Blog - Diabetic « Affiliated Foot and Ankle Center

Posts Tagged ‘Diabetic’

Smoking or Your Feet?

Monday, November 1st, 2010

Smoking and foot care are a dangerous combination; especially, if you have poor circulation, diabetes, or heart disease. There are increased incidences of infections and amputations, but it ceases to amaze me that patients will sacrifice a piece of their foot for that dreaded cigarette.

Cigarettes contain the compound nicotine and this substance causes the blood vessels to narrow which limits the blood flow to different parts of the body. The heart can be affected by limited blood flow. With diabetes, smoking can prove fatal.

Diabetes can cause calcification with the arteries and this can impede the flow of blood to the feet. When cigarettes are added to the mixture, the opening of the arteries becomes narrower. This can cause discoloration in the toes, cramping in the legs and feet and delayed healing the legs and feet.

Recently, I had the opportunity to speak with a person who has been a patient of mine since I started practice. In the past, I have advised the patient to stop smoking because of the possible danger pertaining to his feet. Just to give you a background, he has had 3 amputations on both feet; plus, he enjoys his two to three cigarettes before he comes into the office. Approximately three weeks ago, he comes to the office and says’ “Doc, I have a sore on my foot…” I knew something was strange because he came in on an odd day and he did not smell like a carton of cigarettes. Well, he had a giant hole in his foot. He told me it just started two days ago (it looked like it was there 2 weeks). I treated him that day and told him he must see the vascular specialist. While all this is going on, I still told him, practically begged, that he must stop smoking. Well, he told me to just cut it off…..I am not going to stop smoking.

Well, on the next visit, the wound got larger and there was a stench and puss. I advised him to go to the hospital and he had an amputation of one of his toes.

The moral of this story is that you have to make a healthy choice….Smoking or Your Feet!!!!!

If you have any wounds or infections of the lower extremity, come see the limb salvage specialists of Monmouth and Middlesex County, Affiliated Foot and Ankle Center, LLP with locations in Howell, Edison, Carteret and Monroe, NJ.

By Dr. Jasen Langley

Tags: blood flow, Diabetes, Diabetic, Dr. Jasen Langley, feet pain, foot, foot injuries, foot pain, howell, wound
Posted in General | No Comments »

Beating the Odds on Amputations

Monday, August 16th, 2010

Amputations are a serious concern whether it is related to traumatic or diabetes. Traumatic amputations are usually from injuries sustained in motor vehicle accidents and lawn mower injuries. These injuries can make the foot and ankle unsalvageable as well as non-functional. Sometimes the debris and remnants of the injury can lead the patient to severe infections. Diabetic amputations are subjected to patients who have high sugar levels and neuropathy, which are patients who have a loss of sensation in the foot and ankle.

Podiatrists are your first line of defense if it relates to the lower extremity. Diabetic amputations are the number one cause of losses of limb. Diabetics are subjected to these surgical procedures if different parts of the foot and ankle are infected. Infections can be prevented with regular check-ups of the foot and ankle.

As many diabetic patients know, there is much fear when a diabetic has markings on their feet and ankles. Whether it is redness, bruising or an abscess, these are painful conditions that can become out of control. Some may need to be hospitalized for further work-ups such as vascular, infectious and medical.

Once the patient has been evaluated, they may have an infection or vascular condition that can limit blood flow to the foot and ankle. This can lead to a gangrenous, painful and non-functional foot. Usually this rotted part of the foot and ankle must be amputated to prevent other medical problems.

According to a recent announcement from Bloomberg Newsweek, Dr. James Wrobel states that most diabetics who visits the podiatrist once prior to a diabetic foot ulcer, reduces their risk of amputation and hospitalization by 15-17 percent! This may be due to the patients becomes educated on how to self examine their foot and also, most diabetic patients will become aware of the warning signs of pre-ulcers and infection. By the same token, patients will acquire and learn about shoes that they should be wearing to prevent ulcers and pressure spots on the foot and ankle.

