When you visit the podiatrist, he will ask you about calluses, blisters, and minor infections, all of which can lead to ulcers. These are usually painless sores on the bottom of the foot. They can be under a corn, callus or blister. Sometimes neuropathy can cause an ulcer to develop without you knowing it because there is no associated pain.
If you have poor circulation you can develop an ischemic ulcer. Podiatrists treat these depending on when they developed. They can be padded to redistribute pressure away from the ulcer. Sometimes, when the problem is more difficult to treat, a cast is used to redistribute weight. Certainly, keeping calluses and corns under control, treating small cracks in the skin and prescribing the interventions necessary including dressings, medications and orthotics can save you from developing gangrene, which as we know may lead to surgery.
Now let’s get back to my appointment. When you have a chronic disease like diabetes, you get to see the inside of many waiting rooms, and the longer you have diabetes, the more offices you wait in. Visiting the podiatrist was quick and easy. While I waited, I noted some patients coming in with bandages from foot operations.
I also noted some patients who limped and those whose balance was obviously impaired. However, for the most part, the patients looked healthy, but overweight. During my stay in that waiting room and taking note on my way out, I did a very unscientific study, and I and an elderly gentleman were the only two people who were thin. During that time I counted eight other people coming out of the office, coming in or waiting.
When it was my turn I was seated in a comfortable chair that moves up and down. The podiatrist came in after his technician came in to go over the history I had filled out. She had also softened the calluses on my feet with a lotion of some kind. The podiatrist and I exchanged “hellos” and filled each other in on what was happening in our lives, and then came the question, “Why are you here?”
My endocrinologist was concerned about the build up of even more calluses on my feet and he wanted them gone. Done. With instruments that are obviously very sharp, my corns and calluses were dispatched. My toe nails were trimmed properly and then after a goodbye the tech returned and went over the areas with mechanical pumice.
My nails were also sanded and then she covered the bottoms of my feet where the calluses had been removed with pads. The same was true for the corn removal areas. I was ready to go. No pain, no fear, just a qualified man who asked me to come back four times a year for an appointment. Bless him.
He told me my feet were not the ugliest dancers’ feet he had treated and, with appointment card in hand, I left. Those pads are supposed to stay on for some time, but mine came off after a few 6 mile runs. My feet underneath the pads looked fine; in fact good enough for my husband to make an appointment for his feet. That’s a recommendation for you.
What do podiatrists say is the best way to care for our feet if we have diabetes? I present a list compiled from various lists presented to the public from podiatry professional organizations. Some of these are common sense, but all will cut your chances of developing complications that affect our feet.
- It goes without saying that checking your feet daily is a must. If you can’t see your feet, make sure someone else does. If you have to stand on your feet for long periods of time, make sure to examine them when you can. If you have on new shoes, check to make sure your feet are not sweaty as this can lead to a fungal infection.
- If you have new shoes make sure you are not developing blisters or areas of rubbing.
- Keep your toenails short and neat. It’s easiest to do this after a shower or bath as the nails are softer. Note any thickening or discoloration and report these to your doctor. If you are uncomfortable doing this task, get a referral to a podiatrist.
- Do not have a manicure or pedicure before you are cleared to have one. Cutting cuticles in a salon may not be what the doctor would order.
- See your doctor at the first signs of a fungal nail infection. This is a persistent problem and if not taken care of, the infection can invade the toes and feet through broken skin.
- Do not try to treat or remove hard skin, corns, calluses, or warts by yourself or with home remedies or chemical compounds. Have these taken care of safely by a professional.
- Wash your feet every day and dry them well. Use warm, not hot water and a mild soap. Do not soak your feet for very long periods of time. Dry, especially between the toes. This is very important to remember so that you leave no area for fungal infections to grow.
- Change your socks and hose every day. Change after you have stood, walked or exercised a while to control sweating.
- Purchase socks without a seam on the toes as these can chafe or cause cramps. Avoid woolen socks that can shrink and impede circulation and also avoid cotton socks as they tend to keep moisture on the shin.
- If your skin is dry, use an unscented moisturizer like baby oil or petroleum jelly, but never put on socks or hose unless your feet are dry. Again, moist feet can help fungal infections start.
- Avoid baths or showers that are too hot. Neuropathy can impede our ability to feel pain so you might burn yourself if you step into a hot tub.
- Don’t go to bed with an electric blanket on or heating pads and hot water bottles. These too can burn feet that no longer sense pain.
- Avoid going barefoot. This leaves us vulnerable to injury and possible infections from mold spores and other organisms.
- When you go to the beach if the sand is hot, keep your shoes on. Make sure you wear shoes that will keep the hot sand from burning any part of your skin.
- If you get a sports injury, don’t tape your feet or ankles, as this could compromise circulation. Get professional advice.
- When sitting, avoid crossing your legs, as this also compromises circulation.
- If your feet are cold at night, seek medical advice. This will depend on if you have neuropathy.
- Exercise. As you know from reading this site, exercise is a very important part of treating diabetes. It improves circulation and makes all of us healthier. Speaking of healthy, when you decide to exercise, make it a dual decision to stop smoking if you still light up. Diabetes and smoking is a dangerous combination.
- Finally, lose weight if your doctor has told you it is important that you do so. Being over weight doubles your chance of developing complications.
Take care of your feet; you only get one pair for life.