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Suggest Treatment For Peripheral Neuropathy With Severe Spinal Stenosis

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Posted on Mon, 4 Jul 2016
Question: My dad has diabetic sensory and peripheral neuropathy with severe spinal stenosis. Dad was able to walk independent and literally overnight lost all mobility. Dad is unable to go from a sitting to standing position. Dad feels it is his knee but nothing is being done about dads knee and he keeps being told it is all down to the nerves in his back and legs. When dad tries to stand he falls. We have not been given any equipment or anything other than a commode but he cant transfer. What can we do and do you believe dad will never walk again even if its with a zimmer frame? Please let me know your thoughts and if you think Dad will be able to walk what can I do? Physio is not helping and OT I have given a commode and now been discharged there must be something out there to help
doctor
Answered by Dr. Shehzad Topiwala (34 minutes later)
Brief Answer:
Hormone tests

Detailed Answer:
Sorry to learn about your dad's bothersome symptoms.

His vitamin D and thyroid status must be checked because abnormal blood levels of these can lead to symptoms similar to the ones he is reporting.

Moreover, his diabetes needs to be controlled well because the nerve damage form diabetes also affects mobility. In advanced stages of diabetic 'neuropathy' there is no cure and it can be irreversible too.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:

CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (13 minutes later)
dad is on vitamin d and thiamine all other bloods are normal. can dad ever walk again? he can take a few steps with zimmer frame but then his leg just goes underneath him. is this due to neuropathy? knee never been investigated keep be told its due to nerves . what equipment can I use to get Dad in and out of a car x
doctor
Answered by Dr. Shehzad Topiwala (14 hours later)
Brief Answer:
Follow up

Detailed Answer:
It is impossible on an online forum to comment on whether a person can ever walk again or if he has neuropathy. These things require the opportunity for a physical examination in-person.

However I can guide you that he needs to be thoroughly checked by the following specialist doctors:

1 Endocrinologist
2 Neurologist
3 Physio/ Occupational therapist
4 Orthopedic surgeon

He needs all the help he can get to arrive at the right diagnosis before any diagnosis can be made with reasonable certainty.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (4 hours later)
my dad has had nerve conduction studies mri scan blood tests and thats how I know dad has peripheral and sensory neuropathy with severe spinal stenosis. can this cause dad knee and leg to keep collapse underneath him?
doctor
Answered by Dr. Shehzad Topiwala (52 minutes later)
Brief Answer:
Second follow up

Detailed Answer:
Yes it can. A spine surgeon and neurologist will need to liaise and make a final decision after comprehensive analysis as to the final diagnosis. The outlook can be pronounced after this
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shehzad Topiwala (5 minutes later)
endocrinologist neurologist and orthopaedic are involved and say nothing can be done. we have physio but dad says its his knee that feels weak. can this resolve?
doctor
Answered by Dr. Shehzad Topiwala (6 hours later)
Brief Answer:
Third follow up

Detailed Answer:
If all 3 experts have concluded this, it is very likely they are correct. I suggest you take another opinion from a spine surgeon
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

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Suggest Treatment For Peripheral Neuropathy With Severe Spinal Stenosis

Brief Answer: Hormone tests Detailed Answer: Sorry to learn about your dad's bothersome symptoms. His vitamin D and thyroid status must be checked because abnormal blood levels of these can lead to symptoms similar to the ones he is reporting. Moreover, his diabetes needs to be controlled well because the nerve damage form diabetes also affects mobility. In advanced stages of diabetic 'neuropathy' there is no cure and it can be irreversible too. When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination: CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts) Electrolytes (Sodium and Potassium in particular) HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase) Kidney function tests (BUN, Creatinine) TSH (checks your thyroid) 12 hour Fasting Lipid profile Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney) 25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)