Monday, January 13, 2014
Preventative Surgery: Is There Such a Thing??
Is there such a thing as preventative surgery? We usually think of surgery as something that we need to fix a problem that is currently present. That makes perfect sense! Why would we ever need to have surgery when there is no current need for it? To the average healthy person, preventative surgery seems like too much of a risk. Why fix something that doesn't hurt? Every surgeon would agree that in most cases this is correct assumption. Lets think outside the box for a minute. I will give an example to make it easier: I have been seeing a diabetic patient for several months who has a callus on the tip of his toe. His toes bend and don't straighten well. They are stuck in that position (we call those hammertoes). This is why he gets the callus. No biggie right? Shave the callus and all is well right? Say this patient has very little feeling in their foot(they have diabetic neuropathy) and cannot tell if the callus is getting irritated and they do maybe a little more than usual that day. By days end, they may end up with swelling and redness to that toe! Now that is a problem! Shave the callus this time to find a wound under it! If all is working in the patient's favor, we treat the wound and, over time it gets better. Eventually though, a callus forms over the healed skin because nothing in the patient's lifestyle has changed. Over and over this is the cycle. Callus, wound, heals. Callus, wound, heals. That is the best it gets. It heals at least. Here is the sacrifice. Every time the wound heals, scar tissue is left. Scar tissue is not as flexible or forgiving as regular skin. It forms callus more quickly because it is less resistant to friction. Some times it doesn't matter that they are in the best shoes and inserts,(and seeing the best podiatrist here at FAANT!),the skin is just too vulnerable. The worst case is that eventually, and this happens more times than you can imagine, the wound gets infected and the infection gets into the bone! That could lead to an amputation!! Who wants to risk that? Surgery in this case is a feasible option! Even if there is no wound, surgery is a viable consideration. What if we could do a surgery to straighten the toe (while they have no active wound), so that there is less pressure at the tip? We may be able to halt that vicious cycle and make visits to our office much more pleasant! Much needs to be considered health wise to make the best choice for this patient as there are risks with any surgery, especially in a patient with health problems. Is there more risk having this surgery or to continue cycling with a wound that keeps popping up, increasing the risk of infection every time it does? Next time you visit, keep an open mind about this possibility. If preventative surgery is an option for you, we will do all we can to make sure it is done under the best of circumstances!
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My dad is diabetic and I am not sure if he is aware that he could experience problems with his feet. I don't think he has had any trouble so far. Is there any way we could know if he will in the future? Is there any way to prevent him having problems with his feet? http://www.mesafootandankle.com/diabetic-foot-care.html
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ReplyDeleteI had no idea that callus's can cause so many problems, when they are constantly rubbed on when a person has no feeling or poor circulation. This makes me more cautious about foot care as a disabled person.
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My grandpa and all his sons have the hammer toe thing. He said that it gets really annoying because the natural position of all of his toes is the hammertoe. He has been talking about getting a surgery to fix the problem for relief.
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Very interesting, I always thought callus was a good thing. especially for those with diabetes. Thorougher skin leads to less wounds. I was way wrong. I didn't even know that the wound could be under the callus and the article said.
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I have a family friend who has severe diabetes. He has been told that eventually he will have to have his feet amputated if he doesn't take care of himself. I didn't know that diabetes had such serious foot problems until my friend has had such severe problems. http://www.michaelscanlondpm.com/diabetic-foot-care/2150575
ReplyDeleteInteresting article. Even more insightful or interesting is the fact that individuals with diabetic neuropathy can potentially do a surgical decompression procedure to relieve their symptoms. I have heard of some people having a good result with this from a group in Houston. You can find more information at http://www.fixfoot.com
ReplyDeleteI think there is also some data on decompression of nerves in the published literature. To add to the previous comment, can go to FixFoot for more information.
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Of course there is such this as preventive surgery ! Have you ever heard of microcirculation? Basically what it does is they put back CO2 to your body (not at harmful level) , and from there our body will do its magic...well im not a doctor ..but I know that this small device can do the magic.
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This is very nice blog, very nicely explained. Once i was also searching for Podiatrist in Bangalore that time one of my Neighbors suggested me The Family Doctor center. It is very nice one i visited here and got best results if you want any more info. you can go through the link http://www.thefamilydoctor.co.in/
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