Archive for May, 2015

Who Might Have Charcot?

This week, I would like to tell you of the diseases that affect Charcot making it worse. Then, follow up with my experiences with Charcot and how My husband and I dealt with this devastating disease along with Bonnie’s experience with Charcot Foot as an amputee. I will add comments and up date information when possible.

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 which appeared in an article in emedicine on Feb. 21, 2007 with one new disease added.

* Diabetes
* Use of Corticosteriods
* Alcoholism
* Trauma
* Infection
* Amyloidosis
* Prenicious anemia
* Syphilis
* Syringomyelia
* Spina Bifida
* Myelomeningocele
* Leprosy
* Multiple Sclerosis
* Congenital vascular disease
* Charcot-Marie-Tooth disease
* Cord compression
* Asymbolia
* Connective disorders, such as rheumatoid arthritis and sclerodema
* Ehlers-Danlos syndrome
* Raynaud disease
* Adrenal Hypercorticism
* Thalidomide Embryopathy (congenital Arthropathy in offspring of exposed mothers)
* Paraneoplastic sensory neuropathy
* Cauda Equine Lipoma
* Restless Leg Syndrome

Since diabetes heads the list, diabetics need to be aware that this article says 15% 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. Recently, January of 2015 The American College said of the 30 million diabetic in the USA that have diabetes, 10 million have Charcot and aren’t wing diagnosed.

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.

Since neuropathy is a loss of sensation in the foot, one is unable to detect painful sensations. 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 help you check your feet. Check them daily. Also, avoid going bare foot.

Message by the Founder Annita

Brought to you by Charcot Awareness Education Foundation

Charcot Symptoms

Often a person finds out they have Charcot Foot before they even know what the symptoms are. You may have realized one foot was warmer than the other and that your foot was changing shape, maybe a bulge on the side, or the arch had fallen and the toes were now becoming hammer, or claw toes. You’ve had an x-ray. You may have been told you have arthritis. Looking back in time, you most likely have had a trauma to the foot, such as, a can fell out of the cupboard and hit your foot or, maybe you fell and injured your foot. If you have Peripheral Neuropathy, you have a loss of sensation. All of these may be indications of Charcot.

Because this is all very gradual, you may not be aware of the changes in your foot or feet. You may realize that you are not as stable when walking, your feet bother you more, but, Oh, well, it just seems like it’s part of a normal aging process.

This joint destruction process has a classification scheme of its order created by Eichenholtz decades ago called the Eichenholtz Classification.

Stage 0 – Clinically, there is joint edema, but radiographs (X-rays) are negative.

Stage 1 – Development stage (acute)

* soft tissue edema (swelling, fluid in cells)
* joint fragmentation
* dislocation

Stage 2 – Coalescent ( merging ) phase

* edema reduction
* bone callus proliferation (growth)
* fracture consolidation

Stage 3 – Reconstruction phase

* osseous ankylosis (bony joint stiffening)
* hypertrophic proliferation (abnormal enlargement of growth)

Charcot Foot (joint or bone) is serious for if this pathological process goes unchecked, it could result in joint deformity, ulceration, maybe infection and loss of function. The worst thing that could happen is amputation. Taking care of the feet and having a knowledgeable professional working with you will help stop further joint destruction.

Unfortunately, it seems, many doctors, podiatrist and surgeons come across with the attitude amputation is no big deal. Unfortunately, once this happens you won’t be seeing him or her any more. You will be working with the per on who fits you with a prosthesis.

I can’t stress this enough. One of my nurse friends said to treat it like you are coding a breats exam for breast cancer. Check your feet daily note any changes in shape, toes arch skin, such as sores, callus. Tell the podiatrist.

Message by the Founder Annita

Brought to you by Charcot Awareness Education Foundation

Two Charcot Cases: Same Beginning Two Very Different Outcomes

Over the next several weeks I would like to show you how two people the same age with the same background can have very different Outcomes with diabetes and Charcot.

The stories are of Bonnie and me. We both grew up on a farm nearly eight miles apart. We went to different schools, graduating from different High Schools the same year. We even knew some of the same people, but we didn’t know each other. That was over 50 years ago. She ended up in Alaska in 1962 working for as a bank teller and eventually worked for Alaska Airlines. Her son was born in 1963. I ended up in Washington teaching Jr. H. and High School near Seattle in 1973. Our son was born in 1974. We didn’t meet until 2007 in Gering, NE as we bank in the same bank and our paths crossed. A God send I would say.

Bonnie was on her feet long hours as in 1990 she was working full time as Customer Service Teacher/Trainer instructing new employees. I was teaching primarily Jr. H. and Sr. H. Art classes which meant moving around the classroom and on my feet a lot on concrete floors. After much pain and swollen feet. In 2003, Boni had a bone break and discovered it when she threw the covers back and put her left foot on the floor as there was blood all over the bed and floor. Once at the podiatrist office he confirmed what he had suspected. Bonnie had Charcot Foot.

Prior to our moving to Washington, we had been in Las Vegas during the summer. I
had been wearing sandals with socks on my feet. We had walked a lot that day. Not unusual even though I had not felt very stable on my feet and usually walked near a wall or something that could help catch me if I felt I would fall. That also meant holding on to my husbands arm when he was near. Any way, as I stepped up into the RV I had blood on my socks. Removing my socks, I discovered bloody blisters. This should have been a clue to me about diabetes and Charcot (had I known of such a disease).

In 2003 I retired from teaching because my eyesight was going down hill fast. Not good for an art teacher. At the same time the right foot was beginning to deform and the hammer toes were getting worse. The callus on the little toe was red and more pronounced. In November of 2004 I woke with a cramp, hit the floor and heard my ankle snap. It sounded like a bone broke. Like someone broke a pencil. Since we were in Nebraska, we finished up there and hurried back to WA to get x-rays as I didn’t want to seek medical care there. However, once again I was told I had arthritis and nothing could be done. This time I asked for my x-ray and took it to my podiatrist. He informed me I had Charcot.

I will, over the next few weeks, give you the details of what Bonnie and I went through to be able to lead our lives. The medical treatments, very different from each other. Yet, we were not that far apart geographically.

If you are having problems with your feet please seek a good podiatrist and have your feet checked. If you have peripheral neuropathy be aware that it is not a friend. Have your feet checked for Charcot. Even If you are cleared and told you don’t have it only breathe a sigh of relief now, but check it again in a year as it can show up any time.

Early diagnosis is Key. A nurse said think of it as if you have breast cancer. Do a self exam. Check your feet daily for any changes. Note them and tell you podiatrist.

Message by the Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

Charcot Awareness Education Foundation results from the Kitsap Great Give May 5th

Kitsap Great Give is now history. They had hoped to reach a goal of $750,000 but surpassed the goal fairly early in the day. They then decided to see if they could reach a goal of $1,000,000 and that was achieved just after 11P.M. There were over 225 nonprofits involved in this event.

It was a long process and lots of planning and effort on many groups and individuals. We are a small organization so were responsible for everything. However, next year should be easier a I have several people who now want to help us as they see a larger need for us to get the word out so people with Charcot, or those that may have it can become diagnosed and not loose their feet to amputation.

If you would like to view our interview that was aired on BKAT, our local TV station in Bremerton, WA May 5, 2015 at 6:45 P.M. It is on their website.

To access the BKAT website, type in then go to interviews Kitsap Great Give. The interview showing Charcot will be streamed live May 10, 2015 at 8:30 PM Pacific Standard time. Again there will be a showing May 13, 2015 at 12 noon Pacific Standard time. Charcot Awareness Education Foundation’s interview should air 45 minutes in to the beginning of the broadcast.

We are so thankful to everyone who helped us and other foundations with this event, for their donations, their advertising, promotions, sponsorship, pool of matching money, just everyone who gave encouragement and moral support. It was an awesome experience.

The money we raised will go toward our work on producing an informational documentary on Charcot Foot Defornity.

Message by the Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation