Diabetic Foot Checks?

Do you all get your feet checked at least once a year and by whom?

How many manage to see a NHS Podiatrist or see someone privately?

Or do you rely on a practice nurse having a quick look and prod?

Has anyone ever given you advice on how you should look after your feet?

Nick

No one ever checks my feet and when I asked my GP he said he wouldn't refer me to a podiatrist unless I was having problems.

All the advice I was given was at an education day when I was first diagnosed. I was told not to go barefoot and I need to wash my feet daily. I was also advised not to use foot spas.

I use a company called Cosy Feet for shoes and socks. They are expensive, but I can get suitanle shoes and xocks and as a diabetic I get VAT relief too.

When I require to see a podiatrist,I phone their office and make an appointment. I have just had my feet tested (needle/blunt) and then given lots of info and half a dozen leaflets on how to look after your feet.

I had my feet checked when I was diagnosed by the practice nurse who "specialises" in diabetes..

They nag me, they ring me, they beg me ................

I just can't do it, I have a foot phobia, no-one, but no-one goes near my feet or else ........

(I don't do belly buttons either - though thats personal preference rather than phobic) *shudders*

I found a lump in a girly place and I have a phobia of those being touched - after scanning and squeezing/Xraying they wanted to put a NEEDLE in and take a sample.... I said "no", very un-emotionally and politely (YEAH, RIGHT!!).

So they put me under and whipped them out! Thank crunchie for anaesthetic...

So I know what ya mean, honey! 'Bout phobias 'n' junk...

caroline wilson wrote:No one ever checks my feet and when I asked my GP he said he wouldn't refer me to a podiatrist unless I was having problems.

All the advice I was given was at an education day when I was first diagnosed. I was told not to go barefoot and I need to wash my feet daily. I was also advised not to use foot spas.

I use a company called Cosy Feet for shoes and socks. They are expensive, but I can get suitanle shoes and xocks and as a diabetic I get VAT relief too.

Hi Caroline,

Cosy Feet are good shoes. Have a look also at DB shoes www.widerfitshoes.co.uk 01933 311 077. I'm very impressed with them and was talking to one of the guys at the Podiatry Conference in Bournemouth on Friday.

Ask your GP to take a look at the NICE guidelines. Your feet should be checked at least once a year if you are a low risk patient by a health professional (albeit a practice diabetic nurse) who should check your sensory perception at the minimum with a monofilament. If your risk category is higher then you are entitled to more frequent checks and by a fully qualified Podiatrist (not a Foot Care Assistant!)

Just by the fact that you are buying shoes from Cosy Feet makes me think that you would not necessarily be in the Low Risk cat.

Take care
Nick

Admin wrote:I had my feet checked when I was diagnosed by the practice nurse who "specialises" in diabetes..

Unfortunately specialist nurses are not specialists in feet hence why we have Pods who are !

Their checks are inevitably time orientated along with taking your bloods etc and normally only cover palpable pulses (one of which is absent in 10-18% of the population), monofilament tests which have to be done correctly or they are meaningless and not quantifiable. They don't seem to do sharp/blunt or hot/cold or vibration tests, all of which are very important. Most of all a Doppler Vascular check is very important so that the degree and strength of arterial blood flow into the foot (and therefore the durability of the arteries themselves) should be checked.

I pick up quite a few arrythmias on patients just by performing a simple Doppler check.

Other tests can be visual on various conditions of the feet/skin and nails.

It may sound daft but just by the fact that a diabetic has athletes foot (Tinea Pedis), this can increase their rating from Low to Medium risk! Similarly nail infections/ingrowing nails can also flag up future problems if not sorted out.

BTW if some didn't know diabetics are at more risk from contracting athletes foot / thrush /dhobie itch etc and other yeast and dermatophytic infections than Jo Public ...

Nick

Junglegirl wrote:They nag me, they ring me, they beg me ................

I just can't do it, I have a foot phobia, no-one, but no-one goes near my feet or else ........

(I don't do belly buttons either - though thats personal preference rather than phobic) *shudders*

Ahhh you just haven't met the right Pod yet!!

I know someone just like you (including the belly button thing ).

I think their mind over matter kicks in cos they realise it's better to see me than risk having a foot off.........

Plus I'm a nice bloke !

Nick

Nick - do you think it's worthwhile for a newly diagnosed to go to a pod?

Hi Imogen,

Yes I do and there are a number of very good reasons for that.

Most importantly is that the vast majority of people are diagnosed some months or years after they would technically be said to have diabetes. In that time micro or even macro changes can have taken place with the smaller blood vessels and nerves in the feet/legs. Blood supply and good nerve sensitivity go hand in hand....if the nerves aren't fed with blood they die. If nerves die then muscles that they control can atrophy or can lose their control over their opposing muscles...i.e muscles on one side of a bone say always have a muscle on teh other side that opposes their actions. It's a pull/push scenario.

Diabetics frequently suffer from a condition called anhydrosis (dry skin). This can lead to lesions or splits in the skin and this then opens up the chance of infection. As I said in another thread Tinea Pedis (athletes foot) is prevalent in many people but again in diabetics can lead to secondary infection if left unattended.

Pods can spot changes in colour of the feet, the capillary refill time + signs of good venous circulation etc.

Nerve damage can be checked and assessed and advice given. Footwear and self health help (try saying that first thing in the morning!) checks can be given to try and keep the feet in as good a condition as possible.

Drs don't have that training.
Nurses (even diabetic 'specialist' nurses don't)
That's why Pods in NHS and lots outside in private practice do a 3 year degree (and not like many 'chiropodists in private practice who have only done a correspondence course!) Check their qualifications carefully cos lots of letters doesn't mean that they are qualified to degree level and always make sure that they are HPC registered. (Thsi can be checked on the HPC web site.
http://www.hpcheck.org/lisa/onlineregister/MicrositeSearchInitial.jsp

Hope that helps a bit
Nick

Edit : removed the colour from the link as it was hard to read... Imogen

As the wife of a T2, what are the signs I should be looking for before nagging my hubby to see a Pod?

Clare wrote:As the wife of a T2, what are the signs I should be looking for before nagging my hubby to see a Pod?

Hi Clare,

Have you seen the latest diabetes awareness posters around the place? 'The Silent Killer' ones? It very similar with feet.

Unfortunately by the time some signs appear in feet it is already to late. My father waited til his foot went a little black. He lost his foot in 3 separate operations and then leg below the knee.

Early diagnosis can help a great deal with most things...and awareness is the best prevention. Self help health checks are so valuable and if the patient is even slightly neuropathic then checking footwear (socks and shoes) and feet regularly can prevent all sorts of horrible things happening. I removed part of a broken egg cup from a neuropathic diabetic's heel a couple of years ago! They didn't feel it and hadn't checked and luckily we got it before it went into deep tissue sepsis.

Basically your feet carry you for around 100,000 miles in a lifetime. At this moment they aren't renewable and we need to look after them as well as we can and expert assessment can make that all so much easier for you - mentally and physically.

Hope that helps

Nick

Hi,

Thank you, I'm sure you're a fantastic, brilliant, great person..........but wild horses wouldn't get me anywhere near you (well my feet anywhere near you).

Not to be too grim, my other half has strict instructions never, ever, ever to sign any operational consent form regarding my feet (should I be unable to sign myself for any reason of course). I came into this world whole, I'm going out whole!

*shudders* sorry, I just can't, no-way, ever, ever, ever.

Junglegirl wrote:Hi,

Thank you, I'm sure you're a fantastic, brilliant, great person..........but wild horses wouldn't get me anywhere near you (well my feet anywhere near you).

Not to be too grim, my other half has strict instructions never, ever, ever to sign any operational consent form regarding my feet (should I be unable to sign myself for any reason of course). I came into this world whole, I'm going out whole!

*shudders* sorry, I just can't, no-way, ever, ever, ever.

Hehehehehehehehe OK done.

and yes I am all those things that you mentioned....and you are obviously soooo astute to see it

Nik

There are no diabetic specialists at my GP surgery, and it feels like no one gives a care. They phone if I don't go down and when I do they loose samples.. I need a decent GP or more specialist care.

The Cosy Feet Shoes, it is only because high street shoes hurt my feet and rub my heels so much, they are worth it to put everyone else ou of my agony. I always had trouble with shoes rubbing my feet, even asa teenager...

caroline wilson wrote:There are no diabetic specialists at my GP surgery, and it feels like no one gives a care. They phone if I don't go down and when I do they loose samples.. I need a decent GP or more specialist care.

The Cosy Feet Shoes, it is only because high street shoes hurt my feet and rub my heels so much, they are worth it to put everyone else ou of my agony. I always had trouble with shoes rubbing my feet, even asa teenager...

Hi Caroline

What can I say?? If nothing else this web site has managed to go public with so many people's gripes and concerns and experiences. It seems astonishing that there is no diabetic nurse available to a health centre nowadays. If you feel that you aren't getting the proper care you can demand that you be referred to the diabetic multi agency team at your hospital (main hospital instead of a cottage/local type). If they don't have one ask to see the diabetologist Consultant or Endocrinology Consultant. If they refuse to do that then complain to your local area health authority (probably a waste of time) or start to go public !!

This is treatment that you are entitled to !!

Re the shoes...do have a look at the DB site too similar shoes but some better styles. If you still have problems with shoes rubbing feet then you could ask for a referral to an Orthotist to have some bespoke shes made for you (and no they aren't all horrible looking nowadays either)

Take care
Nick

Thanks for all the advice and support, Nick - it's really appreciated.

One of my neighbours is also diabetic. I think she is having even more problems with the doctor than me. I am going down later with a list of things I want answers for.

This forum is at least good for everyone sharing experiences...

Our new surgery is fantastic (we left the last one as they let us both down badly - their negligence left me comatose for the best part of 3 weeks )
They are there when you need them and are quite happy to book you in for a double and even a triple appointment if you feel you need one. They've sorted out Dougs' meds and have got me back on the right track with my asthma.

I can't praise them loudly enough

Nick ...... I always knew I was fantastic at spotting good things!
As far as I am aware there is no diabetic specialist person at my GP surgery either.

Junglegirl wrote:Nick ...... I always knew I was fantastic at spotting good things!
As far as I am aware there is no diabetic specialist person at my GP surgery either.

Guess I had better become the 'Flying Pod' then !

My god, you can fly as well (Makes a note that I missed that on my "spotting things" list)

Nick seems to be a very rounded person!!!!

Do you think Nick has a "super pod" outfit .......... any telephone boxes near you Nick?