Life is always busy!. There will never be a better time!. Sometimes it becomes so easy to neglect the obvious in favour of daily responsibilities and routine. Here is why you cant.
Judging by the images below we can see this guy works in a physically demanding environment. There is clearly a structural/functional instability in his foot structure as demonstrated by the heavy callous on certain parts of his right foot and complete absence on others. The force under these hard inflexible callouses have caused so much pressure that blood vessels have been damaged causing the bleeding and discolouration of the skin. He is literally standing upon the edge of cliff!.
What the picture doesn’t tell us is he is pre-diabetic, meaning his blood sugar is teetering on the point of being out of control. If control cannot be achieved then he increases his likelihood of requiring medication, and developing a myriad of complications not the least of which are, peripheral vascular disease (reduced blood supply), neuropathy (loss of sensation), increased susceptibility to infection and reduced ability to heal wounds.
Our task in this situation is first to prevent these callouses from causing tissue breakdown and ulceration. This needs to be performed on a regular basis until the crisis can be prevented. Prevention comes in the form of normalizing blood sugars, through dietary changes and if necessary medication. Next, the underly structural foot problems must be identified and addressed to improve foot function otherwise the these lesion will become a ticking time bomb.
Much of our day is spent with patients like this helping them fully understand their diabetic condition, the relationship the foot has with the condition, monitoring their systems for indicative changes and helping them take control of their disease to lead full active lives. For our diabetic patients we classify their condition based on several criteria, depending on that we re-examine on a more or less frequent basis. These results we communicate to their primary care physician thus ensuring negative changes can be addressed as quickly as possible.
The consequence of ignoring or partially addressing the situation is both predictable and life altering.
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