All diabetics should be evaluated by a foot and ankle specialist whether there are complications are not. Education is the best prevention. Please inquire to your family doctor, endocrinologist and vascular specialist regarding having a foot exam. CDFE (Comprehensive Diabetic Foot Exam) is very important exam and as Dr. Dewaters of Affiliated Foot and Ankle Center, LLP discusses in a prior blog, this exam can be a matter of life and loss of limb.

By Dr. Jasen Langley

Tags: Diabetes, Diabetic, Dr. Jasen Langley, feet pain, foot, foot injuries, foot injury, foot pain, howell, neuropathy, red hot foot, redness, wound
Posted in General | No Comments »

CDFE…It Can Save Your Life!

Thursday, July 15th, 2010

According to the American Podiatric Medical Association (APMA), “Every 30 seconds, a lower limb is lost due to diabetes-related complications. That comes to 2,880 legs and feet every day. Diabetes is an epidemic of national proportions, and currently affects nearly 24 million Americans. It is also a family affair, as the disease is commonly passed down from parents to children. Amputation and ulceration prevention has been a major focus by Medicare in order to reduce complications and contain costs. Patients should take advantage of Medicare’s initiative to help prevent complications caused by neuropathy and peripheral vascular disease. Diabetes may cause a decrease in circulation called peripheral vascular disease. This is similar to a drought were there is not enough water and causes things to die. If there is not enough blood flow, a wound may not heal or develop gangrene, or death to tissue. Diabetes may also cause peripheral neuropathy, which decreases the ability to detect a wound or sore. This may allow tissue breakdown and an ulceration to occur. Areas of increased pressure like calluses are especially at risk.

If there is an ulceration or wound to the feet it may difficult to heal due to these conditions. This has caused a significant amount of spending by Medicare that they have invested a large amount of funding in preventing wounds. The new recommendations are to do a Comprehensive Diabetic Foot Evaluation, CDFE, once a year. This is an examination that is dedicated to the evaluation of pressure to the feet, sensation and circulation. If there are signs of neuropathy or peripheral vascular disease, then patients may qualify for diabetic shoes with special insoles to decrease the pressure to the feet and risk of ulceration.

Other precautions that should be taken is to see a foot care specialist such as our podiatrists located in Howell, Edison, Carteret and Monroe, and to have toenails and calluses taken care of every couple of months. This prevents any problems with patients cutting themselves and allows the doctor to keep a close eye on any future concerns. It is also recommended that patient apply lotion to their feet on a regular basis and check their feet twice daily. If you are unable to see the bottom of your feet, use a mirror to check them. Also check the inside of your shoes, especially if little children are around as they may leave toys in there. If you or someone that you love has Diabetes, make sure that they are seen by a podiatrist in order to prevent amputation.

By Dr. Alison DeWaters

Tags: Diabetes, Diabetic, Dr. Dewaters, feet pain, foot, foot pain, howell, neuropathy, proper footwear, ulcer, wound
Posted in General | 2 Comments »

Swollen Feet?

Tuesday, July 6th, 2010

Many patients will come into our office at Affiliated Foot and Ankle Center located in Howell, NJ asking the question, “Why are my ankles so swollen?” Usually this time of the year, it is caused by the increase in salt intake from too many barbequed hot dogs and the increase in humidity during the summer months. There are many possible causes for swollen feet and ankles, ranging from the common and harmless to the rare and dangerous.

Occasionally, the ankles and feet swell as the result of something localized to that part of the body. If you recently suffered a traumatic injury to one or both of your legs, for instance, it’s expected for the onset of swelling and bruising to occur. The ankles and feet can also swell as the result of an infection. For instance, a severe ingrown toenail or an insect bite that you’re having a reaction to may cause unexpected swelling. Burns, including sunburns, can also cause swelling.

