Any Suggestions???

Hi Everyone hope you are all ok?I have a question .... I am a type 2 diabetic have been for a few years now ,but every now and then my ankle and foot swells up and it is so painful cant put any weight on it ...its like bad tooth ache could the weather be causing it? or just high blood sugar it was 13.5 when i checked ,it is a bit better down to 9 . I have had it since Tuesday. Any suggestions.........Thanks Dave x

Hi Dave, welcome to the board. Perhaps Nick has a suggestion about your problem....

Mind you, we may have to wait until he wakes up.... he's probably having a nice lie in (something I no longer get because of a small boy and two small kittens who've taken to throwing themselves at the door in the mornings)....

Thanks for the welcome Imogen .Thanks to your great site, i think i know what it is .....Charcot foot.In the past i have been told by doctors that it is gout. I would welcome feedback from Nick and im sorry about your lie in lol thats children for you

Charcot foot does sounds like a bundle of fun, Dave... I have found a bit of info here if anyone is interested:

http://www.footphysicians.com/footankleinfo/charcot-foot.htm

Do you suffer from neuropathy?

I dont think i do,but im learning new things each week about diabetes!!

Yep, it's a big, scary subject.

Yes it is , the more i dig the worse it gets lol....So many different things that could go wrong......time to start looking after myself me thinks!!

davet1966 wrote: Hi Everyone hope you are all ok?I have a question .... I am a type 2 diabetic have been for a few years now ,but every now and then my ankle and foot swells up and it is so painful cant put any weight on it ...its like bad tooth ache could the weather be causing it? or just high blood sugar it was 13.5 when i checked ,it is a bit better down to 9 . I have had it since Tuesday. Any suggestions.........Thanks Dave x

Hi Dave,

Sorry re the tardiness in replying, for some reason your mail didn't flag up on my screen until today ...or I just didn't see it !

Ok first off I guess that because you can feel pain and discomfort - you are not neuropathic, or do you have some lack of sensation anywhere in your feet or fingers?

What is the blood supply to your feet like? Do you have regular check ups with a NHS Podiatrist and if so do they listen to the pulses in your feet with a Doppler? (It's not sufficient just for them to feel your pulses - as most diabetic nurses may do)

What colour are your feet normally and when the pain kicks in and they swell?

Do you have any dimpled marks on your legs or ankles like an orange skin?

Have you had any ulcers on your legs/ankles before?

Do you have varicose veins in your legs or around your ankles?

Does the swelling or oedema come from your knee downwards or from your ankle and top (dorsum) of your foot?

Is it puffy and if you pushed your finegr into it and held it there for 5 seconds, are you able to leave a pitting mark which recovers...and how long in seconds does it take to recover?

What do you do for a living? Do you stand a lot? Do you walk much and if so how quickly or slowly? How is your balance?

What footwear do you have and does it occur when you are wearing a certain shoe or boot?

Do you use lace ups and if so do you tie them tightly?

If you use velcro do you have it done up tightly at the top?

If you use slip ons or any other shoe, when you put them on ... look at the top of your foot and see if it swells out a little over the top of the tongue area (or front of the shoe in a slip on) or over the sides a little? If it doesn't...look again after a few hours and see if it does so then.

Do you put your feet up (sorry I don't know how old you are) when you get a chance to?

Does this happen in one or both feet?

Have you had any accident to your foot or ankle? i.e sprains etc?

What meds are you on?

How long has this been happening and does it happen only in warm weather?

Do you drink plenty of water (not tea or coffee or fruit juice...just water)?

Do you get plenty of exercise or walk much?

Wow.. so many questions !!!

Sorry about that but can't give you answers without knowing any details

If you'd rather send some of it through to me on a personal email rather than put it all on here...feel free to do so. Just hit the PM button and it will arrive in my email box.

Best wishes

Nick

davet1966 wrote:Thanks for the welcome Imogen .Thanks to your great site, i think i know what it is .....Charcot foot.In the past i have been told by doctors that it is gout. I would welcome feedback from Nick and im sorry about your lie in lol thats children for you

Gout only occurs really in your big toe and normally comes on over night and your big toe swells dramatically and you can't even stand bedclothes on it! If they thought it was gout then they would have put you on allopurinol to prevent it.

