A hole in the foot...!

Diabetics are prone to ulcerations (refer back to my previous blog on foot ulcer) and unfortunately still many do not take this fact seriously until it is too late. Monitoring for ulcerations should be conducted regularly by a podiatrist in order to not only prevent an ulcer formation but to also prevent an amputation. Poorly fitted shoes or something very subtle or unimportant such as a stocking seem can create a wound that may not be felt in those whose skin sensation to feel is diminished as a result of peripheral neuropathy. When this is left unattended, the ulcer forming can become infected very quickly and can lead to the spreading of the infection causing even more serious consequences.

Your podiatric physician is the go to person for prevention of such problems since they know how to prevent and if too late, to treat these wounds which is a very important factor in prolonging the life and use of your feet and keeping them healthy and strong. Podiatric physicians are equipped with cutting edge products for wound healing that feel and work just like the human skin and have taken the science of wound healing to another level. These living, skin-like products are applied to wounds which are properly cleaned by your podiatric physician. Clinical trials have shown impressive success rates.

I will leave with a quick video of a person with an ulcer on his toe. These types of wounds are very common amongst patients with uncontrolled diabetes so please take everything written in these blogs very seriously to prevent something like this happening to you…

http://www.youtube.com/watch?v=_9YO1zx2MzE

What to do if you already have Diabetes...?!!

Despite the stage and extent of your diabetes, listed in this blog are many important tips. These should be followed and maintained throughly to ensure utmost safety and to keep your condition from getting worse. If you have diabetes already, you should..

-          Wash your feet daily using a mild soap and warm water and dry carefully with a soft towel especially between toes.

-          Inspect feet and toes daily for cuts, bruises or changes in toenails such as coloring or thickening.

-          Lose weight which can decrease the chances of further complications by nearly half.

-          Wear thick, soft socks and try to avoid those with seems or any kinds which could potentially rub and cause blisters or skin problems.

-          Stop Smoking

-          Cut toenails straight across and if they are too hard to cut and or have grown too much into the corner. Asking your podiatrist for assistance is the safest bet.

-          EXERCISE to keep your weight down and improve the blood circulation in your body. No need to get fancy, even 20-30 minutes of walking is considered one of the best exercises for diabetic patients. Make sure to wear proper shoes by asking your podiatrist which kind is the best fit for your foot type.

-          Don’t go barefoot, not even in your own home! Always make sure to at least wear slippers.

-          Don’t wear high heels, sandals, and shoes with pointed toes as this can put a lot of pressure on certain parts of the foot causing great complications in the future.

-          Don’t drink alcohol in excess as alcohol can increase the rate of nerve damage, and can make minor cuts seem unimportant, both of which can lead to problems.

-          Don’t wear anything that is too tight around the legs like panty hose, thigh-highs, knee-highs, anything that can cut off circulation to the legs and feet. Men socks which have really tight elastic should also be avoided.

-          Never try to remove calluses, warts or corns by yourself or try to use over the counter preparations as they can burn the skin and can cause irreversible damage to the skin and feet. Do not try to cut, shave, trim the calluses because the risk of cutting yourself is too high and such wounds in diabetics can often lead to greater complications. Seeing our podiatric physician for these cases is a must.

Last but not least…SEE YOUR PODIATRIC PHYSICIAN. Regular checkups, annually at the very least, are the best and safest way to ensure that your feet remain healthy and to uncover any subtle changes that an untrained eye might not be able to discover.

Diabetic Feet !

To continue from the previous blog regarding the great tendency for uncontrolled diabetes to affect all body parts, this blog will focus more on the effects of diabetes on your feet. We will also teach you ways to ensure you are daily taking the right steps to keep yourself at bay from harm caused by diabetes.

According to a nationally conducted survey, about 86,000 lower limbs (legs and feet) are amputated every year; mainly because these patients had uncontrolled diabetes or they were unaware of their symptoms. When you don’t know, then you can’t do anything about it, right? Well firstly, it is very important to visit your doctor if you or someone you know suffers from any of the symptoms listed in the previous blog or any of the following: family history of diabetes, obesity, being over the age of 40, and or being African American, Native American or Latin American. African Americans are 1.7 times more likely than anyone else to develop diabetes!

