October 2, 1998 (Ira Pilgrim)

The Numb Toes Mystery

A smart mother makes often a better diagnosis than a poor doctor.

August Bier (1861-1949)

There is an old story about a man of about 50 years of age who started to have headaches and saw spots before his eyes. He went to his doctor and, after many tests, was informed that he had an incurable disease and that it was unlikely that he would live for much more than a year. When he got over the shock, he decided that he was going to use his remaining days spending his money and doing things that he had always wanted to do. In other words, he intended to live it up. His first act was to go to a very expensive custom tailor. He told the salesman that he wanted to be outfitted from head to toe in the best that money can buy. After he had selected fabrics and patterns, the tailor was called in. The tailor, a short gray-haired man with a heavy accent, was accompanied by a young man with a note pad and pencil. The tailor took out his tape measure and proceeded to take measurements. He would call out the measurements and his assistant would echo them:

"Head, seven and a quarter."

"Neck, sixteen and a half."

At that, the customer said, "I've always worn a fifteen collar."

The tailor sarcastically repeated, "Neck, sixteen and a half."

"But I tell you that I always wear a fifteen collar," the customer protested.

"Look, mister," said the tailor, "don't tell me my business. If you keep wearing a fifteen collar, you'll get headaches and you'll see spots in front of your eyes.

That story is a prelude to what I choose to call "The Numb Toes Mystery." Several years ago I noticed that the middle three toes of both of my feet were numb. This was especially noticeable at night, when they were sometimes painful enough to interfere with my sleep. I told my physician about it and he gave me a very thorough going over. He could find nothing. My blood pressure was okay and the pulses in my feet were what they were supposed to be.

I started reading about the subject and the only condition that I could find with those symptoms was the disease beriberi, which is due to a vitamin B1(thiamine) deficiency. In this country, about the only people who have this condition are alcoholics. My alcohol consumption consists of a single glass of beer or wine before dinner. However, there are medical conditions that aren't in the books. So I decided to try a high dose of vitamin B complex. Three months later, guess what? No change at all.

I plugged "beriberi" into the search engine for the National Library of Medicine. There was a paper on what the author called "substrate deficiency beriberi," This was about beriberi caused by a deficiency in alpha 2 essential fatty acids. So I got a bottle of flaxseed oil(linseed oil) and took it daily . Three months later, still no change.

After exploring several more blind alleys, I asked The National Library of Medicine about "paresthesia(numbness) of the toes." I came up with one article out of the medical department of the Israeli army, where they found a substantial percentage of recruits had numb toes. Could it possibly be related to shoes? Could the Israeli army be less efficient than the US Army was in World War II? In WWII, after a recruit was fitted with shoes, they had him hold two buckets of sand while someone felt his feet to make sure that the shoes fitted properly.

I decided to get some new shoes. If that didn't help, my next visit would be to a neurologist. I spent quite a bit of time at the shoe store in order to get a perfect fit. One of the first things that I noticed was that, to get a comfortable fit, I had to go to a size 10 1/2 wide shoe, whereas before I used to wear a 9 medium width shoe. Could my feet have changed that much? The shoe salesman assured me that it was not my feet. It was that shoe sizes have changed. They are now being cut about a size smaller and people now needed shoes a whole size or a size and a half larger that they used to need. I bought a comfortable pair of street shoes and a similarly comfortable pair of hiking boots. They helped somewhat, but it took a pair of $200 very wide toed Birkenstocks to really do the job.

So, in view of the fact that my numb toes have been repaired, I've decided to go on living rather than living it up.

P.S. Actually, the numb toes have not gone away, so the mystery remains. I'll keep you posted, dear reader, of any new developments.

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