Think about the walk from your bed to the bathroom. It is short, you have done it thousands of times, and it is probably the single highest risk journey in your week. Here is why, and what to do about it, because this is one of the more preventable problems we see.
There is a condition that affects a substantial number of people, has significant health consequences, is treatable, and routinely goes undetected for a long time. Obstructive sleep apnoea. It goes undiagnosed largely because its most obvious sign happens while you are asleep, which means you are the one person who cannot observe it.
Most people describe their night pain in general terms. I don’t sleep well because of my pain. That sentence contains almost no useful information. But the specifics of which joint wakes you, when, and in which position, are genuinely diagnostic, and they frequently point somewhere quite precise.
Here is a guide to reading your own nights.
Almost everyone with persistent pain assumes the relationship runs one way. The pain is the problem. The bad sleep is a consequence. Fix the pain and the sleep sorts itself out. The research suggests the arrow points in both directions, and possibly more strongly in the direction nobody expects.
“Stay active” is the advice almost everybody with neuropathy receives, and it is almost never followed by anything specific. Active how? For how long? What if your feet are numb and your balance is poor and you are worried about falling?
Most people with new sciatica have two questions, and neither gets answered well. How long is this going to last? And am I doing the right things? The information available tends to be either alarming or vague. So here is a practical week by week guide to what a typical recovery looks like, what to do at each stage, and crucially what should make you stop and seek help.
If you have sciatica in Bermuda, there is a good chance a significant part of your day is spent in exactly the position that provokes it. On a scooter. In a car seat. Sitting at a desk between the two.
Sitting is frequently the single most provocative activity for sciatica, and most people never connect it, because the pain arrives later rather than during. Here is why, and what to do about a commute you cannot simply stop doing.
Most advice about looking after neuropathic feet is written for somewhere else. It assumes shoes year round, carpets, a temperate climate, and a lifestyle that does not involve regular contact with sand, salt water and boat decks. Bermuda is a different proposition, and the standard guidance needs translating.
Here is the version that fits where you actually live.
Two very different conditions produce leg symptoms that people describe in almost identical words. Pain. Cramping. Heaviness. Burning. Difficulty walking as far as you used to. One involves your nerves. The other involves your arteries. They need different investigation, different treatment, and in one case the implications extend well beyond your legs. Telling them apart is not something to do from an article. But knowing which questions matter means you can describe your symptoms in a way that gets you to the right answer faster.
Bermuda has a problem that most people living here have never seen quantified. In a study comparing 30 affluent countries with high rates of diabetes, Bermuda was found to have the highest lower limb amputation rate among women, at 46 per 100,000, and the second highest among men, at 43 per 100,000. The average across those countries was 15 per 100,000.