Unlikely to be Charcot..a) you need to be neuropathic (so you wouldn't feel the pain)
b) you need bounding pulses and this should have been picked up by health care professionals

If they thought that then your weight bearing should be offloaded and special orthotics or more likely special footwear to prevent any damage and potential puncturing of your foot

Do you have a very high instep and clawed toes? (forgot this one on last interogation)


Nick

Hi Nick,
Thanks for your reply.I will answer as honestly as i can !

Ok first off I guess that because you can feel pain and discomfort - you are not neuropathic, or do you have some lack of sensation anywhere in your feet or fingers?

No i dont .

What is the blood supply to your feet like? Do you have regular check ups with a NHS Podiatrist and if so do they listen to the pulses in your feet with a Doppler? (It's not sufficient just for them to feel your pulses - as most diabetic nurses may do)

I have had a Doppler and The pulses were good

What colour are your feet normally and when the pain kicks in and they swell?

The Colour in my feet are normal ,but when the pain kicks in the ankle and foot go a blotchy red,where it swells.

Do you have any dimpled marks on your legs or ankles like an orange skin?

No dimpled marks.

Have you had any ulcers on your legs/ankles before?

No ulcers .

Do you have varicose veins in your legs or around your ankles?

I think i have varicose veins on my legs and sometimes the backs of my calves are heavy.

Does the swelling or oedema come from your knee downwards or from your ankle and top (dorsum) of your foot?

It swells around my ankle and top of foot

Is it puffy and if you pushed your finegr into it and held it there for 5 seconds, are you able to leave a pitting mark which recovers...and how long in seconds does it take to recover?

When swollen it is as hard as a brick and when pressed in goes to the colour white.It takes about 5 seconds to recover

What do you do for a living? Do you stand a lot? Do you walk much and if so how quickly or slowly? How is your balance

Im a flooring contractor and do lots of bending and work on my knees.I walk a bit at work always on my feet but not fast and my balance is good

What footwear do you have and does it occur when you are wearing a certain shoe or boot?

I wear slip ons and boots but i dont have them tight fitting.

Do you use lace ups and if so do you tie them tightly?

No

If you use velcro do you have it done up tightly at the top?
No

If you use slip ons or any other shoe, when you put them on ... look at the top of your foot and see if it swells out a little over the top of the tongue area (or front of the shoe in a slip on) or over the sides a little? If it doesn't...look again after a few hours and see if it does so then.

No it doesnt

Do you put your feet up (sorry I don't know how old you are) when you get a chance to?

Im 44 and yes when i get the chance i put my feet up.


Does this happen in one or both feet?

It happens in both feet maybe 3 times a year but lasts for a week on average.

Have you had any accident to your foot or ankle? i.e sprains etc?

I used to alot when i played football in my early years.

What meds are you on?

Im on metformin and simvastatin

How long has this been happening and does it happen only in warm weather?

on and off for the past 8 years and no it happens in cold weather too

Do you drink plenty of water (not tea or coffee or fruit juice...just water)?

No i dont drink a lot of water

Do you get plenty of exercise or walk much?

My job is quite physical , digging , heavy lifting etc.

Thanks for your reply Nick it is very much appreciated ,

Dave

Hi Dave,

OK that's got my brain thinking ! Just off for a full day's clinic so may not be able to get back to you today but will do as soon as I can.

Best wishes

Nick

Lol Ok Nick, Thats what they said at the hospital when i went years ago and had an x ray on it. Once again i know you are a busy man and it is very much appreciated.
Regards

Dave

Hi Dave,

Trust me I haven't forgotten you.... will get something on here for you this week.

Best wishes
Nick

ok mate, no worries

davet1966 wrote: Hi Everyone hope you are all ok?I have a question .... I am a type 2 diabetic have been for a few years now ,but every now and then my ankle and foot swells up and it is so painful cant put any weight on it ...its like bad tooth ache could the weather be causing it? or just high blood sugar it was 13.5 when i checked ,it is a bit better down to 9 . I have had it since Tuesday. Any suggestions.......Thanks Dave x

uhm think so, it good ideal

What is the blood supply to your feet like? Do you have regular check ups with a NHS Podiatrist and if so do they listen to the pulses in your feet with a Doppler? (It's not sufficient just for them to feel your pulses - as most diabetic nurses may do)

I have had a Doppler and The pulses were good

What colour are your feet normally and when the pain kicks in and they swell?
thank for your post . Nice to meet you
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Hi,
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Thanks
Nick