What is Diabetic Neuropathy?

Diabetic Neuropathy - Pictured above is a diagram of how it affects a person

Diabetic neuropathy is a type of nerve damage that makes it hard for the nerves to carry messages to the brain and other parts of the body. This type of nerve damage happens in people who have diabetes. When you have diabetic neuropathy it can cause the following symptoms:

• Numbness or painful tingling and burning in parts of the body. This mainly occurs in your fingers, toes, hands or feet.


• Difficulty walking and muscle weakness.


• Cuts, sores or blisters on your feet that do not hurt like you would expect them too. They will also heal very slowly.


• Bladder problems such as urinary tract infections and loss of bladder control.


• Digestive problems such as bloating, abdominal pain, constipation, nausea, vomiting and diarrhea.

What causes the neuropathy? To get to the answer of this question, you need to understand what happens in your body when you have diabetes. Diabetes causes the level of sugar in your blood to be higher than normal. Over time, the high blood sugar levels damage your blood vessels and nerves. So this is why people who don't control or can't control their blood sugar levels seem more likely to have diabetic neuropathy. Also, men or more likely to have diabetic neuropathy than women, as well as, high cholesterol levels. Smoking can also increase your risk.

Diabetic neuropathy causes numbness in the feet and toes it can lead to ulcers. Mainly because the ulcer can form and continually get worse without the person knowing it. They will not be able to tell that there an ulcer unless they are checking their feet on a daily basis. It is very important that a diabetic check their feet daily and look for signs of ulcers forming. List below are the stages of ulcers:

• Stage 1—Characterized by reddening wounds over bony areas. The redness on the skin does not go away when pressure is relieved.


• Stage 2—Characterized by blisters, peeling, or cracked skin. There is a partial thickness skin loss involving the top two layers of the skin.


• Stage 3—Characterized by broken skin and sometimes bloody drainage. There is a full thickness skin loss involving subcutaneous tissue (the tissue between the skin and the muscle.)


• Stage 4—Characterized by breaks in the skin involving skin, muscle, tendon, and bone and are often associated with a bone infection (osteomyelitis).

Pictured above is the Natural Step Gabriella. Diabetic shoes are one of the best ways for people with diabetic neuropathy to prevent ulcers from forming. Diabetic shoes are a built for comfort and designed to meet Medicare guidelines. They have a wider toe box and a rocker bottom sole. Diabetic shoes are designed as a preventative measure for people who have diabetes. Pictured below, Natuaral Step Palmero .

If you have diabetic neuropathy and do not have diabetic shoes or if you are diabetic and do not have diabetic shoes, contact our office at 419-423-1888 to schedule an appoint to see Dr. Vail. You can also visit us on the web at www.vailfoot.com , where you can find our online store and plenty of information regarding your feet.

Diabetes and Natural Step

Diabetes is a condition not to take lightly. One simple measure that can be taken by diabetics is the purchase of diabetic shoes. Diabetic shoes are designed with a deeper heel counter and a wider toe box. This allows for the custom inserts to fit properly and cause less foot irritation.

Diabetic shoes are made with a variety of material which include leather, mesh, and neoprene. The shoes should tie up or have velcro straps. Diabetic shoes should have no seams on the inside of the shoes to avoid rubbing and irritation. Be sure to feel the inside of the shoes and ask how they were constructed. Your local podiatrist and certified shoe fitter will work together to ensure the right shoe type are provided for your foot type.

When purchasing diabetic shoes it is very important to get the right size of shoe that will fit your feet the best. Make sure that you have your feet measured prior to purchasing any shoes. Even as we get older and we stop growing are feet still grow. It is common to have a change in the length and/or width of a persons feet as they get older. You should also keep in mind that each shoe company is different. A size 8 of one brand may fit while a size 8 of a different may not. Some shoe companies have their own measuring devices that are custom the their product. It is not uncommon to have different size feet. For example, the left foot may be a size 7.5 while the right foot is an 8. If this is the case, you should always fit shoes to the longer of the two. As a general rule, you should have your feet measured at least once per year.

