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March 19, 2024
Stealing Your Steps
Stealing Your Steps
Causes, risks, complications & preventions of Foot Ulcer
Causes, risks, complications & preventions of Foot Ulcer
Imagine a 65-year-old patient I recently treated who was suffering from diabetic gangrene on his right foot. When he visited my outpatient department (OPD) for a check-up, only his big toe was affected, yet he was in excruciating pain and bleeding incessantly. Despite seeking treatment from various practitioners, including alternative medicine doctors like myself, his condition remained unresolved. After conducting a Doppler examination, it became evident that the blood vessels in his foot were severely clogged and damaged due to decades of diabetic complications. The only viable solution proposed was a foot amputation.
Imagine a 65-year-old patient I recently treated who was suffering from diabetic gangrene on his right foot. When he visited my outpatient department (OPD) for a check-up, only his big toe was affected, yet he was in excruciating pain and bleeding incessantly. Despite seeking treatment from various practitioners, including alternative medicine doctors like myself, his condition remained unresolved. After conducting a Doppler examination, it became evident that the blood vessels in his foot were severely clogged and damaged due to decades of diabetic complications. The only viable solution proposed was a foot amputation.
The mere mention of amputation sent shivers down his body. Two of his brothers, who had undergone similar procedures, had not survived, fueling his fear of a similar fate. After thorough counseling, he reluctantly agreed to undergo surgery. Today, he wears a prosthetic foot, albeit with some adjustment challenges, but overall, he is smiling with joy at the newfound relief from his suffering.
The mere mention of amputation sent shivers down his body. Two of his brothers, who had undergone similar procedures, had not survived, fueling his fear of a similar fate. After thorough counseling, he reluctantly agreed to undergo surgery. Today, he wears a prosthetic foot, albeit with some adjustment challenges, but overall, he is smiling with joy at the newfound relief from his suffering.
This case underscores an important lesson for practitioners of traditional medicine, including Ayurveda, Siddha, and Homeopathy. While our systems have many strengths, we must also acknowledge our limitations and approach patient care holistically. Attempting off-the-hand measures in vain can exacerbate patients' suffering rather than alleviate it.
This case underscores an important lesson for practitioners of traditional medicine, including Ayurveda, Siddha, and Homeopathy. While our systems have many strengths, we must also acknowledge our limitations and approach patient care holistically. Attempting off-the-hand measures in vain can exacerbate patients' suffering rather than alleviate it.
According to a survey by the World Health Organization, an estimated 40 million people in the developing world are amputees. In India, the 2011 census reported approximately 2.68 crore people with disabilities, accounting for 2.22% of the total population. Foot ulcers are a concerning complication, often arising from a combination of factors. [1] These open sores, slow to heal and prone to infection, can significantly impact mobility and quality of life. Understanding the reasons behind foot ulcers is crucial for both preventing their occurrence and managing them effectively.
According to a survey by the World Health Organization, an estimated 40 million people in the developing world are amputees. In India, the 2011 census reported approximately 2.68 crore people with disabilities, accounting for 2.22% of the total population. Foot ulcers are a concerning complication, often arising from a combination of factors. [1] These open sores, slow to heal and prone to infection, can significantly impact mobility and quality of life. Understanding the reasons behind foot ulcers is crucial for both preventing their occurrence and managing them effectively.
Unveiling the Culprits: A Multifaceted Problem
Unveiling the Culprits: A Multifaceted Problem
Foot ulcers don't arise in isolation. Several underlying conditions play a role, like a detective scene with multiple suspects:
Foot ulcers don't arise in isolation. Several underlying conditions play a role, like a detective scene with multiple suspects:
The Prime Suspect: Diabetes:
The Prime Suspect: Diabetes:
Leading the pack is diabetes. It causes nerve damage (neuropathy), making you less likely to feel injuries that can turn into ulcers. Additionally, poor circulation in diabetes hinders healing.
Leading the pack is diabetes. It causes nerve damage (neuropathy), making you less likely to feel injuries that can turn into ulcers. Additionally, poor circulation in diabetes hinders healing.
Peripheral Arterial Disease (PAD):
Peripheral Arterial Disease (PAD):
This culprit narrows arteries, restricting blood flow to the legs and feet. Starved of oxygen and nutrients, tissues become vulnerable to breakdown and ulcer formation.
This culprit narrows arteries, restricting blood flow to the legs and feet. Starved of oxygen and nutrients, tissues become vulnerable to breakdown and ulcer formation.
Circulation Woes:
Circulation Woes:
Beyond PAD, other conditions like heart disease and varicose veins can also impair circulation, increasing the risk of foot ulcers.
Beyond PAD, other conditions like heart disease and varicose veins can also impair circulation, increasing the risk of foot ulcers.
Bony Prominences:
Bony Prominences:
Bunions, hammertoes, and other bony protrusions can create pressure points that rub against shoes, leading to skin breakdown.