Sometimes a more systemic problem can lead to edema in the ankles and feet. Problems of the heart, liver, and kidneys can eventually cause swelling in the lower legs, ankles and/or feet. Pregnancy and obesity can both cause obstructions of the circulatory system leading to swelling of the feet and ankles. Arthritis and other joint diseases can lead to pain and swelling in the feet and ankles, although this swelling will be focused in the joints themselves and you shouldn’t expect a generalized puffiness.

A certain amount of swelling in the ankles and feet is not uncommon in the summer months, especially if you’ve been standing or walking for long periods. It’s also common to get swollen ankles or feet if you’ve had to do a lot of prolonged sitting, such as during an airplane flight. I regularly visit the spa while on vacation to treat myself to a relaxing massage because of the swelling. A massage assists your body to rid of excess fluid. Some women get swollen ankles and feet during menstruation.

Medications such as antidepressants, steroids, blood pressure medications and hormone supplements are a common cause of swelling in the ankles and feet. Diet can also play a role. If you’ve been taking in too much salt, it can lead to swelling.

Finally, gaining weight and being more sedentary can often cause an increase in the size of your feet and ankles.

If you are unsure of the cause of your swollen feet or ankles it is imperative to make an appointment with one of our physicians at our office in Howell, our office in Edison, our office in Monroe or our office in Carteret. BETTER SAFE THAN SORRY.

Possible Causes of Swollen Feet/Ankles

- Foot or Ankle Injury

- Diet

- Insect Bite

- Allergic Reaction

- Pregnancy

- Water Retention

- Nephritis

- Side Effect from Medication

- Poor Fitting Shoes

- Cellulitis

- Lymphedema

- Varicose Veins

- Poor Circulation

- Deep Vein Thrombosis

- Heart Failure

- Anemia

- Kidney Disease

- Diabetes

- Gout

- Rheumatoid Arthritis

By Valerie Gregory, MSPT, CKTP

Tags: ankle, ankle pain, Diabetes, Diabetic, feet pain, foot, foot injuries, foot injury, foot pain, howell, pregnancy, swollen foot
Posted in General | 4 Comments »

Charcot Foot; “The Red Hot, Swollen Foot”

Wednesday, January 6th, 2010

Charcot arthropathy is a form of arthritis that affects patients with peripheral neuropathy. The typical symptoms are a red hot, swollen foot. It usually happens to the middle of the foot and presents with pain to the area. This is unusual for patients that typically did not have pain previously. Diabetes is often the underlying cause of peripheral neuropathy. Charcot is a progressive disorder that is characterized by three stages of the disease process: acute, coalescent, and chronic. During the acute stage, there is a red hot swollen foot that is painful. This is often confused with an acute infection or cellulitis. It is necessary that there be immobilization during this stage as if it continues to progress, the joints will begin to breakdown. If there is resorption of the bones, this will allow the middle of the foot to breakdown and the arch to collapse and even bow outward. The joints will calm down and solidify in that position and develop a “rocker bottom foot.” If this develops, it is not only difficult to cut but also at risk for ulceration. Careful inspection and routine diabetic foot care is essential for prevention of this condition.

By Dr. Alison DeWaters

Tags: Diabetes, Diabetic, foot injury, foot pain, red hot foot, swollen foot
Posted in General | 2 Comments »

Exercising with Diabetes

Friday, March 13th, 2009

If you have diabetes, consult your physician before starting or changing a fitness routine. This is especially important if you are overweight or have a history of heart disease, peripheral vascular disease, or diabetic neuropathy. Your doctor may recommend a stress test to make sure it’s safe for you to exercise and to determine the intensity that’s best for you. You may also need special footwear to protect your feet. Exercise doesn’t have to be strenuous to be beneficial, but try to spend at least 30 minutes a day engaged in some physical activity. (more…)

Tags: Diabetes, Diabetic, Exercise, Exercising
Posted in General | 1 Comment »