Do you have questions about diabetic foot care? We have answers.
Do you have questions about diabetic foot care and problems? Tanglewood Foot Specialists provides the answers to frequently asked questions (FAQs) about diabetic foot care. If you would like to schedule an appointment to talk to a doctor about your foot problems, call Tanglewood Foot Specialists at (713) 785-7881.
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What do I do if I see a problem on my foot?
There is a direct correlation between noticing a diabetic foot problem and seeking treatment for it. The sooner a problem, such as a diabetic foot ulcer, is identified and treated, the better the chance is that it will be effectively treated and healed quickly. Time and time again, I see my Houston patients wait weeks, months, and even years, to have their foot treated with results that range from slow healing to disastrous loss of limb.
I always recommend that my patients with diabetes perform a self-inspection of their feet every night. This is a quick, 30 second look at the bottom and top of their feet, as well as between their toes. What you need to look for is anything that wasn't their the night before...areas of redness, bleeding, pus, cracking or anything that doesn't look right. The good news is that if you do find something, you know it is not more than a day old. Just pick up the phone, call our Houston podiatry office, and say "I am diabetic and I think I have a problem." We'll get you in the same day.
When it comes to my patients with diabetes, I'd rather you call and it be nothing than have you wait and it become a major problem. If you see something on your foot that you think may be a problem, contact Houston podiatrist Dr. Andrew Schneider for an immediate appointment.
What is the right foot cream for a diabetic to use?
There are so many creams available in the pharmacy, the choices can be daunting. Add to that, manufacturers who market creams specifically for the diabetic foot. Many of these creams, however, are the same general use cream, but repackaged for the diabetic and significantly marked up.
There is no "best" cream for a diabetic to use. It is important for you to use a cream to maintain the health of your skin and to avoid dry, cracked skin which can lead to an infection. My favorite commercially available creams are Cetaphil and Eucerin. I also carry Foot Miracle cream in my Houston podiatry office which many of my patients, diabetic and non-diabetic alike, prefer.
In situations where your foot is particularly dry, or if the skin is cracked, you will need a creme that is stronger. In these cases, I recommend a creme with Urea or Lactic Acid to better soften the skin. While these used to be covered as a prescription product, most insurance companies have stopped providing this benefit. For this reason, we carry two Urea creams, Gormel creme (20% urea) and Kera-42 creme (42% urea).
No matter what cream you use, the most important thing is to use it at least daily. If you stop applying the cream, your feet will return to their previously dry condition. Apply cream to the top and bottom of your feet and rub it in so it disappears. You should NOT, however, put cream between your toes. If you have dry skin between your toes, Dr. Andrew Schneider can recommend an alternative that is safe for you to use. If you are unsure what cream is the best choice to use, contact Tanglewood Foot Specialists to receive recommendations.
Why doesn't my diabetic foot ulcer heal on it's own?
A diabetic foot ulcer is one of the most frustrating conditions to have and get healed. There are many factors that cause a diabetic foot ulcer to form, including diabetic peripheral neuropathy, peripheral arterial disease (PAD), and excessive pressure beneath the foot. In order to have the ulcer heal, all of these contribute factors must be controlled.
Diabetic foot ulcers also have different characteristics. Some are dry, while others drain; some are infected, and others are not; some are deep to bone, while others are superficial. Different wounds will require the appropriate treatment in order to heal properly. All, however, should be considered to be medical emergencies.
The management of a diabetic foot ulcer is too complex to handle on your own. If the wound is not treated properly, it can worsen and become infected. An infection such as this, particularly if you have diabetes, can result in you losing a toe, your foot, or even your leg. Don't put yourself at risk! At the first sign of a diabetic foot ulcer, contact your podiatrist. Houston podiatrist Dr. Andrew Schneider has the means to evaluate your wound and recommend the best treatment to get the ulcer healed as quickly as possible.
What can you do for a diabetic Charcot foot?
A diabetic Charcot foot is a severe form of diabetic peripheral neuropathy. While peripheral neuropathy most commonly only effects sensation, causing numbness or pain, the Charcot foot occurs when the motor nerves are involved and results in the breakdown of joints in the midfoot.
When a Charcot foot occurs, it creates many problems. First of all, it is common to have a diabetic foot ulcer form beneath the collapsed arch. The ulcer forms because of the increased pressure beneath the bones in the arch. In order to prevent a diabetic foot ulcer from forming or returning, an ankle-foot orthotic (AFO) may be needed to provide support and redistribute the pressure beneath the foot.
