Archive for December, 2014

What Makes A Perfect Gift?

This is the time of year many people around the world celebrate religious events. Now, a time to reflect on the past year and give thanks for the blessings that have come along. A time to thank a higher power for guidance and assistance to achieve. If you have followed Bonnie and my stories over the past two years, I’m sure you have noticed we are both very thankful for the blessings we have been given as people with Charcot Foot.

I was raised on a farm in western Nebraska by Christian parents, though quite poor by today’s standards. I had no idea we were poor. It wasn’t an issue. We merely did with what we had and no one felt sorry for anyone. In fact they helped each other.

My mom made many of my clothes. We didn’t go hungry as we raised our own cattle, hogs and chickens and a large vegetable garden. She sold tomatoes, cabbage and lots of sweet corn. She saved this money for things we needed during winter and spring. Mom canned most of our food until the home freezer came to be. We did freeze beef, pork, chicken and corn, but that was kept at our local turkey processing plant that had wire cage storage boxes that people could rent to store their frozen food. That meant driving several miles to get it. Our refrigerator was an Ice box. Men in the area would cut ice on the river and store it in an ice house near the river. Those that helped harvest the ice could get the ice at the ice house to put in their ice box when they needed it.

I was just big enough to look over the edge of a table when my parents had butchered a hog. The meat was on a large table in our basement and my parents were wrapping the meat to take to the turkey plant to freeze. It was near Christmas and I was so excited every time I saw a present. I was told we didn’t have money to buy gifts for everyone, sooo… As I came down the long stairs to the basement, I saw all those packages. I wanted to give one of them to an elderly couple I had adopted as my grandma and grandpa. My parents tried to discourage me as they told me the package I had picked out had pork chops in it and it wouldn’t make a very good gift. Apparently I liked pork chops and wouldn’t agree. They finally gave in. We got into the car and drove to their home. I presented them with my gift. They were thrilled. However, I didn’t learn until later that was the first meat they had eaten in weeks. They had canned dandelion greens from their yard and were living primarily on that. Need I say when the word got out, the neighbors and friends saw to it that they were fine from then on.

As I look at our world at this time, I really wonder what has happened. Who or what has gotten in the way? I look at all the rules and regulations that have come about to “help or protect” us from ourselves. I wonder if the “Greatest good for the Greatest Number was really the answer to many probems. People afraid to say something for fear it will offend, or it will be taken “wrong”. Where is the trust and the true helping hand?

My dad told me a story about the time I was going out on my own to find a place to live. He told of a man searching for a place to relocate his family. He stopped a man on the street and asked, “What type of town is this? The man said, “What kind of a town did you come from?” The man replied, “The people were terrible, They were greedy, mean and unfriendly. The man then said, “That’s what they are like here too.” The man moved on. Soon another man came to the town looking for a place to move his family. He happened upon the same man on the street and asked, “What kind of a town is this?” Again the other man asked, “What type of town did you come from?” His reply. “Oh, the people were kind, helpful loving people.” The man said, “That’s the type of people you will find here.”

You make the difference! And the only way I can say it, as a Christian, is “Merry Christmas and a Prosperous New Year” to each of you.

Message by the Founder Annita

Brought toby Charcot Awareness Education Foundation

Infection: A Silent Destroyer

In re reading Bonnie’s last posting where the suture had been left in her first amputation, a sore developed into an infection which required amputation of another 6 inches of her leg which caused me to do further research concerning infection.

My surgeon was very concerned about infection. I had a very minor one after surgery to correct Charcot in my left foot. He aggressively treated it and it was soon gone. There were signs around the hospital warning people about MRSA.

I was watching a popular TV program that had a guest doctor and the topic was Sepsis. I had no idea what it was, and was shocked when they said more people die from this than diabetes and cancer. It was infection.

I then began to talk with health care professionals and having my husband search the web. There is a lot of information for you to read, so I will break down some of the information for you.

You have probably heard of Necrotizing Faciitis (NF), but more commonly called Flesh-Eating Bacteria. This is really scary to me. It can destroy skin, fat, and tissue covering the muscles within a very short time. Fortunately, this infection is very rare, but deadly if you contract it. In fact 1 in 4 that get this infection dies.

Higher Risk Group
• Has a weak immune system
• Have chronic health problems such as diabetes, cancer, or liver or kidney disease
• Have cuts on your skin, including surgical wounds.
• Recently had chicken pox, or other viral infections that cause a rash.
• Use steroid medicines, which can lower the body’s resistance to infection.

• Skin is red, swollen, and hot to the touch.
• A fever and chills.
• Nausea and vomiting.
• Diarrhea.

These usually happen after an injury with pain worse than expected for the size of the injury. In fact it may feel fine and a day or so later it suddenly gets worse. You could go into shock. The bacteria destroys the soft tissue and fascia, which quickly becomes gangrenous (dead) This tissue must be surgically removed to save the life of the patient. NF can cause excruciating pain, dangerously low blood pressure, confusion, high fever, and severe dehydration due to the toxins poisoning the body. It can also occur under the skin resulting in a misdiagnosis.

If it occurs in the muscle or bone, major limb amputation is necessary. Death from this condition is not uncommon. Aside from tissue decay, the bacteria causes the rest of the body’s organs to go into systemic shock.

NF is not a recurring condition. Once treated the bacteria is eradicated from the body. (A good thing) However, this is a very fast moving infection, so time is the most important factor in survival.

For further information on Necrotizing Faciitis use your favorite search engine. Much of this was based on NNFF’s information from Dr. Steven Triesenberg, MD (Infectious Disease Specialist) in Grand Rapids, Michigan.

Bonnie’s continuing story

Brought to you by Charcot Awareness Education Foundation

Let’s Take Another Look At Charcot Foot

Since I was diagnosed with Charcot Foot in 2005, I have marveled at my findings. There are many in the medical field that do not seem to know about Charcot Foot or aren’t feeling confident enough to work with it. In fact, many that have the designators behind their name are content to cut Seniors toenails and do minor surgeries.. I have found those with experience in fitting people with orthotics or prosthetics seem to be able to identify those with Charcot Foot best. They probably won’t tell you what the disease is, but will refer you to a Doctor or clinic that deals with limb preservation. Ironically, these usually deal with amputations.

Symptoms of CharcotI, like many I have talked to diagnosed with Charcot had no idea what it was. The first response is often shocked silence, then “And that is what?” The explanation I received was that is was a bone deterioration disease. Nothing could really be done to stop it. No pills, and surgery wasn’t recommended. Since I had pain, discomfort and deformity coming on, the Neuropathy masked much of the problem. I didn’t really think it was too serious. I guess you could say I was in denial, but not completely as I had my husband, Max, research Charcot on the computer. We found very little information just enough to have a doctor refer us to the limb preservation clinic at Madigan Army Medical Center (MAMC) where the man who fitted me with my orthotics had said I needed to go months earlier.

Over the past years I have learned a number of things positive and negative.

Hardware in Annita's right foot

Hardware in Annita’s right foot

There is help out there for those with this devastating disease. Your best bet is to find a good foot and ankle surgeon. If you are a diabetic, using corticosteriods, or an alcoholic, these are the top three that accompany and expedite this malady. You really need to talk with your doctor and get those under control so your health is stable.

Because you, my readers, are asking more questions and seeking answers from your doctors, there is more information on line. This is exciting to me as together we are making a difference. They will still tell you Charcot foot deformity is rare or uncommon. This is true when you look at all diseases in the world. However, it is very common in the diabetic community. In fact Loyola University says there are 4,000,000 diabetics in the USA alone that have Charcot Foot, are undiagnosed and will loose their feet to amputation. Think about it that’s big business for doctors to do amputations and the prosthetic industry to manufacture hardware, pharasuital industry to now manufacture and come up with new drugs to combat depression and pain. Well, you get the idea I am sure. If surgery can be formed early enough, one may only need orthotics and/or special shoes to walk normally with no pain, or pain medications

Others, I have talked to, were told by their doctors the amputation is easier to deal withFoot Care 2than the recovery time from an operation to repair or rebuild the foot. They were also told surgery won’t work. Since my reconstruction surgery in 2006, I feel so much better and am able to walk. I know of another Charcot patient who had surgery 25 years ago and he walks well. Some of the specialists would rather cut toenails in the “old folks” home than use their skills and training to help the Charcot patient have a better quality of life. Amputees can still walk, but the majority of those I have met with Charcot use a wheel chair because it is easier than learning to walk with the prosthesis. Most are over 60 years old and not flexible as a younger person. Since they believe my Charcot Foot began when I was thrown from a horse at age 10, there was plenty of opportunity to identify Charcot before I was 60. This is best done now by radiograph, however the person reading the x-ray needs to know what to look for as I was told I had arthritis and nothing could be done.

Your feet are so important to your independence. Charcot Foot results in a severely deformed and disabling foot that is difficult to shoe and brace properly. You could have recurrent infections and ulcerations with a final result amputation. Check your feet daily, note any changes and keep them healthy. Contact a Charcot knowledgeable professional if these things happen.

Message by the Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

Charcot Foot Deformity Is Made Worse By Diabetes and 24 Other Diseases

I had been diagnosed with type 2 diabetes nearly 10 years before I was diagnosed with Charcot foot deformity. Yet, during that time I watched my very well formed foot change shape. The toes began to go into hammer toes, my arch began to flatten out and my balance was shakey. I began to fall again. I was getting calluses on the bottom of my feet. I noticed wear patterns on the bottom of my shoes, but I didn’t think much about it.

I was told I had some neuropathy. I really didn’t know what that was except that I couldn’t feel that little filament on some of the areas on my foot when the doctor checked it. Not feeling pain is a good thing right? Wrong! That pain let’s you know there is something wrong. One with neuropathy and foot problems needs to be extra vigilant.

Some in the medical community believe Charcot comes about from a trauma, such as my being thrown from a horse when I was ten and landed on my feet. Because we walk, nothing was done and the fractured bones never really healed. Then getting diabetes in later life it becomes an issue. The trauma, however, can be quite minor, such as a can falling from a cabinet and hitting one’s foot. Another group believes it is related to the neuropathy and progresses.

Foot care is really important no matter what. What about the callus that forms on the bottom of your foot? Take care of it. Soften the area with a good lotion, many are advertised, but if you aren’t sure what you should use check with your podiatrist, or primary care doctor for a recommendation. Lotion softens and soothes the infected area. That’s really important because if it goes too long the area under the callus can become infected causing an ulcer. This is where problems really begin and can lead to amputation.

Moisturize your skin and get rid of cracked and dry skin on your feet. They need to be healthy. You can’t see your feet? Use a mirror, place it on the floor, or ask someone to look at your feet for you. Do this on a daily basis.

Recently, I noticed calluses forming on my feet,

Bottoms of slippers with wear patterns

Bottoms of slippers with wear patterns

but I hadn’t looked at my slippers that I use at night , nor my orthotics in my shoes. When I did I was shocked as I thought I was doing a good job caring for my feet. Whoops! There were actual holes in the soles of my slippers. The soles were really too thin and that’s not good as something could come through the bottom and puncture your foot. The orthotics are specially made for me and would be replaced this month anyway, but were more worn that I had expected. Yesterday, I met with my specialist and I was informed that I needed to be more watchful as I could get an infection and be in BIG trouble.
Close-up of right slipper toe area

Close-up of right slipper toe area

Heel area of right foot

Heel area of right foot

Need I say, I now have an appointment for new shoes, orthotics and am getting new slippers as I have to have something on my feet when not in bed. Why? My neuropathy is so bad I have run a toothpick in my bare foot and did not feel it until the area festered and it popped out when the heel was squeezed.

Bottom of Left slipper wear pattern

Bottom of Left slipper wear pattern

Check for wear patterns on you slippers or shoes. They give you a clue about the health of your feet, how you walk, or your pressure points. Is your Achilles tendon too tight? This is another sign your feet need attention.

One of the Podiatrists said yesterday that Charcot is very common among the diabetic. When you speak of all diseases in the world it is considered uncommon. Charcot also is known to cause some people to have severe flat feet.

Message from the Founder, Annita Shaw

Brought to you by Charcot Awareness Education Foundation