• A person who has one of several local (leg, ankle or foot) or systemic (total body) conditions is said to have "high risk feet" if that condition threatens the very existence of part or all of the foot.
• Advanced artery disease (A.S.O.) ranks high as a cause for delayed healing in the feet and as a cause of (dry) gangrene in the feet.
• Diabetes mellitus (with complications) can also cause a multitude of dangerous changes in the body which can harm the feet directly and indirectly.
• Impaired nerve sensations (e.g. poor perception of pain) puts the feet at risk of gradually worsening deformities, painless injuries and unperceived infections. Chronic, advanced vein disease with its threat of ulcerations and blood clots increases the risk of local and spreading infection and acute lung problems.
• To a certain degree also, the use of warfarin (Coumadin) for the clot prevention can also decrease a person's healing ability in the feet.

Any of these and other conditions has the potential for contributing to the loss of toes, parts of the foot, all of the foot or part of the leg.

WHAT YOU MUST CONTRIBUTE:

• If you have high risk feet then you must take a special interest in your feet -- or risk losing them.
• You must take it upon yourself to learn more about your special condition and the special risks associated with it.
• You must learn about the particular situations which can push your foot health over the edge into the abyss.
• You must willingly and faithfully guard your feet and follow preventative advice to avoid the start of problems.
• You must realize that protecting your challenged feet will require the interest and care of a group of specialists.
• You must be diligent in following the treatment advice given to you if problems do arise.
• A problem in high risk feet rarely "goes away by itself."

WHAT ARE THE WARNING SIGNS?

• Anything on the foot which does not look like it belongs on a happy, healthy 40 year-old foot should be a reason for concern in the high risk foot.
• Don't assume that a problem will hurt enough to draw your attention to it. You must use your eyes and your hands.
• Look at your feet; use a mirror if needed to check all areas.
• Feel your feet with your hands; they will be less likely to have altered sensations.
• Have someone else in the house look at your feet.

Each of these signs or symptoms should prompt you to seek the advice of your podiatric (foot doctor) physician:
• Abrasions, blisters, cracks, sores, scratches, cuts
• Bleeding, black & blue areas, blackened spots
• Pus, drainage, red spots or streaks, puncture wounds
• Ingrown toenails, changing "moles", splinters
• Sunburn, frostbite, scalding, burns
• Inflamed, odd or painful corns or calluses
• Bad or odd odors from feet / shoes
• Rashes, athletes foot, fungus or thick toenails
• Recently appearing swollen spots or areas
• Accidents, broken bones, bruises, stubbed toes

Changes for the worse can occur rapidly in your high risk feet. Get into the habit of checking your feet daily and whenever you suspect that something may have happened to them. It is better to promptly call your podiatrist for an exam and (hopefully) be told there is "nothing" to worry about than to wait and hear that there is "nothing can be done to save" your foot.

WORK WITH YOUR PODIATRIST!

When warranted, we will order special tests such as blood flow assessments (e.g. Doppler), x-rays, bone scans, CT scans, MRI, MRA, cultures and biopsies. We will make general and specific recommendations to you about what is found. If even more specialized attention is indicated, you will be promptly referred for that care. Saving your toe or foot will require attention to details.

Treatments may run the complete gamut from the simple to the complex, from the physical to the medical to the surgical, from office care to out-patient care, to in-patient care, and from the conservative to salvage procedures. Wound care may require few or many visits in addition to self-care or assisted care at home.

PREVENTING PROBLEMS - HOW?

Preventing problem is always the best "treatment".

Carefully and faithfully follow the advice of your primary care physician and other specialists, regarding the control of your diabetes, circulation problems, nerve impairments, your general health and nutrition status, etc. Exercise and work at staying healthy. Participate in a support group. Find a "sole" mate to help nudge you on and keep you on track with your health goals.

Carefully and faithfully follow the advice of your podiatric physician (foot doctor). Get the special shoes, stockings or socks and shoe inserts which may be recommended to you and USE them. Be sure that there is nearly perfect match between what your foot needs and your foot gear provides. Check the inside of your shoes daily with your hand, looking for worn areas or foreign objects.

• Some "DON'Ts:"
  • Avoid applying anything "hot" to your feet.
  • Avoid the use of "medicated (acid)" corn plasters or harsh chemicals on your feet.
  • Don’t smoke at all!
  • Never walk without shoes on.
  • Don't sit with your legs crossed or wear constrictive clothing.

• Some "DO‘s:"
  • Visit your podiatrist frequently for foot exams, for the correction or control of foot problems, for receiving periodic care for nails, corns, calluses, etc.
  • Do it whether or not your insurance plan "covers" the care; your feet are worth it.
    
    
  • TREAT YOUR FEET AS IF YOU ONLY HAVE ONE PAIR !.

We look forward to serving you, your family and friends for this and other foot and ankle concerns.

Dr.Ken Sokolowski