1. < Neuropathy

What to ask a podiatrist?

Posted by Ray Kemble @ray666, Jun 8, 2023

Hello!
I am a 78-year-old man with idiopathic polyneuropathy. Otherwise, I'm healthy. I was diagnosed only last August. It appears my PN is either sensory, motor, or a mix of the two, Oddly enough, I have no pain, but my balance and gait are terrible. I have been wearing orthotics for decades, starting long before my PN diagnosis. Some have suggested I talk to my podiatrist (he doesn't know yet about my PN) to get his advice on PN and foot care. I'm wondering if others here have met with their podiatrists and whether your meeting proved to be of some help, especially with your balance and gait. For any stories you might share, thank you!
Ray (@ray666)

Interested in more discussions like this? Go to the Neuropathy Support Group.

karleenhubley | @karleenhubley | Jun 12, 2023

My podiatrist concurs that SAS, Merrell and Hoka running shoes are the best. It is hard to fit Sketchers and they don't hold up. SAS for dress up, Merrils for gardening and Hokas for the grocery store. My feet like the change of presure points and the solid support. These brands are expensive and of course are not covered by insurance but they last. Good shoe stores measure your feet.

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1 reply
Ray Kemble | @ray666 | Jun 12, 2023

Hello!

I've been AWOL from Mayo for a couple of days. Because I'm the fellow who started this thread about talking to a podiatrist about your PN and your feet, and because tomorrow is the day I'll be meeting with my podiatrist for that very reason, I thought I'd tell you about the couple of questions I plan to ask, wondering if you've any others you'd like to pass along:

1. Can podiatry help someone (I'm 78) with a sensory-leaning idiopathic PN? (I have no pain, only a worrying balance and a way of walking (fishtailing) that only seems to be getting worse. I was diagnosed last August after an EMG and battery of spinal MRIs.)

2. What do you think of my shoes? (Nunbush) I've tried so many different kinds. I have severely flat feet (Size 13) that have seen too many miles of distance running. None that I've tried has made much of a difference. From your experience, have you a brand you'd recommend I try?

3. And then there are my orthotics. I've been wearing orthotics since the late-1980s (not the same pair!). Are there orthotics specially designed for people with PN?

4. My walk has deteriorated. I can no longer walk comfortably, even a half city block. And I know I'm duck-walking (is that what they call it when your toes point outward?) and looking down too much, all the unfortunate by-product of my PN. Should I try some PT specifically to relearn proper walking? If yes, do you know of a therapist specially trained to help persons with PN?

5. Around the home, I go barefoot (or sock-foot). Outdoors, of course, I wear my Nunbush. When I'm barefoot, my feet feel great (and my balance is pretty good, too), but after a while, my lower back begins to ache, and sometimes my knees, too. (Because of no orthotics?) And if I try wearing my shoes indoors, my backache will go away (knees will feel better, too – because my orthotics are in?), but my feet tend to feel all "crampy" (not always, and I believe I'm wearing the right size shoes). My balance (which wasn't too bad when I was barefoot) becomes more challenging. It seems one of those damned if you do, damned if you don't situations. LOL Can you give me some advice on what I should do?

I'll probably have other questions, but these are a few of my biggies. Can you suggest others?

Ray (@ray666)

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Ray Kemble | @ray666 | Jun 13, 2023

I just returned from a meeting with my podiatrist. I hope you'll not misunderstand me when I say I was satisfied that he didn't have much to offer. Why I took that as a positive, from the moment we began talking – and we talked for a good half hour, if not more – my podiatrist made it clear that he'd not say anything that would give me false hopes. In my book, that's a positive. Of course, that also means his confirming that there is no cure.* (*He was being specific to my particular PN: predominantly sensory – with possibly a motor mix – idiopathic peripheral neuropathy.) He told me he has a surprising number of other patients with PN (surprising only to those who don't know how widespread our illness is) and that, for all of us, he informs himself of all (and there's not much; we wish there were more) late-breaking research news. He looked at my orthotics but didn't say I needed a new pair. Also, he thought I'd done well in buying Nunbush shoes. I know we discussed other things, and they'll come back to me as I put together my notes later today. He warned me about not getting suckered into buying one of the PN "devices" I see hawked online with a $$$$$ price. If I see a device – or other unorthodox therapy – something I find interesting, I should call him and we'll go over the pros and cons together.* (*Again, he was talking about my particular form of PN.) I left with his invitation that if I should need to see him, I don't have to wait for an appointment but to call him and he'll make time for me. So, all in all, that's why I was pleased with this morning's get-together. My goal was to inform one of my specialists of my PN, a doctor I've seen for several years, and even if I didn't return home with some miracle "fix" (not that I had expected to), I've met my goal. If anyone has any questions, please ask! Trying to remember the answers will be a big help to me.

