AF&A Blog

As diabetes awareness month comes to a close, let’s spend some time talking about wounds. Earlier in the month we talked about the determination it takes to properly heal wounds complicated by diabetes. Because of complicating factors, this is definitely an area where ‘an ounce of prevention, is worth a pound of cure’.

By examining your feet daily for changes in color, texture, and temperature, you can detect problems early and seek appropriate intervention. There is actually a lot of ongoing research within the podiatry field to assess or predict wounds before they occur. This research attempts identifying ‘hot spots’ or areas under increased stress, so that your podiatrist can put you in specialized footwear or inserts to stop the problem before it occurs.

Examining your feet daily is doubly important if you have any neuropathy of sensation loses. When you lose the ability to feel pain, a small cut or splinter can go unnoticed and quickly lead to infection. Infections that are undetected can easily invade the muscle and bones. If the infection becomes septic, or reaches your blood, you may experience nausea, fever, chills or vomiting for which you must go immediately to the hospital. The sooner you see a podiatrist or make a trip to an appropriate medical facility the quicker steps can be taken to limit the damage and put you on the path to recovery. Delays in treatment, especially when infection is involved, can result in surgery and amputations.

We would encourage everyone who has diabetes or is close to someone who has it to join the American Diabetes Association. The ADA offers plenty of resources and helpful advice. One such recommendation is yearly foot check-ups with a podiatric physician. Regular healthcare can help you avoid many of the complications we’ve mentioned. We at AFAS are calling all to action by continuing to learn about and be aware of diabetes.

Stay tuned next month as we discuss holiday travels and some the things you should keep in mind. Until next time, keep those feet happy and healthy, Austin!

While most holidays involve some component of gathering with others for a meal, Thanksgiving, by far, focuses the most on eating. This holiday typically conjures up images of feeling stuffed, ‘turkey coma’, or post meal naps. Unfortunately, this type of gorging isn’t healthy for anyone. Living with diabetes should mean that you focus on what you eat. Your body’s inability to keep the sugars in your blood at the appropriate levels translates into you changing the when you eat, what you eat, and the level of activity you get.

It may be helpful to think of diet as all the good things you can eat and not the limiting of other not so good things you may be used to eating. If you have any input into the types of foods you’ll be eating this holiday, visit the American Diabetes Association website. This is an excellent organization to be a part of if you live with diabetes. They offer a plethora of resources and ideas for living better while managing your sugars. For the holiday season, they offer such ideas as mashed sweet potatoes, sage stuffing, and pumpkin pie with maple ginger crust to help you have an enjoyable meal without sacrificing your blood sugars and ultimately your health. If you have the luxury of letting someone else prepare your meal, you should use a little caution in what and how much you eat. Standard fair like turkey and yams can actually be ok as long as you don’t stuff yourself. Sweet rolls are one of the foods you should limit or remove altogether as simple breads are one of those foods that can quickly elevate your blood sugars. You should take full advantage of the many resources to help guide your choices at meals this Thanksgiving.

While we talked last time about ‘hidden’ exercise, you should consider taking an easy walk after your meal instead of that nap.

Until next time, keep those feet happy and healthy, Austin!

There are so many topics to address when it comes to talking about diabetes. Living with diabetes, provides daily challenges and many changes to the routines you have developed over the years. Early diagnosis of type 2 diabetes is often first managed with changes to diet and exercise. Hopefully the word ‘diet’ doesn’t elicit images of tasteless cardboard like food (we will dispel this idea in the future). ‘Exercise’ shouldn’t conjure images of hours on the treadmill, repetitive weight lifting, or being covered in sweat. Small changes to your daily activities can add some of the exercise you need to best manage your diabetes. Here are a few ideas from your friends at AFAS:

· Raking leaves: While you should take caution if you have any kind of lung or heart condition, raking the leaves in your yard can really get your blood flowing. The action of raking includes muscles in your back, arms, chest, and legs. By using these muscles, your body can better process the glucose in your blood and more efficiently use the insulin you produce.

· Parking in the back: You may have heard this one a few times before, but instead of parking right up front, opt for one of the many open spaces in the back. This, of course, requires that you have a little extra time. Instead of looping around the parking lot to find a space closer to the entrance of your work or shopping center of choice, grab one of the many empty spaces in the back of the lot and get a little extra walking in everyday. Walking is one of the best and simple exercises you can do to boost your health.

· Take the stairs: If you work on the 20^th floor of the office building, hoofing it up the stairs in your business attire probably won’t do. Now taking it to the 18^th floor and walking a couple flights of stairs will provide some added activity without sweat beading up on your forehead.

Remember that living a healthy lifestyle, no matter how long or severe your diabetes is, can only help you better manage your blood sugars. This November be aware of your diabetes or help a friend or family member to be aware of theirs. There is a wealth of information from the American Diabetes Association^®, family doctor, podiatrist, dietitian and other health care providers to help you best manage this challenging disease.

Until next time, watch your blood sugars and keep those feet happy and healthy Austin!

In honor of diabetes awareness, this month’s blogs will focus on different topics concerning the disease. We have discussed some aspects of living with diabetes in past blogs. It is a challenging disease to manage, but one that should not limit your aspirations. With a growing incidence of diabetes in a growing population, not even athletes, a physically fit population, are immune to acquiring this problem. There are actually a number of athletes who have reached the professional level while living with diabetes. The NFL boasts three such athletes in Jay Leeuwenburg, Mike Echols, and Mike Sinclair.

