PCOS-MEDICATION Messages for January, 2002: Diabetic Neuropathy

Diabetic Neuropathy

From: Renee (anonymous@obgyn.net)
Fri, 18 Jan 2002 08:15:33 -0800

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In layman terms, what I was saying is that because the problem is worse when your leg is down and gravity is pulling blood into your leg, it does not match the typical presentation of arterial (heart-to-extremities) problems. With arterial problems, having the leg down is good, since gravity pulls blood into the leg. Elevating it results in gravity pulling blood out of the leg, making it hurt more, and get very pale. This is not what happens to you, so arterial insufficiency (blood going into your leg) is probably not what you have.

It seems to me that it sounds a lot more venous (blood coming out). Is your leg swollen? Is the skin and tissue under it on your lower leg firm and woody? Do you have a mottled rust/brown discoloration of your lower leg? Those are signs of more severe venous insufficency (blood coming out). That would match your description of what happens with elevation and putting it down. If they did a venous study, did they just look for clots (the typical study), or did they look at the direction of blood flow as well? They can do that with a non-invasive test, but it's not what they usually look for with a "venous doppler" test; they usually just look for clots. If you haven't had a venous flow study, ask for it. You don't need varicosities to have venous insufficiency. And, moving your legs helps venous insufficiency, because moving your calf muscle helps the blood to only go up in the veins, not back-wash. It makes more sense as I think about it.

Have you seen a vascular surgeon (they deal with all vascular problems, not just the ones that need surgery)? I don't remember if that was on your list of docs seen. They might be able to determine the exact problem. It sounds circulatory to me.

Renee

Barbra Camara wrote: >
> I'm with you that the gravity dependency is significant. That would
> rule out arterial insufficiency (that gets pale with elevation, then
> cherry/brick red upon lowering down below the heart, then it resolves a
> little bit later. People with arterial insufficiency prefer their legs
> dependent, because gravity helps blood flow. However, your description
> of claudication (pain with walking) is consistent with arterial
> insuffiency, where the pain is muscle being damaged because the blood
> flow is not sufficient for metabolic need. Walking can improve
> circulation through the development of new collateral circulation.
> >
>
> Hi Renee,
>
> I am sorry-I still don't understand it.
> You state that you possibly agree with the gravity dependency being
> significant,which rules out arterial insufficiency.I am a bit
> confused....so can you just elaborate a little.I am definitely not
> familiar with this type of terminology when it comes to arteries and
> veins.
>
> What I basically am asking advice on(in just plain laymen terms,,,,I'm
> illiterate here,,,,lol!),is what do you think caused my legs and feet to
> turn purple/blue upon standing or sitting?When I move my legs...the
> color is normal.'
{snip}

-- Renee Cordrey, MSPT, MPH, CWS

---

Don't follow in the footsteps of the masters. Seek what they sought. --Zen saying

Next message: Panacea: "Re: Diabetic Neuropathy"
Previous message: lynsey: "Dr Sam and BCP's"
Next in thread: Panacea: "Re: Diabetic Neuropathy"
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Reply: Barbra: "Re: Diabetic Neuropathy....in response to Renee's answers..A big thank-you! from Barbra"
Maybe reply: Renee: "Re: Diabetic Neuropathy"

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