Just as you should do certain things when you have diabetes, there’s also a list of things you should avoid and why. I provide this list reminded of my kids. I asked them to NOT splash water out of the bath tub and of course what ends up happening? Alas, I am comforted only by the fact that most of you are going to be older than they and better able to apply this information of what you should not do and replace it with the positive behavior. Here they are.
- DON’T go barefoot – Whether in your house or out of it, your feet may encounter things on the ground that cause damage, like small plastic toys, bits of glass, nails, or very sharp rocks. (Although you should also keep your floors free of these potentially dangerous bits of things.) Because you may not notice when you step on something like this, (and thus damage your foot as you continue to walk on your injury), you can avoid the problem entirely by wearing shoes (WITH socks) pretty much all the time. Except in bed. Your feet are usually pretty safe there. (Although you can wear socks in bed for warmth.)
- DON’T put tight things around your legs – Foot or leg-wear like garters or knee-high stockings (or elastics to hold UP the stockings) can reduce circulation to your foot, thus exacerbating your bloodflow problems. Panty girdles, thigh highs, and even sometimes men’s socks can also be problematic if the elastic is too tight. This should not be mistaken with physician prescribed compression stockings.
- DON’T expose feet to extreme heat/cold – Again, because of nerve problems, you may not be able to feel when the skin of your foot is too hot or too cold, and thus be unaware when extreme heat or cold causes damage. In order to avoid problems, don’t walk on hot pavement, never use a hot water bottle or heating pad on your feet (wear socks instead if your feet are cold), be careful of car heaters on road trips, and don’t put ice on your feet if they feel hot. Also, apply sunscreen to your feet to avoid sunburn.
- DON’T cut corns or calluses yourself – If you try to perform “bathroom surgery” on your corns or calluses, you run the risk of cutting too much off, or getting an infection. If you need them removed, your podiatrist is very skilled at taking corns and calluses off. He or she can also instruct you how to work on calluses (the ones that aren’t too thick) using pumice stones or emery boards, but only if you promise to follow their instructions carefully. NEVER use medicated callus or corn removers, since these can eat into healthy skin and cause infections.
- DON’T use commercial foot supports – Your podiatrist may wish to prescribe orthotics for your use, but avoid over-the-counter arch supports or foot pads as you run the risk of them not fitting properly and rubbing a sore in the foot.
- DON’T smoke – Smoking can further reduce your circulation, causing even more complications with healing. Quit smoking as soon as possible to avoid these complications.
- DON’T drink excessively – Just as smoking can further damage your circulation, so alcohol can speed up the damage to your nerves already caused by neuropathy. This increases the likelihood that you’ll be unable to detect injury or other problems with your foot. Avoid drinking in excess.
- DON’T cross your legs – Crossing your legs while sitting (or even lying down) can compromise the circulation in your legs and feet. You may look great while doing it, but remember that it’s your health that’s most important, not your appearance. (Yes. Despite what the fashion industry may tell you.)
Warning: The following paragraph is scary to read but is something all patients with diabetes should know. Okay, here it is:
Despite your best efforts and the best efforts of your podiatrist, amputation is sometimes necessary in order to curb infection before it spreads to the rest of the limb, or to the body as a whole. Such amputations might be the best way to save the rest of your limb or your life. Your podiatrist will discuss your options with you if this step becomes necessary. Always remember though: amputation is a last-step resort. In most cases, it can be prevented by regular screenings with your doctor, proper management of your diabetes, and daily self-checks. Early recognition of problems and immediate treatment are essential in preventing serious complications. So, in short, stay on top of your diabetes, and it’s much less likely to bowl you over.