Diabetes Self-Management Blog

Let’s talk about feet. Or, instead, let’s let you let me talk about my feet. Allow me to ramble — or amble — with no particular place to go during this blog entry. I’ll roam about, with my feet as my subject. Merely a stroll.

I’m a person with diabetes. Type 1 diabetes, if that matters to you. I’m insulin-dependent, and I’m complication-free. I wear an insulin pump, and I take pretty good (some might say above-average) care of my condition. However, next week I go to the podiatrist for my second visit (ever) to a foot doctor. Shall I be honest with you? OK, I will: among all of the doctors I’ve visited over the past two or three years — and there’ve been a lot of doctors — the one doc I worry most about seeing is the podiatrist.

Why? I’m not sure. One reason may be that my feet make me feel old. My feet are no longer the feet of youth. They bear the wear and tear of three-and-a-half decades of use. They have those little veins I remember seeing in my father’s feet when I sat at them when I was a kid.

And feet? Well, they’re feet. Add to that they’re feet coupled with diabetes, and you get the chance that things can go pretty wrong if they go wrong. Neuropathy. Ulcers. Amputation. Oh it all sounds horrible, gross, painful, and not something that would happen to me.

“Can you feel this?” (poke with little tool on the bottom of my feet). “Tell me when you stop feeling this” (tuning fork placed on my big toe). “Are your shoes comfortable?” “How long have you had this callus?” “Does it hurt?” “When did you start to lose that toenail on your small toe?”

There are a lot of foot-related questions I’ll have to endure. She asked me quite a few at last year’s visit. See, doc, my feet have taken a beating for most of my life. Don’t most people’s? I’ve only been someone with diabetes for three years, but I’ve been on my feet for 36, and I’ve been a pretty active person — a pretty active person who had no reason to pay much attention to his feet.

When I ran cross country and track during college, yes, there were calluses, blisters, sometimes pain, but I ignored these issues. When I ran and cycled in my twenties, my feet, at times, hurt; and there were foot injuries, odd aches, but they healed, and I ignored them.

Did I pay attention to how my feet looked? Did I examine my toes? Browse the bottoms of my feet? Look for signs of injury? No, no, no. And no.

Today, these days, I rarely practice what might be considered proper diabetic foot care. Blame it on my mostly nondiabetic past as a foot-ignorer. But hey, I don’t have any complications from diabetes, and so there’s that — that is, I mean, there’s nothing going wrong at the moment; I have complete sensation in my feet (normal sensation for someone my age), and upon my last visit to the podiatrist, aside from her scraping down a few calluses, she didn’t chastise me or warn me about my foot care. In fact, I was told I was doing fine.

But still. Still, there are things I should do more of, be more mindful about. I’m so good about my diabetes management in so many of its “pay-attention-to” realms. Except in foot care. I go barefoot in the house (most all of the time). I go barefoot in the yard (quite a bit of the time). I walk outside barefoot in winter to take out the trash (stupid, but I kind of enjoy the brisk wake-up it gives me). I will wear a pair of shoes, repeatedly — and I may just have them on today — that I know should go into the waste bin because of how they make my feet feel (they’re Dr. Scholl’s brand, but they don’t agree with my little toes; and it’s because I’m a lazy shopper, not because I enjoy the sore toe or two).

I also don’t thoroughly dry my feet after showers before putting on socks. I don’t closely examine my feet each day for signs or changes in color, appearance, or sores. I rarely look at the bottoms of my feet. I don’t clip my toenails by squaring them off (what the certified diabetes educator recommended).

I just do not follow feet instructions well.

And that’s probably why I worry about the podiatrist’s visit next week. My own issues. My own guilt. My own foot laziness.

I’m sure it’ll be fine, but I’m sure — well, I know — I could do better. I won’t go from where I’m at now, which is probably being only a halfway-there awesome diabetic foot person, to a 100% awesome diabetic foot person. Not overnight, and not for the next year or two. Maybe not ever.

But as I age, I do promise you I’ll become more feet-aware.

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Comments
  1. You are quite correct that you should begin to take much better care of your feet. Shortly before my 60th birthday last Spring, I had two toes and part of the foot amputated, due to a diabetic ulcer that not only did not heal but became infected–the infection moved into the bone and resulted in the amputation.

    Also, studies indicate that about 80% of diabetics will ultimately show signs of neuropathy, even if they themselves are not aware of it for some time. The loss of sensation can result in unnoticed wounds that can become distinct problems.

    You are still a relatively new diabetic–so it is far better to develop the best habits of regular examination and care now, so you don’t wind up in my position or worse.

    Good luck!

