The Case Of A Woman With Tingling Feet

A fifty year old woman, weighing 260 pounds was complaining of tingling feet, feeling weak and having cramps in her legs. Upon further investigation, it was found that she also had vision problems. She urinated frequently, and she wasn't able to hold it in for a long time.

She was always thirsty and had a big appetite for sweets, carbohydrates, and soda. When asked about her family’s medical history, it surfaced that both her parents and grandparents had diabetes.

After a physical examination, checking her blood pressure, heart rate, muscle tone, reflexes, and sensitivity to position, vibration, temperature and light touch, the doctor initially diagnosed her tingling feet as a complication of Diabetes Mellitus but he then did a series of blood tests to confirm whether he was right. These results revealed very high levels of blood glucose, the doctor confirmed her illness as diabetic neuropathy.

The patient was further assessed on the extent of the nerve damage. She admitted that she had been feeling these symptoms for several months but just didn’t give any importance to them until it interfered with her work. She worked as a salesclerk in a shoe store and had to stand all day wearing tight-fitting high-heeled shoes. A month before, she started to feel those tingling sensations on her feet which makes it harder for her to stand up for a long period of time. If not because of a small accident, wherein she fell down at work due to an attack of this tingling accompanied by a sudden weakness, she would never have even thought of going to the doctor for a consultation. And by now, the numbness had even spread to her legs and arms.

The patient was subjected to a foot exam to assess the skin, blood circulation and sensation by using a single nylon filament attached to a wand and touching the foot. The patient was unable to feel any pressure. An electromyograph was used to check the response of the muscles to electrical signals and a slow response was seen. A quantitative sensory testing was then used to recognize loss of sensation and excessive nerve irritability to indicate a neuropathy. All the results were conclusive of diabetic neuropathy.

The doctor advised her to go on a diet since her excess weight was already putting more undue pressure on her feet, plus bringing up her blood sugar levels that may further be aggravating the neuropathy. Acetaminophen was prescribed for the pain and numbness of her tingling feet. She needed to control her blood glucose levels to help alleviate the pain. She also was to keep her feet clean and dry at all times, free from any cuts, blisters, calluses, or swelling. Since her work required her to stand, she was instructed to wear more comfortable shoes, with stockings to support and protect her feet. And it was recommended that she see a good podiatrist to help care for her feet.

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