Archive for March, 2016

INFECTION: A SILENT DESTROYER

In re reading Bonnie’s 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.

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.

Symptoms
• 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.

Donations are Welcome: Join the team to educate, helping those with Charcot avoid amputation. Thanks for caring. Send donations to:
Charcot Awareness Education Foundation
P.O. Box 3902
Silverdale, WA 98383-3902

This weeks article was contributed by Founder Annita Shaw
Brought 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.

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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.

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Donations are Welcome: Join the team to educate, helping those with Charcot avoid amputation. Thanks for caring. Send donations to:
Charcot Awareness Education Foundation
P.O. Box 3902
Silverdale, WA 98383-3902

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

What You DON’T Want: An Infection

Two places where an infection could start. The one above was the worst one.

Two places where an infection could start. The one above was the worst one.

About a week had gone by since my surgery on my left foot when 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.

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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

Donations are Welcome: Join the team to educate, helping those with Charcot avoid amputation. Thanks for caring. Send donations to:
Charcot Awareness Education Foundation
P.O. Box 3902
Silverdale, WA 98383-3902

Charcot Symptoms . . . ?

After meeting with two groups this month I decided to go over my symptoms of
Charcot as this was the most asked question. What are the symptoms or what do I watch for?

I saw my foot changing over the years, but didn’t realize there was any problem, just thought it was part of the aging process amd didn’t send out any alarm. My falls or poor balance didn’t trigger anything either. Never thought to mention any of these to a doctor. Do you fit this pattern? I hope not. I nearly became an amputee because of this.

How my foot looked prior to surgery to correct the deformity. Notice the hammer toes, fallen arch, bulge on the inside of the big toe, and the color of redness of the foot.

How my foot looked prior to surgery to correct the deformity. Notice the hammer toes, fallen arch, bulge on the inside of the big toe, and the color of redness of the foot.


Questions:

1. Do your feet hurt? When did they begin to hurt?

2. Do you feel your feet? Do they feel like cardboard on the bottom?

3. Do you know what peripheral Neuropathy is? (loss of sensation)
(long term peripheral Neuropathy, 10 or more years will result in
Charcot Foot Deformity)

4. Do you have swollen feet?

5. Is one foot warmer than the other?

6. Do you have a tight Achilles tendon? Have you heard it snap over bone?

7. Have you noticed changes in your feet? Hammer toes? Calluses?
Wound that won’t heal? Ulcers? Infection? Visual lump? A falling arch?

8. Are you having balance problems?

9. Are you having a tendency to walk on the side of your foot?

7. Is your foot sore to the touch?

8. Have you been diagnosed with diabetes, or any other disease that
has peripheral neuropathy associated with it?

If you answered yes to many of these please find a knowledgeable foot and ankle specialist. (DPM, FACFAS or a knowledgeable Orthopedist) Early diagnosis and care can help you avoid amputation.

Donations are Welcome: Join the team to educate, helping those with Charcot avoid amputation. Thanks for caring. Send donations to:
Charcot Awareness Education Foundation
P.O. Box 3902
Silverdale, WA 98383-3902

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

The Organized Support Group: Pros and Cons

3/4/2016 The Organized Support Group: Pros and Cons

Last week I talked about a support group being my best medicine this was probably considered an informal group as no time or date for meeting was specific and maybe only a phone call away.

A person with Charcot once asked me if I had a support group for Charcot. At that time I only knew of a few people with this malady and hadn’t even thought about a support group.

Max and Annita Shaw Annita the founder of Charcot Awareness Education Fondation (CAEF)

Max and Annita Shaw
Annita the founder of Charcot Awareness Education Fondation (CAEF)


I then began researching the possibility. I found three types.

Organized—one where speakers were meeting your needs and some sharing from individuals. Usually meeting once a month.

Group support—where those within the group merely talk with each other concerning things related to the disease they have such as COPD or Diabetes. These meet once a month or in some cases only 4 times a year.

Another is going on line at a certain time each week or day of the month, such as having a conference call, many are able to come together anywhere in the world. This needs a strong leader that is very accessible and knowledgeable.

Speaker at COPD group talking about new equipment for breathing problems.

Speaker at COPD group talking about new equipment for breathing problems.

I have since been in several of the organized groups, as well as, group led and combinations. The one I have enjoyed the most is the organized group offering knowledgeable speakers that can offer valuable information and answer our questions. My husbands COPD group has been very good example, even for me a diabetic and Charcot patient. To begin with, the leader of the group asked us what we needed. He and his assistant found resources that would help those with COPD and their families cope, helping make life easier. We have met with pulmonary rehab personnel, care facilities people, pharmsists, those that supply oxygen and equipment, and individual sharing plus a social time where we get to know each other and even have played some non threatening games and feel free to offer ideas and suggestions.
This takes a lot of work on the moderators part. If presenter doesn’t show he/she still needs to have something in place rather than cancel the session.

The Group sessions has a leader that comes and lets the group that shows up run the show. My first experience was with a diabetic group. All the members were in their 70 and 80’s. It really turned into a chat session dealing more with the moniters children and her building a new house than the needs of the attendees. She did try to get speakers, but most of the time they never showed. Our suggestions seemed to be important when given, but seemed to get lost in the long run.

COPD group in discussion

COPD group in discussion

Last night my husband and I went to our local hospital diabetic support group for the first time. We were all informed she was changing the format to group run rather than getting speakers. She said it was too much work. This didn’t set well with me, especially since they only meet 4 times a year. Since everyone just sat there and nothing was happening. She finally decided to go around the room and have us introduce ourselves and say a few things.

There were the usual names and “I was diagnosed with diabetes X number of years ago and my blood sugar is under control” statements. Then my husband introduced himself, basically the same way but added his concern about Charcot and my having it and at that time turned it over to me. He suddenly had everyone’s attention. I asked if anyone knew what Charcot was and not one including the moderator knew. She is a diabetic educator and should have known, since I have a friend who is also a diabetic educator who actually diagnosed my condition before the doctor did. Diabetes is number one on the list of over 30 diseases that makes Charcot worse.

Need I say I spoke on Charcot for the next 30 minutes and handed out our foundations brochure and post card to everyone. Even after everyone introduced themselves and told about their situation, several came back to me and asked questions. The moderator then asked if we knew of anyone who they would like to speak at our next meeting to let her know. She said this was very informative. My husband said he was glad we had come and that he had mentioned Charcot and that we had brought usable literature.

Support groups do help you. Your immediate group of family and friends, plus your medical team are the most important, but there are times that an outside group adds a new perspective or more information. Try them out and see which works best for you.

Donations are Welcome: Join the team to educate, helping those with Charcot avoid amputation. Thanks for caring. Send donations to:
Charcot Awareness Education Foundation
P.O. Box 3902
Silverdale, WA 98383-3902

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