Two more diabetic foot disasters arrived in the practice and at my Hospital clinic this weekend. Another hot water bottle burn, plus a corn paste induced abscess.
Loss of sensation and lack of foot health education contributed to the elderly lady with Type 2 diabetes burning her left little toe and the lower part of her calf, plus blistering her right big toe. The lower calf is about 2mm deep and the blisters were still covering intact skin.
If you are in any way involved with people with diabetes this winter please warn them of the dangers of hot water bottles, heating pads etc. Remind them of the tips I put out recently for winter foot care.
When diabetes causes loss of sensation in the lower leg then putting hot objects like hot water bottles next to the skin can lead to serious damage.
Medicated corn plasters and pastes have been around for years and are usually used by desperate people who don’t know that a podiatrist can give them relief from their painful corns and calluses.
Sadly my patient is also a Type 2 diabetic, but without complications and therefore was in great pain.
I drained the abscess, applied appropriate dressings and prescribed antibiotics. This lady is booked off work for 3 days plus the weekend and I will see her again on Thursday.
That’s a big penalty in lost working time for a lady who was simply trying to take care of her feet but did not understand the value of taking professional advice until it was too late.
So who is to blame for these disasters? If the patients concerned didn’t know, then I am for not getting the good foot health message across to enough people. On the other hand the patients did know who to come to for help.
Men usually escape the painful feet we associate with poorly-fitting shoes. Surely it’s women who are wearing high heels and sharply pointed toes. They were doing it when I was at varsity. However I was amused by an article by Thando Pato entitled ” Men in sharp shoes miss the point” in the Sunday Times Lifestyle section on May 18th.
I checked with my associate Tshidi and sure enough “P&Bs” as they are known, are a real fashion item. Especially amongst black men. Ms Phato expresses her concerns about the growing number of South African men in all situations wearing shoes “so long and pointy that they look like spears.” (The word ‘bhoboza’ means to pierce in Zulu).
She also expresses a concern that I often use as a humour line in foot health talks – that shoes for women are designed by “cruel European men who claim to love women”. The message from Thando Pato is a great – not only are these shoes sold in garish colours, apparently white is cool – but she is also “traumatised” by the damage inflicted on the wearer’s feet.
She uses a great expression to describe corns, bunions, calluses and a host of other foot deformities that we traditionally associate with women; “Hammer Time”. I think this should become part of podiatry terminology. Her description of the pain experienced by one guy she sees is really funny. Thando Pato you must have been a podiatrist in a former life!
If you want to study the effect of high heels on how you walk, get along to the Victory Theatre in Johannesburg and take in The Rocky Horror Show. We went last night and it was a great show. Obviously I went for the anatomical study!
By the way the references for Angiosomes are: Taylor 1991. Plastic & Reconstructive Surgery.102.599. There is a fully illustrated article in Plastic & Reconstructive Surgery. 2006.117. 261-293.
I know these are not 100% accurate but that’s what I wrote down at the congress, so put on your best Google and see what you get!