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Dr. Nickerson is an orthopedic surgeon who practiced in rural Wyoming for 20 years until diabetic neuropathy complications forced his early retirement. Soon thereafter the option of treating neuropathy complications of diabetes and Hansen’s disease as being in part a nerve compression was being suggested. He became interested in this approach to providing partial reversal of these neuropathy complications and risks and has been studying, writing scientific articles, and participating in neuropathy research for the past two decades. His situation of being a careful and competent clinician and an attentive observer of the progression of his own neuropathy gives him a special perspective.

Explaining this revolutionary surgical approach for neuropathy to patients, practitioners, surgeons and academics is his continuing commitment. Dr. Nickerson plans, promotes, and participates in academic conferences, patient care and research projects to define the place of nerve decompression surgery in preventing and treating neuropathy complications.

Dwayne S. Yamasaki, PhD is the President and Co-founder of Enso Medical Technologies, Inc. He is a graduate of the Rutgers Medical School (now Robert Wood Johnson Med. Sch.) and UMDNJ- Graduate School of Biomedical Sciences. He is a neurophysiologist who studied recovery mechanisms of injured cerebral cortex in the visual and oculomotor systems of awake, behaving, non-human primates. He conducted this research as a Postdoctoral Fellow, and later Scientific Staff Fellow at the National Eye Institute, NIH; and as Assistant Professor at the Univ. of Wisconsin Medical School, Madison. In his corporate career he was a Technical Fellow and lead stroke expert for Medtronic PLC for 17 years.

Summary

• Nerve decompression surgery for diabetic peripheral neuropathy. 0:00
  • Dr. Barrett welcomes listeners to the podcast and introduces the guests, Dr. Sonny Yamasaki and Dr. Scott Nickerson.
  • Dr. Yamasaki is the president and co-founder of ENSO Medical Technologies, and he discusses his research on reversing diabetic peripheral neuropathy symptoms.
  • Dr. Nickerson retired from orthopedic surgery due to diabetic peripheral neuropathy symptoms, then became dedicated to sharing his experience and promoting nerve decompression surgery.
  • Dr. Barrett and Dr. Nickerson and Dr. Yamasaki discuss pressure-induced vasodilation physiology and its relevance to nerve decompression surgery for diabetic foot ulceration prevention.
• Nerve decompression for diabetic neuropathy. 5:09
  • Neurophysiologist turned Medtronic employee investigates claims of nerve decompression improvement.
  •  Dr. Nickerson spent 20 years working to understand diabetic neuropathy mechanisms.
  • Dr. Nickerson developed diabetes and retired from orthopedic surgery, then discovered nerve decompression treatment.
• Nerve decompression surgery for diabetic foot ulcers, with insights on its effectiveness and the role of autonomic nerve damage 10:37
  • Dr. Barrett initially skeptical of Dr. Dellon's work but saw patients' positive results firsthand.
  • Study found that patients who didn't return for second surgery experienced pain relief in their legs.
  • Dr. Nickerson highlights the importance of nerve decompression in treating diabetic foot ulcers, citing a 30% incidence of complications in the opposite leg without surgery.
  • The autonomic nerve damage caused by diabetes can be relieved by nerve decompression, which is particularly relevant to diabetic foot ulcers.
• Diabetic foot ulcers and their prevention through nerve decompression. 16:12
  • Dr. Barrett emphasizes importance of addressing non-pain aspects of entrapment and diabetic peripheral neuropathy.
  • Dr. Nickerson emphasizes nerve decompression's effectiveness in treating diabetic foot ulcers.
  • Dr. Nickerson explains that diabetic peripheral neuropathy (DPN) is caused by hyperglycemia and vascular disease, leading to microvascular insufficiency and autonomic dysfunction.
  • Dr. Nickerson and Sonny believe that entrapment, rather than neuropathy, is a major contributor to autonomic changes in diabetes, through a metabolic process called the polyol pathway.
• Nerve decompression and diabetic neuropathy. 23:07
  • Dr. Dellon's ideas on nerve decompression for painful diabetic neuropathy were initially met with skepticism by neurologists and endocrinologists.
  • Accumulation of sorbitol and fructose in axons leads to hyperosmolarity and nerve swelling.
• Nerve compression and its impact on diabetic foot ulcers. 29:04
  • Nerve decompression releases compressed nerve, improving function.
  • Sorbitol and fructose are isolated in the inter membrane space due to lack of transporters.
  • Nerve decompression may be appropriate for diabetic foot ulcers, chemotherapy-induced neuropathy, and other situations.
• Chemotherapy-induced neuropathy and its impact on diabetic foot ulcers. 35:45
  • Expert reveals chemotherapy-induced neuropathy may cause nerve swelling, undetected by neurologists and endocrinologists.
  • Dr. Barrett observes unusual nerve involvement in chemotherapy-induced neuropathy.
  • Dr. Nickerson explains vascular shunting in diabetic neuropathy, compromising epidermis resilience.
• Diabetic foot complications and potential treatments. 42:57
  • Dr. Yamasaki explains how diabetes affects blood flow to the epidermis, leading to less oxygenated skin cells.
  • Dr. Nickerson explains pressure-induced vasodilation in diabetic feet.