Top 5 Ways Diabetics Can Prevent Foot Problems & Amputation
“Here today, gone tomorrow” can describe a diabetic’s foot.
Here are five ways that a foot surgeon says a diabetic can prevent amputations and other problems with the feet.
Diabetics do NOT have to lose their feet, let alone legs, to amputation!
There are five key things that a diabetic can do that will prevent the need for a foot amputation or the development of serious foot problems, says Peter D. Highlander, DPM, Reconstructive Foot & Ankle Surgeon, Director, Wound Reconstruction Center, The Bellevue Hospital, Bellevue OH.
Routine Foot Checks
“The first line of prevention is checking the soles of the feet at least twice daily (morning and night),” says Dr. Highlander.
“If your eyesight or flexibility prevent you from observing the bottoms of your feet, then have a spouse check or purchase a plexi-glass mirror to aid in the process.”
If you live alone or otherwise do not see a caring individual on a daily basis, you must acquire the habit of using a mirror, and you can supplement this with reading glasses (depending on your vision) that will magnify the area of inspection. A magnifying glass will also help for those with visual issues.
Shoes
“Avoid going barefoot and open footwear,” advises Dr. Highlander. Seems like these days, going barefoot is the thing to do.
Though our very ancient ancestors routinely went barefoot, this doesn’t mean that in today’s day and age, it’s safe – especially for diabetics.
Nor is it sightly if you don’t keep your feet and toenails clean and healthy looking.
Dr. Highlander continues, “See your local podiatrist [foot doctor] for diabetic shoes and protective orthotics which is a paid service by most private and government insurers to those patients who qualify.”
Routine Foot Inspections by a Doctor
A doctor of podiatric medicine (DPM) should regularly inspect your feet. Don’t rely on only a primary care physician.
Shutterstock/Alexander Raths
“Research has shown that diabetic patients who routinely see a podiatrist were much less likely to undergo an amputation compared to diabetic patients who did not see a podiatrist,” says Dr. Highlander.
“Depending on risk factors determined by your podiatrist will determine how often you should be seen, but a minimum annual to biannual checkups are necessary for those with low risk. Patients with higher risk are to be seen more often.”
Seek Treatment ASAP
“Accidents happen and we all get blisters and other minor injuries from time to time,” begins Dr. Highlander.
“If a break in the skin is noted then you should be seen. It is much easier for your foot doctor to issue successful treatment early in the process.
“Nearly all patients who undergo amputations will note putting off being seen by a foot doctor for many reasons; none of them are justified.
“If you’re diabetic and you notice a break in the skin to a foot, then call today to be seen by a podiatrist ASAP.
“If you are concerned for infection, then go to the nearest emergency department.”
Don’t think for a second that you have some kind of built-in protection factor for foot amputations, such as being young or athletic.
Years ago along Chicago’s famed Magnificent Mile, where throngs of people gather to play “power” volleyball, I spotted a young man in a wheelchair eagerly watching some players in action.
He was made up of a head, torso and a single arm. The rest of his body was short stumps – raw and fresh looking, as though the limbs had been cut off just a few days prior.
I asked someone what had happened. I was told that just a few weeks ago, that very man had been on the beach playing power volleyball with those same athletes – but that he had gotten careless with his type 1 diabetes management.
Type 1 or 2 diabetes, a sore or wound does not turn into a raging spreading infection and dead tissue sooner than you can get to a medical clinic for an evaluation and treatment.
Stop Smoking
Cigarettes are called “cancer sticks.” They can also be called “amputation sticks.” They are among a diabetic’s worst enemies.
Dr. Highlander explains, “Diabetes alone affects the immune system and the body’s ability to heal on its own.
“Smoking or any source of nicotine also compromises the ability to heal. Nicotine causes the blood vessels in your lower extremities to constrict which restricts blood flow, and this process continues for up to 45 minutes after the last nicotine exposure.
“With chronic nicotine exposure, the blood vessels become permanently diseased.
“All in all, diabetes and active nicotine use is a recipe for disaster and often ends with someone losing a limb.”
