Let's Talk about the Loss of Toes Too

Happy #WDD! Hope you guys all spent some time to check your plates, send love to friends/family who have family history or are diagnosed, and if you have diabetes...check your toes? 

Oh yes. 

Diabetic Neuropathy

Another reason why keeping tabs on your diet is important when you have diabetes. Diabetic neuropathy is nerve damage caused by chronically high blood glucose levels and causes numbness or insensitivity to pain and temperature. According to the American Diabetes Association, about half of all people with diabetes have some form of neuropathy. Peripheral neuropathy refers to the nerve damage in the fingers and toes. 

When your fingers and toes are numb, you won't be able to feel when you stub, bump, bang, scrape, scratch them on things in your environment. You won't be able to tell if you've stepped on a nail, touched something hot, or scraped yourself on something under the table. If you tend to sit or lay down all day long or your shoes always rub against your feet in certain spots, you have a higher chance of developing pressure ulcers and sores. These sores can become infected without you knowing, and by the time you notice, they will start to become black and might start to smell. By the time you go to the emergency room, the doc may have to tell you that the sore is infected all the way to the bone and that they will have to amputate to stop it from infecting more bone.  

You might come out of the hospital missing toes and fingers, maybe even entire limbs. 

So Check Your Skin

From the minute you are diagnosed, you will want to be diligent about checking your skin for any scrapes, cuts, and sores. Do not wait until you have decreased sensation or numbness. 

Because our feet are usually hidden by socks and shoes and are generally harder to get a good look at, it will take more conscious and physical effort to remember and check them. When was the last time you looked at the bottom of your foot? Can you reach your toes? Can you put your foot on top of your opposite knee to take a good look? 

Get Someone to Help

Ask someone for help if you cannot check your own toes. 

If you sit in a wheelchair, ask them to take a look at your bottom as well. It may seem like an uncomfortable situation, but trust me, when you're in the hospital and a nurse, doctor, therapist, wound nurse, CNA, etc. are all poking and prodding at you and telling you to turn this way and that during the night...that's much more invasive. 

Another solution is to buy a long-handled mirror, like this one on Amazon, so that you can still see hard-to-reach places. 

Include Skin-Checking in Your Daily Routine

I have heard too many times, while working at the hospital, people saying that they forget to check their skin. Common reasons why include, "I just forget," or "I can't always check it myself." A solution to this is to include this activity in your daily routine when it works best for you. 

Here are some questions to consider when finding a good routine for skin-checking:

  • At what time of the day are you the most energetic and are able to reach those hard-to-reach places?
  • When do you usually bathe/shower? Can you do it in the shower safely? 
  • Where would you be the most comfortable and safest to sit and check your feet and stand and check your bottom?
  • If you have a caregiver or helper, when do they come in? Can 

Found a Cut - What Next? 

If you do find a cut or a scrape, you want to get it checked out by your doctor. Even minor scrapes. Don't take any chances because minor issues are much easier to treat than big ones.

In the meantime, you want to

  • Immediately use regular first aid to make sure bacteria doesn't build up in the wound and cause an infection. First rinse the wound out with water, then apply antibiotic ointment and a sterile bandage (bandaid).
  • Keep pressure off that area until it heals. 
  • Change the bandage once a day and keep checking it for extra redness or irritation. If it becomes more red, then it is most likely becoming infected. You will want to have a doctor take a look at it immediately. 
  • Keep your blood glucose levels in healthy ranges to ensure proper healing. 

Now...try to lick your elbows and toes. And get a good look at the skin while you're at it. Happy Skin-Checking! 

 

Resources

American Diabetes Association: Neuropathy

American Occupational Therapy Association: Occupational Therapy's Role in Diabetes Self-Management

American Podiatric Medical Association: Diabetic Wound Care

U.S. National Library of Medicine - MedlinePlus: Diabetes and nerve damage