Archive for Diabetes
Diabetic Neuropathy
Posted by: | CommentsDiabetic neuropathy is a peripheral nerve disorder caused by diabetes or poor blood sugar control. The most common types of diabetic neuropathy result in problems with sensation in the feet. It can develop slowly after many years of diabetes or may occur early in the disease. The symptoms are numbness, pain, or tingling in the feet or lower legs. The pain can be intense and require treatment to relieve the discomfort. The loss of sensation in the feet may also increase the possibility that foot injuries will go unnoticed and develop into ulcers or lesions that become infected. In some cases, diabetic neuropathy can be associated with difficulty walking and some weakness in the foot muscles. Diabetic neuropathy affects all systems and has an enormous impact on every patient.
The goal of treating diabetic neuropathy is to prevent further tissue damage and relieve discomfort. The first step is to bring blood sugar levels under control by diet and medication. Another important part of treatment involves taking special care of the feet by wearing proper fitting shoes and routinely checking the feet for cuts and infections. Analgesics, low doses of antidepressants, and some anticonvulsant medications may be prescribed for relief of pain, burning, or tingling. Some individuals find that walking regularly, taking warm baths, or using elastic stockings may help relieve leg pain.
The prognosis for diabetic neuropathy depends largely on how well the underlying condition of diabetes is handled. Treating diabetes may halt progression and improve symptoms of the neuropathy, but recovery is slow. The painful sensations of diabetic neuropathy may become severe enough to cause depression in some patients.
Amputation prevention in East Texas
Posted by: | CommentsAs a podiatrist, amputation prevention is one of my primary goals. Every day I see patients with serious wounds, infections, injuries and insults that put them at risk of losing a toe, foot or limb. Patients that are lacking adequate circulation and/or have lost feeling in their feet are particularly at risk as well as those patients who have not taken their problem seriously and have allowed too much time to pass before seeking care. All this to say that recently I was reading an article about a diabetic limb salvage team in Arizona that is having a great impact on their community through the efforts of a multi-specialty approach to at risk limbs.
These physicians work together to improve communication, share expertise and speed up the delivery of medical services to their patients. When reflecting on this article I was reminded of how fortunate I am to practice podiatry in a community of committed physicians who make these hurdles nearly invisible. Every day I work with primary care physicians, internists, vascular surgeons, neurologists, general surgeons and orthopedists who want to help. They appreciate the seriousness of wounds and the impact they have on our community and they work together as a team to save limbs.
I want to say, Thank you, to my medical colleagues who are committed to this effort and I look forward to many more years working together.
Diabetes Myth from Sowell Podiatry
Posted by: | CommentsA common diabetes myth is that because diabetes is so prevalent it must not be that serious. I beg to differ. Every day I meet new patients who suffer greatly due to their diabetes. Blindness, amputations and a shorter lif are just a few complications from the disease. Diabetic care is a core value of Sowell Podiatry. Please control your blood sugar and get regular check ups. If we can be of any help, please give us a call.
Neuropathy at Sowell Podiatry in Nacogdoches and Carthage Texas.
Posted by: | CommentsNeuropathy is a condition that affects the nerves in the body. Each nerve has a special covering and when that covering is damaged, the nerve doesn’t function normally. A “tingling” sensation or a feeling of “pins and needles” may be a warning sign to the patient that he or her nerves are functioning abnormally. When the condition of neuropathy worsens, the patient may lose complete feeling in different parts of the body. Most commonly, neuropathy tends to affect the hands and feet. When the hands and feet become neuropathic, it is very difficult for one to carry out the activities of daily living.
What causes it?
Many diseases such as diabetes, alcoholism, vitamin deficiencies, trauma and certain drugs can cause neuropathy. The most common cause of neuropathy is diabetes mellitus. In diabetes, the elevated sugar affects the nerves and can result in pain or loss of sensation. If the sugar is not well controlled, the neuropathy progressively worsens and can cause serious disability in one’s life. Simple tasks such as walking barefoot or soaking your hands and feet can be potentially dangerous in the neuropathic patient. Constant monitoring of water temperature before bathing is essential in preventing unintentional burns or injury.
How is it treated?
A neuropathy can be a very difficult condition to treat. In general, a doctor can treat the symptoms that accompany nerve damage however, certain types and stages of nerve damage are permanent. Oral medications can be given to control the pain and other associated nerve-like symptoms. With advanced nerve damage in the hands and feet, it is essential for the patient to be cognizant of all precautions.
It is mandatory for patients with neuropathies of the feet to constantly wear shoes and socks. Examination of the bottom of one’s foot is required as well as checking the inside of shoes before putting them on. Having another family member evaluate the temperature of the water before bathing can help prevent unnecessary burns to the hands and feet. Neuropathy can be a very devastating condition. However, the more one knows about this ailment, the more effective is the clinical management.
Diabetes and Your Feet – Take Care of Them! Sowell Podiatry
Posted by: | CommentsAccording to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.
Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.
With a diabetic foot, a wound as small as a blister from wearing a shoe that’s too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it’s at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.
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 everyday. 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.
When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced “sharko”) foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn’t hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.
The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot’s movement and supports its contours if you don’t put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.
Orthotics at Sowell Podiatry in Nacogdoches
Posted by: | CommentsOrthotics, also known as orthoses, refers to any device inserted into a shoe, ranging from felt pads to custom-made shoe inserts that correct an abnormal or irregular, walking pattern. Sometimes called arch supports, orthotics allow people to stand, walk, and run more efficiently and comfortably. While over-the-counter orthotic are available and may help people with mild symptoms, they normally cannot correct the wide range of symptoms that prescription foot orthoses can since they are not custom made to fit an individual’s unique foot structure.
Orthotic devices come in many shapes, sizes, and materials and fall into three main categories: those designed to change foot function, those that are primarily protective in nature, and those that combine functional control and protection.
Rigid Orthotics
Rigid orthotic devices are designed to control function and are used primarily for walking or dress shoes. They are often composed of a firm material, such as plastic or carbon fiber. Rigid orthotics are made from a mold after a podiatrist takes a plaster cast or other kind of image of the foot. Rigid orthotics control motion in the two major foot joints that lie directly below the ankle joint and may improve or eliminate strains, aches, and pains in the legs, thighs, and lower back.
Soft Orthotics
Soft orthotics are generally used to absorb shock, increase balance, and take pressure off uncomfortable or sore spots. They are usually effective for diabetic, arthritic, and deformed feet. Soft orthotics are typically made up of soft, cushioned materials so that they can be worn against the sole of the foot, extending from the heel past the ball of the foot, including the toes. Like rigid orthotics, soft orthotics are also made from a mold after a podiatrist takes a plaster cast or other kind of image of the foot.
Semi-Rigid Orthotics
Semi-rigid orthotics provide foot balance for walking or participating in sports. The typical semi-rigid orthotic is made up of layers of soft material, reinforced with more rigid materials. Semi-rigid orthotics are often prescribed for children to treat flatfoot and in-toeing or out-toeing disorders. These orthotics are also used to help athletes mitigate pain while they train and compete.
