Peripheral Neuropathy & Necrosis

Yes I know this is not the most appealing of titles so kudos to you for even moving beyond the title!  These are medical conditions I run across quite frequently in the patient population of which I am involved in the care.  Peripheral neuropathy is the loss of nerve endings or gradual nerve damage that begins in the toes and fingers, most often affecting the toes and legs first.  It is especially prevalent in those who have a history of diabetes and especially uncontrolled diabetes meaning that they were non-compliant with treatment options.  Necrosis is a much more serious condition in which there no longer is blood flow to the body parts and they eventually die.  Necrotic toes are one of the more disturbing things I’ve stumbled across in my career to date.

The other week I had a patient who was very non-compliant with his diabetes regimen and had uncontrolled blood sugar.  He came to the ER with a blood sugar in the 500 to 600 range.  An ideal blood sugar is 70 to 100, but can get as high as 180 before we start administering insulin.  His daughter persuaded him to come in because she came to spend the holidays with him and noticed a toe was missing and that others were turning black.  The story was he noticed his toe beginning to fall off because it had become completely necrotic so he cut it off the rest of the way.  The surrounding tissue was infected and he had  a major diabetic ulcer on the top of his foot and two other toes were completely black with the tissue continuing to die off continuing up the foot.  The smell of rotting flesh was overpowering and one had to be very careful when changing the dressing of the infected area that in unwrapping the gauze, you wouldn’t inadvertently cause the dying toes to fall off.  Because of his peripheral neuropathy and dying tissue, he mercifully had no pain with any of it.  But still you would think that there would be a psychological aspect to the act of cutting off one’s body part even if there was no pain involved.

This patient’s condition stuck with me and kept niggling in my brain how there is a lesson in all of that for me.  I’m still not sure if I can piece it all together.  The questions that kept coming back to me is the question of how non-compliant am I with the condition of my heart?  Do I have peripheral neuropathy going on in my spiritual life?  Worse still, is there parts of my soul that are completely necrotic?  Am I guilty of cutting off sections of me that I fear are turning black?  Where am I losing feeling and not even caring enough to go for intervention of my own volition?  Do I recognize the blackness creeping in and name it for what it is?  Is the smell of rotting flesh in the air around me?  Do others attempt to help me redress the wounds that I have but fear the falling off of parts of me that are dead?

Spiritual neuropathy to me looks like a numbness to God’s Word.  A loss of nerves sensitive to God’s voice and leading in my life.  A heart that is damaged by my non-compliance to daily maintenance of my sin-sick condition with which I was born.  To actively look for necrotic areas in my heart is a fearful proposition for me.  To do vasculature repair and return blood flow to the areas allowed to become necrotic is a painful solution.  But without oxygenated blood, those areas of my heart will only turn blacker and die a little more each moment.  To allow Jesus to breathe life into those areas that I’ve tried my hardest to cut off from me so they no longer hurt, it seems too big of a risk.  Necrosis of dreams squashed because I was scared of failure, love held back because I feared rejection, joy tamped down because I was afraid of sorrow.  Neuropathy creeping in because the harsh realities of life numbed my sensitive heart, the heart that I shrank from taking care of because sensitivity equaled weakness in my dictionary.

Which will I choose: neuropathy numbing me into necrosis or life lived with abandon breathing love and delight into every part of me?


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