When being fitted for shoes it is important to ask questions. Just because you are in a therapeutic shoe store does not mean the person fitting you is qualified. A proper shoe fitting is crucial to your feet staying happy and healthy. Here are a few sample questions you should ask when being fitted:

• “What is your experience with fitting diabetic patients?



• ”Are you certified to fit diabetic shoes?"



• ”What is your level of certification?"



• Ask the person questions about the shoes - "Tell me about the construction of the shoe?" "What size did my feet measure?" You should be told the length and width of each foot

We, at the Advanced Foot Care Clinic, highly recommend Natural Step diabetic shoes. Natural Step shoes have a 2 times narrower heel than the toe box. This narrow heel helps to reduce the slipping of the shoe. No other shoe company has this feature. Natural Step offers both tie up and Velcro shoes for your convenience. There is a wide variety of color and style of shoes. Pictured below is one of our best selling women's shoes, Gabriella.

Pictured below is one of many men's styles of shoes called Palermo:

If you are diabetic and are interested in a new pair of diabetic shoes we can be reached by calling 419-423-1888. You can also visit us on the web at www.vailfoot.com . Our website has information regarding diabetic foot care, as well as, other foot problems you may be experiencing. You can also find a large selection of diabetic shoes on our website by clicking on our "Step Alive Shoes" link.

Diabetic Foot Care and Prevention

Diabetes affects nearly 16 million people in the United States. Neuropathy, or nerve system damage, affects roughly 60-70% of the people with diabetes. Neuropathy can lead to the loss of feeling in the hands or feet.

Diabetics are at risk for foot problems. It is very important that diabetics monitor their feet daily. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror, if you are unable to check your feet yourself. Some other tips that are important to diabetics is washing your feet daily, keep your feet dry, do not soak your feet, do not smoke or cross your legs (both decrease blood supply to the feet), use quality lotion, and diabetic shoes/socks. It is also important to schedule routine visits with your local podiatrist. In some cases, amputation is required when diabetic foot problems go untreated. No matter the size or type of foot wound it is crucial that it be checked out by your local podiatrist immediately. Because diabetes lowers the blood flow in the body injuries take a longer time to heal. Wounds that are not healing are at risk for infection.

Since neuropathy affects so many diabetics it is important to know that when your feet become numb deformities, such as ulcers, can occur. Another bone deformity that can occur is Charcot foot. Charcot foot is one of the most serious problems that can occur with a person who has diabetes. Charcot foot can warp your foot when the bones began to fracture and disintegrate. You will continue to walk on your feet without even knowing the damage you are doing because you can not feel the pain.

Pictured above are our Dr. Comfort socks. Dr. Comfort socks have nano bamboo charcoal fibers for padding in the ball and heel. The socks also provide superior comfort designed to keep feet dry, they have smooth seam construction, the socks also have anti-microbial odor control, and the Dr. Comfort socks have superior breathability. Diabetic socks are a very easy, yet important, solution to the prevention of possible diabetic foot problems. These socks can be purchased in our office. We have a variety of styles and colors to suit your needs. We are also running a special with any three pairs of Dr. Comfort socks that you purchase you also get a free diabetic foot creme. So if you are diabetic and are looking for simple solutions to prevent foot problems please contact us at 419-423-1888 or visit us on the web at http://www.vailfoot.com/ , where you can browse our online store for additional products.

Ulcer Prevention

The vast majority of diabetic foot complications resulting in amputation begin with the formation of skin ulcers.  Early detection and treatment of these ulcers may prevent up to 85% of amputations.  If you are diabetic, or know someone who is, prevention of ulcers should be your number one concern.  Below are some tips to help with your prevention of diabetic ulcers.

Inspect the feet daily.  This should be done by the patient or caretaker, if the patient is unable to do so.  If you are unable to see certain areas of the foot, use a mirror.  Make sure there are no blisters, torn skin, or cuts.

Wash your feet daily.  Use a gentle cleansing soap and water.  Pat your feet dry, do not rub them.  (Diabetics can develop an ulcer if they rub their feet too hard.)  When dry, use a topical moisturizer-this will help maintain healthy skin that can better resist breakdown and injury.  A good lotion to use is Amerigel Barrier Lotion known as the "Body Armor for your skin".  This lotion stays on the surface of the skin and does not penetrate through the protective layers.  Because of this, it provides you the best protection on the market today.  This lubricant minimizes skin tears in friction prone areas and reduces inflammation caused by irritants.