Because of the foot deformity involved with Charcot, it is often impossible to fit the foot into a regular shoe. In these cases a extra-depth diabetic shoe is needed. In some cases, a shoe must be custom made for you.
At Tanglewood Foot Specialists in Houston, TX, Dr. Andrew Schneider provides a comprehensive evaluation for your diabetic foot and to make sure a Charcot condition does not cause you trouble. We will get you in the footwear and support needed to ensure your feet last a lifetime.
My foot doesn't fit in a shoe, what do I do?
A number of diabetes complications can prevent you from wearing a store-bought shoe. These can include swelling, foot deformities, such as Charcot deformity, and the need to use an insole inside your shoe. There are a couple of options to handle this.
Many people with diabetes, and certainly those with any of the above issues, are qualified to receive diabetic shoes and insoles which are covered by Medicare and private insurance. These shoes are made with extra-depth to accommodate feet that are less able to fit properly in a regular shoe.
If you find that even an extra-depth diabetic shoe still doesn't allow your foot to fit into a shoe. In these cases, a custom shoe can be made from a mold of your foot and ankle. Because the shoe is made custom for you, it is able to be fabricated to the specific requirements of your foot.
At Tanglewood Foot Specialists, we work with several lines of diabetic shoes to ensure we can cover a multitude of foot types and offer different colors and styles. In addition Dr. Schneider is one of the few podiatrists in Houston that evaluates for custom therapeutic shoes. If you have been having trouble finding shoes that fit properly, contact our Houston office.
Once my diabetic foot ulcer is healed, how do I stop it from returning?
A diabetic foot ulcer is very serious complication of diabetes. It is when the skin breaks down in an area of excessive pressure. The wound has a great potential to become infected. Because of reduced circulation, a diabetic foot ulcer puts your foot and entire lower limb at risk for amputation. This is why a diabetic foot ulcer is an emergency that must be treated immediately.
An important element to heal your diabetic foot ulcer is to control the pressure that had caused the wound to form. After it is healed, it is critical to manage that pressure or the ulcer will reopen. In most cases, the pressure can be controlled with a diabetic shoe and appropriate custom insole to reduce the pressure beneath the foot. The use of a therapeutic shoe after a diabetic foot ulcer is healed is covered by Medicare and many private insurance plans.
In some cases, a diabetic shoe is not enough to adequately control the pressure that causes the diabetic foot ulcer to return. In these cases, such as a Charcot foot or a very flat foot, an ankle-foot orthotic (AFO) can provide more comprehensive control of the pressures and more completely prevent the wound from reopening.
If you have a diabetic foot ulcer, it is to not wait any longer to seek attention. Call Houston podiatrist Dr. Andrew Schneider for an immediate appointment. Once healed, we will do what is necessary to make sure the wound does not reopen.
Is there a cure for diabetic neuropathy?
Diabetic peripheral neuropathy is a common complication of diabetes. It causes your feet to feel pain or uncomfortable numb sensations. It is prevalent in diabetics because the high concentration of blood sugar can impact your nerves and circulation. Some describe their neuropathy as constant burning, others feel itching or a pins and needles sensation, still others feel that their feet feel numb as if encased in wax. There is no right or wrong way to experience peripheral neuropathy.
There is really no cure for peripheral neuropathy. When neuropathy is painful, it can be managed with prescription medication, such as Lyrica or Cymbalta. Topical analgesics can also help take the edge off. These can be a prescription compound or something more common such as Biofreeze.
For diabetic peripheral neuropathy resulting in either numb or painful feet, there are a few more options that are effective. MicroVas therapy is a non-invasive modality that increases the blood flow to the nerves in your feet. By providing more oxygen, the nerves can "wake up" and numbness and pain is reduced. MicroVas is an in-office therapy provided in our Houston podiatry office.
Addressing nutritional deficiencies that can contribute to peripheral neuropathy is one other way to control the discomfort of peripheral neuropathy. For that we use two medical foods, Neuremedy and Metanx, to provide sufficient amounts of B vitamins, folate, and other nutrients necessary for proper nerve function.
If you have been suffering with Diabetic peripheral neuropathy and have not found relief, contact Tanglewood Foot Specialists in Houston to schedule an appointment with Dr. Andrew Schneider. After a comprehensive evaluation, Dr. Schneider will recommend the most appropriate treatment for you.