Both Leeuwenburg and Echols have type one diabetes. This type of diabetes is also known a juvenile diabetes as it is frequently discovered when you are young. Before the advent of the portable glucometer, a blood glucose measuring device any diabetic is quite familiar with, the ability to manage this disease was quite difficult. Medicine today offers many tools to monitor blood sugars and treatments to stop damage caused by changes in blood sugar from occurring. While a different beast than adult onset, or type two diabetes, the diligence of management is of equal importance in juvenile diabetes. The players we mentioned have to keep very close tabs on their blood sugars, using diet and insulin to keep the proper levels.

Players like Mike Sinclair, DE Philadelphia Eagles, face the same disease that affect tens of millions of Americans. Type two diabetes is often associated with obesity and poor diet and increases in prevalence with age. When diagnosed early, changes to diet and exercise can often be enough to keep this disease a bay. In the case of Mike, who is getting plenty of exercise, swapping the double bacon, half pound burger for a turkey sandwich helped him get his blood glucose in check. Regular checkups with your primary doctor as well as your podiatrist can help you detect changes early. By discovering glucose changes early, changes to diet can have a greater effect on managing this disease. Lifelong medication may be needed to manage if your diabetes goes undetected for months or years.

Don’t let diabetes interfere with your life. Educate yourself about your disease, visit your primary doctor, consult Dr. Thomajan and learn the things you can do you keep your diabetes in check. Doing so early will help you continue doing the activities you like to do.

Until next time, keep those feet happy and healthy Austin!

The Texas Rangers face the San Francisco Giants in Game 5 of the World Series tonight.  Trailing the series 3 games to 1, a win at Rangers Park is the only thing to keep hope alive.  This team has won some tough games throughout the season to arrive at this point.  They have had a rough time with the Giants for several of the first 4 games, but they’re not about to let that history play on their future.  Every member of that team is going out to win tonight and bring that trophy back to Texas. Doing so will make them only the 6^th team in history to make such a comeback.

We want to use all that excitement and determination to explore a facet of foot health.  Wound care, especially combined with diabetes, can be a difficult challenge.  For our younger audience, wound care more than likely consists of a bandage and maybe a little Neosporin.  This paradigm becomes a little more complicated when age and disease, like diabetes, are added in.   Wounds that occur in the diabetic foot can require a large dose of determination to go along with the proper care.  While there are many different doctors who will help to get you well, the care of a podiatrist is of utmost importance when dealing with problems in the feet.  Some of the components that go into healing foot ulcers may be overlooked by other physicians.  One such component may be what is causing the wound. Typically, footwear and foot structure can cause unfavorable pressure points which eventually lead to ulceration.  A podiatric physician will off-load these pressure points with a special boot or shoe. Doing so, allows the wound to heal by eliminating further insult.  Along with this assessment, a podiatrist may take a swab of the wound to assess for possible infection.  Flushing, debridement, gels, grafts, or other modalities may all be used individually or together to promote healing.  What methods are utilized is all dependent on the type of wound you have.  As the patient, you need the determination to follow your doctor’s instructions for the weeks or months it may take to get you better.  Just a reminder, but anyone living with diabetes should examine their feet every night and seek treatment at the first sign of a problem.  If you have diabetes and a foot wound that won’t heal, make an appointment at AFAS today!

Until next time, keep those feet happy and healthy, Austin! Go Rangers!

The President mentioned the costs associated with it long before the healthcare bill was passed. For anyone living with diabetes or struggling with ulcerations that won’t heal, it is a scary thought. Amputation is the last resort option to save an individual’s life, but at a cost that can only be understood by someone who has experienced it. According to the National Institutes of Health (NIH) diabetic complications are the main cause for amputations of the leg not due to trauma.

Earlier this summer members of the American Podiatric Medical Association gathered for their yearly seminar to teach, learn, and share knowledge with one another. One of the studies that were presented at that meeting dealt with the issue of amputation. The researchers examined 32,000 patients with diabetes and compared their risk factors to their ultimate outcomes. Their findings were that diabetic patients who visited a podiatrist had a significantly lower number of amputations than those who did not. If you are already a patient at AFAS, you should receive a yearly letter to remind you to schedule your annual diabetic foot exam.

We try to take our weekly blog space to educate you on keeping in good health and preventing problems with your feet. Inspecting your feet for changes and maintaining your blood glucose within the recommended ranges are your daily priority if you have diabetes. Living with diabetes can mean changing habits you may have had your whole life, but anything you can do to live healthier can add years to your life. Regular visits with Dr. Thomajan can detect problems early. By assessing where an ulcer might occur, proper off loading and changes to your shoes can stop the issue before it even happens. Don’t become an NIH statistic and make sure a podiatrist is involved in your healthcare.

Until next time, keep those feet happy and healthy Austin!

While not a local story, we’re sure you have heard about the man who had his toe bitten off. No, it is not a story that has been passed around the campfire, but rather a Michigan man’s experience earlier this month. The headline “Dog eats Rockford man’s big toe, saves his life” is pretty odd but not entirely out of place in the Midwest. If you take the time to read the article, you’ll see that an Illinois woman had the same thing happen to her only 2 years ago!

But what does all this have to do with the AFAS blog? Well, it gives us a perfect opportunity to talk about diabetes and the associated complications. The man from Michigan was delaying getting checked for fear he might have diabetes. By delaying the diagnosis, the nerves of his feet became so damaged that a small injury to his toe became infected and spread into the bone. This type of infection, osteomyelitis, can spread quickly becoming life threatening.

Diabetes is complicated disease, but you will stay healthier longer by managing your sugars and regular visits with your healthcare team. Simple injuries to your feet can progress quickly if you don’t maintain vigilance. Wearing protective footwear, even while at home, is a good way to protect your feet. Another important step to take is to have your yearly diabetic foot exam. Don’t wait for your family pet to try and help, rather opt for a quick visit to AFAS. Dr. Thomajan can do a lot to keep you on your feet and avoid complications. Until next time, keep those feet happy and healthy Austin!