The U.S. Centers for Disease Control and Prevention reports that by the year 2025, approximately 300 million people worldwide will have diabetes. About 60 percent to 70 percent of people with diabetes have mild to severe forms of nervous system damage, which includes impaired sensation or pain in the feet and/or hands, slowed digestion, carpal tunnel syndrome and other nerve problems. Severe forms of diabetic nerve disease contribute to lower extremity amputations. More than half of lower limb amputations in the United States occur among people with diabetes.
A new procedure at The University of Texas Health Science Center at San Antonio (UTHSC) is helping local diabetic patients regain lost feeling in their lower limbs. Suhad Hadi, DPM, director of resident education in the department of orthopaedics at the UTHSC, oversees testing being done with the new Peripheral Specified Sensory Device (PSSD), which was brought to the Health Science Center in November 2000 from Baltimore. A. Lee Dellon, M.D., professor of plastic surgery and neurosurgery at the Johns Hopkins University School of Medicine, invented the device. Dr. Hadi and Dr. Dellon will discuss the PSSD, surgical neurolysis and its benefits in diabetic patients during "The Diabetic Foot Update 2001: A Multidisciplinary Approach," to be held Dec. 6-9 at the Westin Riverwalk Hotel, 420 W. Market St.
Drs. Hadi and Dellon are among more than 35 diabetes experts from throughout the nation who will speak at the symposium.
"We use the PSSD to assess patients with painful diabetic neuropathy and early neuropathy (neuropathy is any disorder affecting the nervous system)," Dr. Hadi said. "Candidates are selected for surgical neurolysis, or the release of specific peripheral nerves, in an attempt to decrease or eliminate their neuropathic symptoms."
Dr. Hadi said the PSSD is capable of detecting nerve damage earlier than a nerve conduction study, which can be a more painful method of testing patients.
"Unlike the nerve conduction study, the PSSD can detect degenerating nerve tissue before it is completely dead," Dr. Hadi said. "As a result, we can identify and repair the tissue before it's too late."
Janie Arguello, 30, considers herself lucky to have been chosen for the procedure. She has lived with diabetes for 12 years. Last year, the pain in her feet, caused by entrapment of the nerves around the ankle, became so unbearable that Arguello took codeine daily for a few weeks to ease her discomfort. She was unable hold down a steady job because of the pain and swelling.
In the spring, Dr. Hadi used the PSSD to assess Arguello's condition. Arguello underwent surgery in June. "Prior to the surgery, I couldn't feel my feet, but within one month of the surgery, I could wiggle my toes," Arguello said. After five months, the sensation in her feet was almost back to normal. "Now I know where my feet are when I'm walking because I can feel them," she said. Dr. Hadi said the sensation in Arguello's feet has increased by 95 percent. Today she works as a full-time medical claims specialist at USAA. She says she has no problem getting around at work.
Between 10 and 12 diabetic patients have benefited from the PSSD and surgical neurolysis at the UTHSC. "We look forward to using the device more, especially since our patient referrals have grown significantly," Dr. Hadi said.
The registration fee for The Diabetic Foot Update 2001: A Multidisciplinary Approach is $550 for doctors of podiatric medicine, doctors of medicine and doctors of osteopathic medicine. The fee for military physicians, physical therapists and international guests is $400. Cost for Nurses, pedorthists and other health professionals is $375. Residents and students, with a letter of verification from their training directors, will be admitted for $35.
Lawrence Harkless, DPM, professor in the department of orthopaedics, director of the podiatry residency training program and the Louis T. Bogy Professor of Podiatric Medicine and surgery, and Richard C. Adam, DPM, clinical professor of orthopaedics, both of the UTHSC, are the symposium directors.
The department of orthopaedics podiatry division; the American Diabetes Association, South Central Region; the Texas Diabetes Institute; and the Texas Diabetes Council of the Texas Department of Health are sponsors of the event. Dr. Harkless chairs the Diabetes Council.
For more information or to register, call the UTHSC's office of continuing medical education at (210) 567-4446.