancer. A typical adverse effect is painful peripheral neuropathy, particularly in the hands and feet. A common drug used to treat pain from peripheral nerve damage, such as that caused by diabetes or chemotherapy, is gabapentin.
Although I don’t frequently see dosages as high as yours, they are undoubtedly utilized. The goal dosage of gabapentin in a landmark study on post-herpetic neuralgia (shingles pain) was 900 mg four times a day. Although it is highly effective, it frequently takes weeks or months to build up to this level so that people can handle it. Sedation is the most frequent adverse effect; however, this impact is lessened with gradual dose increases.
There is conflicting evidence regarding gabapentin and dementia; two studies that examined hundreds of thousands of participants reached very different findings. According to the study, the risk of dementia was highest among younger individuals.
You are not doomed, I conclude. Some memory and cognitive tests are simple to perform for people who are worried about their memory or whose doctors are worried about a potential change in function, even though the majority of authorities do not recommend screening tests for dementia. A person may then be sent to a memory specialist if there are anomalies.
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Greetings, Dr. Roach You talked about IBS-C (irritable bowel syndrome) in a recent column. For a number of years, I suffered severe episodes of IBS-D. I spent two or three days in bed because of the cramps. Three years ago, the seizures became more regular, occurring every three to four weeks.
I started eating plain yogurt every day after reading that it could assist, however I did add granola and fruit. It’s been two and a half years since I had an episode! Why don’t doctors recommend this? The transformation has been remarkable. — K.V.
ANSWER: Your excellent outcomes make me very happy. Because it contains living bacteria, which are believed to be good for the gut, yogurt is frequently advised. Regretfully, my experience—like most trials—has demonstrated that it is ineffective for most people. For many people with IBS, lactose (milk sugar) is also an issue.
Nevertheless, I support eating plain yogurt, so it might be worth a try.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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