Amputation is necessary when parts of the foot die – the toes or even the whole foot. That way, the area is not going to heal unless you cut the foot back or the leg back to a point where there’s good blood flow, then the skin and the muscle and the bone will heal. Otherwise, you’re just going to have areas of dead tissue that might be sources of infection and also it’s not a useful foot anymore because those dead tissues can’t be used, the muscles can’t be used, so you really need to cut that off and then fit the patient for an artificial limb – either an artificial foot or an artificial lower leg – that enables them to walk again.
When the blood flow is decreased or cut off to the foot, first of all: the patient may feel a lot of pain because tissues are dying in the foot, so that’s number one. Number two: the color of the toes and the foot may change, you may have areas that are pale, you may have areas that have become purple-ish or blue, and you may have sores on the bottom of a foot or on the tips of the toes that don’t heal. All of those are signs that there’s not adequate blood flow going to the foot and that amputation might be around the corner if things are not corrected.
When the blood flow is decreased or cut off to the foot, first of all: the patient may feel a lot of pain because tissues are dying in the foot, so that’s number one. Number two: the color of the toes and the foot may change, you may have areas that are pale, you may have areas that have become purple-ish or blue, and you may have sores on the bottom of a foot or on the tips of the toes that don’t heal. All of those are signs that there’s not adequate blood flow going to the foot and that amputation might be around the corner if things are not corrected.
The diabetic state can damage the nerves to the foot and that can result in two types of problems. One: the diabetic may have severe foot pain, which keeps them awake at night and may require a variety of different medications so that they can sleep. The second one actually deadens the feeling in the foot and puts anesthesia because it kills the nerves and then people can bang their foot and cut their foot and not feel it. So repeated trauma and repeated injuries to the foot can eventually result in such severe damage to the foot that it’s no longer useful.
The best way to prevent an amputation is of course to take good care of your diabetes, blood pressure, cholesterol, all of the things that one does to minimize the diabetic state. But in addition, one needs to be very careful when cutting one’s toenails that you don’t break the skin and many diabetics actually go to a podiatrist to have their toenails clipped. In addition, you want to carefully wash your feet, you want to take very good care of them – often massaging them periodically with oil to keep the skin moist and supple so it doesn’t crack and allow sores and infection to start. Basically, extra good skin and nail care are important in a diabetic and it is recommended that diabetics visit a podiatrist periodically to make sure that foot care is maximal because that’s such a common thing to happen that diabetics lose toes and lose their feet and even their leg.
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