Wear special diabetic socks.  You want to make sure they don't have a seam in the toe.  Seams can cause foot irritations and sores.  Make sure your socks have a snug fit.  You want your socks to stay in place and not wrinkle or bunch up.  Look for socks made with spandex and Lycra, this will eliminate that problem.  You also want your socks to keep your feet cool and dry.  Do not buy cotton socks.  Cotton is a relatively abrasive material and it also absorbs foot perspiration and holds it against your skin.  This gives bacteria and fungus a chance to attack your skin.  Look for socks made with CoolMax technology.  The CoolMax fibers will help wick moisture away from your skin, keeping your foot dry.

Wear diabetic shoes.  These shoes are specifically designed with diabetics in mind.  Diabetic shoes are made wider and deeper than regular shoes.  This allows room for custom insoles, and to insure a proper fit.  They need to be made from breathable materials as well.  There needs to be either no interior seams or covered seams and a roomy toe box to prevent any rubbing or pinching.  You also want to make sure they have an adjustable fit to prevent the shoe from sliding around.

When inspecting the feet daily, if you notice any areas of:

• redness
• swelling
• bleeding
• blisters

or any other problem on the foot surface, call your doctor promptly.

If you are a diabetic and think you may have an ulcer, please contact our office to schedule an appointment with Dr. Vail at 419-423-1888.  If you have any other questions regarding diabetic foot care, visit our website at www.vailfoot.com.

Do your feet sweat or have foot fungus?

Are you tired of embarrassing foot order?  Do you have athlete's foot, toenail fungus or are you diabetic?  Have you tried sprays and foot powder and not happy with the results you get when you use them?  There is now a safe and effective product on the market that kills up to 99.9% of the bacteria and fungi living in your shoes.

If you like high tech gadgets like me, you won't be able to resist getting your hands on this latest product.  The SteriShoe Ultraviolet Shoe Sanitizer is the first product that safely and effectively sanitizes the inside of your shoes by using a germicidal ultraviolet (UVC) light.  
UVC has been used as a germicide for decades in hospitals and water treatment systems, and is clinically proven to destroy microorganisms.  Plus, UVC sanitization is more environmentally friendly than chemicals.  Chemical sprays and powders fill your shoe cushioning and there is no way to wash them out. 

SteriShoe Ultraviolet Shoe Sanitizer

You may ask yourself, do I really need this?  When you think of the health of your foot the answer is easily yes.  You may take care of your feet, but do you really take care of your shoes?  Did you know each foot has more than 250,000 sweat glands and can produce up to 8 ounces of sweat each day?  That sweat soaks into your socks and shoes which in turn produces a breeding ground for the fungus and bacteria that causes toenail fungus, athlete's foot and order.

Also, people who suffer from these ailments are likely to re-infect themselves when they wear their shoes.  It doesn't matter if you are taking prescription medicine to treat athlete's foot or a toenail fungus if you are putting your feet back into a shoe that has never been sanitized.  You would never reuse a dirty bandage to cover up a wound, why put your feet in a dirty shoe when it's undergoing treatment?
Because you have diabetes, the American Diabetes Association and the American Podiatric Medical Association urge you to be proactive in the health of your feet.  Diabetes causes poor circulation which can lead to a loss of sensation.  When you cannot feel pain, an untreated blister or sore can develop into a foot ulcer.  When left untreated, the ulcer can lead to an amputation.  Using the SteriShoe ultraviolet shoe sanitizer is another preventative measure to keep your feet healthy.

To learn more about diabetic foot care or schedule an appointment, call Dr. Vail at 419-423-1888 or visit our website at www.vailfoot.com.

Diabetes Foot Care

Knit-Rite SmartKnit Seamless Diabetic Socks (click to view our online store)

When you have diabetes, proper foot care is very important. Poor foot care with diabetes can lead to serious health problems, including possibly having to remove the foot or leg (amputation).

