I think it is a wonderful thing when I see a diabetic for their first foot check. Most diabetics are oblivious to the fact that every diabetic should be seen once a year for a check up by a podiatrist. It is surprising that so many diabetics have been diabetic for years and never been to a podiatrist. So many times they tell me they have burning pain and tingling in their feet. But many times they don't and wonder why they need to see me "if nothing is wrong with my feet". Inevitably they come in wearing a regular shoe and tell me that they have a relative who has had an amputation of part of their foot or even their limb.
So why see a podiatrist if you are diabetic and have no symptoms that you can perceive?
The answer is simple. Prevention, Prevention, Prevention! You take insulin or medication or if you are lucky, maybe just control your diabetes through diet alone. Why do you bother? You bother because you have learned that if you don’t, you will slowly deteriorate your organs, your body and this will, over time, kill you! Just as you control your sugars with the help of your primary care physician to maintain your body health, you need to see your podiatrist to maintain your foot health. Diabetes is a team effort. Believe it or not, allowing your feet to deteriorate can kill you too! I have seen diabetics who have neglected and infected wounds on their feet; the infection gets into their blood stream and kills them.
These people were once like you. They all started out with no problems with their feet. Having diabetes can lead to numbess (neuropathy) in your feet through the slow deterioration of the nerves that give sensation to your feet. And diabetes is sneaky. The destruction comes on so slowly that most people with this disease don’t even realize they have it. And by the time they do, it is often too late. You need to see a podiatrist BEFORE you develop the numbness, burning or tingling. Do not take the risk of waiting for these symptoms to come on before coming in. Even a small scrape or a blister can be difficult to heal in a diabetic. These small and seemingly harmless injuries are the ones that can just as easily end up in amputations as do so many of the major ulcerations. Calluses may have wounds you may not feel festering underneath. An inappropriate shoe triples the risk of amputation. Allow us to get that importance baseline evaluation and educate you on the imperative information you need to know to keep your feet and limbs for the rest of your life. Amputation rates are ever increasingly closer to 100,000 per year in diabetics. Statistics show that the loss of your limb means the loss of your life in as little as 5 years.
Make your appointment today!
Monday, March 30, 2009
Wednesday, March 25, 2009
Dryness and Cracks in your Feet?
It has been winter for a while and our feet have been safe and snug in our socks and shoes where nobody could see them. The seasons are changing and as we get ready to display our feet for the first time this season...
We wonder why are my feet so dry?? And are those cracks on my heels?
Cracks also known as fissures can lead to infections which can lead to amputations. This is how it works. A diabetic patient is more prone to have dryness in their feet. It is one of the early signs of the disease. When you have a cracks in your feet due to excessive dryness, bacteria are able to get into your body and cause a skin infection. At this time your chance of amputation has just increased.
How do we treat/prevent this from happening?
1) Most importantly you want to check your feet on a daily basis. Always look in between your toes and feel the bottom of your feet. If you cant see your feet, have someone else look at them for you.
2) Moisturize. Not all moisturizing creams and lotions are the same. The best ones to look for are creams that have a percentage of urea in them as well as Vitamin E.
3)Use the cream daily, all over the feet and heels, do not put in between the toes. Wear socks after you put the cream on to help the cream absorb into the skin.
4) Most importantly if you notice any open lesions, any drainage from the fissures or an increase in redness to the area you need to see your podiatrist. For more info on Diabetic Feet click here.
We wonder why are my feet so dry?? And are those cracks on my heels?
Cracks also known as fissures can lead to infections which can lead to amputations. This is how it works. A diabetic patient is more prone to have dryness in their feet. It is one of the early signs of the disease. When you have a cracks in your feet due to excessive dryness, bacteria are able to get into your body and cause a skin infection. At this time your chance of amputation has just increased.
How do we treat/prevent this from happening?
1) Most importantly you want to check your feet on a daily basis. Always look in between your toes and feel the bottom of your feet. If you cant see your feet, have someone else look at them for you.
2) Moisturize. Not all moisturizing creams and lotions are the same. The best ones to look for are creams that have a percentage of urea in them as well as Vitamin E.
3)Use the cream daily, all over the feet and heels, do not put in between the toes. Wear socks after you put the cream on to help the cream absorb into the skin.
4) Most importantly if you notice any open lesions, any drainage from the fissures or an increase in redness to the area you need to see your podiatrist. For more info on Diabetic Feet click here.
