Question: My 37 year old daughter has Type 1 diabetes. She had half her foot amputated 5 years ago due to infection. Being diabetic, it’s never healed totally. Now it’s not infected, but won’t heal. She is also on dialysis 3 days a week. Her orthopedic wants to amputate up to the knee. My question is will she be able to heal or will all this make everything worse?
Dr. Foreman: Blood flow to the extremities is always an issue in patients with diabetes, with some more severely affected than others. There are tests that can indicate the amount of blood flow to the leg which is a fairly good predictor of whether or not an incision will heal. It sounds to me as if that might be a good idea to do prior to doing surgery. Talk to your orthopedist about this.
About 1.25 million Americans live with Type 1 diabetes, according to the American Diabetes Association. Foot problems are a major concern for diabetics which can sometimes lead to amputation of a toe, foot or leg. Orthopedic experts say most diabetic foot problems arise from two serious complications of the disease — nerve damage and poor circulation. The CDC offers these additional precautions for diabetics:
- Look for cuts, cracks, sores, red spots, swelling, infected toenails, splinters, blisters, and calluses on the feet each day. Call your doctor if such wounds do not heal after one day.
- If you have corns and calluses, ask your doctor or podiatrist about the best way to care for them.
- Wash your feet in warm—not hot—water, and dry them well.
- Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.
- Rub lotion on the tops and bottoms of feet—but not between the toes—to prevent cracking and drying.
- Wear stockings or socks to avoid blisters and sores.
- Wear clean, lightly padded socks that fit well. Seamless socks are best.
- Wear shoes that fit well. Break in new shoes slowly, by wearing them 1 to 2 hours each day for a week to 2 weeks.
- Always wear shoes or slippers, because when you are barefoot it is easy to step on something and hurt your feet.
- Protect your feet from extreme heat and cold.
- When sitting, keep the blood flowing to your lower limbs by propping your feet up and moving your toes and ankles for a few minutes at a time.
- Avoid smoking, which reduces blood flow to the feet.
- Keep your blood sugar, blood pressure, and cholesterol under control by eating healthy foods, staying active, and taking your diabetes medicines.
If you need to see an orthopedist, call Azalea Orthopedics at 903.939.7500 or request an appointment online.