You and I have known one another, through this blog and two before it, for some years now. Ours has been more than a cordial relationship; it’s been friendly. Warm, even. And yet, incredibly enough, I have never offered you a glimpse of my bare feet. Not even once.
Well. Let’s remedy that, eh?
There they are, way down there, two of a kind and flat as the prairie. It is precisely because they are way down there that it is easy to overlook them, day in, day out. At least, it used to be easy to ignore them. Nowadays, the feet come first on my list of things to think about. Yes, you guessed it; it’s all because of dat ol’ debbil diabetes.
People with diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications. Foot problems most often happen when there is nerve damage, also called neuropathy, which results in loss of feeling in your feet. Poor blood flow or changes in the shape of your feet or toes may also cause problems.
Problems, indeed. Neuropathy, skin changes, calluses and foot ulcers, poor circulation, and the threat of amputation, all the kinds of things that can keep you up with worry late at night. My brother Greg, my junior by two years and a diabetic for – geez, twelve years? fifteen? – had to surrender not only a foot but a lower leg. When I visited him shortly after the amputation, I made a point of watching while the dressing on his stump was being changed by a nurse; I wanted to see the cross-section of his leg. I wanted to see if it would look the way I might expect, and I wanted to remember it.
It did, and I do.
Important, those feet!
I am freshly returned at this moment from a trip to a podiatrist – prompted by concern over an ingrown toenail and am pleased to share that he pronounced my tootsies in pretty good shape, all things considered. Those things include the incredible flatness of my feet, which gives rise to annoyingly curled nails which can easily become ingrown. The doctor cheerfully offered the prospect of in-office surgery to cut away the sides of the biggest offenders, the nails on the big toes, should the need arise. There’s no need for that at the moment, assuming continued good luck and vigilance on my part, but the prospect of cutting those bad boys down to size doesn’t trouble me. After all, I hardly ever wear strappy shoes.
To add to the regular shopping list, then: pumice!
Great post! Diabetics must pay particular attention to their foot health for a number of reasons:
Diabetes can lead to a loss of sensation in the feet (distal polyneuropathy), meaning that damage is more likely to go unnoticed.
There can be changes to the muscle power in the leg, leading to changes in foot shape and high pressure areas.
The skin can become dry (anhidrotic) due to autonomic nerve neuropathy. Dry skin is more likely to crack and create a portal of entry for infection.
Diabetics are more likely to develop problems with their blood supply to the feet (due to calcification of arteries in the periphery).
A podiatrist can perform vascular, neurological and functional tests which will tell you your foot health status. It is important to have your feet checked regularly, and you should check your own feet daily if you are a diabetic. Podiatrists are experts at offloading pressure from areas of the foot that are at risk of ulceration.
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