Dr. Highlander provides advanced treatment and prevention options for lower extremity wounds with a special interest in deformity correction and soft tissue coverage for non-healing wounds.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/MRAORAOR –
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There are certain things that you should do upon discovering your very first diabetic foot blister, and there’s one thing you should NOT do – and that is panic. (more…)
Stiff Feet in the Morning: Causes and Solutions
Are you under 50, not previously injured but keep waking with stiff feet in the morning that soon return to normal once you’re up and about?
Stiff Feet, No Injury
“Stiff feet in the morning can be caused by a number of underlying conditions,” says Arielle Levitan, MD, board certified in internal medicine and co-founder of Vous Vitamin LLC and co-author of “The Vitamin Solution: Two Doctors Clear the Confusion About Vitamins and Your Health.”
“Most commonly, a condition called plantar fasciitis causes people to have stiffness in their feet when they first wake up,” continues Dr. Levitan.
“This is an inflammation along the bottom of the foot.” The tissue affected are ligamentous bands called plantar fascia.
Along with the morning stiffness in the foot caused by plantar fasciitis is also a burning type of pain — in the arch and/or bottom of the heel.
Only one foot may be affected, but for some people, both feet are affected by this common disorder for which being overweight is a risk factor.
Other Causes of Stiff Feet in the Morning
“Other conditions that can cause stiffness in the feet upon waking up also include various forms of arthritis, tendinitis (Achilles) or less commonly certain vitamin deficiencies such as vitamin D deficiency that results in muscle stiffness,” explains Dr. Levitan.
Prevention of Stiff Morning Feet
“Stretching out the feet can make a big difference,” says Dr. Levitan.
“Some people also sleep with ankle braces to prevent the stiffness in the morning.
Stretching out the feet can make a big difference. Freepik/yanalya
“Vitamin D replacement and sometimes a magnesium replacement can help with these types of symptoms.”
If there is no pain with the stiffness, and soon after you’re up and about, your feet feel normal, there’s no need to be concerned.
The situation may simply be related to lying still in a bed for many hours – especially in an older body. Inert joints can become stiff, and all they need is some movement to unstiffen.
To help prevent or minimize morning foot stiffness, you should consider taking up a physical activity that stretches and really uses the feet, such as yoga, hiking, jogging, step aerobics or martial arts.
Now if there’s pain along the arch and/or the bottom of the heel, you can place your bet on plantar fasciitis – for which there’s a variety of treatment options available such as ultrasound-guided injection, Botox or stretching, and exercises.
Dr. Levitan is board certified in internal medicine and has a special interest in women’s health and preventive medicine.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/okawa somchai
Causes of an Overnight Cough Other than Acid Reflux?
If you don’t have a coughing problem during the day but only overnight while you sleep, acid reflux isn’t the only potential cause.
You may not even be aware of repeated coughing throughout your sleep, while other members in the household will hear it.
If they tell you that you cough throughout the night, take them seriously and find out what the cause is.
Often, the cause is acid reflux — making its way to the throat and irritating the larynx. This is called LPR: laryngopharyngeal reflux.
It doesn’t always come with heartburn, either. Sometimes, chest symptoms are absent, and the symptoms occur only in the throat.
Nevertheless, you should not self-diagnose.
Don’t guess; make an appointment with your physician, who may end up referring you to a specialist to uncover the cause.
Of course this idea is always scary, but the cause may be very benign and easily fixed.
“Common causes of an overnight cough include asthma (often worse at night), a sinus infection or an allergy (especially consider things in the bedroom such as carpeting, dusty drapes, pets or dust mites found in bedding),” says Arielle Levitan, MD, board certified in internal medicine and co-founder of Vous Vitamin LLC and co-author of “The Vitamin Solution: Two Doctors Clear the Confusion About Vitamins and Your Health.”
Dr. Levitan is board certified in internal medicine and has a special interest in women’s health and preventive medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/EHStockphoto
How Long Is It Normal to Lose Smell and Taste from a Cold?
Don’t you just hate it when you’re looking forward to a delicious meal and you realize you can’t taste or smell due to your cold?
And no matter how hard you blow your nose — which may not even feel stuffed — you just can’t get back your sense of taste and smell. This stinks (no pun intended)! (more…)
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Clavicle Popping in and out Near Sternum: Causes?
Depending on your level of health anxiety, you might think that your popping clavicle is due to cancer or a neurological disease.
And in fact, if your clavicle pops in and out, you will notice that this occurs with certain movements of your upper body.
