An estimated three million Canadians currently live with diabetes [sub]1[/sub] and, although they may not realize it, many of them have reduced sensation (neuropathy) or poor circulation in their feet. Footwear is designed to protect feet but people who cannot feel their feet properly are often unaware that their footwear is causing irritations. If you have poor circulation these small sores can develop into wounds, foot ulcers and serious foot conditions. In fact, 85 percent of all leg amputations (for Canadians living with diabetes) are a result of non-healing foot ulcers – more than half of which may have been prevented with more effective nail and foot care, and by people with diabetes wearing appropriate footwear[sup]2[/sup]
As a Canadian Certified Pedorthist I have helped many patients with neuropathy and poor circulation care for their feet. One of them was a 79-year-old gentleman from a small community near Waterloo Ontario, who I first met in September 2011. This good spirited patient, who suffered from diabetic neuropathy, had already had his right leg amputated below the knee following a complication from an ulceration on his right foot. He was no longer able to do the things he wanted and was basically confined to his home. When I saw him he was suffering from blistering on his heel from propelling his wheelchair forward along with numbness in his toes. He was bound and determined to walk again and to preserve his left leg and foot
Following the recommendation of the patient’s surgeon I constructed an orthotic for his left foot to offload areas that were of concern. I also recommended a properly fitted shoe with a wide supportive base that would accommodate the orthotic and help offload areas of high pressure. The change that resulted was tremendous. Within a month of wearing the footwear and orthotic the blister on the patient’s heel had healed and his balance and stability had improved, he had regained some mobility and was learning to use a walker and prosthesis. When I last saw him, six months after our first visit, he was walking daily and was determined to return to his volunteering during the week.
In addition to the orthotic and accommodative footwear, regular and thorough foot care was essential for this patient as he had extremely poor circulation. He started seeing a foot care nurse bi-weekly and he checked his entire foot daily for high pressure, open sores and abnormal redness to ensure an ulcer did not develop. The pedorthic treatment, combined with regular foot care gave this patient his freedom back and he was delighted and grateful.
As a Pedorthist, it is very satisfying to help patient’s regain their mobility and return to the activities they always enjoyed. The most important advice I give Canadians living with diabetes is to have an annual foot exam from a qualified food expert and to check their own feet daily. When you are suffering from reduced circulation or sensation catching an irritation early can prevent a life changing injury.
Submitted by: Shawn Duench, C. Ped (C) Kitchener, ON