### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello, My dad is 89yrs old and had a heart bypass 17yrs ago. Since then he has become a diabetic the type that effects the nerve endings. This can cause him alot of pain but for the last while his left arm has gone very numb and he is finding it very difficult holding anything without letting it fall. A couple of weeks ago he complained of a pain under his left armpit, that has gone now but he is still getting a very strange feeling there and all the muscel and skin have gone very flabby. The hospital are doing an MRI scan on him next week, they were going to do an angiogram but thought better of it because of his age, We were wondering could he have had a mild stroke without us knowing or is it the diabetes.

### output:

Hi dear, have noted all your detailsPeripheral neuropathy is a long term complication of diabetes mellitus to long term uncontrolled blood sugar levels the nerves in the body are desalinated(withered and damaged), hence causing abnormal sensations like tingling, numbness or as if insect is crawling like feeling is therefrom your history It's highly unlikely that it is stroke, though a MRI of brain should be done to rule out its possibility peripheral neuropathy can be treated by methylcobalamine, 1500mcg of methylcobalamine should be given daily for 3 months to see the effects his age is 89, and he is a diabetic it can be anything from coronary blockage to peripheral euro to a mild stroke, hence MRI, angiogram should be done, and methyl calamine should be started thank you