“The clavicle can pop out of joint with certain upper body movements,” says Arielle Levitan, MD, board certified in internal medicine and co-founder of Vous Vitamin LLC and co-author of “The Vitamin Solution: Two Doctors Clear the Confusion About Vitamins and Your Health.”
“This is typically because the joint is lax,” says Dr. Levitan. “It can, however, be painful and sore to touch. If you have lax or ligaments you are more likely to have this happen.”
Certainly, for peace of mind as far as the cause, you can schedule a visit with your general practitioner or a sports medicine physician.
Your doctor can recommend exercises and also which movements to try to avoid to limit the popping in and out of your clavicle.
But rest assured, you do not have to worry about cancer or a neurological disease as the cause of this annoying condition.
Your health care professional can advise on particular exercises to engage in, and also which movements to do on a daily basis, to try to avoid or reduce the frequency of the popping in and out of your collarbone.
After all, this situation can also cause soreness or aching.
It is important to get plenty of calcium and to do strength training exercises for strong bones, especially as you get older.
A great shoulder exercise is that of pressing a heavy ball overhead for repetitions, bringing it down to chest level before pressing it back up again — while standing.
A variation is to grasp either side of the handle of a kettlebell with each hand and press overhead.
The clavicle will be strengthened with weight bearing exercises such as the ones just described.
A regimen of strength training, however, will not cause a clavicle to pop in and out.
Dr. Levitan is board certified in internal medicine and has a special interest in women’s health and preventive medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Cause of Catching a Cold Every Two Months
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Actinic Keratosis Mimicking Seborrheic Dermatitis
If a dermatologist tells you the rough red or pink patches on your face are seborrheic dermatitis, beware:
They may be actinic keratosis mimicking the more benign condition. (more…)
Drinking a Lot of Water but Barely Peeing: Causes, Solutions
Some causes of not peeing despite drinking plenty of water are life-threatening, while others are quite harmless.
When urine output is abnormally low, this is called oliguria.
Benign Causes of Infrequent Urination
“A person who is behind in their fluids (dehydrated) can drink a lot of water but not urinate much,” says Arielle Levitan, MD, board certified in internal medicine and co-founder of Vous Vitamin LLC and co-author of “The Vitamin Solution: Two Doctors Clear the Confusion About Vitamins and Your Health.”
Ask yourself the following questions:
• Have you been working out intensely and not replenishing your lost fluids?
• Have you been working many hours in a hot environment?
• Have you been experiencing a lot of menopausal or postmenopausal hot flashes?
Any of the above situations could dehydrate the body, requiring more water intake than usual. You can be dehydrated and not be all that thirsty.
Serious Causes of Infrequent Peeing
Dr. Levitan says, “Another cause for this could be retaining water — due to congestive heart failure, liver disease or having lots of sodium intake.”
Congestive heart failure is when the heart does not pump adequately.
Either the pumping action is weak, or the amount of blood that fills the heart prior to each pump is insufficient.
Heart failure. Shutterstock/EstherQueen999
Either way, the body is not getting optimal amounts of blood with each heartbeat.
Things begin backing up, causing fluid retention – most commonly seen in the lower extremities as a puffy or swollen appearance.
Edema. Shutterstock/AppleDK
If congestive heart failure is not being treated, the result may be oliguria. The treatment includes taking diuretics (“water pills”) every day to encourage urination.
Liver disease has many potential causes including chronic heart failure. In heart failure, the liver receives a reduced supply of blood.
Over time this will damage the liver in that it will perform suboptimally.
Chronic kidney disease or renal insufficiency is another fallout of chronic heart failure. If the kidneys aren’t working properly, you may not pee as much as you should even if you’re drinking a lot of water.
Acute kidney failure will definitely result in oliguria. Acute kidney injury can be caused by acute heart failure, acute liver failure, an adverse drug reaction, poisoning or a urinary tract obstruction, to name a few.
However, severe kidney distress will be accompanied by other symptoms.
Filling up on water is not a treatment for any of these conditions.
If you cannot explain away your “I hardly pee” situation with any of the benign causes listed above (which include a high sodium intake), then you need to see your doctor.
This is especially true if even after increasing your water intake more, you are still seemingly barely urinating.
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Dr. Levitan is board certified in internal medicine and has a special interest in women’s health and preventive medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.