Mine is a complex history of personnal bad eating habits and neuropathy misdiagnosis...
I am a 48 year old French guy and my English is not perfect.
My history narrative is quite long so I split it into two digestible parts. I am trying to remain objective and not confusing.
Part1:
3 years ago, during the month of February (I was 45 then) while walking up the street I felt a totally new and strange sensation in my lef foot: a mix of mild numbness and mild tingling at the left tip of the foot, it was associated with some sort of vibration in sole. It felt like I had not total control of my foot: not painful but a little disturbing and worrying.
That sensation was mostly present while walking and I wondered what might be the cause of it (tight shoes? pinched nerve?)
Over the next few days it did regress a bit but it remained so I visited my GP a week after and after performing some sensitive tests she concluded with "a possibly benign loss of feeling in left foot".
A that time I had been overweight (97kg/1.86m) for quite some years, gaining even more weight in the preceding year. It was the end result of bad eating habits but I thought that there was noting to worry about since I always had been a jogger, a healthy person with some physical strength and running resistance. Some people around me had at times pointed out to my not so fit belly but I was in denial (I still can't figure out why I was eating that much, a progressive unconscious growing habit I suppose). I was then considering that being slightly overweight was far from being obese, I thought I only had extra weight I could get rid of if I wanted to.
At the same period I very progressively had started to feel unwell (a really annoying mix of nausea, fatigue, gastroparesis and complete appetite loss) to the point that I lost weight (-10kg) rapidly over a period of 8 weeks.
Those additional new symptoms became disturbing and worrying so I had several visits to my GP and she prescribed a battery of tests with different specialists (endoscopy, cerebral MRI to discard MS, echography which induced a CT-Scan, etc.) and all came out OK, I only had mild steatosis (fat) in liver which I still have and apparently many people have. A bit worried by the mild fatty liver diagnosis I imposed myself a very short lived "no fat"diet.
With fatigue I could no long work: I had been long distance train commuting one week in two for an office job during almost 2 years.
Before all the specialists visists I had done lab blood tests that showed some slightly elevated fasting BG (first test was 5.9 and second one was 5.61) but normal A1C (37) though this was I think biased by the recent weight loss: surely higher figures would have come out without the weight loss induced by the appetite loss. I had also had quite elevated triglycerides (>2.5) and low HDL-cholesterol which both are bad constants for me over the last 10 years.
Reassured by those "close to the prediabetes limit but within the limit" fasting BG and A1C figures my GP totally discarded any past or present diabetic issue.
It is to be noted that prediabetes in France is only considered at 6.1 (World Health Organization criteria) compared to the more stringent 5.6 in the US.
My GP naiveley viewed my A1C good figure as some sort of constant without more wisely considering that it was only a temporary 3 month oneshot that did not then refelect at all my usual and long term eating habits. I tried to explain my view on this to her recently but she won't change her mind: on diabetes she tends to base her analysis more on sparse test figures than a patient intuitive narrative that covers his whole history.
Also at the time I noticed some progressive mild muscle loss in my left calf (compared to my right calf) and suffered twitching and cramps in both legs (foot and calf), I started having some trouble walking long distances on my stiff legs and I became even more anxious (for some odd reason I started thinking of ALS), I was mostly bed-ridden, I could not sleep well and had night sweats.
So my GP eventually refered me to have an EMG by a neurologist that came out OK: the diagnostic being "no neuropathy identified, the loss of sensitivity being probably due to a pinched small nerve (tight shoes?)" and she concurred with my GP that I was mainly suffering from some sort of burn-out induced by work stress and long hours.
So in June of that same year I was left all by myself without having a real clue on what was the source of all my health problems: I somehow felt that the burn-out dignosis was too much of an easy and handy answer.
