I can understand why the full routine may get skipped by my patients: each task by itself might seem somewhat inconsequential, but the whole is greater than the sum of its parts. The real beauty of the routine is what happens when every piece is done regularly. If you stay familiar with your feet and take care of them on a regular basis, you have your best chance of avoiding wounds, infections, and amputations.
Here are my Four Habits for Diabetic Feet.
Habit #1: Look at them every day. Seems simple, right? It's amazing how many people don't pay any visual attention to their feet. I've asked patients how long a large freckle, healed scar, or wound has been present on their foot, and often they reply that this is the first time they've ever noticed it. If you become familiar with your feet, you'll notice when something out of the ordinary pops up, like a bit of swelling, discoloration, loss of hair on your toes, or texture changes in your skin. All of these things give your doctor information. For instance, hair on your toes is a sign of good blood flow; if you notice you've lost that hair, it might be time to start monitoring your blood flow a bit more closely. If you've got diabetic neuropathy (loss of sharp sensation, or numbness in your feet), you may even step on something without noticing. Looking at your feet each day can alert you to possible wounds or other problems much faster, and the quicker you jump on these things, the faster you heal with fewer complications.
Habit #2: No going barefoot. Especially if you have diabetic neuropathy, but even if you don't, you should be in shoes. This one is tough: many people like to take their shoes off at home, out of habit, for comfort, or for cultural reasons. But most accidents happen at home when it comes to diabetic feet. People will stub their toes on bedroom furniture, get splinters on the back deck, or step on a dropped insulin needle or broken glass in the kitchen. A supportive pair of well-fitting shoes are a diabetic's best friend. Ask your doctor if your insurance will cover them. Also be mindful of the fit: if you have diabetic neuropathy, you may not feel the pressure from your shoes the way you used to. Properly fitting shoes may feel too big, and the increased pressure from a size too small may feel more appropriate. Don't be tricked--check with a sales associate or your doctor to make sure the shoes fit you. If your nerves have been compromised, you can't always trust them to tell you when a shoe fits.
Habit #3: Use lotion; don't soak. The idea that soaking your feet is good for them is a common misconception. Soaking your feet in warm water after a long day can feel fantastic, but it's not actually helpful--it will dry out your feet and can make calluses worse. Just like chapping your lips by licking them, too much water over the skin on your feet will pull the natural oils and moisture out and leave the skin dry, irritated, and cracked. If you're using epsom salts or something similar added to the water, this will pull even more moisture out. A better bet is to use a hydrating lotion (there are some good over-the-counter brands, or you can ask your doctor for a prescription). Apply it liberally to your feet, massaging it into your heels and areas of dry skin or cracking. Put a pair of clean white cotton socks on over top to trap the moisture of the lotion on your feet. You don't need to put lotion between your toes--this area tends to stay moist enough, and adding to it can promote skin breakdown or athlete's foot. Wipe out excess lotion that gets in there with a tissue before putting on your socks. This is also important after bathing: dry thoroughly between your toes.
Habit #4: Control your blood sugar. This is the most important habit, and unfortunately requires the most time and energy. When your blood sugar is too high, it damages nerves, as well as small blood vessels--not only in your feet, but in your entire body. If your nerves no longer function normally, you may experience pain, burning, tingling, or numbness. These malfunctioning nerves can't tell when you've hurt yourself, whether it's a blister forming in too-tight shoes, or a shard of glass you stepped on. And once you've lost the sensation, it's usually irreversible, which is why this is so important. In order to keep your nerves working for you and not against you, you need to keep them happy, with appropriate blood sugars throughout your day. If you're having trouble controlling your blood sugar, talk to your primary care physician to work out a plan.
It is much, much easier to prevent problems in diabetic feet than it is to heal an ulcer or recover from an amputation. Take a few minutes at the end of each day to take off your supportive shoes, and look at your feet as you apply some lotion. Pair this routine with an active goal to keep your blood sugar low and level, and together with your doctors you can prevent diabetic foot complications.
If you or someone you know has diabetic foot problems, call our office and make an appointment today, we'll treat you like family. 1-888-506-6652 or log on to http://www.AtlanticFeet.com
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