    Posted by David |
  2. Before diagnosis, I had feet that gave me problems for years. I had some thickening of the skin, callouses, and it was very common for the skin between my toes to crack and hurt like you-know-what. Once diagnosed, and like you, working hard to stay controlled, my feet dramatically improved. The skin is once again soft and smooth and no more cracking between the toes. I go barefoot when I want. I know if I step on something sharp, I WILL FEEL IT. If I cut my foot, IT WILL HEAL. As a controlled diabetic, my feet are no different than anyone elses - better than many non-diabetic ones. I’ve had well-meaning friends give me all kinds of lotions and creams and other foot stuff for gifts because they know I’m diabetic and everyone hears about diabetics and foot problems. I have no use for any of that stuff. It gets given away or tossed. So I wouldn’t worry too much about this doc visit - should be a breeze for you.
    Take care, and I always enjoy your writing
    Jane

    Posted by Jane |
  3. Eric,

    I’m the same exact way. I played high school football and three years at the University of North Texas. I was never in bad shape and I always worked out. It wasn’t until six years ago that I found out I had diabetes. I’m supposed to check my feet? Why? I’m a big guy, my feet take a beating. I’m like you and I have had to retrain myself to take care of myself in a different way than I used to.

    -Weston

    Posted by Weston |
  4. Thanks, Eric!
    I have short, fat feet that makes finding shoes very difficult. I used to wear size 6 shoes for the width but it gave me calluses on my small toes.
    I used to wear children’s shoes but they’re now as expensive as adult shoes.
    For the last 2 years, my sister has been buying shoes for me - SAS brand shoes.
    A single consult w/ a podiatrist suggested wearing athletic shoes - New Balance 600 series.

    I’ve given up zoris, open-toed shoes,shoes w/o backs. You have perfect diabetic control, I have good shoes. Some exchange, huh?!

    Posted by miss kitty |
  5. Eric, thanks for discussing this topic!
    I started limping several months ago and attributed it to my back problems. I finally looked at my right foot and my great toe had a corn at the tip. I used a medicated corn pad and the little corn came off. I kept doing that for about 6 months and finally showed to my doc. He trimmed the dead skin away and said to use the medicated corn pads, but if it didn’t go away soon, to see a podiatrist. After x-rays, I learned I have a bone spur. After several visits, he told me to wear shoes with open toes. That was last November/December and I didn’t have any open toe sandals that worked. So I have walked around the house with just socks. I cut the toe out of a sock and also in an old houseshoe and wore that for a while. I saw the podiatrist the first of March, and he is afraid to remove it due to my diabetes….he wants to avoid infection of the skin and bone. He said it looked a little red and that indicated poor circulation. So I’ve been putting my treadmill to work, wearing a silicone toe cap which doc gave me at first visit. If I wear shoes, I have to use the toe cap, and gosh it is so easy to forget to put it on the toe before putting on socks and shoes.
    I am 74, have a big tummy, and it is very difficult to look between my toes. But I do keep them clean and dry. I just ordered 3 pairs of new sandals and now I realize I’ll have to keep my toenails trimmed and looking good. That is no easy task to accomplish with my tummy and old bones/joints.
    I go back to the podiatrist in 6 months, so hopefully the bone spur will heal itself. I don’t feel pain as long as I use the toe cap with my shoes. Easy Spirit is my favorite shoe, and have the same style in several different colors. I sure don’t want to stop wearing those.
    Betty (type 2, no meds)

    Posted by Betty |
  6. My podiatrist trims my nails and calluses. After hearing that infected toes are one of the major cause of amputation I quite trimming my own nails. I have enough things wrong without also risking lose of feet. Pay attention to what your dr. says. It is too important not to.

    Posted by granny Pat |
  7. I can only say, I hear you… but there are options that can help you help yourself very easily with this issue. Emotional issues can be released quickly, if you’re up for it:).

    Posted by Opheana |
  8. Eric, I am a retired Podiatrist and Diabetes Educator and I really enjoyed your “frank” discussion of your feelings about your feet and Foot Care. So many others on this blog get a chance to comment about their own foot care (at least THINK about feet) because of your sharing as well. My major “prejudice” in foot care for those with Diabetes, is that I would like you to have the same chance to keep both your feet (whole) as a person without Diabetes. Sometimes when we can’t feel our feet or see our feet, we tend to forget about them. It is so easy to take our feet for granted and especially when they are not saying “ouch” and so many other parts of our bodies do preoccupy us, do “complain” to us or “worry” us. But…if you ever had a fine hat that somebody sat on, or a “hand-me-down” glass or china figurine that dropped and broke into many pieces; you can never put it back together quite the same as it was before breaking it. So feel some LOVE for your feet and ask a Diabetes Educator who knows about feet for some suggestions that I know (and you know) you can follow. I know there a lot of good habits that will keep you in touch with your feet and save your sole. Thanks for your stimulating thoughts. Doc David.

    Posted by Dr David E Klein, DPM |

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Foot Care
Healing Numb Feet (10/08/14)
Getting a Foot Up On Diabetes Care (02/25/14)
Simple Steps Can Reduce Amputation Rate by Half (02/01/13)
Limb Loss Awareness Month (04/05/12)

 

 

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