Neuropathy

DIABETIC NERVE DAMAGE (neuropathy) affects approximately 60-70 percent of patients with diabetes. Once again, the longer the duration and severity of diabetes, the greater the risk of neuropathy.

There are many different types of diabetic nerve damage. Commonly, diabetic neuropathy affects the peripheral nerves, first in the feet, and then progressively in the hands and arms as well, in a characteristic stocking-and-glove distribution. Damage to different types of nerves will result in different symptoms, including

• tingling,
• numbness,
• burning, and
• pain.

The incessant pain of severe diabetic neuropathy is debilitating, and the symptoms are commonly worse at night. Even powerful painkillers such as narcotic medications are often ineffective. Instead of pain, patients may sometimes experience complete numbness. Careful physical examination reveals decreased sensations of touch, vibration, and temperature, and a loss of reflexes in the affected parts of the body.

While a loss of sensation may seem innocuous, it is anything but. Pain protects us against damaging trauma. When we stub our toes or lie in the wrong position, pain lets us know that we should quickly adjust ourselves in order to prevent further tissue damage. If we are unable to feel pain, we may continue to experience repeated episodes of trauma. Over the years, the damage becomes progressive and sometimes deformative. A typical example is the foot. Significant nerve damage can lead to the complete destruction of the joint-a condition called Charcot foot-and may progress to the point where patients are unable to walk, and may even require amputation.

Dr. Jason Fung, The Diabetic Code p.28

Diabetic neuropathy has led directly to my willingness to undergo a radical lifestyle change, including intermittent fasting, and major changes to my overall dietary behavior. In particular, major pain to my hands and feet has increased exponentially in the last couple of years.

This type of pain is almost invisible to the people around a diabetic. They often wonder, I’m sure, what the hell is wrong with me, as I stumble from step to step, at times looking for all the world like a drunk after one too many.

Despite my best efforts to appear normal, it is sometimes impossible for me to avoid an outburst from a sudden onset of sharp pain in my hands or feet, without any advance warning that my chronic pain will suddenly become extreme, even if only for a few moments.

Dr. Fung mentions that it is worse at night while a diabetic sleeps or rests. Well, there are many times when neither is really possible, and my partner lays across from me worrying as I toss and turn in pain. And neuropathic pain is only one of the causes of pain in my body at night. Others are arthritis, bursitis, and severe muscle cramps.

Combine these with fibromyalgia and I guess that I have won the sweepstakes of pain, so far without winning the big prizes, premature death or paralysis. Even without the immediate threat of dying, chronic intense pain is exhausting, often leaving me so tired that days go by without being able to accomplish even the smallest things. Even I tend to feel like a lazy sonofabitch because my progress in so many things is fractional or even non-existent.

I wish I were faking it, of which I have been accused at times. If I could make it go away, I would indeed. The best thing my doctor ever told me about neuropathy is while I can still feel the pain, it is still at least possible that my nerve damage may partially recover as I reduce my diabetes and stop making it worse. Once the nerves are deadened to the point where my feet are simply numb, there would be no hope of ever recovering any of the la\ost sensitivity in my feet or hands.

This is one of the reasons why I am so determined to take any measure that has even a promise of helping me eliminate or radically reduce the effects of diabetes in the future.