At that time I did not even know what diabetic peripheral neuropathy was (I only learned maybe 2 months ago). Of course I had some vague knowledge of what is called "diabetic foot" but I viewed it as related to old people having untreated long term full-blown diabetes, I did not think about it. I am not too sure my GP was (and is) well informed on the subject and I suppose the neurologist did not seem to be interested into it because she never refered to my foot symptoms as a possible peripheral neuropathy during the examinations and conclusions. I did go back for a second visit to that neurologist because I was somehow left unsatisfied by her initial diagnosis but it was of no avail, she rumbled at me and insisted on her initial diagnosis.
In retrospect I really do regret not having at that time a minimum of personal information and prevention on diabetes-induced neuropathy. Neither at that time did I know that most neurologists are not the best qualified (nor maybe interested) to diagnose small fiber nerve troubles (peripheral neuropathy).
The most competent and efficient specialist for my foot symptoms would probably have been an endocrinologist (one with good intuition and a solid experience in diabetes). If if...
Let's go back to my history. During the months of July and August I started feeling better, having my appetite back and no cramps in calves and feet. The weird feeling in the foot was almost a thing of the past, it had regressed somewhat and I had got used to the intermittent leftover mild tingling and very slight numbness.
But rapidly (and stupidely) I came back into my old bad eating habits: some vegs but lots of white bread, white rice, potatoes, butter, milk, cheese, charcuterie, chocolate, eating 2 or 3 portions instead of one. Added to that the COVID epidemy over the next 2 years : I was not specially physically active...
So in definitve what should/could have sounded like an alarm (neuropathy induced by prolonged prediabetic/metabolic syndrome) became ignored and instead of following a prediabetic strict diet and having a close monitoring of my BG level and triglycerides I went back to my metabolic syndrome. Many serious studies insist on the metabolic syndrome being a major cause of peripheral neuropathy which can't be resumed to only diabetes.
In 2019, my body had shown the screaming signs of sugar and fat excess - the forced weight loss having brought a temporary lull - but I did not get the message. Why worrying since qualified experts said my troubles were due to "burn-out".
See next coming Part2 post for the rest of my history.
I am a 48 year old French guy and my English is not perfect.
My history narrative is quite long so I split it into two digestible parts. I am trying to remain objective and not confusing.
Part1:
3 years ago, during the month of February (I was 45 then) while walking up the street I felt a totally new and strange sensation in my lef foot: a mix of mild numbness and mild tingling at the left tip of the foot, it was associated with some sort of vibration in sole. It felt like I had not total control of my foot: not painful but a little disturbing and worrying.
That sensation was mostly present while walking and I wondered what might be the cause of it (tight shoes? pinched nerve?)
Over the next few days it did regress a bit but it remained so I visited my GP a week after and after performing some sensitive tests she concluded with "a possibly benign loss of feeling in left foot".
A that time I had been overweight (97kg/1.86m) for quite some years, gaining even more weight in the preceding year. It was the end result of bad eating habits but I thought that there was noting to worry about since I always had been a jogger, a healthy person with some physical strength and running resistance. Some people around me had at times pointed out to my not so fit belly but I was in denial (I still can't figure out why I was eating that much, a progressive unconscious growing habit I suppose). I was then considering that being slightly overweight was far from being obese, I thought I only had extra weight I could get rid of if I wanted to.
At the same period I very progressively had started to feel unwell (a really annoying mix of nausea, fatigue, gastroparesis and complete appetite loss) to the point that I lost weight (-10kg) rapidly over a period of 8 weeks.
Those additional new symptoms became disturbing and worrying so I had several visits to my GP and she prescribed a battery of tests with different specialists (endoscopy, cerebral MRI to discard MS, echography which induced a CT-Scan, etc.) and all came out OK, I only had mild steatosis (fat) in liver which I still have and apparently many people have. A bit worried by the mild fatty liver diagnosis I imposed myself a very short lived "no fat"diet.
With fatigue I could no long work: I had been long distance train commuting one week in two for an office job during almost 2 years.
