Step wisely with The Diabetic Foot Clinic – Keeping feet healthy & maintaining mobility

by Rebecca Shadowen, M.D., FACP, FSHEA

From the time we come into this world, we start a journey. Every step we take defines the comfort, quality, and accomplishments of our lives and impacts those around us. What would happen if we were not able to take any steps? What if we could not leave our home or drive a car? This happens to many Americans when they develop problems with their feet.

There are several diseases that can affect our feet and legs. Some of these include spinal stenosis, venous disease, arterial insuffic

iency, fractures, and arthritis. The most common, however, is diabetes. In someone with diabetes, nerve endings in the feet may become numb and sensation is lost. This is called neuropathy. When this happens, normal daily walking can actually lead to injuring the feet and legs. If you have neuropathy, you can’t tell that you are walking wrong or causing too much pressure on one part of the foot. This results in breaks in the skin, ulcers, and fractured bones. Normal skin is a barrier to the invasion of bacteria and yeast that live on and around us. When this barrier is lost, these organisms can invade and c

ause serious infections of the skin, joints, tendons and bones.

Skin breakdown and infections are not the only things that can affect the feet and legs; arterial disease can decrease blood flow to the extremities. If the tissues cannot get enough blood flow, wounds or fractures cannot heal, and tissue may become dark or black and require amputatio

n. Additionally, medications carried by the bloodstream – such as antibiotics – cannot reach the infection if the arteries are narrowed or closed off. Large arteries or small arteries can be affected. Large artery disease can often be corrected by balloon (angioplasty) treatment, stents or bypass surgery. Prevention of skin breakdown and medications to make blood flow better are important in small artery disease.

The really good news is that there are newer and more standardized treatments for these problems. Several new medications to control diabetes have become available. Advanced vascular interventions are very effective to improve blood flow. Individual, tailored treatment of infections has led to a cure in a majority of cases. The most important way to keep our feet and mobility is to get the proper diagnosis and treatment – and to get this done as soon as the problem develops.

Med Center Health recognizes there is a need for better access to specialized care for patients with foot or leg wounds, artery insufficiency, or infections. To address this problem, the Diabetic Foot Clinic opened February 1 at The Medical Center at Bowling Green, and the Step Wisely program was developed. The program provides standardized, state-of-the-art medical care for patients with foot or leg wounds and includes physical therapists, dietitians, wound care nurses, vascular surgeons, general surgeons, orthopaedic surgeons and infectious disease physicians. These p

rofessionals work with each patient’s primary care provider to correct and treat underlying problems based on standards of care and expert recommendations. In each case, an individualized plan is developed to address the problems. The goal at the Diabetic Foot Clinic is to improve the quality of life by providing better access to needed care.

The Diabetic Foot Clinic is for anyone with diabetes, wounds or neuropathy. Patients or providers may contact the clinic at 270-796-6500 for more information or to make an appointment.

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