DEAR DR. DONOHUE: I have had diabetes for 20 years. I haven’t been all that careful about checking my blood sugar and watching my diet. My doctor tells me I now have diabetic neuropathy, which causes both feet to burn terribly. My doctor says that not much can be done for it. What do you say? — L.B.
ANSWER: Nerves are our electric grid. They bring messages from the brain that direct muscles how to move. They send messages to the brain that tell us how hot or cold we are, when a mosquito bites, when we scrape our skin and how close we are to a burner on the stove. Neuropathy is nerves gone bad. The causes of neuropathy are many. They include inherited conditions, vitamin deficiencies, infections, poisons, drugs and illnesses like diabetes. The manifestations of neuropathy are equally diverse. Muscle weakness can lead to things like a dropped foot — the inability to raise the foot off the ground. Or they can be altered sensations, like the burning pain you experience. They might be a lack of all sensation — numbness. Or they can be seen in nerves that serve such functions as sweating and digestive tract contractions.
As many as 55 percent of people with type 1 diabetes and 45 percent of those with type 2 diabetes develop some degree of neuropathy. The most important aspect of treatment is control of blood sugar. You have to take diabetes seriously. You should have your own glucometer, a meter that gives you your blood sugar value in a matter of minutes. You have to be vigilant about your diet. You should be exercising. Control of diabetes often can stop the progression of diabetic neuropathy and may, in some instances, lessen its symptoms.
Cymbalta and Lyrica are two drugs approved for treatment of neuropathy. Lidocaine, a numbing agent, comes in patches that can be applied to the skin of the painful area. Alpha-lipoic acid, a natural product that protects nerves from the harmful byproducts of cell chemistry, has been effective for some with sensory neuropathy.
Get in touch with the Neuropathy Association at 800-247-6968 or online at www.neuropathy.org. You’ll find the association a good friend that can keep you abreast of the latest developments in the treatment of neuropathy, both diabetic and all other varieties. May 16 to May 20 is National Neuropathy Week, and the association is prepared for an influx of questions during that week.
DEAR DR. DONOHUE: Recently, we moved to a farmhouse in the country. All our sinks and toilets have iron rings. We have well water. Is this iron a danger to health? — M.R.
ANSWER: Even when iron rings are found on porcelain, the iron concentration in your water isn’t at a level that’s a health threat.
If you want to know the exact iron content, you can have your water tested. Call your local health department, county extension service or the Department of Natural Resources for information.
DEAR DR. DONOHUE: My boyfriend is in the habit of belching. I can put up with it when we’re alone, but in public places it’s embarrassing. He doesn’t turn the volume of his belching down at all. He says he can’t, and he says it happens before he can do anything about it.
What causes belching? Can the noise level be turned down without harm to the belcher? — H.H.
ANSWER: A stomach filled with air is the cause of a belch. Your friend should slow down when he eats. Gulping air with each mouthful of food is the biggest contributor to filling the stomach with it. He ought not to drink carbonated beverages, and he should use a straw for drinking. These are two other ways that air gets introduced into the stomach.
Your friend can turn down the volume of his belch without any harm to himself. He also can be conscious that he’s about to belch. He simply is ignoring nature.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.