Diabetic Foot Ulcers are Scarier Than Sharks

As a podiatrist, one of the most dangerous and scary conditions I deal with is a diabetic foot ulcer. There are around 30 million Americans with diabetes and every one of them has a 25% chance of developing a foot ulcer in their lifetime. Once you have a diabetic foot ulcer you are in a medical crisis. I know it is not often represented this way. Most of my patients don't understand the grave nature of a diabetic foot ulcer. Many factors contribute to this underestimation of the morbidity and mortality of a diabetic foot ulcer. Fear, denial, lack of understanding and the failure of the medical community to explain how deadly serious this condition is, have all added up to a severe lack of urgency. I hate scare tactics. Our news media uses fear to get our attention about all kinds of very unlikely events, such as shark attacks. Diabetes, however, is very real. It is the 7th leading cause of death in the US. While sharks accounted for just 6 deaths in 2015, diabetes accounted for over 75,000! In fact, if you have a diabetic foot ulcer you have a 5 year mortality rate of 45%. This means that almost half the people with a diabetic foot ulcer today will have passed away by 2021. Prostate cancer, breast cancer and Hodgkin's lymphoma, all have much better 5 year survival rates. Think about that, forms of cancer are actually a better diagnosis than a diabetic foot ulcer. Why am I telling you this? I promise my motives are not to ruin your day. Quite the opposite. I want to sound the warning bell. You probably don't have to worry too much about the sharks in the water, but your foot ulcer or your mom's foot ulcer is deadly serious and by ignoring it or delaying care you make yourself or your loved one that much more vulnerable to this devastating disease. They say a ounce of prevention is worth a pound of cure. Nowhere is that adage more appropriate than with diabetic foot ulcers. If you or someone you love is among the 30 million American diabetics, treat your disease proactively and aggressively. Manage your blood sugar with diet and exercise. Get help from your primary care doctor or an endocrinologist...or both. Get your feet checked by a podiatrist, often. Wear properly fit shoes and inspect your feet daily. If you do have a diabetic foot ulcer take it very seriously. Listen to your doctor. It is much more dangerous than a shark. Committed to your health, Dr. Craig Conti Sarasota Foot Care Center http://www.sarasotafootcarecenter.com

