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Diagnosed with diabetes at age 60, Richard Nord began managing the disease with medication. Still, diabetes damaged his nerves, causing his feet to go numb – a condition called neuropathy. Today, Nord has normal sensation in both feet, thanks to an advanced surgical technique that is performed by Michael R. Gallina, D.P.M., at Venice Regional Bayfront Health.
“I had no feeling in my feet (in 2006),” said the retiree, who lived in Nebraska at the time. Nord was evaluated by a surgeon who, like Dr. Gallina, trained at the Dellon Institutes for Peripheral Nerve Surgery at Johns Hopkins University. The Nebraska surgeon performed the “Dellon procedure” on Nord’s left leg in 2006, restoring normal sensation in the foot.
The procedure – named after its originator, A. Lee Dellon, M.D., Ph.D. – frees pinched nerves in the lower leg, ankle and foot to restore sensation and eliminate pain. The surgery requires three incisions – foot, ankle and lower leg – to gain access to tissue that is pressing on nerves and must be surgically removed. Patients are able to walk on the leg following the one-hour, out-patient operation.
After retiring to Lake Placid, Florida, with his right foot still numb, Nord and his wife, Annemarie, traveled to Venice to consult with Dr. Gallina at the suggestion of Nord’s Nebraska surgeon.
“Following a thorough evaluation, including examination by a neurologist, we determined that Richard was an ideal candidate for the Dellon procedure,” Dr. Gallina said. “He had already seen dramatic, positive results with the surgery in Nebraska, and as we expected, his outcome on the second leg has been equally positive.”
Board-certified in podiatric surgery, Dr. Gallina specializes in treating foot, ankle and lower leg conditions at Gulf Coast Medical Group. He also is a certified wound care specialist. Many of his patients have diabetes and suffer related complications to the lower extremities.
“Patients with diabetes are prone to complications affecting the foot, ankle and lower leg,” Dr. Gallina said. “With the older population in Venice, we see many patients with conditions that not only limit their mobility, but also can lead to amputation, greater strain on the heart, and worse.”
Diabetes causes problems with sugar metabolism. When the sugar, or glucose, level remains too high in the bloodstream for too long, nerves may be damaged causing numbness in the finger tips, toes and feet. These individuals may not feel pain when they injure their feet, such as from stepping on a nail.
“A common cause of hospitalization for people with diabetes is a foot wound, and usually because patients try to treat the condition themselves, or they aren’t even aware they have a wound,” Dr. Gallina said. “I had a patient who stepped on a nail while wearing sandals. He didn’t know the nail had gone through the sandal and into his foot until his wife saw a trail of blood across the floor.”
Elevated blood sugar can also make the skin less elastic, leading to blood-filled callouses on the feet. Even more serious, patients may develop peripheral arterial disease – hardening of the arteries – that decreases blood flow, usually below the knee. This condition can lead to amputation.
“I tell patients that between the two of us, our job is to keep your feet out of trouble,” said Gallina, who carefully evaluates and consults with each patient to determine the best course of treatment. When needed, Gallina works with vascular and infectious disease specialists to treat patients through a team approach to save a limb.
To learn more about complications from diabetes and potential treatments, call 941-484-2602.
Remember that this information is not intended to replace the advice of your doctor, but rather to increase awareness and help equip patients with information and facilitate conversations with your physician that will benefit your health.
Venice Regional Bayfront Health
