Middle Age

Let’s talk about feet.

BY J.B. COLLUM

Okay, I just lost half my audience. I get it. For most folks, feet aren’t the sexiest or most interesting parts of our body to talk about (but if you think they are, I’m not judging). But let’s face it: if you want to remain ambulatory as you age, you have to take good care of them. I haven’t been exemplary in this regard. That is changing though. I went to Augusta Foot & Ankle yesterday for my first visit.

I have written before about some issues with my feet, but today, I am stepping forward to tell all. I’m putting my worst foot forward to stand up for these humble body parts that, while at the lowest part of our bodies, can be critically important to our health. Alright, those were my last feet jokes (maybe).

To catch you up, I have type 2 diabetes (Did you just hear Wilford Brimley say that word in your head? Me too. I miss that guy.) and along with that comes the likelihood of foot issues. I have those and then some. Poor circulation, neuropathy, severely dry skin, and toenail fungus. You don’t need diabetes for all of these, but it sure helps. I also have Haglund’s deformity. This is essentially an enlargement of the bony part of the heal where the Achilles tendon attaches. It can make finding comfortable shoes more difficult and in the worst cases, cause constant severe pain. The nice folks at Augusta Foot & Ankle took good care of me yesterday and we are now walking the path to healing my feet. (I couldn’t resist.)

Let’s take these issues one step at a time. First, poor circulation. Many diabetics have peripheral artery disease often called simply PAD. This reduces blood flow to the feet. Fortunately, my doctor said I am not too bad off in this regard, but it is common and can be countered by specific exercises that your doctor can recommend, by putting your feet up when you sit down (I like that one), maintaining low blood sugar, stopping smoking, wearing diabetic socks (how do socks even get diabetes???), and eating heart-healthy. That last one is tough for me as I love fat in my diet, but not in my blood stream. Neuropathy, which is just a fancy way of saying nerve death. Diabetes can cause damage to the sheathing around your nerves. My doctor said to think of this like the coating around extension cords. If it is missing, you can get short circuits. Being exposed to the elements, over time the wire can get damaged and eventually it won’t let the electricity flow anymore. It is kind of the same with nerves. Controlling high blood pressure and cholesterol, losing weight, maintaining low blood sugar, and staying under 40 years of age can all help.

In regard to the dry skin of your feet, this is related to the nerve damage because it affects your body’s ability to control the oils and moisture in your feet. So, you have to handle this manually by following these steps recommended by The American Diabetes Association:

• Wash your feet thoroughly every day.

• Dry them thoroughly. Yes, between your toes too.

• Moisturize those puppies! (Okay, I paraphrased)

• Keep your toenails trimmed, and file down the sharp edges.

• Inspect your feet for sores cuts, corns, blisters or redness, every day. Tell your doctor about anything you observe in regard to this.

• Wear moisture-wicking socks.

• Check your shoes for rocks or other potential sharp objects before putting them on.

• Don’t go barefoot. Even in the house.

• Don’t soak your feet.

• Don’t smoke.

Having diabetes also puts you at a higher risk for toenail fungus. Aging and other factors play a role too, but don’t make the mistake of thinking it is just a cosmetic issue. For diabetics, it can lead to amputation, so see your doctor about this. In my case, they took a culture to see exactly what fungus we are dealing with, if any. My doctor said that sometimes damage to toenails from other causes can look like fungus, and taking a culture can make sure that you get the correct treatment. Some of the treatments, especially the internal ones, carry some risk in regard to your liver. Although he assured me it is a very small risk, you wouldn’t want to take that risk if it wouldn’t help anyway, as would be the case if it wasn’t caused by fungus.

The one outlier for me, is my Haglund’s deformity. This isn’t related to my diabetes. Happily in my case, my tendons still look like they are in good shape and the pain I feel from this is rare and not severe and usually results from accidentally smashing my heal into something. And let me tell you, when that happens, anyone within a few miles of me will know about it because I will scream louder than a howler monkey — and that is saying something because their screams have been measured at 140 decibels. For the sake of reference, the decibel scale is a logarithmic base-10 scale. What does this mean? 0 decibels is the lower threshold of human hearing. Not my hearing, mind you, a normal, young person’s hearing. Normal human speech is around 50 decibels, which is 100,000 times more intense than 0 decibels. A rock concert is about 90-120 decibels. Hearing damage starts at around 85 decibels. Sorry for the sound science lesson interruption (unless you enjoyed it).

My only real daily struggle with Haglund’s deformity is that it makes it hard to find shoes that both look good and feel good, and don’t cost a fortune, so once I find a good pair, I tend to wear them until they completely fall apart, much to my wife’s chagrin when I get all dressed up except for wearing raggedy shoes.

If you have diabetes, please don’t neglect your feet. They need to carry you around for a long time, so take a moment today to give them a long hard look and see if your humble feet might need some well-deserved attention.

After all, a certain world-famous man whose life millions celebrate even washed the feet of his friends as a lesson for us all.

For more information about diabetic foot complications, check out the tips here: https://diabetes.org/diabetes/foot-complications

J.B. Collum is a local novelist, humorist and columnist who wants to be Mark Twain when he grows up. He may be reached at johnbcollum@gmail.com