Last Sunday, I inadvertently opened a Pandora box, when I discussed “How to overcome disabilities as we grow old”. I did not know that so many elderly people read me, every Sunday. Let me paraphrase that. I did not know that so many elderly people with diabetes read me. I do not know whether to be proud or humble. To be happy or sad. That I command such readership. The elderly in search of good health. All I know was that such knowledge took an emotional toll on me.
As the texts and emails were pouring in, I wished to turn back the hand of the clock so that these retired elders, who gave their yesterdays for Nigeria’s tomorrow, would be healthy again. One particular colleague, also a retired Permanent Secretary after reading me last Sunday, made my emotions to spiral out of control by the figurative description of his malady.
Hear him – “ Doc, I have had diabetes for 23 years. At first, I was managed with insulin injections for 2 years. Then I changed to Glucophage tabs 500mg twice a day, and Daonil 10mg twice a day, with more or less, depending on my sugar level. My blood sugar has been well controlled over the years, although occasionally, I tend to guzzle more quantity of…..you know what? But I never over did it. Recently, I noticed that my left leg feels numb, as if I am wearing above knee woolen stockings, the type worn by Colonial Headmasters in the early 60s – very graphic.
Now you are talking of gangrene, foot drop and amputations. Let me tell you doc, if they cut my leg, I shall commit suicide”. How do you react to such a threat? How did I respond? A story for another day, but I was very downcast through out the day. I took the liberty of substituting his word “cut” with “amputated”.
Then I received two specific emails from responders, asking me to explain what I meant by “foot drop” I contemplated entitling this piece “What is foot drop”, but my colleague’s threat was more weighty, and I wanted us to get strengthened with the dictum “If you were crying because you have no shoes, what of those without legs”?
Some elders, sent me texts that they were also suffering from hypertension in addition to diabetes, wondering whether the hypertension will complicate their diabetes.
Now let me briefly discuss foot drop, since many emails requested for it.
What is foot drop?
Let me just explain it.
λ Foot drop is usually a symptom of a greater problem, not a disease in itself. Foot drop is a gait abnormality in which the dropping of the fore-feet happens due to weakness, irritation or damage of the common fibular nerve, including the sciatic nerve, causing paralysis of the muscles in the anterior portion of the lower leg.
λ Foot drop is sometimes called “drop foot”, and described as the inability to lift the front part of the foot. This causes the toes to drag along the ground while walking.
λ Foot drop can happen to one foot or both feet at the same time. It can strike at any age especially to those suffering from diabetes and leprosy. Foot drop can be temporary or permanent.
What are the causes of foot drop?
Diabetes – This is the major cause of foot drop. Those with diabetes can avoid this by regular blood sugar control.
Leprosy – This disease is still prevalent in Nigeria
Slipped disc – This leads to compression of the nerves that control movement of the foot.
Genetic disorders – Example sickle cell disorder and other haemoglobinopathies.
Tumours
Stroke – As a result of hypertension.
Sports injuries.
Hip replacement surgeries.
Cerebral palsy
Poliomyelitis.
All these can lead to foot drop and if complicated by gangrene could lead to amputation.
How do we treat foot drop?
Most of my diabetic patients with foot drop improved tremendously when managed through a) Adequate blood glucose control and b) Physiotherapy in form of physical therapy – This is used to strengthen foot and leg muscles. It usually improves a person’s ability to walk.
λ In some cases electronic devices that stimulate the leg nerves during walking may be appropriate. Your doctor will explain. Be medically guided.
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