Bunions, hammertoes, and other bony protrusions can create pressure points that rub against shoes, leading to skin breakdown.
Trauma on the Loose:
Trauma on the Loose:
Cuts, scrapes, blisters, or burns, especially unnoticed due to neuropathy, can develop into ulcers without proper care.
Cuts, scrapes, blisters, or burns, especially unnoticed due to neuropathy, can develop into ulcers without proper care.
Ill-fitting Footwear:
Ill-fitting Footwear:
Shoes that are too tight, too loose, or lack proper support can cause friction and pressure, creating an entry point for trouble.
Shoes that are too tight, too loose, or lack proper support can cause friction and pressure, creating an entry point for trouble.
Foot Care Neglect:
Foot Care Neglect:
Not washing and drying your feet daily, neglecting toenail care, and failing to inspect them regularly for injuries can increase the risk of infection and ulcer formation.
Not washing and drying your feet daily, neglecting toenail care, and failing to inspect them regularly for injuries can increase the risk of infection and ulcer formation.
Who's Most at Risk? Identifying the Vulnerable
Who's Most at Risk? Identifying the Vulnerable
Certain factors make individuals more susceptible to these unwelcome visitors:
Certain factors make individuals more susceptible to these unwelcome visitors:
- Age: As we age, our skin becomes thinner, and circulation can decline, making us more vulnerable.
- Weight Woes: Excess weight puts additional stress on the feet, raising the risk of ulcers.
- Smoking: Smoking constricts blood vessels, hindering circulation and wound healing.
- Weakened Immune System: Conditions like HIV/AIDS or medications that suppress immunity can make it harder to fight infections in foot ulcers.
- Nutritional Deficiencies: Lack of essential nutrients can hinder wound healing.
Complications: Why Early Detection Matter
Complications: Why Early Detection Matter
Foot ulcers are not to be taken lightly. Potential complications include:
Foot ulcers are not to be taken lightly. Potential complications include:
- Infection: Ulcers are prone to infection, which can spread to the bone (osteomyelitis) and even become life-threatening.
- Gangrene: Tissue death can occur due to a lack of blood flow, potentially leading to amputation.
- Charcot Foot: In severe diabetic neuropathy, bones in the foot can weaken and fracture, leading to a deformed foot shape.
Early detection is crucial. Regularly inspect your feet for any breaks in the skin, redness, swelling, or drainage. Don't hesitate to consult a healthcare professional promptly if you notice any concerning signs.
Early detection is crucial. Regularly inspect your feet for any breaks in the skin, redness, swelling, or drainage. Don't hesitate to consult a healthcare professional promptly if you notice any concerning signs.
Taking Charge: Your Foot Health Arsenal
Taking Charge: Your Foot Health Arsenal
The good news is, you have an arsenal of weapons to fight foot ulcers:
The good news is, you have an arsenal of weapons to fight foot ulcers:
- Manage Underlying Conditions: Effectively managing diabetes, PAD, and other underlying conditions is your first line of defense.
- Daily Foot Care Routine: Make foot care a daily ritual. Wash and dry your feet thoroughly, paying special attention to the spaces between your toes. Moisturize dry skin to prevent cracking.
- Become a Foot Inspector: Regularly inspect your feet for any injuries, redness, or swelling. Use a mirror if needed to see the soles of your feet.
- Find the Perfect Fit: Invest in well-fitting, supportive shoes with ample toe space. Avoid shoes that are too tight or constricting.
- Nail Care Matters: Trim your toenails straight across, avoiding ingrown nails. Seek professional assistance if needed.
- Fuel Your Body Right: Eat a balanced diet rich in fruits, vegetables, and whole grains to ensure proper nutrition for wound healing.
- Weight Management: Losing excess weight can significantly reduce stress on your feet.
- Quit Smoking: Smoking cessation is essential for improving circulation and wound healing.
Foot ulcers are a serious concern, but with proper awareness and preventive measures, you can significantly reduce your risk. By managing underlying conditions, practicing meticulous foot care, and choosing appropriate footwear, you can keep your feet healthy and mobile for years to come. If you have any concerns about foot ulcers, consult your doctor or a podiatrist (foot specialist) for personalized guidance and preventive strategies.
Foot ulcers are a serious concern, but with proper awareness and preventive measures, you can significantly reduce your risk. By managing underlying conditions, practicing meticulous foot care, and choosing appropriate footwear, you can keep your feet healthy and mobile for years to come. If you have any concerns about foot ulcers, consult your doctor or a podiatrist (foot specialist) for personalized guidance and preventive strategies.
Remember, early detection and intervention are key to preventing complications and ensuring optimal foot health.
Remember, early detection and intervention are key to preventing complications and ensuring optimal foot health.
[1]. Reference :https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643056/
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