2016-11-5
VCU research neurologist Dr Jason Wong answered a LOT of questions <Notes PDF>. We hope to have him back some day.

Personal Note: I’ve always found it puzzling that PN seems to continue even though its “cause” is no longer present. I used to be pre-diabetic but now am not – PN started back then and continues now. It seems mysterious. Is PN like going over a cliff – one step more and all is lost? According to Dr. Wong, this is a familiar story and a familiar belief. He thinks this belief is wrong. To paraphrase: “If nerves are dying, something is killing them. Remove the something (the cause) and the nerves will stop dying. They may never regenerate, but they will stop getting worse.” In his view, we often don’t REALLY know what the continuing cause is. Or, rather, we see an association but we don’t know what is going on under the covers. Not a global mystery. Mostly just ignorance about the grubby case-by-case details. According to this logic, since there are effective treatments for some cases that stop PN progression, there should be treatments for all the other cases, too. If we could find them.

Even if the tests (there are LOTS of tests) do not show it, maybe my pre-diabetes or something is still there, thrumming in the background, continuing to kill my nerves. Maybe there is something going on that could be stopped (and PN progression halted) if our ignorance was not so deep. 

Or maybe some wonderful single discovery will stop all PN.