Diabetic Neuropathy-what does it mean for your feet:Diabetes Monitor:"Diabetic nerve damage to the feet, sometimes called diabetic neuropathy, or more
correctly, diabetic distal symmetric sensory polyneuropathy, frequently causes
people with diabetes to lose sensation in their feet, which is usually describe as
"numbness." There's really not much available to help this loss of sensation.
However, diabetic neuropathy occasionally creates a severe burning pain, or other
very unpleasant sensations, that are extremely frustrating. The following treatment
program is suggested for painful diabetic neuropathy.Get your diabetes straightened
out as best you can! Aim to keep your blood sugar tests normal as often as possible,
and to get your glycosylated hemoglobin value into the normal range. The blood sugar
should ideally be about 100 before meals, and 140 or 150 as the highest blood sugar
that is ever seen. This extremely tight control may require shots of insulin several
times daily, very careful attention to meal planning and frequent monitoring of your
blood sugar level, under the care of a knowledgeable physician specializing in
diabetes, working together with a nurse who is a Certified Diabetes Educator" http://www.diabetesmonitor.com/dm-feet.htm
A MULTIDISCIPLINARY APPROACH TO DIABETIC NEUROPATHY TREATMENT:Yngve Bersvendsen, Bergen, Norway:"The information about diabetic neuropathy which is presented here represents
up-to-date research work. By publishing this document on a Website, we hope that
others can find information which can be useful in managing this painful disease. If
someone personally wants to follow up on some of the suggestions given here, we
would appreciate knowing.First, it is important to get an examination by a physician
to get a correct diagnosis. Second, controlling neuropathy means very strict control
of BG levels and the avoidance of hyperglycemia. Near-normoglycemia is the aim.
(Personally, I think that diabetics should aviod the use of artificial sweeteners
such as Aspartame (NutraSweet), which is used in sodas etc. The merest hint that
Aspartame could possibly metabolize into formaldehyde and methanol should cause
defections en masse. Rather, drink clean water! YB). But the intention of this
article is to set up a nutritional programme ancillary to conventional treatments of
diabetic neuropathy." bersvendsen@nsd.uib.no http://www.geocities.com/bsy53/dn/neuropat.html
Local wound care in diabetic foot complications:POSTGRADUATE MEDICINE:"Foot infection is the most common reason for hospitalization among diabetic
patients, accounting for up to 25% of admissions (1,2). Regrettably, less than 14%
of patients admitted for diabetic foot complications receive adequate lower
extremity evaluation (3,4), and when foot ulcers do develop, one in five of these
patients eventually has to undergo amputation (1,2). It has been estimated that with
appropriate knowledge of risk factors and treatment by a multidisciplinary team, up
to 85% of foot and leg amputations in diabetic patients could be prevented (3,4).
Early identification of risk factors for diabetic foot ulcer and initiation of
proper treatment reduce the occurrence of complications, including the need for
amputation. Several factors contribute to ulceration in diabetic patients (5). Among
the most common are neuropathy, structural deformity or limited joint mobility,
previous history of ulceration or amputation, and poor glucose control (3,5).