Since diabetes is a systemic disease, meaning it incorporates the entire body, the best approach towards it is a professional team approach. In this team approach, the biggest responsibility to limit the number of amputations is the podiatrists. As specialists of the foot and ankle, they are one of the first to notice when things start to turn in the wrong direction and when the disease is on the verge of doing its damage. The key to amputation prevention is frequent checkups and regular foot screenings with your podiatrist.

If you notice the following signs, you should go to your local podiatrist immediately: skin color changes and or increase in temperature, swelling of the foot or ankle, pain in the legs or feet, open sores in the foot which are healing very slowly, ingrown toe nails, fungal toe nails, dry cracked heels and bleeding corns and calluses.

Early detection of these signs is very important for diagnosis and can prevent future amputations. As always, diet and proper exercise are very important to keep a body in balance. Also keep in mind that many times, diabetics are not wearing properly fitted shoes causing them pain in the foot resulting in serious problems such as ulcers and wound healing complications. Your podiatrist will evaluate your feet and the shoes you wear and depending on your foot type and whether you have diabetes or not, will make suggestions regarding the best shoes to wear thus decreasing the chances of further problems.

Look out for the next blog which will talk about the necessary steps needed to be taken ritually if you already have diabetes. And remember, just because you already have diabetes does not mean that there is no hope, there is actually just as much possibility to maintain your daily lifestyle as there is to lose it. So be regular with your checkups and keep learning ways to keep yourself in good health!

Diabetes: Better tame than too late!!!

The next couple of blogs will be primarily educational about the basics of diabetes. Since uncontrolled diabetes is one of the worst outer and inner body diseases, we want to ensure you know about the preventative measures possible in your lifestyle. Basic statistics about the commonality of diabetes will also be included so that diabetes is no longer taken lightly. When reading, keep in mind that uncontrolled diabetes symptoms begin usually in the extremities, mainly the feet. This is one of the reasons why your podiatric physician becomes a crucial part in the treatment team of doctors for this condition.

Diabetes is a common condition in which the body is not able to utilize the sugar in the blood in a proper, productive way. One problem with diabetes is known as Hyperglycemia, which results when the body is not able to absorb the sugar from the blood into the cells. Uncontrolled hyperglycemia will cause the nerves in the body to deteriorate affecting the eyes, heart, kidneys and feet. This can lead to problems which can cause the body to literally deteriorate which eventually can cause amputations of body parts when the condition gets worse.

Some symptoms of hyperglycemia can include frequent urination, excessive thirst, extreme hunger, weight loss for no apparent reason, tingling or numbness of the feet or hands, blurred vision, slow to heal wounds, and increased susceptibility of certain infections. If you or someone you know has any of these symptoms and has not been checked for diabetes, it is urgent that one should go see a doctor without further delay.

Diabetes currently affects 16 million people in the United States, of whom 5.4 million people do not even know they have the disease! Every day 2,200 new cases are identified and 780,000 people are diagnosed with diabetes every year.  Diabetes is the sixth leading cause of death in the United States and the number of people with diabetes is going to double in the US within the next twenty five years. Furthermore, diabetes costs roughly $98 billion annually, much of which can be lowered if preventative measures and continuous follow ups are maintained with physicians.

I will bring an end to this blog describing a little more about the systemic (bodily) complications diabetes can cause and write more in the next one regarding the specifics dealing with diabetes and feet. Diabetes is a horrible disease that can and will literally take a persons’ life if left untreated. It will cause one to develop a condition known as Retinopathy causing visual changes leading to blindness, kidney damage and failure, worsen heart conditions that can cause heart failure and it can also cause people to lose sensation in certain body parts, causing them to become so infected and diseased that the amputation would be the only solution to keep the infection from spreading.