REPLY
4 replies
Mentor
John, Volunteer Mentor | @johnbishop | Jun 13, 2023
In reply to @ray666 "I just returned from a meeting with my podiatrist. I hope you'll not misunderstand me when..." + (show)
@ray666

I just returned from a meeting with my podiatrist. I hope you'll not misunderstand me when I say I was satisfied that he didn't have much to offer. Why I took that as a positive, from the moment we began talking – and we talked for a good half hour, if not more – my podiatrist made it clear that he'd not say anything that would give me false hopes. In my book, that's a positive. Of course, that also means his confirming that there is no cure.* (*He was being specific to my particular PN: predominantly sensory – with possibly a motor mix – idiopathic peripheral neuropathy.) He told me he has a surprising number of other patients with PN (surprising only to those who don't know how widespread our illness is) and that, for all of us, he informs himself of all (and there's not much; we wish there were more) late-breaking research news. He looked at my orthotics but didn't say I needed a new pair. Also, he thought I'd done well in buying Nunbush shoes. I know we discussed other things, and they'll come back to me as I put together my notes later today. He warned me about not getting suckered into buying one of the PN "devices" I see hawked online with a $$$$$ price. If I see a device – or other unorthodox therapy – something I find interesting, I should call him and we'll go over the pros and cons together.* (*Again, he was talking about my particular form of PN.) I left with his invitation that if I should need to see him, I don't have to wait for an appointment but to call him and he'll make time for me. So, all in all, that's why I was pleased with this morning's get-together. My goal was to inform one of my specialists of my PN, a doctor I've seen for several years, and even if I didn't return home with some miracle "fix" (not that I had expected to), I've met my goal. If anyone has any questions, please ask! Trying to remember the answers will be a big help to me.

Jump to this post

Sounds like a win win to me. Don't you like it when doctors listen and are supportive even if they don't have all of the answers. Happy Monday!

REPLY
Ray Kemble | @ray666 | Jun 13, 2023

I definitely do, John! (" … like it when doctors listen and are supportive … ") It makes me feel like there are two grownups in the room. Happy Monday to you, too!

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Angie P. | @ancopau1998 | Jun 13, 2023
In reply to @dbeshears1 "Sounds familiar- while the room for toes should no doubt be beneficial for my hammering toes,..." + (show)
@dbeshears1

Sounds familiar- while the room for toes should no doubt be beneficial for my hammering toes, the body parts on me that did seem to shrink are my ankles and mid-foot. Shoes with wide toe boxes usually come with wide everywhere, and I need support for my upper heel/ankle- I can’t walk if I’m going to twist my ankle because it’s moving around in my shoe. So even if I pad with the thickest sock possible, the padding is on the toes too, so I’ve crammed the toe box again! Vicious cycle isn’t it? For me, I need my shoe with a little cushion and more like it’s a “brace”, not a flip flop. My best trial & error (from recommendations here too) landed me on Skechers. It seems to have the best overall fit with the socks I also need to wear for the ankle support I need. I hope you find the best fit for you!

Jump to this post

Hi Debbie, good idea I will try Skechers. All the shoes I have hurt my feet. Years ago a Podiatrist had made inserts for my shoes and they were awful to wear. So next will be the Skechers, can be expensive buying shoes,

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NJ Ed | @njed | Jun 14, 2023

@ray666 Ray, all good news!! I have a saying; no news IS good news! John Bishop makes a good point on the win win. First, sounds like you have a great doctor. Second, no bad news on his end. The fact that your PN has no cure is not a shocker. As you know, I experience identical symptoms as you, no pain, numbness and bad balance ... and getting worse. Being in our range of mid 70's to me, we make adjustments in how we deal with this for our own safety is basically recognizing our abilities in the safest manner. Sounds like you're doing the same. Again, all good news. Ed

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1 reply
philkill4 | @philkill4 | Jun 14, 2023
In reply to @ray666 "I just returned from a meeting with my podiatrist. I hope you'll not misunderstand me when..." + (show)
@ray666

I just returned from a meeting with my podiatrist. I hope you'll not misunderstand me when I say I was satisfied that he didn't have much to offer. Why I took that as a positive, from the moment we began talking – and we talked for a good half hour, if not more – my podiatrist made it clear that he'd not say anything that would give me false hopes. In my book, that's a positive. Of course, that also means his confirming that there is no cure.* (*He was being specific to my particular PN: predominantly sensory – with possibly a motor mix – idiopathic peripheral neuropathy.) He told me he has a surprising number of other patients with PN (surprising only to those who don't know how widespread our illness is) and that, for all of us, he informs himself of all (and there's not much; we wish there were more) late-breaking research news. He looked at my orthotics but didn't say I needed a new pair. Also, he thought I'd done well in buying Nunbush shoes. I know we discussed other things, and they'll come back to me as I put together my notes later today. He warned me about not getting suckered into buying one of the PN "devices" I see hawked online with a $$$$$ price. If I see a device – or other unorthodox therapy – something I find interesting, I should call him and we'll go over the pros and cons together.* (*Again, he was talking about my particular form of PN.) I left with his invitation that if I should need to see him, I don't have to wait for an appointment but to call him and he'll make time for me. So, all in all, that's why I was pleased with this morning's get-together. My goal was to inform one of my specialists of my PN, a doctor I've seen for several years, and even if I didn't return home with some miracle "fix" (not that I had expected to), I've met my goal. If anyone has any questions, please ask! Trying to remember the answers will be a big help to me.

Jump to this post

Ray,
My husband suffers with neuropathy very similar to yours with gait imbalance, funny walk and rubbery legs etc. We follow your posts closely. He does have a few episodes of unbearable pain when walking that come on sporadically and his foot gets swollen but he is usually with out pain unless he is on his feet alot. We have made an appointment with a podiatrist at my urging that isn't until 7/6. I told him he looks like he has a claw foot/feet. He was diagnosed with idiopathic, primary axonal polyneuropathy by a neurologist last year. This is such a hard condition to navigate and the neurologist only seem to want to dole out medication. We appreciate this websight for all the good suggestions and comradery of fellow sufferers! Best- Debbie and Scott

REPLY
2 replies
Debbie | @dbeshears1 | Jun 14, 2023
In reply to @ray666 "I just returned from a meeting with my podiatrist. I hope you'll not misunderstand me when..." + (show)
@ray666

I just returned from a meeting with my podiatrist. I hope you'll not misunderstand me when I say I was satisfied that he didn't have much to offer. Why I took that as a positive, from the moment we began talking – and we talked for a good half hour, if not more – my podiatrist made it clear that he'd not say anything that would give me false hopes. In my book, that's a positive. Of course, that also means his confirming that there is no cure.* (*He was being specific to my particular PN: predominantly sensory – with possibly a motor mix – idiopathic peripheral neuropathy.) He told me he has a surprising number of other patients with PN (surprising only to those who don't know how widespread our illness is) and that, for all of us, he informs himself of all (and there's not much; we wish there were more) late-breaking research news. He looked at my orthotics but didn't say I needed a new pair. Also, he thought I'd done well in buying Nunbush shoes. I know we discussed other things, and they'll come back to me as I put together my notes later today. He warned me about not getting suckered into buying one of the PN "devices" I see hawked online with a $$$$$ price. If I see a device – or other unorthodox therapy – something I find interesting, I should call him and we'll go over the pros and cons together.* (*Again, he was talking about my particular form of PN.) I left with his invitation that if I should need to see him, I don't have to wait for an appointment but to call him and he'll make time for me. So, all in all, that's why I was pleased with this morning's get-together. My goal was to inform one of my specialists of my PN, a doctor I've seen for several years, and even if I didn't return home with some miracle "fix" (not that I had expected to), I've met my goal. If anyone has any questions, please ask! Trying to remember the answers will be a big help to me.

Jump to this post

I think it’s a good thing he approved your shoe. Mine had a good thing about saying my Skechers were a good choice for my feet at the moment. I found that was an encouraging step.

REPLY
1 reply
Mentor
John, Volunteer Mentor | @johnbishop | Jun 14, 2023
In reply to @philkill4 "Ray, My husband suffers with neuropathy very similar to yours with gait imbalance, funny walk and..." + (show)
@philkill4

Ray,
My husband suffers with neuropathy very similar to yours with gait imbalance, funny walk and rubbery legs etc. We follow your posts closely. He does have a few episodes of unbearable pain when walking that come on sporadically and his foot gets swollen but he is usually with out pain unless he is on his feet alot. We have made an appointment with a podiatrist at my urging that isn't until 7/6. I told him he looks like he has a claw foot/feet. He was diagnosed with idiopathic, primary axonal polyneuropathy by a neurologist last year. This is such a hard condition to navigate and the neurologist only seem to want to dole out medication. We appreciate this websight for all the good suggestions and comradery of fellow sufferers! Best- Debbie and Scott

Jump to this post

Hello @philkill4, I thought I would jump in and add my welcome to Connect along with @ray666, @dbeshears1 and others. Neuropathy can be a difficult condition to navigate and it definitely pays to learn as much as you can about the condition and different treatments that may provide some relief. If you haven't already seen this site, you might want to save it for learning more about the condition and how to manage it.

--- Foundation for Neuropathy - Living Well: https://www.foundationforpn.org/living-well/

I wear compression socks daily to control the swelling in my legs and feet. I also have lymphedema in addition to my neuropathy. Is it just your husbands feet that have the swelling or is it the legs also?

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