By Sally Rummel
Your first step in foot health as a diabetic or pre-diabetic patient is to keep close watch over your feet. Yes, you are very attached to them, and they are the key to your future mobility.
Prosthetist Mike Bugg and his team at Orthotech Prosthetics & Orthotics, with five offices in mid-Michigan, understand the importance of foot health in the life of every diabetic. Their goal is to save limbs from the ravages of the nation’s No. 1 chronic disease—diabetes. “It’s the No. 1 reason for amputation in America,” said Bugg, who has worked with diabetics for more than 35 years as a second-generation prosthetist and orthotist. “I take it very seriously.” As the former director for the Diabetes Prevention and Control Program for the state of Michigan, Bugg relates very closely to the need for diabetic education through the doors of his own practice. Seventy percent of Bugg’s practice at Orthotech is related to diabetes, although not all of his diabetic patients end up wearing prosthetic limbs.
PROPER FOOTWEAR IS KEY
When diagnosed as a diabetic, you start from the ground up, beginning with proper footwear. Wearing the proper shoes or custom-fit orthotic inserts can counteract the issues of diabetic peripheral neuropathy—the numbness, burning, tingling sensations caused by nerve damage from the disease.
Diabetics are no longer limited to wearing “ugly orthopedic shoes,” said Bugg. Today’s orthotic footwear includes stylish shoes for jogging, cross-trainers, work boots, cowboy boots, dress shoes, even small heels for women.
While many companies can sell orthopedic footwear, Bugg considers the proper fitting to be an art—which can only be accomplished by expertise and experience.
“It’s a true art; otherwise, they cause more harm than good,” Bugg said. “Once you have a diabetic foot, your foot can get so set in its ways that any change can cause issues. I custom-fit every single pair of shoes.”
He also works very closely with a diabetic’s primary care physician, so “the left foot knows what the right foot is doing,” so to speak.
TAKE CARE OF YOUR SKIN
It’s also very important for diabetic patients to watch carefully for cracks in the skin of their feet, plus hangnails and ingrown toenails which can result in an infection that can lead to a diabetic foot ulcer (an open sore or wound on the bottom of the foot).
“Get the right shoe, the right inserts,” Bugg said. “The skin on your feet is very thin. An infection can happen very quickly.” He recommends the use of Vaseline petroleum jelly to protect feet from dryness and cracking. “You don’t need expensive lotions,” he said. “Rub it in, put socks on and go to bed. Once your feet are soft ‘like a baby’s bottom,’ you can apply as needed.”
SERIOUS FOOT COMPLICATIONS
Sometimes, complications from diabetes can become very serious and life-changing. Charcot foot is a rare but serious complication that can affect diabetics with peripheral neuropathy. Charcot affects the bones, joints and soft tissues of the foot and ankle. The bones become weak and can break, and the joints in the foot or ankle can dislocate.
If not caught in its earliest stage, the joints in the foot collapse and the foot eventually becomes deformed. A deformed foot can cause pressure sores to develop in the foot or ankle. An open wound with foot deformity can lead to an infection and even amputation.
NEW LIFE WITH A NEW LIMB
Bugg can work with a diabetic patient battling Charcot foot by putting him or her in a custom boot to control the shape of the foot. But they usually have what’s called a “rocker-bottom foot,” with the middle of the foot being the low point. More than likely, they get a sore, an ulcer, and weeks, months and years go by. Sometimes they heal, but they will always have issues with them, as they are very prone to reoccurrence.
“When a person has been losing the quality of their life from battling pain, sores that won’t heal and immobility, you have to look at alternatives,” Bugg said. “How many years of a person’s life have been taken away, compared to eight to 10 weeks and you can be ‘on your feet’ again with a prosthetic limb, and walking through Walmart?”
Bugg evaluates these patients and their spouses and circumstances very carefully, along with their doctor. “I work as a team with them,” he said. “It’s all about education. I treat a diabetic amputee with a little more critical care because I understand their susceptibility to sores, which require more comfortable, non-abrasive materials and liners.
People in this situation often come to the conclusion on their own that they would be better off with a prosthetic limb. Mike Bugg and his team are with him or her and their families every step of the way.
2254 S. M-30,
4725 Wenmar Dr.
4511 Miller Rd.
6240 W. Main St.