Tuesday, March 24, 2009
Diabetic Foot Infections Can Kill You!
Diabetic amputations can be avoided. View this short video public service announcement from Dr Crane at Foot & Ankle asssociates of North Texas in Grapevine, TX.
Podiatrists Save Diabetic Feet...It's Just What We Do
I had an experience yesterday that almost moved me to tears. In December I wrote about a gentleman who was incredibly close to losing his leg, if not his life (Here's the original post). Within a short time frame of days, he went from having a "minor" ulcer treated to a major infection of the foot which ended up with him losing two toes, but has retained the functional foot. Before the first operation, I had a conversation with the infectious disease physician caring for him who was insistent that my surgery was futile and he needed an amputation above his knee to save him. The patient and I discussed this and agreed that we wanted to try anyway.
During the first operation, I experienced an infected foot like I'd never seen before, even in my training. It was very apparent that the surgery didn't get rid of the infection like it should have. A few days later, another surgery with a toe amputated. The following week a third surgery with a second toe amputated. Then the miracle...
His fever dropped to normal, all the color came back into his face, his appetite returned. He looked healthy. He made a commitment to his wife, me, and most importantly, himself, to take this horrible time in the hospital and take charge of his diabetes. He did everything right to lower his blood sugar to normal levels. We sent him for Hyberbaric oxygen treatments which helped the residual minor infection to resolve and started to promote healing. As he was discharged, we put a negative pressure "VAC" dressing on his foot to further promote healing.
Our initial hope was to get the wound to the point that we could use a skin graft to close it. Yesterday, that changed. He is doing everything right, including being vigilant about controlling his diabetes. The bottom of his foot is close to healing on its own...without a skin graft! This is ideal, since that would make the skin much thicker and would minimize the risk of breaking open again. Thinking where we were just a few short months ago, I'm staggered to think that soon he'll be back to wearing shoes and even back to work with two functioning feet.
Good thing we decided not to take the easy way out by amputating the leg, don't you think?
During the first operation, I experienced an infected foot like I'd never seen before, even in my training. It was very apparent that the surgery didn't get rid of the infection like it should have. A few days later, another surgery with a toe amputated. The following week a third surgery with a second toe amputated. Then the miracle...
His fever dropped to normal, all the color came back into his face, his appetite returned. He looked healthy. He made a commitment to his wife, me, and most importantly, himself, to take this horrible time in the hospital and take charge of his diabetes. He did everything right to lower his blood sugar to normal levels. We sent him for Hyberbaric oxygen treatments which helped the residual minor infection to resolve and started to promote healing. As he was discharged, we put a negative pressure "VAC" dressing on his foot to further promote healing.
Our initial hope was to get the wound to the point that we could use a skin graft to close it. Yesterday, that changed. He is doing everything right, including being vigilant about controlling his diabetes. The bottom of his foot is close to healing on its own...without a skin graft! This is ideal, since that would make the skin much thicker and would minimize the risk of breaking open again. Thinking where we were just a few short months ago, I'm staggered to think that soon he'll be back to wearing shoes and even back to work with two functioning feet.
Good thing we decided not to take the easy way out by amputating the leg, don't you think?
Diabetic Foot Care Tips
The most common reason diabetics are hospitalized in the United States is foot infections. I know that’s hard to believe, but true. Diabetes can be dangerous and devastating to your feet.
The most common causes of these foot infections are improperly cut toenails and poorly fitting shoes. Yes, something as simple as a visit to the podiatrist to have your toenails cut and shoes custom fitted can avoid many amputations. Add poor circulation and lack of feeling known as peripheral neuropathy, and you have the prescription for disaster for diabetic feet.
What is a diabetic to do to protect their feet from a sore that can lead to infection and amputation?
1. Inspect your feet daily. If you can’t see your feet, have someone else look at them every day for redness, cuts, swelling, blisters, bruising, or nail problems.
2. Wash your feet daily. Sounds simple, but many people do not bathe their feet daily. Make sure to clean in between your toes and dry them thoroughly.
3. Moisturize your feet daily. Again, a simple habit to get in to, yet most people fail to upkeep their skin every day. Diabetes can cause very dry, flaky skin, so extra moisture is needed.
4. Cut nails carefully, and straight across. If you can see and reach your toes, be careful to cut your toenails carefully, taking time not to nick yourself or cu them too short. When in doubt, visit Healthy Steps Pedicure salon for a therapeutic medically supervised pedicure or see the podiatrist at least every 10 weeks.
