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Surgery relieves neuropathy
By WILLIAM K. ALCORN
YOUNGSTOWN
Numbness, tingling, excruciating shooting pains and a burning sensation ... all symptoms of an often disabling condition called peripheral neuropathy.
“My feet feel like they are on fire,” said one sufferer.
Frances Cox of Youngstown, a waitress who spends long hours on her feet on the job, said the onset of neuropathy in both feet made it impossible to stand, let alone walk and work.
“It was even difficult to sleep. It was to the point that my husband, Albert III ‘Butch,’ had to literally pick me up from work and carry me to the car. My husband and children, Allen and Albert IV, have been so helpful. I don’t think I could have made it without them putting up with my anger and crying,” Cox said.
She said she soaked her feet in ice to relieve the burning, but as soon as she lifted them out of the ice, the pain was back. “There were times I thought I was going to have to start living off drugs,” she said.
And then she found relief.
She had been off work for nearly three years because of the pain when she was referred to Dr. Lawrence DiDomenico of Ankle & Foot Care Centers and learned about nerve decompression surgery.
He did surgery on her left foot June 30, 2009, and on her right food Nov. 30, 2009, on an outpatient basis. The surgery takes about 45 minutes, Dr. DiDomenico said.
According to the Ankle & Foot Care Centers website, peripheral neuropathy affects the nerves outside the central nervous system, in areas such as the wrist, and in Cox’s case, the feet and ankles.
The symptoms are caused by compression or entrapment of nerve fibers, which occurs where they pass through naturally occurring tunnels, such as the “carpal tunnel” between the wrist and the hand, or “tarsal tunnel,” which occurs in the foot and ankle, according to Ankle & Foot Care Centers.
There are many causes of peripheral neuropathy, including diabetes, arthritis, chemotherapy, radiation, sports injury, thyroid disorders, vitamin deficiencies, heavy-metal toxicity, alcoholism and side effects from drugs. It is estimated that peripheral neuropathy affects about 60 percent of all diabetics at some time, Dr. DiDomenico said.
Nerve decompression surgery is not new, but it is relatively unknown to many who suffer from neuropathy, said Dr. DiDomenico, who was trained in the procedure in 2003.
The pain is caused when nerves swell and press against the tissues of the “tunnel,” compressing them. Disease, such as diabetes, can cause the nerves to swell and also can cause stiffness of connecting tissues such as tendons and ligaments around the nerves, worsening the problem, the doctor said.
For Cox, the surgeries were a success.
She says 90 percent of the pain is gone and what little pain she has now is the result of the surgery, not the neuropathy.
“I’m out doing what I love to do. My employer is very pleased with me. My goal was to get back to work, and so far, thank God, I made it back. I’m one of the lucky ones to be able to feel my feet again when I walk on them,” Cox said.
Despite Cox’s success, Dr. DiDomenico, who does 20 to 30 decompression surgeries a year, said it’s not for everyone.
The ideal patient is one who is faithful about doing physical therapy and movement after surgery, and if they are diabetic, keeping their blood- sugar level down, he said.
For most patients, the condition is 80 percent better within a couple of months if they follow instructions, but it can take a year or two for the nerves to completely regenerate. Some patients haven’t gotten better, but Dr. DiDomenico said no one he knows of has gotten worse because of the surgery.
In Cox’s case, decompression surgery relieved the symptoms in her feet within a few weeks, the doctor said.
“I went from being able to walk for about 10 minutes to being able to walk as I please,” Cox said.