Feet First
By Stephanie Levin
With proper care, foot problems can be prevented or caught before they become serious
The human foot is a structural masterpiece comprised of 26 bones, 33 joints and about 100 muscles. Tendons, ligaments, a network of blood vessels, soft tissue and skin all reside there, too. Factor in years of walking or standing, and it's no surprise that a constellation of foot problems can develop later in life, some so seemingly minor that they almost go unnoticed.
That's what happened to 82-year-old George Freeman. Two years ago, Freeman noticed a callus on his toe. He put a bandage on it and continued puttering around his garden. But when the callus started to bleed and his lower leg swelled, Freeman dialed his doctor.
"The doc took one look at my foot and admitted me to the hospital," recalls the Concord, Mass., retiree. His doctor, podiatrist Greg Catalano, DPM, recognized that Freeman had cellulitis, a serious bacterial infection of the skin. Once the swelling receded, Freeman needed surgery on his foot to treat the infection. "I limped into the hospital, walked out on crutches, graduated to a boot, and a few months later had special shoes made to take the pressure off of my toes when I walk," he says.
While foot ailments are common, individuals with diabetes have more to contend with. Neuropathy (nerve damage), coupled with poor circulation, which causes insufficient blood flow, decreases sensation in the lower extremities. With proper care and attention, however, foot problems can be prevented or caught before they become serious.
One of the best ways to foil foot problems is with an annual or biannual checkup.
"The more you move, the more blood the heart pumps through According to Catalano, one prevalent problem is peripheral vascular disease (PVD), which often goes undetected by people who have it. PVD develops when the arteries in the legs narrow. A person may feel pain or fatigue in their calf while walking or going upstairs, then the pain disappears when he or she sits down. But the pattern continues — walk, pain, rest — without the person realizing the gravity of the problem. "Calf fatigue is a symptom of PVD and it should be evaluated by your doctor," says Catalano.
Awareness and prevention are the keys to staying one step ahead of foot problems. Because diabetes is systemic, affecting everything from your cardiovascular system to your circulatory system, diet and exercise are crucial to keeping it at bay.
"The more you move, the more blood the heart pumps through the body," says Catalano. "I've seen patients control their diabetes through diet and exercise alone. Others require medication, but diet and exercise are not negotiable."
One of the best ways to foil foot problems is with an annual or biannual checkup. Your physician will check your feet for wounds or calluses, feel for a pulse, measure sensation, examine tendons and check foot reflex. Even the most fastidious individual can overlook minor ailments due to reduced sensation.
George Freeman was diagnosed with type 2 diabetes 25 years ago, yet he says he had no intention of letting the onset of adult diabetes alter his life. "I followed my doctor's recommendations, changed my diet, stayed active, took my medication and read everything I could get my hands on," he says. "I kept my weight down and my blood sugar as close to normal as possible, and my blood pressure is good. Sure, I can't get around like I used to, but as my doctor says, 'You've come a long way, George.'" HM
Tips for keeping your feet healthy
inspect your feet daily from front to back and from toe to heel.
avoid wearing shoes that are too tight or that have rough or torn places inside that can irritate your feet. Wear shoes that fit properly. Corns, calluses and blisters are all caused by pressure from uncomfortable shoes rubbing on the same spot repeatedly.
check for ingrown toenails. Cutting toenails incorrectly can cause them to grow into the skin. Avoid cutting the corners of your nails, or have a podiatrist trim them.
look at the soles of your feet, even if you need a mirror to do so. Plantar warts can form there and be difficult to spot. A virus is the culprit, and usually the warts disappear eventually, but some require treatment.
moisturize. Dry, cracked heels invite infection. Always use lotion on your feet to soften the skin, but avoid putting lotion between the toes.