Archive for October, 2015

Charcot Foot Deformity Fact Sheet

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This weeks article was contributed by Founder Annita ShawBrought to you by Charcot Awareness Education Foundation


In re reading Bonnie’s last posting where the suture had been left in her first amputation, a sore developed into an infection requiring 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.

Recently, 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
• Have a weak immune system
• Have chronic health problems such as
diabetes, cancer, 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.

This weeks article was contributed by Founder Annita ShawBrought to you by Charcot Awareness Education Foundation

Infection: Don’t Take It Lightly

Until I had the incident with an infection and saw how concerned my doctor was, I really didn’t realize the effects it could have. Foot ulcers in the diabetic is problematic. It is easy to injure the foot and not know it. Years ago, my husband and I went to Las Vegas. I was wearing socks and sandals on my feet. I was not a diabetic at the time. It was a very hot day. We walked a long distance taking in the sights, malls and casinos, then worked our way back to the RV Park where we were staying. I looked down at my feet as I stepped up into the RV only to discover my bloody feet. I had worn blisters on them. They had broken and bled. I should have gone to a doctor, but didn’t, as we were in a strange place and didn’t know any one. We used a home remedy for over a week. I stayed off of my feet and took really good care of them. They healed and I didn’t get an infection. I think back now and believe I had the neuropathy then. Unfortunately, many don’t check their feet. They may even believe the ulcer, or wound will heal on its own. It may be under a callus and become infected. Infection compounds the problem.

What is infection? It is a bacterial invasion that under favorable conditions multiplies and produces injurious effects.


What does it look like? (Symptoms) It could be sore, red, warm, or tender to the touch, swollen, and could even weep with a fluid, or pus. These could be ulcers and could turn into calluses anywhere on the bottom, side or toes of the foot. If ignored and nothing done to heal these, amputation could be the end result.

Where should I look for infection? Infection can be anywhere on the body, but with Charcot Foot one should be most concerned with the feet. Examine your feet often. Check for wounds, blisters, bruises and cuts. If the heels are cracked or areas are showing evidence of increased pressure, one needs to moisturize the skin and possibly be fitted for orthotics by a professional to cushion the foot.

Is infection easily missed? If one has Nueropathy some of the symptoms will not be evident. We have the tendency to think it will just go away, or heal on its own. One needs to check the area often, both morning and night. If it is not healed in a couple of days, one should seek medical attention.

Since MRSA has become a very serious concern, I would like to share this poster which was on display at the hospital.


This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

What You DON’T Want: An Infection

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About a week had gone by and I noticed the incision on the leg where the muscle had been slipped was a little red. My next appointment was July 10th only a few days away. Unfortunately, when we went in I learned I had an infection in both the surgical incisions. These still had stitches. He removed the staple from my ankle and left the stitches on the leg and ankle. Then scraped both areas that were red and infected. We were all disappointed and weren’t sure what caused the problem. Maybe because it looked so good earlier we were in too big of a hurry.

Again, my leg was wrapped like a cast and sent home for bed rest. I could wear the boot, or surgical shoe. The surgical shoe was best as the boot was too tight and hurt the foot. For the first time, I had to take an antibiotic once a day. Because of this, I had to be back on Wednesday as infections are serious.


Dr. Roukis Fitting Shoe

July 16th Dr. Roukis scrapped the infected section on the leg, purposely making it bleed. He cleaned and packed it in such a way that the infection would heal. He was very meticulous.

He said it looked good and we were to repeat what we had done last week. We had another appointment July 24th and things were progressing well. He removed the scabs with a scalpel and not a drop of blood. His skill never ceases to amaze me. Then we learned he was going to be out of the country for a couple of weeks.

Max rewrapping

He wrapped my leg and put me back in the surgical shoe. He gave Max the instructions for care and wrapping. Things went well. The entire process was about six weeks and I was back to walking quite normally, with caution. Infections are scary and shouldn’t be taken lightly as many amputations take place because of them.

This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

The Confession and Surgery Follow up

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(June 16, 2008) Three days had past since surgery and now I have to tell Dr. Roukis about my fall the night after surgery. Not sure I was lucky, or not, as his assistant came in to prepare my foot foe Dr. Roukis to check it. I told her what had happened. Of course she relayed the message to him. They unwrapped my foot and leg, removed the betadine strips and washed my foot and leg generously with the surgical scrub. I had 14 staples and 4 or 5 stitches. Everything looked really good.

When Dr. Roukis came in, it was obvious he was very disappointed in me even though he said very little. He sent me for x-rays.

Because of my fall, Dr. Roukis decided to put me into a cast even though the x-rays came back okay, no damage. I was surprised when he decided to do the cast himself. He rounded the bottom of the cast, making it nearly impossible to stand or walk on. I wasn’t to put any weight on the cast.

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June 26th back at MAMC. The cast was removed. Everything looked good. In fact so good, Dr. Roukis removed most of the staples and stitches. He put bandaids on the stitched areas. He let me go back into my shoes. I was really nervous about this. He also said we could bathe the area and wear my compression socks. We were to care for it ourselves. I was really uneasy about this, since it was such a short time since surgery.
Not sure we were really prepared to know that to watch for as Dr. Roukis was so thorough and knowledgeable. I now understand how quickly an infection can occur and how quickly it need full attention.

This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation