Archive for November, 2012

Charcot Foot Instability

Major Driver, my doctor at Madigan Army Medicatl Center MAMC, was very positive, but said I needed to get my feet healthy. She wanted the bottom of my feet as soft as the top of my foot. That meant using a cream on my feet twice a day, seeing my podiatrist regularly to have my nails cared for. You see, because of the Neuropathy, I actually cut the end of one of my toes on my left foot off when I tried to trim my own toe nails. I didn’t realize it until I saw all the blood. Several of my toe nails were very thick and hard to cut.

In a relatively short time, my feet were getting soft, my cracked heels were healing and my feet were feeling better. She was not in favor of my tight shoes, but let me stay in them as they determined my Charcot Foot was stable, but to continue the care routine.

I truly believe the tight fitting shoes that I wore all those years is what kept my foot, or maybe my feet, from deforming any more than they did. Also, checking my feet often kept them from the ulcers, as any hint of a sore I tried to take care of it immediately.

P4010081 copyJuly 2005, we had to go to the farm. This trip wasn’t good for my foot and upon my return home Dr. Driver put me into a walking boot for 30 days. October, I learned Dr. Driver had been transferred to Chicago. She didn’t have a replacement. We had a fall trip planned to London. The Doctor who filled in for her told me not to get sick while we were in London. He had great concern for my getting good health care while traveling. He gave me some pain medication in case I needed it and told me to use the walking boot and any assistance possible. Example: at the airport use the wheel chair.

2006 Dr. Roukis, now head of the Limb Preservation Clinic, walked into my examination room. He was so young, about the age of our son. He held my right foot checking the temperature, blood flow and anything necessary. He then said “We are going to have a couple of dates. Then we are going to have a courtship and then you and I are going to get married.” Both Max, my husband, and I were a bit shocked. He then went on to say I was in stage 4 of Charcot Foot and I had a window of about four years to have surgery to save my foot. After that, it would just be a matter of time before the foot would be amputated.

He didn’t push us, but we went over the surgery, the areas in the foot that would be worked on and what would be done, the time line for surgery, length of the hospital stay and recovery. He even went over my care after surgery, suggesting I go into a care facility for recovery and rehabilitation.

We knew I would opt for the surgery The question, now, was when?

Brought to you by Charcot Awareness Education Foundation

HAPPY THANKSGIVING!


Happy Thanksgiving from the Charcot Awareness Education Foundation. Max and I are very proud and extremely thankful to you our readers. We decided to start this website three years ago, beginning in January of 2010. We were excited that we were in twenty countries and had 1000 hits, now less than three years later, we are in over 120 countries and 30,000 hits a month.

When I was first diagnosed with Charcot Foot, we went on line to research the topic. It was nearly 6 weeks before my husband found an article on Charcot. We now find articles on Charcot Foot written by knowledgeable Podiatrists, Foot and Ankle Surgeons and others well versed in this area of medicine.

So many of you have asked about Charcot Foot, and because of you, you have caused the information to surface. You are helping many people. I get e-mails and phone calls thanking us for our stories and information which has helped them find answers. We have had personal contact with several who have been diagnosed with Charcot. Charcot Awareness Education Foundation is here to inform and educate the public concerning Charcot Foot, a devastating bone deterioration disease made worse by Diabetes, Corticosteriods use, Alcoholism and 21 other diseases. Neuropathy masks the pain much of the time. Hopefully, this knowledge will help individuals avoid amputation.

We were so thankful and blessed that Bonnie agreed to share her story as she is an amputee who lost her foot to Charcot. Her story has helped many. We have given out hundreds of our Charcot brochure. We visit with individuals everyday. We do presentations for diabetic groups and seniors. we even sat a bazaar to raise money for our cause. Young people are showing interest and doing research papers on the topic thus bringing more awareness to the younger population and nursing fields.

If you would like to help us get the information out and help more people. We would appreciate any donation. We are an IRS 501(c)(3) nonprofit foundation. All donations are tax deductible. You can send your donation to Charcot Awareness Education Foundation, P. O. Box 3902, Silverdale, WA 98383-3902

Again Thank you for your help and have a Wonderful Thanksgiving!

Brought to you by Charcot Awareness Education Foundation

Misdiagnosis & Other Complications

By April of 2010, I had gone to our local hospital two times because of pain in my feet. Each time they took x-rays and the attending physician told me I had arthritis and that I was going to have to “Learn to live with it.”

After my dad and husband had such success with a chiropractor, Dr. Button, I finally joined them. He helped me with my neck and diabetes. After a few years, I asked him to check my ankle. He realigned my foot and ankle. This happened every few months, then every month, then every two weeks.

Another diabetic complication began to consume my time, that of going blind. Being an art teacher, eye sight was extremely important. In 2003, my last semester, we had completed about six weeks. During my high school calligraphy class, I had just finished demonstrating some strokes to form new letters on the board. As usual, I began to walk around the room to help individuals. One of the boys stopped me. He asked me to demonstrate the strokes on his practice paper. When I reached down for the paper, I couldn’t see the lines. I straightened up. He asked what was wrong. The class became deadly quiet. Thinking I was going to loose control of the class, I said, “I might as well tell you. I’m going blind.” A couple of girls quickly raised their hands and volunteered to walk around the class and assist the other students. They were excellent calligraphers. The student that had stopped me reached up, touched my shoulder and said, “You did a good job on the board. If we need, you could help us there”. This brought tears to my eyes. With peer tutoring and my working at the board, the students were great. The class, one of the best I ever had. I retired at the end of the school year.

