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What Causes Foot Numbness In An Elderly Person?

Posted on Mon, 9 Jan 2017

Question: I'm 86 y.o. type 2 with P.N. numbness in feet and lower legs which I'm currently moderating with B12 and Benfotiamine. Also recurrent tingling/numbness in right hand when elevated above desk level. Diminishes when lowered. Thinking could be T.2 concomitant but also possibility of localised thrombosis, following recent transient clot lodgement in minor cardiac artery requiring hospitalisation with angiogram and CT lung scan. Have now ended Apixaban course for that condition, fixed OK. Would you take a shot at resuming clot busters for the hand? (My current G.P. just retired and his replacement is not up to scratch)

Answered by Dr. Dr.Albana Sejdini (4 hours later)

Brief Answer:
Should determine the right diagnosis first...

Detailed Answer:
Hi,

I have gone through your medical history carefully and understood your concern.

Having numbness in your feet is indicating that the nerves there are suffering( possible neuropathy). Further neurological examination will confirm that.

Next, to determine if new clot is present, Doppler ultrasound is required first.

As you may see, we need to confirm the right diagnosis first, before going for appropriate treatment.

Although you have clopidogrel in your cabinet, without having an accurate diagnosis, I cannot say to administer it. This is for your own safety.

I hope this helps.
Dr.Sejdini

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Albana Sejdini (14 hours later)

Don't think much of your answer. Already told you I have T2 diabetic neuropathy in feet and helping it with B vitamins. I'm asking about my hand. If neuropathy, why only in right hand, not both? Gotta be other possibilities, of which I suggested a clot; there must be others which you don't mention. A Doppler will confirm a circulation problem, but not necessarily it's cause. As for the Clopidogrel, you say don't take it: I say, what's the risk? It didn't kill me when I took it originally. Oh, well, first back to Dr. Google and then to find my new G.P.

Answered by Dr. Dr.Albana Sejdini (7 hours later)

Brief Answer:
We want to make sure the right diagnosis and treatment

Detailed Answer:
Hi back,

Thank you for your additional details.

You say: numbness start when elevated hands and get better when lowering the arm. This is suggestive of circulation problem. To confirm it Doppler ultrasound is recommended.

Having T2 neuropathy and being diabetic also increase the chances for neuropathy issues.

However, taking into account your description of your numbness, I am still thinking to rule out circulation problem first.

Taking clopidogrel shot won't kill you, but I always want to make sure my patients are taking the best advice to ease their health problems. I do not want to make experimental tries.

In case you have bruises in your hand, can send a photo and then and only then I can advise to take clopidogrel shot.

Wish fast recovery.
Dr.Albana

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Albana Sejdini (8 days later)

Thanks again. The hand problem is almost certainly circulation. Carpal tunnel, maybe. Thrombus also possible. I don't want a Doppler for it, I want a fix. There can't be too many treatment options, and none of them risky. I'll just try them all, serially, until I find one that works. Including icing, hot packing, clot busting, Voltaren, anti-inflammatories; Anything else you can think of? I'm an experimental scientist (Chemical engineer), love experimenting on myself. Wanna join in? All I'm getting from my G.P. is a blank stare.

Answered by Dr. Dr.Albana Sejdini (8 hours later)

Brief Answer:
If you like experimenting on yourself

Detailed Answer:
Ok, then, take your own risks.

If you have pain and have a black or purple bruising (spot), then, apply heparin gel/lotion locally. Can also try the clopidogrel shot too.

With regards to hot and cold compresses, can use them, but be observative: in other words, watch what is happening with your limbs locally when applying warm and cold compresses.

Anti-inflammatory meds will help reduce the inflammation and pain. However, if you do not identify what is really causing the inflammation/pain, and treat it adequately, they can't help much. However, they are also recommended to use.

All the best with your experiments.
Dr.Albana

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar