Archive for May, 2014

Diabetes And Preventing An Amputation

The following is a study done in 1992-1993 of 432 Sioux people in the Aberdeen, SD area. They have diabetes. This study came about through grants from the Agency for Health Care Policy and Research and from the Administration on Aging, Department of Health and Human Services.

All of the information remained confidential. The information from this study was then added to other known information about diabetes. Suggestions were made that will help prevent amputations.

Complications from diabetes are: vision changes, kidney problems and blood flow problems. then a very serious complication is Neuropathy, which causes a loss of feeling in the feet.. Because of this people can easily injure their feet without even feeling them get hurt. It is harder for sores on the feet to heal because there is usually a loss of circulation (blood flow) to the feet.

I was very lucky, as I had not been diagnosed with diabetes, yet, when my husband and I had gone to Las Vegas on our way to Nebraska. It was a very, very hot day. We decided to walk several blocks to a shopping center. I was wearing sandals and white socks. When we got back to the RV, I stepped up onto the step and noticed my sock was all bloody. So was my other sock. I suddenly felt really sick to my stomach. Once inside the RV, my husband helped me remove my sandals and socks. He got a large pan and some warm water and proceeded to clean and soothe my very blistered feet. I was extremely fortunate. The care we gave my feet over the next few weeks allowed my feet to heal with no consequences.

Their Study Findings

• Toes are amputated more often than feet or legs.
• The most common problem that leads to amputations is an ulcer (open soar) that does not heal.
• Sometimes ulcers come from common injuries: stepping on a rock in bare feet; getting blisters from tight shoes; getting a splinter from a wood floor; or dropping something heavy on the toes, such as a book or frozen food.
• Foot ulcers can be healed when attended to carefully.
• Foot ulcers can lead to an amputation quickly, even in a few weeks.
• Men seem to be at risk of having an amputation at a younger age than women.
• It is more common for people who have had diabetes for many years to have amputations, but that is not always the case.
• People who have not had diabetes for long are also at risk for amputation.
• Medical problems, such as peripheral vascular disease ( poor circulation) and Neuropathy (loss of feeling), increase the chances for amputation.
• Some people with foot problems wait too long before going to the clinic, and often the problem becomes serious before they get medical help.
• Health professionals do not always check feet during clinic visits so a diabetic person should remind him/her to do a foot exam each time.

Preventing Amputation

• Know about the lack of feeling (neuropathy) in feet and legs that often comes with diabetes.
• Protect your feet by always wearing shoes that are the right size and that fit comfortably.
• Never go barefoot.
• Check inside shoes for nails or rough edges before putting them on.
• Get someone tho help check your feet every day, including between the toes, and on the bottoms to look for any open sores, cracks in the skin, calluses, redness, swelling, or pus.
• Clean your feet every day with water and mild soap, then put lotion on them to keep the skin from cracking.
• Wear clean socks every day.
• Trim the toenails and never use anything sharp on your feet.
• Go to the clinic to check on a small sore, splinter, infection, or callus on the foot, even if it does not hurt.
• Return to the clinic until the sore or infection has completely healed, even it it takes many visits.
• Avoid exreme temperatures to the feet such as hot water bottles, heating pads, or ice packs.
• Quit smoking because it decreases the blood flow (circulation) to the feet.

Please, take care of your feet. they are your foundation.

Bonnie’s continuing story

Brought to you by Charcot Awareness Education Foundation

Needs Of The Amputee & The Perception One Might Have

If you have been following Bonnie’s story, you know she has had her foot amputated to the ankle. While she writes her next posting, I will continue to share some of my research with you. Both Fishman and Goffman are highly revered in the field of psychology.

Fishman identified seven human needs common to amputees.

• Physical function with a prosthesis
• Visual and auditory considerations for the prosthesis
• Comfort of the prosthesis
• Energy expenditure in using the prosthesis
• Achievement in various activities with the use of a prosthesis
• Economic security
• Status and respect of one’s peers.

Fishman affirms these needs cannot be completely satisfied, and the consequences of the frustration that arises can result in psychological conflict and varying behavior

Obviously, an amputee would like the prosthesis to perform somewhat close to what the normal appendage would do. One would also like it to look fairly realistic, or, at least, not be too noticeable. It is great if it is comfortable, relatively easy to put on and after a short period of time, seem like part of your body. If it isn’t too heavy, it won’t take any more energy to use than normal. Thus, making it easy to go about one’s normal activities.

Try to put yourself in an amputees place. How would you feel? Would you want to share your experience, or hide it from everyone? Or would you avoid the situation?

How do you view an amputee when you meet, or see them in public? Do you stare? Are you surprised to see them leading normal lives? Do you feel sorry for them? Do you wonder what happened that lead them to have an amputation? Do you wonder if they are in pain? Do you reject them, or avoid them? Do you ever take the time to talk with them? Do you know someone who is an amputee? Are you their friend? Do you socialize with them? If so, where do you go? What types of things do you do with them?

Goffman states that the amputee often feels less respected, or accepted as a human being and often fears rejection. They can have pain even a ghosting pain. They also have anxiety of anticipated rejection.

Take time to be sensitive to those around you.

Message from the founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

Sharon’s Surprise & My Continued Rehabilitation

Sometime the middle of April – Sharon contacted fellow employees at Penair and many friends at Anchorage International Airport. She said she needed help in finding a way to help Stair GliderTony and I purchase a Stair Glider (also called Stair Lift) for our three story condo. I knew nothing of this in the beginning. I had been overwhelmed by all the calls, cards, gifts and prayers from all of them. I did not feel they needed to do more, but boy did they. Several long time friends at Alaska Airlines, ERA Aviation and Penair, put together fund raisers, silent auctions, and lunch specials at the airport. So many people worked so hard. The end result was over $1400, enough to purchase a Stair Glider for the 1st set of 20 stairs. What a blessing for us. I was totally amazed and so proud of all of them and the blessing they gave us.

As terrible as January, February and March were, April was buzzing by, lots of hard work, but so rewarding. Tony and I were even able to attend Palm Sunday and Easter services in the hospital chapel. It was wonderful. Day to day routine was getting easier – practice makes perfect.

The rehab trainers met with Sharon at our home to see how I would be able to cope with a three story condo. The stair gliders were a must and as Sharon did her investigation, found them very pricey. The trainers decided I would be making my part of our home the living room/kitchen area which did have a half bath on that floor. I needed a hospital bed for sleeping, bathroom stool would need a guard for holding onto for sitting down and being able to rise.

So, I continued workouts, building body muscles back and learning how to roll a wheelchair by my self. (You would think that should be easy.) There is a certain knack to it and definitely good muscles are needed, which I did not have at first.

Bonnie’s continuing story

Brought to you by Charcot Awareness Education Foundation

Who Might Have Charcot Foot

There are some 24 diseases that cause Charcot foot to become worse. The following list of diseases by Ali Nawaz Khan MBBS Riyadh, Saudi Arabia appeared in an article in emedicine on Feb.21, 2007.

  • Diabetes
  • Use of corticosteroids
  • Alcoholism
  • Trauma
  • Infection
  • Amyloidosis
  • Prenicious anemia
  • Syphilis
  • Syringomyelia
  • Spina bifida
  • Myelomeningocele
  • Leprosy
  • Multiple scierosis
  • Congenital vascular disease
  • Charcot-Marie-Tooth disease
  • Cord compression
  • Asymbolia
  • Connective disorders, such as rehumatoid arthritis and sclerodema
  • Ehlers-Danlos syndrome
  • Raynaud disease
  • Adrenal hypercorticism
  • Thalidomide embryopathy (congenital arthropathy in offspring of exposed mothers)
  • Paraneoplastic sensory neuropathy
  • Cauda equina lipoma

Since diabetes heads the list, diabetics need to be aware that this article says15% of the diabetic population has Charcot foot and a 2004 University of Washington study states that 1/600-700 diabetics with diabetes mellitus neuropathy has Charcot Foot.

Charcot is, apparently, difficult to diagnose and is often miss diagnosed as arthritis. One needs to find a Charcot knowledgeable professional. A podiatrist DPM, or a foot and ankle specialist (surgeon) DPM, FACFAS who is able to diagnose correctly. After being told I had arthritis “Live with it!” three times, I took my x-rays to a podiatrist who diagnosed me with Charcot Foot and I was able to get the proper treatment to save my feet from amputation.

Since nueropathy is a loss of sensation. One who has Charcot foot is unable to detect painful sensations. They are also unable to describe what is happening to the foot. A doctor once told me a patient came into her office unable to remove his shoe and couldn’t understand why. When she looked at the bottom of the shoe she found a nail. It had gone through the shoe and well into his foot. It was removed and the shoe taken off to reveal a traumatic situation. Because of Neuropathy, much goes undetected that could save the foot and individual from pain.

If you don’t have someone to help you check your feet, place a mirror on the floor that can be used to check your feet daily. Also, avoid going bare foot. Protect your feet. We were visiting my husbands mother. She had a shagg rug in her living room. I was barefoot. We were there a couple of days. We left and went to Carlsbad Caverns, by this time my foot was really hurting me. Walking was difficult. Inspecting the foot didn’t really reviel anything. However, after touring the cavern, we noticed a swollen red spot. I squeezed the heel and out popped a piece of round tooth pick. We figured I had picked it up in the shagg rug, breaking part of it off in my heel. Please check your feet daily and keep them healthy.

Next week we will return to Bonnie’s story.

This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

What is Charcot Foot? And PLEA for help.

(Sorry to interrupt Bonnie’s story, but will return to it in two weeks)

Six years ago my husband, Max, and i began the paperwork to create the Charcot Awareness Education Foundation. The website is now five years old. We have had over 1,500,000 hits, and are viewed in 186 countries and have had many personal contacts. We will be posting more stories of others with Charcot Foot in the near future. We also hope to redesign the site so it is easier to use.

We have recently learned that Loyola University believes there are 4 million diabetics in the USA that have Charcot Foot and will lose their feeet to amputation because they won’t be diagnosed. Our m9ssion as an educational foundation is to get the information out. In other words, we educate and inform those directly and indirectly affected by Charcot Foot deformity, helping to avoid amputations.

We have recently learned we are the only community based foundation of its type in the entire world. We need your help to further this mission. United Way here in Kitsap Co, Washington state USA is having one day of donations called the GREAT GIVE on May 6, 2014. Note the inset.

Charcot Awareness AD

Charcot foot (neuropathic osteoarthropathy) deformity is a serious progressive and disfiguring condition often unrecognized because of loss of sensation. The area of the foot most commonly affected is the mid arch. It can also develop in the rearfoot and ankle.

charcot foot

Neuropathy often masks damage and pain from a trauma to the foot as one lacks feeling, or sensation. This makes a diagnosis difficult. The trauma, however, could happen years before any sign of Charcot is present. It could be as severe as fractures in the foot from a fall to a seemingly minor incident as a can falling out of the cabinet hitting the foot, or walking, or jogging.

The end results are:

  • a severely deformed and disabling foot that is difficult to shoe and brace properly.
  • recurrent infections and ulcerations.
  • amputation

Charcot Joint was discovered in syphilis patients in 1868 by Jean-Martin Charcot in France. Charcot and Charles Féré published the first scientific investigation of this condition in 1883. It wasn’t discovered in the diabetic patient until W. R. Jordan made the link in 1936. It is believed Charcot was not discovered earlier because diabetic patients didn’t live long enough. Some 24 diseases causes Charcot Foot to emerge.

After talking with my surgeon, it was decided my Charcot Foot came about because of being thrown from a horse at the age of 10. I landed on my feet and dropped to my knees. While in Jr. and senior high school, I often fell. This was always embarrassing, as I was usually with friends. Even after I was married, we were in Washington, DC sight seeing when for no apparent reason I fell. I was quite used to this and learned to fall with out hurting myself too much…..maybe a scratch, or bruise. It simply became part of my life.

It would have been wonderful if this condition could have been identified when I was young. The surgery would have been much less complicated.

This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation