00:01
Now let's talk about neuropathy.
00:03
We introduced it in the
beginning, but
this is a life changer
for Mr. Sanchez.
00:09
My dad had neuropathy and I
watched him suffer with this,
it broke my heart.
00:14
See high blood glucose from
diabetes can damage those vessels,
we know that and the nerves
and that's what we're going
to focus on both of those.
00:22
Now, there's four different
types of neuropathies.
00:25
I'm going to show
you what those are
but just kind of have that
framework before we start.
00:29
There are four different
types of neuropathies.
00:32
So high glucose
leads to neuropathy.
00:35
That's why our picture
there, we have
those aren't super powers,
those lightning bolts on
the side of our patient
are not superpowers, their pain.
00:45
Let's take a look
at these categories
because neuropathies can cause
weakness numbness and pain.
00:52
I mean it was the weirdest thing when
my dad would try to describe it to me.
00:55
It's like his legs were on fire
yet at the same time
he had no sensation.
01:00
They were numb, it was like his foot
had been asleep for a couple years.
01:04
So it was miserable how
you can have intense pain
and numbness feel like fire.
01:09
It's really bizarre.
01:11
But that's because your
nerves are incredibly complex
and when they're damaged,
they just they go haywire.
01:19
So what we have here is this
neuropathy is dysfunction
or one or more of the
peripheral nerves.
01:26
Now what makes a
peripheral nerve.
01:28
Well central nerves go right down
the middle brain, spinal cord,
what branches off your spinal
cord are the peripheral nerves.
01:37
When these guys become damaged
because of high blood sugar,
you're going to see
these horrible effects,
weakness, numbness and pain,
how many times am
I going to say that
till it becomes a priority.
01:49
Because this is a phenomenal
quality of life issue.
01:54
Imagine what it would feel like
if you were trying to drive
and you couldn't feel your feet.
02:00
I wouldn't be safe for
you to drive would it
because you would know
how far you're pushing
the gas pedal or how hard
you're pressing the brake?
Why do you think a lot of
people end up in accidents
before they acknowledged
the challenge?
What about walking
around your house.
02:14
Now you might think hey, that'd be a
cool thing if I stepped on something
and I didn't even feel it.
02:18
It's not.
02:20
Remember that puts me at an
increased risk for infection
because I won't even
know that I did that,
I have pain but I don't have the right
type of sensation that can tell me,
what just happened or that
was focused in that one area.
02:33
So these four categories
we've got peripheral,
autonomic, focal and proximal.
02:39
I'm going to give you
more details between
the differences in these four
and our other presentations,
but for now remember,
that nerve damage leads
to loss of sensation,
motor control and intense pain.
02:52
Loss of sensation,
motor control,
and intense pain.
02:57
Okay, so high glucose
higher blood sugar's is
going to lead to neuropathy.
03:01
We know we've got these
four different types,
we'll go into more detail later.
03:05
But my patients can experience
loss of sensation, motor control,
and intense pain.
03:10
So if Mr. Sanchez is
experiencing this, ask him
Have you noticed when
you're putting on your socks
that you don't feel your
toes as much as you used to?
Any pain in your legs or in your
hands, your arms?
Ask him again for
those clinical cues
because high glucose increases
the risk of amputation.
03:31
See unfortunately,
Mr. Sanchez has already lost
his right leg below the knee.
03:38
Because the nerve and vessel damage
really wreak havoc on his body.
03:42
He had decreased
sensation in his feet.
03:44
He wasn't aware of
when he got an injury.
03:46
He had really
decreased blood flow,
so they couldn't nourish that tissue or
get meds down to it like antibiotics.
03:54
And he ended up losing
that portion of his leg.
03:57
So see he's kind of
already bought into it,
in fact, Mr. Sanchez
is either going to be
at one or two places
when you deal with someone
who's had an amputation.
04:06
They may be very
open to your teaching
or they may be extra defiant
because they are angry,
because of the loss.
04:13
Either way still my patient,
still my job, still my
role, still my profession
to intervene with
him and help him
move toward the next level of stuff
that he's willing going to take.