LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Saturday, December 18, 2010

The Saturday Share #5

Did you know that health topics are the number one internet search item, outstripping even porn? Uh… pardon the Freudian slip there...

So to do my part in trying to keep internet health information correct I’ve been two-timing my blog by writing over at
Sharecare were I am one of their “Experts” answering diabetes questions posted by readers.

I’m having a blast, and I’ve decided that every week I’m going to share one of my favorite questions with you here.

Sharecare Question: What causes diabetic foot problems?

My “Expert” answer: Scary but true story: a man with diabetes came home from work super-tired one day and decided to grab a quick nap. He sat down on his couch, took his shoes off, slipped his glasses into one of the shoes for safe-keeping and nodded off. (About half of you out there know where this is going….)

He was woken with a start by the phone ringing. His wife had just been in a car accident and was in the Emergency Room. He jumped off the couch, pulled his shoes on, and dashed off to the hospital. Don’t worry. She wasn’t badly hurt. But it was eight hours later before they both got home. When he took his shoes off again he found his glasses. In the shoe. For eight hours he'd worn a shoe with a pair of glasses in them and had no clue.

I saw his custom-molded shoe insert, still bearing the exact imprint of his glasses, sort of like fossilized dinosaur tracks.

So, to answer your question, diabetic foot problems actually happen because in some people, many years of high blood sugar causes them to lose all sensation in their feet. Most of us get annoyed when we get a pebble in our shoes. The hero of our story had an entire pair of glasses in his shoe and couldn’t feel it!

Lack of sensation is exactly half the story. The second half is that most people aren’t in the habit of looking at the bottom of their feet, largely because there is no real reason for most people to do so.

If you don’t feel pain when you injure your foot. And you don’t look at your feet, how would you know if you’d been hurt? Right. You wouldn’t.

And that’s exactly what causes 84,000 non-traumatic amputations every year in our county. Of course all amputations are traumatic to the amputee, but in this case we simply mean medically necessary amputations that aren’t the result be being run over by a riding mower or being in a car accident.

The exact progression is: injury, infection, ulcer, gangrene--a.k.a. tissue necrosis, literally the death of part of your body that is still attached to you--and finally, amputation.

So the single best thing you can do to prevent this from happening to you is to “kiss” your feet goodnight every night. Look at your feet at bedtime. If you are to… um…ah... too hefty to see your feet use a hand mirror placed on the floor. Make sure everything looks OK. Start doing this now, even if you have great sensation in your feet, that way if you lose it in the future you will already be in the habit of taking care of them.

You can check out other Expert’s answers to this question, and my answers to many more questions by going here:

Then select the “Answers” tab near the top left.


Blogger Reyna said...

I liked this one Wil. I kind of had a foot issue with Joe about a month ago. He dropped a metal hockey "passer" on his big toe. It was immediately blue...he was screaming. I gave him ibuprofen ATC over the next couple of days.

He didn't complain much for the next day or two. Then he stated that he was going to miss his "favorite" subject. I stated, 'but PE isn't for two days'. He said, 'I know, but my toe hurts so bad'.

Like any ex-ICU nurse...I held the tip of a needle in a flame and put a hole in his nail bed using the hot needle tip...the needle then got stuck in his nail once it made it through. I told Joe to "sit tight" I had to go get some pliers. He then exclaimed 'THE PLIERS!!!! WHAT DO YOU NEED THOSE FOR?"

Well, the long and the short of it is the pliers got the needle out. Joe was and is a champ. And his nail is almost about to fall off. I knew to keep an eye out for infection and boosted up BGs I didn't call the MD. I may get a nasty-gram on this comment if someone doesn't agree. Do you think I should have taken Joe in to see a professional? My thought was, he doesn't have neuropathy yet and I was keeping a close eye on it...

5:48 PM  

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