Before all the specialists visists I had done lab blood tests that showed some slightly elevated fasting BG (first test was 5.9 and second one was 5.61) but normal A1C (37) though this was I think biased by the recent weight loss: surely higher figures would have come out without the weight loss induced by the appetite loss. I had also had quite elevated triglycerides (>2.5) and low HDL-cholesterol which both are bad constants for me over the last 10 years.
Reassured by those "close to the prediabetes limit but within the limit" fasting BG and A1C figures my GP totally discarded any past or present diabetic issue.
It is to be noted that prediabetes in France is only considered at 6.1 (World Health Organization criteria) compared to the more stringent 5.6 in the US.
My GP naiveley viewed my A1C good figure as some sort of constant without more wisely considering that it was only a temporary 3 month oneshot that did not then refelect at all my usual and long term eating habits. I tried to explain my view on this to her recently but she won't change her mind: on diabetes she tends to base her analysis more on sparse test figures than a patient intuitive narrative that covers his whole history.
Also at the time I noticed some progressive mild muscle loss in my left calf (compared to my right calf) and suffered twitching and cramps in both legs (foot and calf), I started having some trouble walking long distances on my stiff legs and I became even more anxious (for some odd reason I started thinking of ALS), I was mostly bed-ridden, I could not sleep well and had night sweats.
So my GP eventually refered me to have an EMG by a neurologist that came out OK: the diagnostic being "no neuropathy identified, the loss of sensitivity being probably due to a pinched small nerve (tight shoes?)" and she concurred with my GP that I was mainly suffering from some sort of burn-out induced by work stress and long hours.
So in June of that same year I was left all by myself without having a real clue on what was the source of all my health problems: I somehow felt that the burn-out dignosis was too much of an easy and handy answer.
At that time I did not even know what diabetic peripheral neuropathy was (I only learned maybe 2 months ago). Of course I had some vague knowledge of what is called "diabetic foot" but I viewed it as related to old people having untreated long term full-blown diabetes, I did not think about it. I am not too sure my GP was (and is) well informed on the subject and I suppose the neurologist did not seem to be interested into it because she never refered to my foot symptoms as a possible peripheral neuropathy during the examinations and conclusions. I did go back for a second visit to that neurologist because I was somehow left unsatisfied by her initial diagnosis but it was of no avail, she rumbled at me and insisted on her initial diagnosis.
In retrospect I really do regret not having at that time a minimum of personal information and prevention on diabetes-induced neuropathy. Neither at that time did I know that most neurologists are not the best qualified (nor maybe interested) to diagnose small fiber nerve troubles (peripheral neuropathy).
The most competent and efficient specialist for my foot symptoms would probably have been an endocrinologist (one with good intuition and a solid experience in diabetes). If if...
Let's go back to my history. During the months of July and August I started feeling better, having my appetite back and no cramps in calves and feet. The weird feeling in the foot was almost a thing of the past, it had regressed somewhat and I had got used to the intermittent leftover mild tingling and very slight numbness.
But rapidly (and stupidely) I came back into my old bad eating habits: some vegs but lots of white bread, white rice, potatoes, butter, milk, cheese, charcuterie, chocolate, eating 2 or 3 portions instead of one. Added to that the COVID epidemy over the next 2 years : I was not specially physically active...
So in definitve what should/could have sounded like an alarm (neuropathy induced by prolonged prediabetic/metabolic syndrome) became ignored and instead of following a prediabetic strict diet and having a close monitoring of my BG level and triglycerides I went back to my metabolic syndrome. Many serious studies insist on the metabolic syndrome being a major cause of peripheral neuropathy which can't be resumed to only diabetes.
In 2019, my body had shown the screaming signs of sugar and fat excess - the forced weight loss having brought a temporary lull - but I did not get the message. Why worrying since qualified experts said my troubles were due to "burn-out".
See next coming Part2 post for the rest of my history.