I don’t mess around with wounds of any kind, and advise anyone living with diabetes or caring for someone with diabetes to do the same.
About 3 weeks ago, I tore a 2-inch section of top layer skin off the mid-section of my calf. How? When I got out of bed in the morning, and came around the corner of my heavy bed frame, I put one foot too close to the edge, felt my skin rip and saw blood. An everyday domestic scrape – right? Small injuries like these happen anywhere and everywhere: in kitchens, on the street, playing fields and so on.
The problem is that cuts and scrapes, no matter how small, must be watched vigilantly if you have diabetes – type 1 or type 2. On the morning of my minor injury, I cleaned the throbbing cut, grabbed an ice-pack to cut down on swelling – got in the car and drove to my daughter to school. That was 7 am in the morning. For the remainder of the day, I used a Neosporin cream and left it open in the air, always ensuring it was clean.
Two days later, it didn’t feel or look great. I admit I have a deep-seated paranoia about foot and lower leg injuries and how they may adversely heal, leading to something much worse. I do not suffer from neuropathy. I feel everything. I don’t have any signs of vascular disease. My blood sugars are in control, and even so, I am slow to recover. Perhaps not as slow as those who have irreversible foot ulcers and have suffered terrible surgeries. * BUT, it does take me longer than it does for my husband to recover from a common cold, the flu, infection and yes, wounds.
Not one to fool around, I immediately knew that sending my doctor a photo of the wound and a brief email would probably catch his attention while he was traveling for the weekend. Here’s what I sent to him:
Dear Dr Lee,
I got this rather bad gash from the bottom corner of my bed. It doesn’t feel
good and I am worried about its location. Can you prescribe something to
speed healing and prevent infection? I have been putting Neosporin on it. It
occurred about 2 days ago. Many Thanks. (see photo) - Elizabeth
_____________________________________________________________________________________
Hi just saw the photo
I have asked the staff to give you some fucidin cream and also augmentin 1g
bD or 625 mg tds for about 5-7 days. regards – Dr Lee
I picked up the medicine and followed Dr. Lee’s instructions, applying the cream 4 Xs daily and taking the antibiotic. On the 7th day (not kidding), I was healed.
Four points of advice:
1. Although this wound happened to my lower calf, it is feet that are usually at greatest risk. I take my feet seriously and I am not a slave to fashion. I will not suffer foot pain in stiletto heels, nor tolerate blisters of any kind. I can’t afford the risk. I have watched the videos and seen patients in clinics and it is tragic. While Type 2 patients do suffer more from advanced neuropathy and vascular problems than type 1s, I urge everyone to keep feet clean and moisturised, don’t go barefoot outdoors (even indoors can be threatening), wear healthy, comfortable correct fitting shoes, girls – limit time in heels, and men – wear socks with loafers.
2. When I was thirteen, I went barefoot on a beach boardwalk – knowing it was wrong and guess what I stepped on? A nail! (of course). I did not tell my mother initially, because I was ashamed and I thought I could manage the injury, but the puncture got worse. I finally told her and she took me straight to the doctor – thank goodness. Under 18s, don’t hide cuts or scrapes from your parents and parents – watch out for your teenagers feet, etc. You never know.
3. Please do not go browsing on YouTube for videos of diabetes and wounds. It will give you nightmares. While the stories are true, and tragic – I implore you to do your part to take care of your feet and be vigilant about your cuts and scrapes. Second, encourage friends or loved ones with diabetes to do the same. This will make a huge difference.
4. PLEASE ensure your feet are always examined when seeing a doctor. Also make sure he does one of these. (see Illustration) It is a monofilament tool (essentially a needle). While patients keep their eyes closed, the doctor tests sensitivity, and asks “tell me when you feel something?” It is old school but VERY important.
See HERE for foot care and wound healing information. While this link does not come from ADA or any of advocacy organisations – it is one of the best I found online.
Keep on Truckin’!
* I hate writing out the doom and gloom of diabetes, but patients must take the reality of the disease onboard. So, apologies if I upset a reader but, every 20 seconds, somewhere in the world, a limb is lost as a consequence of diabetes. Most of these occur to people living with type 2 diabetes in lower and middle income countries.
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