Take Care With Basic Care

Feet should be frequently inspected for changes, but diabetics need to be diligent in their foot care.

Feet are not that large and don’t change that much, so what do you look for when inspecting feet?

• puncture wounds
• bruises
• pressure areas
• redness
• warmth
• blisters 
• ulcers
• scratches and cuts 
• nail problems

Some areas of the feet may be difficult to inspect by yourself. Ask a family member for help or use a mirror to inspect feet daily.

Here's some basic advice for taking care of your feet:

• “Always keep your feet warm.
• Don't get your feet wet in snow or rain.
• Don't put your feet on radiators or in front of the fireplace.
• Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
• Don't soak your feet.
• Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
• Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
• Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
• Wash your feet every day with mild soap and warm water.
• Wear loose socks to bed.
• Wear warm socks and shoes in winter.
• When drying your feet, pat each foot with a towel and be careful between your toes.
• Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair every day. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.
• Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.”

Citation:
Vittori Foot & Ankle Specialist. (2012). Diabetes and your feet. Retrieved from http://www.vittorifootclinic.com/library/1800/DiabetesandYourFeet.html

Image by Matthew T. Rader. (2008). My feet. Retrieved from http://www.flickr.com/photos/infinite-magic/497036269/

Diabetics Need a Team of Physicians

Diabetes affects almost every family these days. The statistics are profound. Take a look at this staggering infographic that the American Podiatric Medical Association has compiled.

Those recently diagnosed with Diabetes should realize they are not alone. A team of doctors will help keep the disease under control and help guide the individual through medical treatments.  Get to know what each doctor or specialist does to keep diabetes in check.

Primary Care Physician – This is one’s family physician, general physician, or internist. They play the role of coordinator by referring to other specialists. When one is seen by a specialist, progress reports are sent to one’s primary care physician. Primary care physicians and specialists work together and keep each other update on the progress of the patient.

Podiatrists – If you’re reading this blog, you know that we treat lower extremity issues of the foot and ankle. It’s imperative to see a podiatrist at least twice a year to reduce amputation rates by 45 – 85%. Diabetes reduces blood flow to the feet and hinders circulation which is why amputation of the lower extremities happens. Many foot complications occur from diabetes; loss of feeling, burning, tingling, nerve problems, circulation problems, and amputation.

Endocrinologist – These physicians deal with hormones and the changes that occur due to the disease. Diabetes affects the endocrine system and endocrinologists focus on how the body is producing insulin.

Dentist – You might be wondering why seeing a dentist is important, but dentists play a key role in diabetes management. Those with diabetes are more susceptible to gum disease and mouth infections resulting from excess blood sugar.

Ophthalmologist/Optometrist – Diabetes affects the eyes, resulting in diabetic eye disease due to restricted blood flow. Just like managing circulation to the feet to prevent amputation, this disease can be prevented if regular check-ups are done.

Vascular Surgeon – They manage vascular diseases, which increase the longer one has diabetes. It’s important to manage blood pressure, stop smoking, eat right, and exercise to minimize vascular diseases.

Pharmacist – Get to know one’s pharmacist. They check to make sure that all prescriptions prescribed by all doctors won’t counter each other or cause unnecessary problems. They also inform diabetes patients about the risks of each prescription. Even if one is taking over the counter medication, consult the pharmacist first to ensure it won’t react badly with other medications.


Citation:
American Podiatric Medical Association. (2012). Footprints. Retrieved from http://www.apma.org/files/FileDownloads/APMA%20Diabetes%20Special%20Edition%20Footprints_2012.PRINT.pdf
American Podiatric Medical Association. (2012). Diabetes by the numbers. Retrieved from  http://www.apma.org/files/images/kyso12_infographic_800.jpg

Broken Bones: Stabilizing & Medical Treatment

The first thing one should do if they believe they may have broken a bone in their foot or ankle is to stabilize the injury and then elevate it. The second step is to contact your Podiatrist, Dr. Vittori, for X-rays and proper medical treatment of the injury.

Stabilizing the injury:

• Find a splint that will keep the injury from moving around. The splint can be as simple as a pillow wrapped around the foot which can be tied with a bandage.
• Do not wrap the foot too tightly. The injury needs to have blood supply circulating. The signs to be aware of if the injury is wrapped too tightly are if the injury hurts worse, turns blue, or if one is unable to wiggle their toes.
• Elevate the injury by lifting the foot at a level which is higher than the rest of the body. This will reduce swelling and pain.
• Ice can also be used to minimize the swelling and pain. Apply ice that is wrapped in a towel and do not put the ice directly on open skin.
• After the injury is stabilized, contact your Podiatrist, Dr. Vittori, since treatment of broken bones varies depending upon what part of the foot or ankle is broken.

Common treatments of broken bones in the foot or ankle:

• Some broken bones in the foot and ankle require the individual to remain off of the injury by using crutches or flat-bottom shoes.
• Other broken bones require the use of splints and casts.
• The most extreme treatment involves surgery to repair the foot.

Citation:
Image by Matthew Cashmore. (2007). Broken toe. Retrieved from http://www.flickr.com/photos/mattcashmore/515785363/

An Athlete's Worst Fear

A tear in the Achilles tendon is an injury that every athlete fears, as it’s the tendon that is torn the most often. Non-professional athletes are just as likely to tear this tendon or suffer from Achilles tendonitis, which is when the tendon becomes inflamed.  The Achilles tendon is a unique tendon because it can withstand 1,000 pounds of pressure. As the largest tendon in the body, it has to be able to support a person jumping, running, and every type of movement that one can think of. One knows there is a problem when pain occurs after exercising and it doesn’t get better. Pain will be localized near where the Achilles tendon and the heel bone meet. Swelling and stiffness can occur.

There are many ways one can tear the Achilles tendon or get Achilles tendonitis. What should one do if either of these occurs?

First, make an appointment with a Podiatrist to get checked out and get a proper diagnosis. Restricting the movement of the foot and ankle through a bandage or cast along with rest will minimize the pressure that is placed on the tendon. If the Achilles tendon is swollen, anti-inflammatory medication helps to reduce the swelling and minimize pain.

Moving forward, it is often suggested to wear orthotics to help support the muscle and relieve some of the stress that is placed on the tendon while exercising or playing a sport. If the sport or exercise is what is causing severe pain and Achilles problems, one might be advised to play a sport that is not as intense on the limbs, joints, and tendons. Swimming is a great exercise and sport that doesn’t stress the tendons. Proper stretching can’t be stressed enough. Weak muscles can cause tendon problems.

In the case of an Achilles tendon tear, surgery is a treatment option. In those cases, physical therapy is required after the surgery in order to strengthen the muscles groups and tendon. Recovery time of an Achilles tendon tear is much longer than a when the Achilles is inflamed or swollen.


Citations:

Image by Phallin Ooi. (2007). Football. Creative Commons. Retrieved from http://www.flickr.com/photos/phalinn/371857372/
Vittori Foot and Ankle Specialist. (2012). Achilles tendonitis. Retrieved from http://www.vittorifootclinic.com/library/1749/AchillesTendonitis.html