The sad truth is, more and more people are going to get diagnosed with diabetes and there is no cure for the disease as of yet, however there is hope. By monitoring diet, getting proper exercise, keeping your blood sugar within normal limits and maintaining visits with your doctor can keep most of the serious complications of diabetes far away and can let one enjoy life for a long time.

The Value of A Podiatrist!

Most of the time it is you podiatrist that will be amongst the first to let you know if you have diabetes or not.” – American Podiatric Medical Association (APMA)

Surprisingly enough the fact above is overlooked by the medical community so much so that it might even come as a surprise to some doctors but that is the truth and it is backed up by hard facts and research studies which show that not only can podiatrist save patients limbs but their preventative measures can impact everyone in the community as a whole. Through regular checkups, especially with diabetic patients, the chances for amputations decrease greatly and the costs associated with it for the patient, the hospital and everyone else paying taxes can decrease in millions, resulting in improvements in our healthcare which is always struggling in our country despite the billions of dollars spent annually.

Thompson Reuters, an internationally respected private research firm whom expertise is especially in healthcare, came out with a new study with results that speak volumes regarding the importance to the whole society regarding a podiatrists involvement in early care for diabetic patients. This study was also sponsored by the American Podiatric Medical Association and the brief synopsis and results are as follows..

The study examined records for more than 32,000 diabetic patients between the ages 18-64 and more than 43,000 diabetic patients over the age of 65. The study focused on health and risk factors between those who had podiatric visits defined as at least one pre-ulcer visit (look in the previous blog to see a picture of a controlled ulcer) to those who did not. The results were as such that those with podiatric visits significantly lowered their risks for hospitalizations and amputations; in the 18-64 age group, 15 percent lowered their odds of amputation and 17 percent lowered their odds from hospitalization. Patients 65 years old and over who had at least one pre-ulcer visit with their podiatrist lowered their risk of major amputation by 23 percent and hospitalization by 9 percent.

Along with the findings adove, the study also demonstrated the cost saving benefits when podiatrists are given the opportunity for preventative care in the chronically ill patients.  Every dollar invested in podiatric care for patients in the 18-64 age group resulted in $27-$51 in health-care cost savings and $9-$13 of savings per dollar invested in patients 65 and older.

Furthermore, even as little as 20 percent increase in podiatric care in just patients with diabetes alone can result in annual savings of $191 million!

These hard facts can only solidify the presence of a podiatrist in the medical community and echo the sheer importance of seeing a podiatrist regularly especially if you are a diabetic patient. Remember always, it is better to be safe than sorry, early than late, especially when it can have life changing outcomes which will impact your daily life forever. 

http://www.drrobertrosenstein.com/

THE VALUE OF A PODIATRIST!

“Most of the time it is you podiatrist that will be amongst the first to let you know if you have diabetes or not.” – American Podiatric Medical Association (APMA)

Surprisingly enough the fact above is overlooked by the medical community so much so that it might even come as a surprise to some doctors but that is the truth and it is backed up by hard facts and research studies which show that not only can podiatrist save patients limbs but their preventative measures can impact everyone in the community as a whole. Through regular checkups, especially with diabetic patients, the chances for amputations decrease greatly and the costs associated with it for the patient, the hospital and everyone else paying taxes can decrease in millions, resulting in improvements in our healthcare which is always struggling in our country despite the billions of dollars spent annually.

Thompson Reuters, an internationally respected private research firm whom expertise is especially in healthcare, came out with a new study with results that speak volumes regarding the importance to the whole society regarding a podiatrists involvement in early care for diabetic patients. This study was also sponsored by the American Podiatric Medical Association and the brief synopsis and results are as follows..

The study examined records for more than 32,000 diabetic patients between the ages 18-64 and more than 43,000 diabetic patients over the age of 65. The study focused on health and risk factors between those who had podiatric visits defined as at least one pre-ulcer visit (look in the previous blog to see a picture of a controlled ulcer) to those who did not. The results were as such that those with podiatric visits significantly lowered their risks for hospitalizations and amputations; in the 18-64 age group, 15 percent lowered their odds of amputation and 17 percent lowered their odds from hospitalization. Patients 65 years old and over who had at least one pre-ulcer visit with their podiatrist lowered their risk of major amputation by 23 percent and hospitalization by 9 percent.

