Diabetic Neuropathy: These SFX Are Not CGI

Wow. You came back after that last post?! I'm a little surprised, what with its "fun" subject matter. Permanent nerve damage probably doesn't seem as scary as going blind because it starts off with pain, and humans start hurting themselves almost immediately in life. Trust me. At some point during your toddlerhood, you took a header that had you wailing. Because we deal with pain from early on, maybe you think you'll be able to cope with the pain of diabetic neuropathy. And who knows? Maybe you can.

There are other things, however, that you'll eventually be unable to deal with due to their increasing severity. These things happen slowly, so you don't notice them until they've become a problem... and they're just going to get worse.

"Ummm..., Rob? You said this blog would infuse humor into all of the bad news. You're not being particularly funny today."

Okay, I'll tell a joke.

A chicken and an egg are lying in bed, with the former smoking a cigarette. The chicken then looks over at the egg and says, "Well, I guess we answered that question."

If you don't get it, you're too young to have it explained.

Now back to our regularly scheduled doom, gloom, and misery.

On the off chance you've forgotten the function of the nervous system, it's the lines of communication that connect everything in the body to the brain. Some of the things the brain does don't require thought. Those are the autonomic functions I mentioned last post. Your heart beating, breathing, etc. Then there are the things you do consciously. Writing, playing video games, calling your arms dealer to demand why the latest shipment of guns is late.

Oh... Is that last one just me? My bad.

Now try to imagine your body performing autonomic and conscious functions together. When you think to reach for the TV remote, you don't activate each muscle individually. The brain automatically handles all of the fiddly little details that allow you to perform your chosen task.

Because diabetic neuropathy wreaks havoc on the nervous system, however, some of those neurological messages won't reach their final destination as swiftly as they should. And sometimes, as a bonus, they don't reach that destination at all. Fear not! Medical science has devised a way of testing for this! Ready for this mouthful? It's called a electromyography, also known by the much shorter "EMG." It measures muscle response to electrical stimulation of the muscle. Like almost everything else pertaining to diabetes, it involves a needle. The technician gets the needle into the target muscle, sends a little electrical pulse through it, and the equipment measures response time... if there IS a response. One technician couldn't get a response out of me, so she called the doctor in and he poked around with the needle until he simply gave up.

Good times. Good times.

If you're not reading into this, I'm leading you to the conclusion that your muscles will start to suffer from atrophication. Muscles atrophy - decrease in size and waste away - from inactivity. You might be able to prolong the life of various muscles with a moderate exercise routine, but once you've started to lose the muscle mass, it's usually all down hill from there.

Loss of muscle mass in your feet can lead to falls that result in injury. Loss of muscle mass in your hands can lead to a weakened grip and cause a loss of motor control - just a fancy way of saying you'd lose control over hand movements.

Now I tried to look for pictures to show you, but I couldn't adjust my search parameters well enough to find what I wanted. So after a bit of struggling - okay, A LOT of struggling - I took pictures of both of my hands. Because of the angle at which I had to hold my hands, they look a lot more wrinkly than they actually are. Without further ado, my hands:

Left hand.

Right hand.

I am, believe it or not, trying to do something very specific in both pictures. Discounting my thumbs, I'm struggling to bring my fingers together. They should all be tight against one another, but I can't do that unless I curve my fingers. It's that loss of motor control I mentioned. In some circles, this is known as diabetic hand syndrome. 

Now for another hand pic. Try to maintain control as I bring back my sexy right hand.

For your enjoyment,

I circled the problem area.

See that area I circled? There should be a thick cluster of muscles there. After a mere 10 years of diabetic neuropathy, medical professionals could see the beginning of muscle atrophy. With over 25 years between me and my diabetic neuropathy diagnosis, laymen can see how that area where muscle should exist is now little more than webbing.

Heavy stuff, right? Let's lighten up the mood with another joke before I go on.

A guy walks into a psychiatrist's office with a duck on his head. The psychiatrist asks, "Can I help you?" And the duck says, "Yeah, get this guy off my butt."

Next on our exciting list of things diabetic neuropathy can do to you is diabetic gastroparesis. I mentioned last post how digesting food is one of the autonomic functions of the body. Diabetic neuropathy can mess that up, leading to such exciting symptoms as nausea, abdominal bloating, feeling full after only a few bites of food, acid reflux, and vomiting undigested food you ate hours ago.

I've experienced symptoms of gastroparesis. I once had such bad acid reflux that I thought I was having a heart attack. Because I was brought to the ER with a complaint of chest pain, they did an entire cardiac workup on me without ever considering that my problem might have been digestive. The ER doctor shrugged after all tests came back negative and sent me home. Acid reflux never entered his mind.

Oh, I have another good one! This involves another autonomic function. It's called orthostasis. When you stand up, the blood vessels in your legs constrict to stop your blood from rushing into your legs. Diabetic neuropathy can lead to orthostatic hypotension, which is a significant delay in constriction of those lower blood vessels. As a result, you become lightheaded and dizzy. Oh, your body eventually catches up and regulates your blood pressure appropriately, but by then it's a question of whether or not you've collapsed from the improper amount of blood in your head.

Much of what I've discussed thus far probably isn't relatable. Muscle weakness? An inability to digest food? Bah! Unimportant hogwash!

Fine. I'll give you a reason to be afraid. This is the part where I go into full Adult Mode, so I'll be straying from what I've tried to do thus far, and that's to keep this blog family friendly.

Erectile dysfunction. Men know it and fear it. Women know it and smirk. (Laugh while you can, ladies. I'll get to you shortly.) Several of my posts have mentioned microvascular damage. No one really thinks about it until it's pointed out, but men becoming erect is a result of increased blood flow to the groin. Thanks to damaged nerves to go along with the vascular issues, your one-eyed trouser snake doesn't even know when it's time to wake up.

"Silly Rob. They got pills for that. I'm not worried." While I nod sagaciously at your well-made argument, let me also point out that many of those pills have side effects that distract from the fun you're hoping to have. The increased blood flow provided by Viagra can make you feel feverish. Cialis can cause severe muscle aches. These are only a couple of side effects, (aside from the four-hour time limit before you should contact a healthcare professional).

To the feminine gigglers I hear on the sidelines, you also get to experience sexual dysfunction. Men will forever be jealous of a woman's capacity for multiple orgasms without the required refractory period. (That's our time to "reload," gentlemen.) Well, ladies, how would you feel if you went from the ability to have many orgasms to... oh, I dunno... ZERO.

Obviously, I can't speak from experience about that last one. I just know that it exists. Truthfully, I don't know if your team also has a pill to address the issue, so talk to your doctor if you want to know more.

There's one other aspect of diabetic neuropathy I want to discuss, but I'm going to save that for another post because it's HUGE! The kind of thing that's impossible to ignore. You'll LOVE it! 😉

I've shared enough pictures this post, so I'll end with one final joke to help you decompress.

A duck and an egg are lying in bed, with the former smoking a cigarette. The duck then looks around with rising panic and says, "I think I'm in the wrong joke!"