It's important to understand the connection between diabetes and foot care. As a person with diabetes, you are more vulnerable to foot problems because diabetes can damage your nerves and reduce blood flow to your feet. According to The American Diabetes Association, it estimates that one in five people with diabetes who seek hospital care do so for foot problems. By taking proper care of your feet, most serious health problems associated with diabetes can be prevented.

Here are some diabetes foot care tips to follow: (follow the link for more information)

Wash & Dry Your Feet

- Use mild soaps.

- Use warm water.

- Pat your skin dry; do not rub. Thoroughly dry your feet.

- After washing, use lotion on your feet to prevent cracking. Do not put lotion between your toes.

Examine Your Feet Each Day

- Check the tops and bottoms of your feet. Have someone else look at your feet if you cannot see them.

- Check for dry, cracked skin.

- Look for blisters, cuts, scratches, or other sores.

- Check for redness, increased warmth, or tenderness when touching any area of your feet.

- Check for ingrown toenails, corns, and calluses.

- If you get a blister or sore from your shoes, do not "pop" it. Apply a bandage and wear a different pair of shoes.

Take Care of Your Toenails 

- Cut toenails after bathing, when they are soft.

- Cut toenails straight across and smooth with a nail file.

- Avoid cutting into the corners of toes.

- You may want a podiatrist (foot doctor) to cut your toenails.

Be Careful When Exercising

Walk and exercise in comfortable shoes.

Do not exercise when you have open sores on your feet.

Protect Your Feet With Shoes and Socks

- Never go barefoot. Always protect your feet by wearing shoes or hard-soled slippers or footwear.

- Avoid shoes with high heels and pointed toes.
- Avoid shoes that expose your toes or heels (such as open-toed shoes or sandals). These types of shoes increase your risk for injury and potential infections.

- Try on new footwear with the type of socks you usually wear.

- Do not wear new shoes for more than an hour at a time.

- Look and feel inside your shoes before putting them on to make sure there are no foreign objects or rough areas.

- Avoid tight socks.

- Wear natural-fiber socks (cotton, wool, or a cotton-wool blend).

- Wear special shoes if your health care provider recommends them.

- Wear shoes/boots that will protect your feet from various weather conditions (cold, moisture, etc.).

- Make sure your shoes fit properly. If you have neuropathy (nerve damage), you may not notice that your shoes are too tight. Perform the "footwear test" described below.

Would you like to find the right diabetic shoes for your feet? (click on the link and we will explain how)

New Patient Welcome Kit

Here at Dr. Vail's office we want your first trip to be a pleasant success. We as a staff are trying to improve on things everyday, and our patients are on the top of that list.

Your First Appointment

To set up an appointment here at the office:

1. Give us a call at (419) 423-1888

2. Ask for Heather, Eric, or Shannon.

3. Have the following information ready for us:

- We will ask for your name & if your a previous patient-

-The problem your experiencing-

- Insurance Carrier-

-Birthdate-

-SSN-

-Address-

- Phone #-

-& Email Address for Appointment Confirmations-

Our Doctor

Thomas F. Vail, DPM, FACFS

Education

Doctor of Podiatric Medicine, Ohio College of Podiatric Medicine

Board Certifications

American Board of Podiatric Surgery

Fellowships

Fellow, American College of Foot and Ankle Surgeon

Hospital/Surgical Center Affiliations

Blanchard Valley Hospital and Findlay Surgery Center

Memberships

Fellow, American College of Foot and Ankle Surgeons, American Podiatric Medical Association, Ohio Podiatric Medical Association, American Diabetes Assocation

Finally, don't think you "New Patients" walk away empty handed. At the conclusion of your appointment you will stop up front, and receive your Welcome Kit courtesy of Dr. Vail and his staff.

New Patient Welcome Kit:
- A sugar free, or regular choc (foot) candy bar.-
- Dr. Vail Hand Sanitizer-
- Gormel 20 Creme (Moisturizer for Dry Skin)-
- 20% off Dr. Comfort Socks-
- Upcoming 2011 Calender-
- Information on our "Top Shoe List"-
-Information on our "Crocs Referral Program"-
- Our Top Shoe List & Orthoses Informational Guide-


ALL FOR FREE!!!