5. Never trim corns and calluses. And absolutely no corn or callus remover! The package says, “don’t use if you are diabetic” for a reason. Have the podiatrist trim them when they are thickened or red.
6. Wear clean, dry socks. And change them daily…..
7. Avoid tight or bulky socks. Tight socks can reduce circulation to you feet and bulky socks can bunch up and cause a blister or sore.
8. Wear socks to bed. If your feet are cold, wear clean socks to be. Never use a heating pad or hot water bottle, you can burn yourself before you realize it!
9. Shake out your shoes and inspect them before you put them on. I have taken everything from a pebble, piece of basket and a doll house chair out of the bottom of diabetic feet after they walked on them all day. Easy thing to avoid!
10. Keep your feet clean and dry. No puddle splashing or snow drifts for your feet!
11. Never, never, never go barefoot. Not even at home on carpet. You can step on something easily and get an infected puncture wound.
12. Take care of your diabetes! Multiple studies have shown the complications of diabetes can be diminished by keeping your sugars under control. Keep that HgA1c under 6 if you can. Work with your doctor and nutritionist for optimal care.
13. Don’t Smoke! Stop smoking if you do. Ever cigarette decreases the circulation to your feet and increases your chance of a non-healing wound.
14. Get periodic foot exams. The recommendations are to have a foot exam at least once a year by your doctor and more frequently if you have neuropathy, a foot deformity, poor circulation, or have had a history of a foot ulcer.
Diabetes can be life’s annoyance or it can kill you. It is your choice! Take care of your feet so they will carry you for a lifetime.
For a free copy of Got Diabetes? Help Us Save Your Soles, click here!
The most common causes of these foot infections are improperly cut toenails and poorly fitting shoes. Yes, something as simple as a visit to the podiatrist to have your toenails cut and shoes custom fitted can avoid many amputations. Add poor circulation and lack of feeling known as peripheral neuropathy, and you have the prescription for disaster for diabetic feet.
What is a diabetic to do to protect their feet from a sore that can lead to infection and amputation?
1. Inspect your feet daily. If you can’t see your feet, have someone else look at them every day for redness, cuts, swelling, blisters, bruising, or nail problems.
2. Wash your feet daily. Sounds simple, but many people do not bathe their feet daily. Make sure to clean in between your toes and dry them thoroughly.
3. Moisturize your feet daily. Again, a simple habit to get in to, yet most people fail to upkeep their skin every day. Diabetes can cause very dry, flaky skin, so extra moisture is needed.
4. Cut nails carefully, and straight across. If you can see and reach your toes, be careful to cut your toenails carefully, taking time not to nick yourself or cu them too short. When in doubt, visit Healthy Steps Pedicure salon for a therapeutic medically supervised pedicure or see the podiatrist at least every 10 weeks.
5. Never trim corns and calluses. And absolutely no corn or callus remover! The package says, “don’t use if you are diabetic” for a reason. Have the podiatrist trim them when they are thickened or red.
6. Wear clean, dry socks. And change them daily…..
7. Avoid tight or bulky socks. Tight socks can reduce circulation to you feet and bulky socks can bunch up and cause a blister or sore.
8. Wear socks to bed. If your feet are cold, wear clean socks to be. Never use a heating pad or hot water bottle, you can burn yourself before you realize it!
9. Shake out your shoes and inspect them before you put them on. I have taken everything from a pebble, piece of basket and a doll house chair out of the bottom of diabetic feet after they walked on them all day. Easy thing to avoid!
10. Keep your feet clean and dry. No puddle splashing or snow drifts for your feet!
11. Never, never, never go barefoot. Not even at home on carpet. You can step on something easily and get an infected puncture wound.
12. Take care of your diabetes! Multiple studies have shown the complications of diabetes can be diminished by keeping your sugars under control. Keep that HgA1c under 6 if you can. Work with your doctor and nutritionist for optimal care.
13. Don’t Smoke! Stop smoking if you do. Ever cigarette decreases the circulation to your feet and increases your chance of a non-healing wound.
14. Get periodic foot exams. The recommendations are to have a foot exam at least once a year by your doctor and more frequently if you have neuropathy, a foot deformity, poor circulation, or have had a history of a foot ulcer.
Diabetes can be life’s annoyance or it can kill you. It is your choice! Take care of your feet so they will carry you for a lifetime.
For a free copy of Got Diabetes? Help Us Save Your Soles, click here!
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