Below knee amputation

As David sat in the podiatry examination chair, he listened closely as I explained all of the potential problems he could get with his feet from diabetes. I talked about how the nerve damage makes it difficult for him to feel when he is getting a blister or an open sore. I explained how his immune system is unable to fight off an infection. I talked about how his wounds would heal much slower because of the decreased blood flow related to his diabetes.

From my left I heard a faint sniffle. I noticed that his wife Doris was crying. She told me that she had a diabetic uncle who had died after he had gotten an ingrown toenail. She said she wasn't sure of all the details but remembered it all started as an ingrown toenail that got so infected he had to go to the hospital, and he died in spite of an amputation. Clearly she was worried that the same would happen to her husband.

This is a scenario that I have seen over and over while practicing podiatry. Although the newly diagnosed diabetic patient seems to understand that they have to do something different in order to avoid complications, the spouse always seems to be more concerned. I'm not sure why this is, but it seems to consistently be the case.

Many times when a male diabetic does get a foot ulcer or infection, it is usually the wife, who calls attention to the problem. For this reason, it is critical that the spouse serve as a guardian and protector the husband's diabetic feet. By following some simple guidelines, anyone can make sure that their husband does not develop a diabetic foot problem that leads to an amputation.

One of the easiest ways to make sure that a diabetic foot problem does not lead to an amputation is simply checking the feet every day. For most patients, this is actually a very difficult task. Diabetic patients become less flexible. This makes it nearly impossible for them to actually look at the bottom of the foot.

Many of these patients also have diabetic retinopathy, which causes vision problems and makes it difficult for them to see from very far away. Although some people suggest using a mirror in order to look at the bottom of the feet, those with any diabetic eye problems find it impossible to really evaluate the skin and even notice a problem when its beginning.

This however is very easy for a spouse to accomplish. All you have to do is check the bottom of the feet and make sure there are no areas of injury or redness. Discoloration such as red spotches or streaks in the skin may be the first symtom or sign of a diabetic foot infection. You should also check between the toes to make sure there's no cracking or that the skin is not starting to turn white. Both of these can lead to openings in the skin that can allow bacteria to cause a diabetic foot infection.

As simple as it sounds you should always make sure that your spouse is wearing shoes. The vast majority of diabetic foot infections that start with the patient stepping on somethong sharp and leading to amputation actually occur within the home. Wearing shoes, even in the house is the easiest way to prevent this.

Another way to decrease the chances of a diabetic foot infection is by making sure that your diabetic husband only wears white socks. Clinical studies have shown that diabetics who wear white socks are less likely to become hospitalized for a diabetic foot infection than those who wear dark colored socks. The study found that diabetics wearing white socks were much more likely to notice discoloration or drainage on the white socks that could signify an open sore. For this simple reason patients would see a foot doctor sooner and faired much better.

Go for a walk together. It is a well researched fact that walking for 30 minutes five days per week can dramatically decrease the chances of a diabetic foot amputation. We know that when a diabetic goes for walks, the blood flow to the feet and legs improves, the immune system begins to become stronger, and the blood sugar becomes better controlled. It will also give you a good chance to spend some quality time together.

Always go to your husband's doctor appointments. If you are concerened enough to see the doctor for a diabetic foot problem, you likely have many question you need to have answered. Unfortunately, because of changes in the way Medicare and insurance companies are trying to control health care costs, doctors get paid much less for office visits than they ever have in the past. You have likely notice that doctors usually seem to be very rushed and anxious to get out of the room.

It's not that doctors don't care about you and your problems, it's just that there are only so many hours in the day and so many people they need to see. By having a spouse present in the room it's much easier to make sure that all of your questions get answered. In addition, a spouse can usually supply a great deal of useful information to the doctor, because they're the one looking at the feet. Just by you being there, there is a much greater chance that all of your needs will be met.

Diabetes can be a frightening disease when you start hearing about all the potential problems. However, with a few simple actions every day, your spouse will never end up with the diabetic foot amputation. Enjoy life on your feet together!