What's the most advanced way to heal a diabetic ulcer?
There are numerous modalities used to heal diabetic foot ulcers. Even so, it continues to amaze me that patients have been told to use the same cream or gel for months or years without seeing any improvement in the wound. In my Houston wound care practice I use a consistent benchmark to dictate my treatment of your diabetic foot ulcer. This means if conventional measures don't heal a diabetic foot ulcer at least 50% in 4 weeks, I change the treatment to get the wound moving again.
An advanced therapy that I use to treat your diabetic foot ulcer that hasn't progressed is to use a dressing made from living tissue. These are known as advanced biological dressings. The two that I use in my Houston podiatry practice are Dermagraft and Apligraf. These dressings are applied in the office and form a matrix of living cells to influence wound healing. These treatments are covered by Medicare and private insurance.
Another advanced therapy for stagnated wounds is the use of Microvas therapy. This non-invasive in-office procedure helps to stimulate blood flow to your diabetic foot ulcer. With the increase in blood flow comes resources to help your body heal your wound.
If you have a diabetic foot ulcer, or any wound, that has not healed if a reasonable period of time, contact Houston podiatrist Dr. Andrew Schneider at Tanglewood Foot Specialists for an evaluation and comprehensive treatment plan.
What's the best way to heal a diabetic ulcer?
A diabetic foot ulcer is a common and dangerous complication of diabetes. An ulcer forms because of increased pressure beneath the foot. This excessive pressure leads to a breakdown of the skin and forms an ulcer. While there are all types of advanced wound dressings, which serve an important purpose, none are as important as controlling the pressure that has caused the ulcer to form in the first place.
It makes sense if you think about it. The pressure beneath the diabetic foot ulcer is the cause and the wound is the result of that pressure. To successfully treat the ulcer, we need to heal the wound while simultaneously controlling the pressure. Unfortunately this important element of wound care is overlooked by many practitioners and resisted by many patients.
Offloading a wound properly requires some inconvenience and disruption in your lifestyle. Different doctors use different methods to remove the pressure from a wound. Some apply casts, others use a cast boot, still others use a specialized healing shoe. There are even times where surgery may be needed to remove the pressure from the ulcer site. Adding padding to your existing shoes, or even using diabetic shoes, is not sufficient to keep the pressure away.
After your diabetic foot ulcer is healed, you are not completely out of the woods. It is vital to continue to control the pressure to prevent the wound from returning. This is where a diabetic shoe is appropriate.
Of course, the best way to treat a diabetic foot ulcer is to prevent one from forming. Every person with diabetes should be seen regularly by a podiatrist in Houston to identify and manage risk factors and ensure you are wearing the proper shoes. If you or someone you love has diabetes, especially if you are concerned about a diabetic foot ulcer forming or not healing, contact Dr. Andrew Schneider for an immediate appointment. Just say "I'm diabetic and have a problem" and we'll get you in right away.
Will an diabetic foot ulcer that's been there for a long time ever heal?
So you have a diabetic foot ulcer that just won't heal. Or maybe it has healed but keeps coming back. I'm sure you are frustrated and feel that it may never heal. In some cases you may have dressed your wound with the same medication for months...even years!
A diabetic foot ulcer should show continuous progress towards healing. If your wound stops healing, there must be a reason why or a change in therapy is needed. First of all, no ulcer will heal if there is not a sufficient blood supply to the foot. Poor circulation is common in people with diabetes. At our Houston podiatry practice, we use a non-invasive, painless system for evaluating your circulation called PADnet. Everyone with diabetes should be evaluated for circulation. Restoring circulation will help your wound to heal.
The underlying cause of your diabetic foot ulcer is pressure. This same pressure that initially caused the wound will prevent it from healing. For this reason, management of your ulcer must include the relief of pressure. The is achieved by casting, wearing a surgical boot, or surgical shoe. If you are not wearing something to manage these pressures, you should ask your doctor or get a second opinion from another podiatrist in Houston.
Finally, not all dressings for a diabetic foot ulcer are the same. Some should be used with a dry wound, others for a draining wound, and still others for a wound that is infected. There are dressings that use living cells and growth factors to speed healing. If the dressing you are using hasn't made your wound close after 4 weeks, ask if another type of dressing may be better.
If you feel that your diabetic foot ulcer is not healing, contact Tanglewood Foot Specialists and schedule and appointment with Houston diabetic ulcer specialist Dr. Andrew Schneider.