If you're diabetic and you are not taking care of your feet, and not only
your feet, but you're not taking care of your blood sugars and making sure
they're managed well, there could be a lot of complications, and one of the
biggest ones is wounds to your feet.
Hi, my name is Jackie Savoie. I'm a wound care
specialist - full disclosure. I love meeting new people I prefer to meet them
on the street than to meet them in the emerge with a limb-threatening wound.
So - listen up. Take care of your feet.
One of the biggest challenges we see is
something that we've coined "bathroom wound care."
Soaking your feet, and a lot of the times I feel like we're contradicting
ourselves, because we're telling you make sure your feet are moist, but at the same
time we're telling you make sure your feet are nice and dry between your toes.
So the reason why it's not something I ever support for diabetic patients to
soak your feet, now just imagine with a lot of our patients the skin is so dry
sometimes they have calluses, sometimes they have what we call fissures in the
heel, which is just cracks in your heel. You're actually just soaking your feet
in a bathtub full of bacteria. That's really all you're doing.
So let's say you happen to have had fungus in your toenails well you've just
now introduced that into a heel wound that you didn't even know that you've
had. Bacteria loves sugar, and when there's a lot of it in your body it's a
lot easier for bacteria to just latch onto it and cause a massive infection.
And the higher your blood sugars, the higher risk you are at an infection when
you have an open area.
So it's funny when you talk about drying between the toes, because we come
out of the showers the last place we think of is drying between our toes, but
again, any moisture between your toes leads to what we call maceration, the
tissues get wet, and the tissues start to break down. Diabetic again breaking down
high blood sugars any breakdown of skin leads to an open wound which can lead to
an infection. So I always say to patients "Always get between your toes," because the
majority of us come out of the shower, dry everywhere else, throw our socks or
whatever on, then we put our shoes on. And we, again, the cup a day sweating,
we're just leading to more moisture.
One of the biggest most common things I find
when we see a patient with a wound, with redness, with swelling on the toe, when I
go in and I see them and I say, "Oh, part of the history, what happened here?"
"Well, my husband was cutting my toes," and I almost want to do one of the 'Home
Alone' screams - "Noooo!" And this is what happens, because people cut it too short,
and if you cut it too short you have now introduced a wound. If you have
neuropathy you can't even say 'ouch!' when that person gets too low because you
have not felt that. And after a while now having this wound open, high blood sugars,
poor footwear, all of the things that go with it, people end up in the emerge with
cellulitis, and sometimes with, people wait, because some people may say "Oh, it's
not so bad, it's only red, I'm gonna put an antibiotic cream on." And not that I'm
slamming antibiotic creams, but this is what I normally hear. Or "I'm gonna put
some alcohol on it." And what ends up happening, without treatment, that wound
continues to deteriorate, deteriorate and by the time you come into the emergency
room it's a very bad wound. And it could be limb threatening or at least it could be
digit threatening, so that toe, the toes fore-
foot, those toes may have to be removed.
When people, again, when I meet them and we've seen the wounds and I often ask"So
what happened here?" And the story's usually, "Well, I had this blister and I
decided that I didn't like this blister here so I took a razor blade,
I took a pen," people have told me some stuff that they've used. Razor blades,
pins, screwdrivers, it depends on what part of the house they're in. And not
only are these things not sterile by any means, they are just not something you
ever want to put near an open wound, especially being diabetic. So I always
say to my patients "Please, oh please, oh please, do not participate in bathtub
wound care."
Any scratch any blister anything on your feet if you are
diabetic you need to seek professional help.
Meaning not a psychiatrist, but a medical person who deals with either wounds, your
family doctor, but you need to see somebody. It's not one of these things
that you look at and you say, "Oh, this will go away." It has to be seen by
somebody sooner than later. Some people this thing might say, "My
goodness you're getting excited." I'd rather be excited and go and somebody says "Oh,
this is not a big deal," than to leave it and by the time patients get to us it's
limb-threatening, which means there's not much that can happen except having that
limb removed.