Dr.'s James DeWitt and Daniel Koschtial
(616) 538-4442
Amputations due to diabetes can be prevented
Diabetes patients urged to take simple precautions to help save their feet
Wyoming, MI, 2009 - Taking a minute or two every day to inspect your feet and observing a few simple rules can make the difference in sparing diabetes patients from a preventable outcome of the disease - a foot amputation.
"Of all diabetes-related complications, a serious foot ulcer and subsequent amputation might be the most preventable with proper care and vigilance in checking the feet at least once a day for small cuts and other abrasions," say James DeWitt and Daniel Koschtial, DPM, AACFAS, members of the American College of Foot and Ankle Surgeons (ACFAS). "Even those with good control of their blood sugar can experience foot ulcers, especially if neuropathy, a frequent diabetes complication, has caused decreased feeling on the bottom of their feet."
Loss of sensation inhibits the body's normal pain response. As a result, walking can apply repetitive, unfelt pressure to a wound, making it larger and deeper. Left untreated, diabetic ulcers lead to serious infections, which may result in amputation.
DeWitt and Koschtial say foot and ankle surgeons use a variety of surgical and non-surgical methods to heal diabetic ulcers, but stressed early intervention yields the most favorable outcomes.
"Daily self exams are the best protection. Too often, patients fail to check their feet for small cuts or punctures that over time will ulcerate and become infected," they say. "If you have diabetes and see anything suspicious on your feet, consult a foot and ankle surgeon for diagnosis and treatment. Even a few days can make a difference in preventing serious foot problems from developing."
An estimated seven in 10 diabetes patients have nerve damage that impairs feeling in their feet. Fifteen percent eventually will develop a foot ulcer. Among those with ulcers, one in four will lose a foot. Each year more than 86,000 amputations are performed as a direct result of diabetes, and studies show half of those who have one foot or leg amputated will lose the other within five years. Proper diabetic foot care, say DeWitt and Koschtial, prevents foot loss.
In some cases, amputation might be the preferred option. If vascular and podiatric surgeries can't improve blood circulation and foot function, resolve infection or restore foot function, amputation may be the only solution that enables the patient to heal. Today, advances in prosthetics make it possible for patients to return to an active lifestyle, a necessity for keeping diabetes under control.
Foot problems are not an inevitable consequence of diabetes. The risk can be lessened significantly by following a few simple precautions:
- Keep your blood sugar under control to help minimize cardiovascular and blood circulation problems
- Lose weight, don't smoke and adhere to prescribed dietary, medication and exercise regimen At least once a day, examine your feet for cuts and other small wounds you may not feel
- Never walk barefoot, outdoors or indoors
- Cut nails carefully - straight across and not too short; never trim corns and calluses yourself
- Wash your feet every day in lukewarm water; dry carefully
- Choose comfortable shoes with adequate room for the toes
- Wear clean, dry, non-bulky socks; change daily
- Shake pebbles or bits of gravel out of your shoes before wearing
- Seek treatment from a foot and ankle surgeon if minor cuts and sore spots don't seem to be healing
For more information on diabetic foot conditions, contact DeWitt and Koschtial's office at (616)538-4442, toll free at 1-866-763-3446 or visit the ACFAS consumer Web site, FootPhysicians.com.
Hikers and hunters: Long, vigorous hikes take toll on feet, ankles
Wyoming, MI, 2009 -As brightly colored leaves dazzle the fall landscape, hikers and hunters nationwide will migrate to mountains, woods and fields, but many, unfortunately, are ill prepared for the beating their feet will take, warn two local foot and ankle surgeons.
"Hikers, hunters and others who love the outdoors often don't realize how strenuous it can be to withstand constant, vigorous walking on uneven terrain," say James DeWitt, DPM and Daniel Koschtial, DPM members of the American College of Foot and Ankle Surgeons (ACFAS) located in Wyoming, MI . "Lax physical conditioning and inappropriate footwear bring scores of outdoor enthusiasts into our office each fall for treatment of foot and ankle problems such as chronic heel pain, ankle sprains, Achilles tendonitis, fungal infections and severe blisters."
"Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if you haven't conditioned properly before hitting the trail," say DeWitt and Koschtial. "Also, many don't realize that cross-training athletic shoes aren't the best choice for extended hiking and hunting. Had some of our patients worn sturdy, well constructed hiking boots, they wouldn't have suffered sprained ankles or strained Achilles tendons."
DeWitt and Koschtial advise hikers and hunters to make the investment in top-quality hiking boots. They say strong, well insulated and moisture-proof boots with steel or graphite shanks offer excellent ankle and foot support that helps lessen stress and muscle fatigue to reduce injury risk. "The supportive shank decreases strain on the arch by allowing the boot to distribute impact as the foot moves forward. So if a boot bends in the middle, don't buy it."
In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections and frostbite. DeWitt and Koschtial recommend synthetic socks as the first layer to keep the feet dry and reduce blister-causing friction. For the second layer, wool socks add warmth, absorb moisture away from the skin, and help make the hiking boot more comfortable. "Wool lets moisture evaporate more readily than cotton, so fewer blisters develop," they add.
What happens if your feet or ankles hurt during a hike or hunt? DeWitt and Koschtial say pain usually occurs from overuse, even from just walking. "If you're not accustomed to walking on sloped or uneven ground, your legs and feet will get tired and cause muscles and tendons to ache," they explain. "To avoid a serious injury, such as a severe ankle sprain or an Achilles tendon rupture, rest for awhile if you start hurting."
According to the ACFAS consumer website, www.FootPhysicians.com, pain is a warning sign that something is wrong. "Serious injury risk escalates significantly if you continue hiking in pain." They likened hiking to skiing, in that beginners should take on less difficult trails until they become better conditioned and more confident.
Evaluation by a foot and ankle surgeon is recommended if there is persistent pain following a hiking or hunting outing. "We're most concerned about ankle instability and strained Achilles tendons. Inattention to these problems at their early stages may lead to a serious injury that will keep you off the trails for a long time,"say DeWitt and Koschtial.
Hikers and hunters seeking further information about ankle sprains, Achilles tendon injuries and other foot and ankle problems may contact Drs. DeWitt and Koschtial at (616)538-4442, toll free at 1-866-763-3446 or visit www.FootPhysicians.com, sponsored by the American College of Foot and Ankle Surgeons.