The image is of the hammer toes and callus on the little toe. The next few months found me having more difficulty seeing out of my left eye. My feet, too, were not doing well. In fact, the right foot was beginning to deform and the hammer toes were getting worse. The little toe’s callus was red and more pronounced.

In November 2004, we took our usual trip to the farm in Nebraska. One morning I woke with a cramp in my right leg. I hit the floor and when I did, I heard my ankle snap. It sounded like I had broken my ankle. Like a kid broke his pencil in two pieces. I was in tears. It hurt so bad. We called my doctor here in Washington state. He suggested I go to the hospital for x-rays. We decided not to, but to finish up business quickly and go home.

Once back in Silverdale, we went to the hospital for the x-rays. Again, Side of foot, I was told it was arthritis. I would have to “learn to live with it”. Since I had an appointment scheduled with my podiatrist, Dr. Brewer, I took my x-rays to him. He looked at them and called me over to see them. He pointed out little flecks and said, “You have Charcot”. I had no idea what he was talking about. I had never heard of it. He explained it was a bone deterioration disease. I’m not sure what he said after that, as I suddenly heard the man who fitted me with my orthotics at Madigan Medical Center saying I had a “very serious foot problem” and that I needed to go to the Limb Preservation Clinic.

We needed a referral from a primary care physician to MAMC. We were told the request was denied. My husband, then hand carried the paper work to MAMC. Within a few days I was called and told I needed to come to the clinic as soon as possible. March 2005, we went to MAMC Limb Preservation Clinic where I under went the exam and x-rays and was told they were doing research on Charcot Foot. My doctor, Major Driver, told me I was now “property of Madigan”.

In May, my left eye went black on a Wednesday and had go to the hospital in Tacoma, WA, to have a victrectomy the following Tuesday. The same thing was done on the right eye a few months later. They were able to restore my sight to nearly normal.

Now to concentrate on saving my right foot from amputation.

Brought to you by Charcot Awareness Education Foundation

Amputation

As a diabetic person with Neuropathy, one is concerned about foot health and the possibility of amputation. Statistic’s note the number of diabetics at 23.6 million and lower-limb amputations per year some where between 71,000 and 86,000. This is scary considering there are other diseases and conditions that warrant amputation.

Because of a foot problem, have you gone to a doctor and found they really didn’t help? Mine sent me to a podiatrist because he didn’t want to deal with my situation. I had no idea what my problem was. The podiatrist didn’t seem to think it was serious and it could be taken care of by changing the type of shoes I wore. Unfortunately, I found it more difficult to walk and my feet hurt worse. I went back to my tight fitting shoes. The very type that a diabetic shouldn’t wear. My feet felt better.

You can read most anywhere that infections and Neuropathy can lead to amputation, but rarely do you hear anything about Charcot Foot and its devastating effects, or that it is responsible for amputations. Why? Because it isn’t being diagnosed. If it were, many feet could go through surgery and be saved.

Doctors don’t often see a patient until the problem is too serious. In fact, so late that amputation may be the only option. The problem may be an ulcer or infection that won’t heal. Because of the impaired circulation system, the body can’t heal the amputation either and another amputation may be in order until the entire leg is amputated. My doctor and several articles stated that, on average, a person over the age of 60 who has a foot amputation has a life expectancy of about five years unless they have a positive attitude, a good support system and a comfortable place to rehabilitate.

Amputees are often diabetic, are often a racial minority, poor, fat, old and often ignored (paraphrased from government data). According to a March 24, 2009 article in the LA Times, “…the US. health-care system is poorly designed for what diabetics need most, preventive care; instead it doles out money for expensive urgent care such as amputations,….”

Brought to you by Charcot Awareness Education Foundation

Be Proactive

A friend of mine said she didn’t understand how her sister ended up with bloody blisters on her feet and didn’t feel them. I had this happen many years ago. We had stopped in Las Vegas on our way home to my parents in Nebraska. It was a hot summer day. We decided to walk to the Mall from Circus Circus. I was wearing socks and sandals. I thought this would protect my feet. We walked back from the mall to the our RV, we were staying in near Circus. As I stepped up in the the RV, I looked down at my foot. It looked like there was blood on my sock. When we got inside, I took my sock off and the foot was bloody and had several broken blisters. My other foot was nearly as bad.

I should have contacted a doctor, but didn’t. After all I really didn’t know anyone there and we would be at my parents home in a couple of days. Of course once there, we didn’t seek a doctors help either. We had washed the feet and treated them with a “home remedy” that seemed to be working. Looking back and knowing what I know now about Charcot Foot, this was a really big red flag.

Have you ever had the doctor check the sensation of your feet with a small monofilliment line? Did he explain the test, or results, or the reason for the test? Mine may have, but it didn’t mean anything to me. I left feeling that everything was normal. It wasn’t. Like many with Neuropathy you don’t feel the pain or sensation you should. So you really need to be proactive with your foot care.

Keep your feet healthy. That means you do need to check your feet daily. Pay attention to the fact you may have stepped on something and check. Keep them clean and free from ulcers, calluses and infection. If you need medication to control blood sugar, or other conditions, take it correctly and get regular check ups so your healing is at its maximum. If you have Charcot Foot, having a healthy foot is extremely important because a healthy foot means you will be able to keep the foot and not likely to have it amputated. It may mean orthotics, custom shoes, other type of bracing, but you will be able to walk.

Even if walking is limited, you can maintain your independence and quality of life. Remember your feet are your foundation.

Brought to you by Charcot Awaareness Education Foundation