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 Diabetic Arthritic Foot (Charcot Foot)

What is Charcot Foot? Charcot foot is a sudden softening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the arch collapses and the foot takes on a convex shape, giving it a rocker-bottom appearance, making it very difficult to walk. Charcot foot is a very serious condition that can lead to severe deformity, disability and even amputation. Because of its seriousness, it is important that patients with diabetes -- a disease often associated with neuropathy -- take preventive measures and seek immediate care if signs or symptoms appear. Symptoms The symptoms of Charcot foot can appear after a sudden trauma or even a minor repetitive trauma (such as a long walk). A sudden trauma includes such mishaps as dropping something on the foot, or a sprain or fracture of the foot. The symptoms of Charcot foot are similar to those of infection. Although Charcot foot and infection are different conditions, both are serious problems requiring medical treatment. Charcot foot symptoms may include: • Warmth to the touch (the foot feels warmer than the other) • Redness in the foot • Swelling in the area • Pain or soreness What Causes Charcot Foot? Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain or trauma. When neuropathy is severe, there is a total lack of feeling in the feet. Because of neuropathy, the pain of an injury goes unnoticed and the patient continues to walk -- making the injury worse. People with neuropathy (especially those who have had it for a long time) are at risk for developing Charcot foot. In addition, neuropathic patients with a tight Achilles tendon have been shown to have a tendency to develop Charcot foot. Diagnosis Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the surgeon will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays are also essential for diagnosis. In some cases, other imaging studies and lab tests may be ordered. Once treatment begins, x-rays are taken periodically to aid in evaluating the status of the condition. Treatment Following the surgeon's treatment plan for Charcot foot is extremely important. Failure to do so can lead to the loss of a toe, foot, leg or life. Treatment for Charcot foot consists of: •Immobilization Because the foot and ankle are so fragile during the early stage of Charcot, they must be protected so the soft bones can repair themselves. Complete non-weightbearing is necessary to keep the foot from further collapsing. The patient will not be able to walk on the affected foot until the surgeon determines it is safe to do so. During this period, the patient may be fitted with a cast, removable boot or brace, and may be required to use crutches or a wheelchair. It may take the bones several months to heal, although it can take considerably longer in some patients. •Custom shoes and bracing Shoes with special inserts may be needed after the bones have healed, to enable the patient to return to daily activities -- as well as help prevent recurrence of Charcot foot, development of ulcers and possibly amputation. Bracing is required in cases with significant deformity. •Activity modification A modification in activity level may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop it in the other foot, so measures must be taken to protect both feet. •Surgery In some cases, surgery may be required. The foot and ankle surgeon will determine the surgical procedure best suited for the patient based on the severity of the deformity and the patient's physical condition. Preventive Care The patient can play a vital role in preventing Charcot foot and its complications by following these measures: •Diabetes patients should keep blood sugar levels under control. This has been shown to reduce the progression of nerve damage in the feet. •Get regular check-ups from a foot and ankle surgeon. •Check both feet every day -- and see a surgeon immediately if there are signs of Charcot foot. •Be careful to avoid injury, such as bumping the foot or overdoing an exercise program. •Follow the surgeon's instructions for long-term treatment to prevent recurrences, ulcers and amputation. Committed to your health, Dr. Craig Conti Sarasota Foot Care Center 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/

New Therapy for People Suffereing With Neuropathy

According to some recent studies, 66% of diabetics have some form of neuropathy. Neuropathy is a condition that affects the nerves. It causes numbness, tingling, loss of balance and in about 10% of cases pain. Those people who have suffered with painful diabetic neuropathy have only a few treatment options. There are several pills that can treat neuropathic pain with differing levels of success, but none of them increase sensation or improve balance.
Recently, a new therapy has been used on neuropathy. This therapy is called electric stimulation or just e-stim for short. The benefits of this therapy are many. First, this is not a medication so it does not interfere with any medications the patient is already on. Second, not only does the therapy decrease pain but it also improves sensation and restores balance.
E-stim is available in the office setting and it is covered by major insurance plans including Medicare.
The therapy takes a hour per session and it is delivered in our comfortable treatment room equipped with a television and reading materials. A total of thirty sessions must be completed for maximal effectiveness. The treatment is painless.
If you have neuropathy, with or without diabetes you should seriously consider e-stim therapy as a safe effective treatment.


Committed to your health,

Dr. Craig Conti

Sarasota Foot Care Center
http://www.sarasotafootcarecenter.com

American Diabetes Association Changes Guidlines

Diabetes is one of the biggest medical issues facing this country and it is only getting worse. One in 3 Americans born after the year 2000 will develop diabetes at some point in their life. The direct and indirect costs of diabetes are absolutely enormous.
Feet and legs are disproportionately affected by diabetes. In fact, diabetes is the number one, non-traumatic cause of leg and foot amputations, accounting for 60,000-80,000 amputations per year. Patients living with diabetes are urged to have a diabetic foot screening with a local podiatrist at least annually. The two major systems the foot doctor will access are the blood flow and nerve systems. We know that any problems with these systems dramatically increases your risk for ulceration and ultimately amputation of the foot and leg.
In order to help catch issues with the blood flow system earlier and ultimately prevent amputation, the American Diabetes Association (ADA) has changed their guidelines on blood flow testing. The ADA now recommends that all diabetics over the age of 50 have a blood flow test at least once every 5 years. This test is painless and is very similar to getting your blood pressure taken with an inflatable cuff.
If you are a patient living with diabetes and you have not had a blood flow test in 5 years or more, please alert your foot doctor or your primary care doctor. By having this painless test done you can help to protect yourself and the people you care about from major complications, including amputation.


Committed to your health,

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

No Need to Suffer with Neuropathy Alone

Do your feet tingle and burn, usually worse at night? Do your feet feel numb? Do you feel like your balance is off recently? If the answer to any of these questions is "yes" you may have peripheral neuropathy. Neuropathy is a condition affecting millions of Americans. The most likely cause of neuropathy is Diabetes. If you are not diabetic other causes include chemotherapy drugs, low back injury or surgery, or exposure to certain chemicals. If none of these apply we call it idiopathic, which is the medical term for, "we don't know the cause." Approximately 15-30% of all cases of neuropathy are idiopathic.
Due to the complex nature of the disease and the varying ways it affects people the treatments can be very varied. Also, the best care for this is by a team of doctors, including a neurologist, an endocrinologist, pain management doctor, back doctor and of course a podiatrist. This complicated system, with many different doctors giving patients a lot of different advice, can lead to confusion.
A new support group has started at the Magnolia Health Center, located at 1507 S. Tuttle Ave. to help sort out all of this confusion. I had the opportunity to speak to this dynamic and informative group. I was there to teach but I think I learned more than anyone else. It was fascinating for me to listen to patients discuss all the difficulties they have had with this disease. They discussed the multitude of doctors, the frustration, the joys of treatments that finally helped.
Anyone suffering from peripheral neuropathy should know you don't have to go through it alone. The meetings are held the 3rd Friday of every month at the Magnolia Health Center, located at 1507 S. Tuttle Ave.
Don't forget that if you do have neuropathy you should not be cutting your own toenails. Your insurance will cover nail care for you. You should also check your feet daily for any redness, swelling, wounds or blisters. These can be signs of serious issues but without pain you may not notice them.
In the end, a neuropathic patient must be very aware of their feet and use their eyes and their mind to compensate for the loss of sensation.

Committed to your health,

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