Special Report On Peripheral Vascular Disease

Peripheral vascular disease goes by many names. PVD, PAD, arteriosclerosis, blockage of leg arteries, claudication, intermittent claudication, vaso-occlusive disease of the legs, arterial insufficiency of the legs and poor blood flow of the legs, are all names used to refer to this common condition. Regardless of what you call it, it is a very serious medical condition that sometimes presents with no symptoms what so ever. When there are symptoms, the most common complaints are recurrent leg pain and cramping and calf pain with exercise. Peripheral vascular disease is a condition of the blood vessels that leads to narrowing of the arteries that supply the legs and feet. The narrowing of the blood vessels leads to decreased blood flow, which can injure nerves and other tissues. Causes, incidence, and risk factors Peripheral artery disease is caused by many factors. Basically, this problem occurs when fatty material, called plaque, builds up on the walls of your arteries. This causes the arteries to become narrower. The walls of the arteries also become stiffer and cannot widen to allow greater blood flow when needed. This is very similar to build up in a pipe that leads to slower drainage of water and ultimately a clogged drain. As a result, when the muscles of your legs are working harder, like with exercise, they cannot get enough blood and oxygen. Eventually, there may not be enough blood and oxygen, even when the muscles are resting. Peripheral artery disease is a common disorder that usually affects men over age 50 but it can affect both sexes and people as young as 30. People are at higher risk if they have a history of: • Diabetes • Abnormal cholesterol • Heart disease • High blood pressure • Kidney disease involving hemodialysis • Smoking • Stroke Symptoms The classic symptoms are pain, achiness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs. These symptoms usually appear during walking or exercise and go away after several minutes of rest. At first, these symptoms may appear only when you walk uphill, walk faster, or walk for longer distances. Slowly, these symptoms come on more quickly and with less exercise. Your legs or feet may feel numb when you are at rest. The legs also may feel cool to the touch, and the skin may look pale. When peripheral artery disease becomes severe, you may have: • Pain and cramps at night • Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful • Pain that is worse when you raise the leg and improves when you dangle your legs over the side of the bed • Skin that looks dark and blue • Sores that do not heal • impotence Signs and tests During an examination, the health care provider may find: • Decreased blood pressure in the affected limb • Loss of hair on the legs or feet • Weak or absent pulses in the limb When PVD is more severe, findings may include: • Calf muscles that shrink • Hair loss over the toes and feet • Painful, non-bleeding sores on the feet or toes (usually black) that are slow to heal • Paleness of the skin or blue color in the toes or foot • Shiny, tight skin • Thick toenails Sometimes there are no symptoms. This is often referred to as a “silent killer.” Unfortunately, people with PVD have a five year mortality rate of 64%. This is higher than prostate cancer, breast cancer or colon cancer. Testing A simple, painless, in office test is all that is needed to confirm this diagnosis. We offer the test at Sarasota Foot Care Center. It is called a vascular test. If you have diabetes and are over the age of 50, the American Diabetes Association recommends getting the vascular test as a screening tool. Treatment Self-care: • Balance exercise with rest. Walk or do another activity to the point of pain and alternate it with rest periods. Over time, your circulation may improve as new, small blood vessels form. Always talk to the doctor before starting an exercise program. • Stop smoking. Smoking narrows the arteries, decreases the blood's ability to carry oxygen, and increases the risk of forming clots. • Take care of your feet, especially if you also have diabetes. Wear shoes that fit properly. Pay attention to any cuts, scrapes, or injuries, and see your doctor right away. Tissues heal slowly and are more likely to get infected when there is decreased circulation. • Make sure your blood pressure is well controlled. • Reduce your weight, if you are overweight. • If your cholesterol is high, eat a low-cholesterol and low-fat diet. • Monitor your blood sugar levels if you have diabetes, and keep them under control. Calling your health care provider Call your health care provider if you have: • A leg or foot that becomes cool to the touch, pale, blue, or numb • Chest pain or shortness of breath with leg pain • Leg pain that does not go away, even when you are not walking or moving, called rest pain • Legs that are red, hot, or swollen • New sores/ulcers • Signs of infection • Symptoms of arteriosclerosis of the extremities Committed to your health, Dr. Craig Conti Sarasota Foot Care Center www.sarasotafootcarecenter.com

More Than Just Foot Care

We at Sarasota Foot Care Center believe that you not only treat the foot and ankle, but the person attached to that foot and ankle. As such, we just want to remind our patients that we are involved in ALL ASPECTS of your lower extremity health. We not only treat skin, nail and bone deformities of the foot and leg, but we also treat sprains, fractures, diagnose blood flow and neurologic problems and treat wounds.

We have the latest technology to diagnose and treat fractures using digital x-rays in our office. As you may have noticed, we use computers in the treatment room as part of an electronic medical record. Not only is this more accurate but it also cuts down on paper and helps save the environment. We also have one of the few cutting –edge lasers in the area to treat fungal nail infections.

Finally, we are a center of excellence for diabetic foot care. We follow all of the American Diabetes Association (ADA) guidelines with regard to blood flow testing and nerve testing and we perform the tests in our office. We offer electrical stimulation therapy for the treatment of painful, tingling neuropathy in your feet. We even offer diabetic shoes for those who qualify.

At Sarasota Foot Care Center we are more than just foot care, we are total patient care.


Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Coffee and Tea Can Reduce Your Risk Of Type 2 Diabetes

Good news for all you Starbucks fanatics out there. A recent analysis of several studies has shown something of a protective effect of coffee and tea when concerning Type 2 Diabetes. The researches are not exactly sure what is garnishing this protective effect. It is not specifically caffine because decaf coffee also showed reduced risk for diabetes.
One theory is that some of the chemical compounds in coffee and tea affect sugar metabolism. Green tea, black tea and oolong tea have shown the ability to boost the effect of insulin. Now the headlines are going to read, "each cup of coffee a day gives you a 7% less chance of getting Type 2 Diabetes." Not so fast. This particular kind of analysis can skew statistics a little because it adds many studies together to make predictions. Some of those studies have very small sample sizes and others are not exactly the most controlled studies. Also, this is talking about coffee and tea, not a 20 oz. carmel-mocha-choca-latte. Those dessert-type drinks have hundreds of calories and tons of sugar.
Bottom line, just like one or two glasses of red wine can have a protective effect against heart disease, coffee and tea can have a similar effect on Type 2 Diabetes. In both of these cases we are talking about supplemental effects. A healthy lifestyle based on diet and exercise can not be overstated. There are no shortcuts on the path to health, but a glass of wine and cup of tea sure can make the journey a little more enjoyable.


Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

Diabetes Awareness Month Is Upon Us

November is National Diabetes Awareness Month. Kind of ironic when you think that you have most of the major holidays in this time of year. The average American gains several pounds and for a diabetic and their family, this can be a very challenging time of year. Staying consistent with your eating habits, limiting the simple sugars and indulgence in alcohol can help to protect the almost 40 million diabetic feet in this country.

For many years we have seen our own patient population in Sarasota, Florida suffer ill affects of this dangerous time of year. Ulcerations, gout attacks, leg swelling all increase as the New Year begins. I know there is a lot of fear and denial about infections, ulcerations and amputations. In order to avoid these horrible complications of diabetes we need to do some simple things and apply some basic discipline.

Step 1: check your sugar frequently and keep your Hemoglobin A1C ( a lab value that your primary care doctor or endocrinologist tests to get an average of your blood sugar over a few month period) in the proper range.
Step 2: see a foot doctor at least yearly and have a neurological test (a test of feeling and sensation in your feet) and vascular test (a test of blood flow to the feet and legs) as recommended by the American Diabetes Association.
Step 3: wear comfortable, well fit shoes with protective inserts when needed. The Medicare Diabetic Shoe Bill allows for one pair of diabetic shoes with 3 pairs of inserts, annually, for those patients who are diabetic with complications and on medicare.
Step 4: check your feet every day for redness, blisters, wounds etc. If you find any of these things on your feet you need to contact your podiatrist right away and take the situation very seriously. Delaying treatment is major obstacle to healing.

This year's theme for Diabetes Awareness month is "it's a family affair." I could not agree more. I would like to extend that definition to your medical "family" as well. Diabetic patients are very complex with many issues that blur the lines of medical specialty. Often a team approach is needed to treat these complicated situations. If we all do our part we can control the disease and take care of all of our loved ones. After all, it is a family affair.

Committed to your health,


Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/

Beware of Holiday Foot

It is that time of year again. The time when cookies and snacks are everywhere. It is the holiday season. The winter holidays are a great way to stay cheerful during the dark, cold part of the year. One mainstay of the holiday season is sweets. We all indulge a little. What harm can it do? Well if you are a person living with diabetes it can be a very dangerous time of year. First, the increase in caloric consumption with the addition of many sugary desserts can throw glucose control out of whack. Second, parties and family gatherings may inspire you to wear a new pair of shoes or a seldom worn pair of dress shoes.
This confluence of events can lead to a wound that will ultimately go on to ulceration. The foot of a diabetic person is a very fragile one. With the decreased sensation and blood flow that often mark the disease, ulcerations form and are very hard to heal. The very best treatment is prevention. How can you prevent yourself or someone you love from getting into trouble with their feet this holiday season? The most important thing is to be aware. Check your feet daily. Look for any red spots, cuts or calluses that were not there the day before. If you are wearing a new pair of shoes check to make sure they are not causing any calluses or blisters. If you have any questions or concerns don't hesitate to contact your podiatrist. Early detection and treatment are of critical importance in this matter. Don't wait until after the holidays to take care of yourself! Oh yeah, go easy on the desserts, you will be glad you did when those New Year's resolutions come around.

Committed to your health,

Dr. Craig Conti
Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com/