Effects of these risk factors are cumulative." http://www.postgradmed.com/issues/1999/07_99/muha.htm
Diabetic Foot complications includes photos:Denver Diabetic Foot and Ulcer Clinic:"CIRCULATION / BLOCKED ARTERIES
Diabetes causes reduced blood flow to the legs and arteries. Reduced circulation can
cause swelling and decreased feeling. Decreased feeling causes other problems with
the nerves, bones and skin.NERVES / NEUROPATHY
Sensations; sharp/dull, hot,cold and pain feeling can change. Reduced pain feeling
in the skin can cause pressure sores or ulcerations. The wrong sensations can cause
changes in the bones and joints to soften and shift." Phone: (303) 761-5454
Fax: (303) 761-5458 info@DenverFoot.com http://www.denverdiabeticfoot.com/English/Complications/complications.htm
Foot care and Prevention of Amputation in Diabetic Patients:The Diabetic Foot Clinic at M.V.Hospital For Diabetes:"The foot of the patient with a long standing Diabetes is often the site of
neuropathic and vascular process which pose a considerable threat, not only to the
lower limb to the life of the patient. This demands much care and attention by both
the patient and health care personnel. Two major problems which predispose the
diabetic patients to amputation are the development of neuropathy due to
uncontrolled diabetes over several years whih result in damage to the nerves in the
feet leading to the loss of sensation. They also develop ceratin high pressure
points under the feet which results in the formative of callus which later turns in
to ulcer. In addition cigarrette smoking will lead to nerve damage and reduce blood
flow in the feet." http://www.mvdiabeticfoot.com/diafoot1.html
Proper Foot Care May Prevent Diabetic Complications:Dr. David Zuckerman, D.P.M.:"The patient was completely unaware of the ulcer. They couldn't feel any pain. This
is why Diabetisc need to be seen by a Podiatrist four times per year. The last
picture is an after treatment of toe ulcer two weeks later. This shows how toes can
be saved with the care of a foot specialist Even the most trivial injury - such as
stepping on a tack or stubbing a toe - can, if untreated, lead to amputation and
even death to diabetics. But they often neglect foot injuries, even scalds, burns
and frostbite, because diabetes attacks the insulation surrounding nerve endings and
short circuits a patient's ability to feel pain or heat.A podiatrist is often the
first health practitioner to diagnose diabetes. A patient might schedule an
appointment to question me about a bump on his foot, and I discover he is walking on
a fractured bone. Another person might want a bunion treated, and I find she has a
needle in her foot and no idea how it got there. Whenever I see a patient who fails
to notice injuries that are normally painful, I suspect diabetes." David Zuckerman DPM
The Foot Specialist, P.C.
341 S. Evergreen Ave.
Woodbury, NJ 08096
Telephone: (856) 848-FEET (3338)
Fax: (856) 848-5122 info@thefootspecialist.com http://www.thefootspecialist.com/diabetic.html
Temperature monitoring device may help prevent diabetic foot complications:Doctor's Guide Publishing Limited:"Diabetics with nerve damage often develop ulcers on their feet because they cannot
feel that their foot is sore from an injury, Dr. Lavery said. "However, prior to
developing an ulceration, the surrounding tissue becomes inflamed, and the
inflammation can be measured by a change in local skin temperatures, often days
before the tissue is damaged enough to ulcerate," he explained.
In order to find out if a home temperature-monitoring device could help high-risk
diabetics prevent foot ulcerations, Dr. Lavery and colleagues performed a
randomised, single blind study, using 173 diabetics with a previous history of foot
ulceration.
Participants were randomly assigned to one of three groups: a standard therapy
group; a structured exam group; or an enhanced therapy group. All patients received
therapeutic footwear, diabetic foot education and regular foot care throughout the
trial, which lasted 15 months." http://www.docguide.com/news/content.nsf/News/8525697700573E1885256C2B0066BBB2?OpenD
ocument&id=48dde4a73e09a969852568880078c249
New treatment for diabetic foot ulcers:Office of Public Affairs:"FDA today approved used of a new type of wound dressing to help heal diabetic foot
ulcers, open foot sores that lead to thousands of amputations each year in people
with diabetes.
The product, called Apligraf, is intended to be used on patients who have not
responded well to standard methods of treating foot ulcers.
Manufactured by Organogenesis Inc., Canton, Mass., Apligraf was previously approved
by FDA to treat leg ulcers caused by circulatory problems.
Apligraf is a cellular, bi-layered skin substitute produced from bovine collagen and
cells derived from human infant foreskins. Its special composition allows it to
provide wound protection and foster the growth of healthy new skin." http://www.fda.gov/bbs/topics/ANSWERS/ANS01022.html
Onychomycosis-a fungal infections common to diabetics:Healthcommunities.com, Inc.:"Patients with diabetes commonly develop onychomycosis because blood circulation is
poor in the extremities, and the body's ability to fight infections is compromised.
