Issue link: https://www.epageflip.net/i/19673
Monday, November 15, 2010 – Daily News – 5A FEATURES Doctors can’t find cause of foot numbness DEAR DR. GOTT: About three years ago, in a slip and fall, I suffered a separa- tion of the quadri- ceps from the left kneecap. The surgery went well, and I have com- plete recovery and use of my left leg. About six months later, I started to feel numbness in the toes of my right foot. This has been getting worse and spreading into the ball of my foot. There is no pain. My doctor ordered a scan of the lower lumbar area. He read the scan and said that he saw a possible arthritic spur in contact with the nerves and that it was the cause of the numb- ness. He then sent me to a pain clinic, where two doctors studied my scan and concluded that I had a compressed disc that could be contacting the nerves. These differing diagnoses have left me puzzled. All three recommended corti- sone injections. I went to a chiropractor and an acupuncturist, with no help. I had an electron- ic test of conductivity of the nerves between the calf and my toes, but no abnor- mality was found. I went to a university hospital and saw a foot and ankle spe- cialist, who could find no reason for the condition. My family doctor sent me to an anesthesiologist who examined my scan, but he saw nothing that would be helped by cortisone. He said that he would give me a shot if I wanted it, but it would do no good. I thanked him very much for his candor. Can you help me? Thank you. DEAR READER: You appear to have covered many of the bases thus far in your search for an answer. I do, however, have a few more sugges- tions, but first, I have some questions. What type of scan did you have? An MRI? CT scan? X-rays? I can’t determine if you should undergo more sophisticat- ed testing without know- ing what you’ve already Dr. Peter Gott had done. For example, if you had only an X-ray, a CT may help clarify the results. An MRI is another step up from the CT scan. Because there is some con- troversy about the results, this may be a good starting point. Next, do you have any other medical conditions such as diabetes or high blood pressure? These conditions (and many oth- ers) can lead to complica- tions, especially in those who are not receiving treatment or are poorly managed. If you’re not sure whether you have any of these conditions, now is the time to have blood work and a physical exam to rule out or confirm a possible underlying condi- tion. Because you have already seen most of the specialists I would recom- mend, request a referral to a neurologist. Testing can determine whether the nerves of your foot are involved and whether you have neuropathy. There are several treat- ment options available, depending on the cause. These may include chiro- practic manipulation, rub- bing mentholated chest rub on the affected areas, cortisone shots, nons- teroidal anti-inflammato- ry drugs (NSAIDs), pre- scription pain relievers, physical therapy, Ano- dyne therapy and surgery. If an underlying disorder, such as diabetes, is the cause, treating the disor- der may relieve your numbness. To give you related information, I am sending you a copy of my Health Report “Managing Chron- ic Pain.” Other readers who would like a copy should send a self- addressed, stamped No. 10 envelope and a $2 check or money order payable to Newsletter and mailed to PO Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form from my website, www.AskDr- GottMD.com. Pupil perpetually pursuing pleasure Dear Annie: I’m a pub- lic school teacher with 20 years of experience, but this one has me shaken. The sweetest and brightest of my 9-year-old students spends most of the day positioning herself so she can rub against her chair in a way that gives her pleasure. Her previous teachers noticed this, too, and it was brought to the principal’s attention when she was in first grade. Out of concern, he contacted Child Protective Services, but they said it was a non-issue. The principal brought the parents in, and they said it’s ‘‘just something she does’’ and the pediatrician told them it was normal. the parents complained that this was humiliating to her. I’m not sure what a teacher is supposed to do in this sit- uation. — Concerned Teacher Dear Concerned: ‘‘Nat- Annie’s Mailbox by Kathy Mitchell and Marcy Sugar ural’’ does not mean the behavior is acceptable in public. All young children masturbate. Responsible parents teach them to do this only in private, and most children stop by the time they reach kinder- I’m not sure there is anything normal about a student spending the entire day masturbating on her plastic chair. Fortunately, none of the other students is mature enough to notice. I suspect the girl doesn’t realize how frequently she’s doing it. It almost seems obsessive-com- pulsive. It certainly wouldn’t be appropriate if a boy were doing the same thing all day long in class. I know toddlers do this, but grow out of it. Are the parents cov- ering something up? I imagine ter- rible things happening if she does it in a public place where a preda- tor might be lurking. Budget cuts have limited our psychological services. In first grade, the teacher used to take her chair away and make her stand, but garten. You and the parents should work together to make the girl more aware of her behavior and to help her control it. At school and at home, it should be explained to the girl that this is something to be done in her bedroom or bathroom. When you notice her rubbing her- self in school, simply call on her to get her attention focused else- where. Dear Annie: We recently were invited to a farewell party for the son of family friends who is enter- ing basic training. It’s an outdoor affair at their home, and the e-mail invitation says it is a ‘‘time to wish him well and enjoy food, fellow- ship, and fun.’’ Are we supposed to bring a gift? Since he can’t take anything with him, should we give him a check? Is there an appropriate price range? — Just Wondering Dear Just: You are not obligat- ed to bring a gift since your friend’s son is likely to be allowed only religious medallions and his wallet. You can ask his parents if there is anything he needs. You also could give him cash, phone cards or gift cards, although he may not be able to use them for a while. The amount is up to you. The most important gift is to be supportive and offer to write him often. Dear Annie: I think you left out an important point in your response to ‘‘Sam in Pittsburgh,’’ whose sister wanted to use the family home for her vacation, but didn’t want to pay anything. By selling the house to Sam, his sister gave up her claim. It is no longer ‘‘the family home.’’ It is Sam’s property. She traded her interest in the home for the estate settlement. Now she wants the money and the use of the home. I say Sam should explain this and then change the locks. — Same Situation in Salt Lake City, Utah Dear Utah: It’s true that Sis may require a better understanding of what constitutes ‘‘her’’ home. However, if Sam doesn’t mind that she uses the place, neither do we, although she should not saddle him with her electric and water bills. Annie’s Mailbox is written by Kathy Mitchell and Marcy Sugar, longtime editors of the Ann Landers column. Please e-mail your questions to anniesmailboxcomcast.net, or write to: Annie’s Mailbox, c/o Creators Syndicate, 5777 W. Century Blvd., Ste. 700, Los Angeles, CA 90045. Lassen attracts snow activities Winter has arrived at Lassen Volcanic National Park. The recent storms and colder temperatures have closed the road through the park to vehi- cle traffic for the winter season. The snow depth at the Lake Helen area is 27 inches and will increase with each storm. "Winter recreation is quickly coming to life in the park drawing cross country skiers, snow- shoers, and snow play activities," said Superin- tendent Darlene M. Koontz. The park road is open to the Manzanita Lake area on the north side and to the Kohm Yah-mah- nee Visitor Center one mile inside the park from the southwest boundary. Lassen Volcanic National Park is open throughout the winter. "The Kohm Yah-mah- nee Visitor Center is a great place for winter park users to watch the park film in high-defini- tion, view the interpretive exhibits, purchase a cup of hot chocolate and keep warm by the stonework fireplace," Koontz said. Preview the winter wonderland on the park and Caltrans webcams looking north from the Kohm Yah-mah-nee Visi- tor Center near the South- west Entrance and High- way 44 at the junction of Highway 89 near the Northwest Entrance and Manzanita Lake Area found at: http://www.nps.gov/lavo/ photosmultimedia/web- cams.htm. For more information regarding weather and road conditions visit the park website at www.nps.gov/lavo or call the visitor center at 595- 4480. 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