Along with the findings adove, the study also demonstrated the cost saving benefits when podiatrists are given the opportunity for preventative care in the chronically ill patients.  Every dollar invested in podiatric care for patients in the 18-64 age group resulted in $27-$51 in health-care cost savings and $9-$13 of savings per dollar invested in patients 65 and older.

Furthermore, even as little as 20 percent increase in podiatric care in just patients with diabetes alone can result in annual savings of $191 million!

These hard facts can only solidify the presence of a podiatrist in the medical community and echo the sheer importance of seeing a podiatrist regularly especially if you are a diabetic patient. Remember always, it is better to be safe than sorry, early than late, especially when it can have life changing outcomes which will impact your daily life forever. 

http://www.drrobertrosenstein.com/

What You Can't Feel, Can Hurt You!

   http://picasaweb.google.com/lh/photo/cROPEDuEEWqFwVoM-0O5BQ 

            What exactly is this horrific picture and why does it look like an acid has been poured on this person’s foot and such a hole has been made that one can see all the way down to the tissues inside a human body; so much so that if that if this hole was any bigger, one could possibly stick their finger in and feel the bones of the foot in that region…

This is a picture of a foot ulcer and this patient is a diabetic person who had unknowingly and unwillingly lost their sensation of the foot and did not maintain continuous checkup with their podiatrist, until they had noticed that their skin had split open and they should probably go get it checked out! Now when I say unknowingly is because people with diabetes have the highest chances of developing peripheral neuropathy, a condition which makes a person loose sensation in parts of their bodies such as the feet, which also happen to be amongst the first areas where this disease process usually manifests itself. So what happens is that without proper consultation or not following up or listening to what your physicians’ advice or recommendations, diabetic patients on a regular basis cannot gauge if they are acquiring neuropathy or if they even do have it! Some of the earlier signs are of pain, tingling, numbness and the later signs are that there is no sensation at all, whether it is pain, cold, heat, or even more importantly pressure. When the earlier signs are not noted of and taken into consideration, the later stages are sure to come, especially in diabetics and a foot ulcer is just around the corner.

So how are these ulcers forming on such a frequent basis in diabetics? Well for starters let me tell you that an ulcer does not always start of this big, however they can become quite large or even so problematic that at times a part of the foot if not all of it needs to be amputated. An ulcer can form due to many many reasons. One can split their skin which has been deprived of fresh oxygen and nutrient and possibly could be infectious and the dead tissue needs to be taken out before it keeps spreading all over the foot. This can start of really small but continue to keep spreading if visits are not persistent and maintenance of cleaning and taking out the dead tissue is not regular.

Sometimes a person can stub their toe or step on a nail or anything else for that matter and not feel it and continue their daily routines while the object is still inside their foot and this can start a local infection that can spread and turn into an ulcer and the end result can again be like the picture up top.

This brief yet scary view of a very serious disease process can be prevented and that is what I want the take home message to be, on top of the fear factor. It will never be emphasized highly enough to someone with diabetes how important it is to control and keep their blood sugar levels in control and to visit their podiatrist on a regular basis so your doctor can take necessary steps into making sure your feet can maintain proper functioning for as long as possible. Sometimes, sadly enough, especially with diabetics who have peripheral neuropathy and other serious medical conditions, ulcers and other complications are inevitable, however, with routine cleansing and protection from your podiatrist, these disease processes can be kept at a minimum which can make life a whole lot better for the patient in the long run.

And so, I will leave you with a quote that perhaps before this article might not have made much sense or would have even sounded as if this doctor was joking, but hopefully after reading this blog, this quote will shed new light and a new approach to looking at things....

“Pain is God’s greatest gift to mankind” – Paul Brand, MD