IF SYMPTOMS PERSIST
By DR. JOSE PUJALTE, JR.
“Is bare now, nor can foot feel, being shod."
— Gerard Manley Hopkins (1844-89), English poet. "God's Grandeur" (written 1877)
Dr. Jose Pujalte Jr.
If you are diabetic, read this. Diabetes is a disease that a person lives with, and in some cases, dies of. Because diabetes damages both large and small blood vessels, a host of other problems are multiplied. One feared complication is amputation of the leg because of poor circulation in the foot (resulting in gangrene). It doesn’t always have to happen.
Diabetic Neuropathy. Diabetes damages nerves. In autonomic neuropathy, there is nerve damage to internal organs specifically the stomach, heart, sex organs, and urinary tract. Symptoms include urinary and bowel incontinence (inability to control voiding) and sexual impotence. Damage to a single, identifiable nerve is mononeuropathy. An example is Bell's palsy where the facial nerve is affected and one side of the face droops. In peripheral neuropathy, the symptoms of burning or numbness are noted in the toes and feet or and fingers and hands. The feet are especially vulnerable because they are not always seen and therefore not easily inspected.
Poor Wound Healing. Diabetes decreases blood flow in the body. Uncontrolled diabetes is associated with poor wound healing. Now combine this with lack of feeling or sensation, and the toes and feet become candidates for ulcers or sores.
Tips for Foot Care.
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Monitor your blood sugar. If your diabetes is poorly controlled, its complications are just waiting to happen. These include wounds in the feet that do not heal.
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Check the feet every day. Look for redness, ingrown toenails, punctures and cuts. Make visual inspection a habit because you no longer have pain to warn you. Use a mirror to see the sole of the foot or ask someone to examine the foot routinely.
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Wash feet every day. Use warm not hot water but do not soak the feet or the skin will become dry. In between the toes, sprinkle foot powder.
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Trim toenails weekly. This is best done after washing, then drying the feet. The nails will be soft so that it can be easier to cut them straight across. Cutting the corners of the toenails can lead to ingrowth, another risk for infection.
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Make skin soft by applying lotion or cream. However, do not apply lotion in between the toes which might again hasten infection.
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Increase blood flow to the feet. When sitting down, prop up the feet on stools. Avoid tight shoes and socks which choke the blood supply to the feet.
In essence, the feet in diabetes are given star treatment. Remember that minor cuts and punctures in the feet can easily turn into serious ulcers. Many hospitals now either have diabetic wound care or chronic wound care clinic. Why not consider a visit?
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