Podiatry: How to look after your feet at home
Most of us take our feet for granted. We wear the same pair of shoes for a bit too long, we keep the same pair of socks that have holes in them out of a sense of attachment and sentimentality and, more importantly, we are all guilty of leaving a problem a little too long. So, when my friends and family ask me for foot advice over the phone, and I am unable to see them myself, a lot of the time I will say “go and see someone local to you so they can assess and offer the best advice.”
Changing Times
Over the past few weeks, a lot of things have changed that we previously took for granted. Easy access to Health Care Services is one of them. If you are suffering from a foot problem, how easy is it to go and see a Podiatrist? How comfortable are you with using up resources at the moment that could perhaps go elsewhere, while sitting in the clinic waiting room with a sore foot alongside a person with a ‘suspicious cough?’
We ALL have a responsibility, during this time, to follow the advice that has been given to us. The most important aspect of that advice is staying at home. To some extent, this advice involves a responsibility to take care of ourselves. To make sure we mind ourselves, so that we do not harm others.
Ignorance and denial
The idea behind this blog is not to spread fear. As Herman Melville said “Ignorance is the parent of fear.” We fear pain, or disability so we leave it alone and engage in denial and ignorance. I have been a Podiatrist for 16 years and any Podiatrist will tell you that many of the issues we encounter on a daily basis can be easily, and simply fixed or prevented and that delay usually causes a much more painful problem. Simply put, prevention is better than cure and with a mix of common sense and a couple of precautions, this can be achieved.
Pay attention to your feet
The first of these is to pay attention to your feet. Admittedly, feet are not the most glamorous body part, with a lot of my patients telling me they “hate feet.” But these are unprecedented times. We need to make changes. Know what your feet normally look and feel like. Normally, pain is our first indicator that something is wrong. Some people with diabetes, do not have the luxury of sensation due to an altered level of feeling within the feet. We therefore need to get into the habit of not only checking in on pain, but observing changes in colour, any changes in the toenails, checking our socks are not too tight, (bamboo socks and comfort cuff socks which are widely available online at www.sockshop.co.uk, amazon and in retail stores such as Marks & Spencer are highly recommended) and feeling our feet for lumps and bumps or asking a member of our household to do this for us are important.
www.iddt.org (The Independent Diabetes Trust), www.diabetes.org.uk (Diabetes UK) and www.cop.org.uk (College of Podiatry) all provide excellent publications and leaflets available to download on different aspects of Diabetes Foot Health.
Keeping your nails tidy
Understandably, a lot of diabetic patients, do not feel confident in cutting their own nails. Quite often we see a small spike left behind so it is safer to file the nail with a good quality nail file. The diamond deb files are fantastic for this. They provide a clean finish and can also be used to reduce the thickness of nails. Always file your nails in one direction, so that if you use too much force, you won’t lift the nail.
The quality of the finish is in the equipment. Use a good quality file, not the kind that you find in a Christmas cracker, not the kitchen scissors and probably not the ones in the garden shed (Yes, that has happened!).
Maintaining healthy skin
Wash your feet regularly, check on bruises to make sure they go away (bearing in mind, bruises under the nail may linger for a longer period of time).
Dry carefully between your toes and apply moisturising cream or balm to areas of hard skin, though never use it in between the toes*.
There are many neat tricks to look at the bottom of the feet. As my Grandmother use to say, “It’s not getting down there that’s the problem Gem, it’s getting back up”. She used to angle a mirror against a wall and elevate her feet a little so she could see underneath. A wise lady indeed!
What to keep an eye out for?
The signs and symptoms of infection have been the same for thousands of years; recognise them.
· Redness
· Pain (remember, not to be relied on solely with diabetes, as some diabetic patients have altered sensation within their feet)
· Swelling
· Discharge
· Loss of function – difficult to move the toe or the affected area of the foot
Milder infections can be helped with the use of antiseptic creams or antiseptic dressings like an iodine dressing. Always check the packaging for instructions on use. More serious infections may need urgent medical attention.
How to Prevent an Infection
The good news is that most infections are preventable by changing your socks and shoes regularly, avoiding walking outside in the garden barefoot, ideally checking your feet every day and keeping a dressing over an open wound. Any breakages in the skin are considered to be ulcers, indifferent of size or depth, so it’s important to seek medical advice as quickly as you can.
Keeping an eye on those around you
If the last few weeks have taught us anything, it is the need to pay attention to each other. A lot of my patients come into clinic with something that someone else noticed; “My Wife mentioned my funny toenail”, “My Husband noticed I have a limp”.
If you know someone who is older and has mobility issues, or problems with their sight, maybe they attend a Podiatrist on a regular basis. Maybe they can’t go to them now or for the foreseeable future. Could someone in the household put cream on their feet or file their nails once a week? Grab those clean, disposable gloves and put them to good use!
If we look out for each other, if we do the best we can for each other, maybe, just maybe we will all get through this together.
Gemma Andrews
HCPC Registered Podiatrist
[* edited March 2021: some of the newer 'mousses' can be used between the toes - check with the manufacturer or a healthcare professional first]