Small cuts, infections, and foot injuries can have serious consequences for
diabetics. It is important to inspect the feet closely each day and work with a
physician on a program of thorough foot care.The primary fungi that cause
onychomycosis are trichophyton rubrum and trichophyton mentagrophytes. They are
dermatophytes (fungi that infect hair, skin, and nails) and feed on keratinized
(nail) tissue. The infections they cause are normally confined to the nails, but
occasionally spread to the surrounding skin.Onychomycosis is difficult to treat.
Medicines can be taken orally to kill these infections (e.g., Lamisil, Sporanox).
Because the nail grows slowly, the medicine works gradually, requiring several
months to completely eliminate the infection." http://www.podiatrychannel.com/onychomycosis/
Foot scan may ward off diabetic foot complications:St. Joseph Health System:"A portable device that measures temperature changes in the feet may help diabetics
avoid foot ulcers, researchers reported Saturday at the American Diabetes
Association's annual meeting here.
Foot ulcers are a common problem in diabetics, whose poor circulation and loss of
sensation in the feet can lead to difficult-to-heal ulcers. Such ulcers can cause
foot deformities or even lead to amputation.
"Temperature monitoring may be a promising adjunct to protect patients' lower
extremities," said study author Lawrence Lavery, an associate professor of podiatry
at Loyola University Medical Center in Chicago, Illinois.
Lavery reported on a preliminary study of the FootScan, a device that uses an
infrared temperature probe to measure spikes in temperature in the foot caused by
inflammation. Patients with higher foot temperature are known to be at increased
risk of developing ulcers." St. Joseph Health System
500 S. Main, Ste. 1000
Orange, CA 92868
(714) 347-7500 mtrujill@corp.stjoe.org http://www.stjhs.org/HealthNews/reuters/NewsStory0617200218.htm
What can I do to prevent foot problems from diabetic neuropathy?:American Academy of Family Physicians:"Check your feet every day.You may need to use a mirror to to check the bottoms of
your feet. Call your doctor at the very first sign of redness, swelling, infection,
pain, numbness or tingling in any part of your foot.
Check inside your shoes every day for things like gravel or a torn lining. These
things could hurt your feet.
Never walk barefoot around the house or outside.
Have your doctor look at your feet during every office visit (at least once a year)
or whenever you notice anything that seems wrong.
Choose the right shoes. The most common cause of foot sores is shoes that are new or
don't fit properly. Buy shoes that fit properly and have a good arch support. Choose
shoes made of soft leather. They should not fit tightly anywhere. To get the best
fit, try on shoes at the end of the day when your feet are a little swollen. If
you've had problems before with shoes that didn't fit well, you may want to be
fitted for a custom-molded shoe with plenty of room for your toes.
Wear white socks and check when you take them off to see if there is any blood or
fluid from a sore on them.
Wash your feet daily in lukewarm water. Dry them well, especially between the toes.
Use a soft towel and blot gently; don't rub. Keep the skin of your feet smooth by
applying a cream or lanolin lotion, especially on your heels. If your feet sweat
easily, keep them dry by dusting them with nonmedicated powder before putting on
your socks, nylons and shoes." http://familydoctor.org/handouts/050.html
SURGEONS COMBINE EFFORTS TO SAVE LIMBS RAVAGED BY DIABETIC COMPLICATIONS AND TRAUMA:UPMC Health System:"Surgeons at UPMC Health System have announced the opening of the Limb Salvage Center
dedicated to saving limbs damaged by diabetic complications, trauma and peripheral
vascular disease. The program is a collaborative effort of vascular, orthopaedic,
plastic and trauma surgeons and specialists in infectious disease.A recent study
published in the journal Diabetes Care reported on the dramatic increase in the
incidence of diabetes in the United States from 1990 to 1998. Diabetes can cause
severe complications including difficult-to-treat foot ulcers, which can lead to
foot or leg amputation. It is responsible for more than 40 percent of all
non-traumatic amputations in the United States. Other causes for amputation are
trauma and ischemic disease." Local:412-647-UPMC (8762)
Toll free: 1-800-533-UPMC (8762)
mailing address:
200 Lothrop St.
Pittsburgh, PA 15213-2582 upmcweb@upmc.edu http://www.upmc.edu/NewsBureau/medsurg1/limb_salvage.htm
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Nurses' Station:"The idea for the Nurses' Station Catalog was conceived in 1989. After searching the marketplace in response to customer inquiries, it became obvious that there were no catalogs of this type serving the nursing profession. To be sure, there were several catalogs offering nurse's uniforms and a smattering of professional items. But there weren't any catalogs at the time offering a range of gifts, clothing, professional items, name badges, shoes and scrubs for nurses. It took two years of hard work to gather samples and put a together a catalog of the most unique and high-quality items for nurses."
Nurses Station
P.O. Box 388
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Choose Nursing Uniforms, Shoes, Scrubs, Accessories By Brand:
ER:"Media products under your influence, particularly the NBC/Warner drama "ER," are harming the profession of 2.7 million American nurses by giving the public an inaccurate and inadequate account of what nurses really do to save and improve lives. Research suggests that "ER" strongly and negatively influences the way children view nursing. These products contribute to the nursing shortage, a public health crisis that threatens millions worldwide." http://www.truthaboutnursing.org/letters/er/
House, MD:"The main patient in tonight's episode of Fox's House was a nurse who believed that a cat tended to sit with those who were about to die--including, recently, the nurse herself. That may not sound like a promising vehicle for House to improve its abysmal portrayal of nursing. But the show actually presents the nurse as someone with health knowledge. And her search for meaning in faith, for some reason in tragic events, is a real counterpoint to House's cold rationality. Indeed, despite the obvious potential for mockery in the cat angle, the mighty House treats the nurse with considerable respect--he seems to care what she thinks, or at least to find her views unnerving. Of course, the nurse plays no real clinical role in the episode, and no other nurses do either. So the episode suggests, as usual, that physicians provide all important care in hospital settings, including all meaningful psychosocial and physical care. Still, any suggestion that intelligent life resides in a nurse is a welcome departure for House (and for the episode's writer Peter Blake, who also penned a November 2005 House episode that was notable for its physician glorification and its casual contempt for other health professions). Tonight's episode, "Here Kitty," drew 13.1 million U.S. viewers. more... see the relevant film clips... and please join our letter writing campaign!" http://www.truthaboutnursing.org/letters/house/
Private Practice:"ABC's Private Practice, whose season ends tomorrow, April 30, may be the only broadcast network show with a major nurse character to return next season. In the February 5 episode (Mike Ostrowski's "Acceptance," 13 million U.S. viewers), lone nurse character Dell Parker, who is studying to be a midwife, shows some tentative clinical aptitude and knowledge to go with his boyish eagerness. Under the close supervision of OB/GYN Addison Montgomery, Dell ably performs a vacuum-assisted delivery. Later he haltingly guides the baby's parents toward breastfeeding. Dell also performs an assured solo ultrasound of pregnant psychiatrist Violet Turner, calming her panic attack and eliciting her agreement to his own suggestion that, though he's "not a doctor," he will likely become a "pretty good midwife." The show still condescends to Dell, who is also the office manager/receptionist at the LA clinic where the show is set. In the March 26 episode (Craig Turk's "Do the Right Thing," 10.1 million U.S. viewers)," http://www.truthaboutnursing.org/letters/pp/
"Scrubs" defines nursing:""Scrubs" defines nursing: it's all about shutting up and following physician "orders. " Tonight's episode of NBC's "Scrubs," which purports to teach nurse Carla Espinosa that nursing is all about doing what physicians tell you, is one of the most virulently anti-nurse prime time television episodes the Center has ever seen. more..." http://www.truthaboutnursing.org/news/2009/may/06_scrubs.html
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