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August 30, 2021
This is the first installment of ---what I hope to be ---the continuing saga of my left foot. It is a saga because it stretches back some forty years to when I first learned that I was suffering from Type 1 Diabetes; and I hope to continue writing about it so long as: (i) my foot remains attached to my body and (ii) my story is able to provide some useful insights in successfully dealing with one of the potentially most serious but, with proper care and treatment, mostly preventable, consequences of diabetes mellitus—the loss of a limb.
First, a brief introduction. I was first diagnosed with Type I diabetes in my mid 30’s. For more than twenty years thereafter, I basically ignored the advice of my endocrinologist and dietitian(s), refusing to alter my carb-laden diet in favor of simply eating what I wished and compensating with excessive and somewhat arbitrary insulin injections. I visited podiatrists mostly after problems occurred rather than seeing them on a consistent schedule and taking prophylactic measures to prevent them. I pranced around in bare feet and chose my footwear based on style rather than suitability. After problems developed, I sought medical advice without adequate investigation or research. In short, I was reckless, and I paid dearly for it. I hope to save my readers from a similar fate.
I am a slightly overweight, if not morbidly obese, 70+ year-old, mostly retired, lawyer. This is important, not because I want to impress you that I have a law degree, but because I want to be certain that you understand that I do not have a medical degree. The thoughts, observations and comments that I will be sharing with you are based on my nearly forty years of real life experience as a diabetic, which although informed by an abundance of dealings with an ever-changing cast of endocrinologists, podiatrists, surgeons, wound care specialists, orthotists and sundry other specialists in diabetic foot care, and aided by my own independent research and one unfortunate malpractice case, are neither intended to be nor should be taken as medical advice. At most, I hope to be able to provide those who choose to follow my blog with guidance on when and to seek competent medical advice—as well as on the steps that may be taken to minimize the need for it. I will also highlight some of the medical and technological advances that have taken place in the recent past that assist in the prevention, diagnosis and treatment of diabetic foot disease that were unavailable during the early years of my struggles to save my foot.
This is a recent x-ray and picture of my left foot:
(For reasons that a not entirely clear, my left foot has suffered most of the complications caused by diabetic neuropathy, including recurrent ulcers, hairline fractures, displaced fractures, a Charcot foot collapse, two (and potentially a third) reconstructive surgeries and ongoing ulcerations. Apart from sharing the daily incidence of incessant neuropathic foot pain with its partner on the left, my right foot is a near-perfect piece of anatomy suitable for placement in a Ferragamo ad in GQ. Unfortunately, shoes are typically sold in pairs). Had I only known earlier what I have learned through experience and hope to impart to others through this blog many of these problems could have been avoided.
My objective in taking on this project is to look back over by four decades of my experience dealing with the ravages of diabetes and highlight the steps that I might have taken to avoid the loss or, at least minimize the damage that impairs the usefulness of my foot and quality of my life. These include tips on monitoring and managing diabetes, daily foot care and preventative measures, podiatric treatment and advice, the benefits and options of reconstructive surgery and diabetic wound care. My hope is to deliver my message in a way that it not only informative but also practical and even entertaining.
In the next installment of my blog, I will describe the background and early years of my experience with diabetes in hopes you will be able to benefit from my recklessness and mistakes – and ward off the resultant complications.
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Siren Socks are smart socks that help detect potential issues with your feet. Siren Socks are an FDA-registered Class I medical device and are designed for people living with diabetes and neuropathy. The socks measure your foot temperature. Temperature monitoring has been shown to help reduce the number of diabetic foot ulcers in multiple clinical studies over the past 20 years and is considered the gold standard in diabetic foot care. The information from the socks is monitored by licensed nurses who contact you regularly to check on your health and the status of your feet. Your doctor reviews any issues that arise and determine if a clinic visit is necessary. Siren Socks are covered by Medicare, Medicare Advantage, and many private insurance plans. Interested patients can find a Certified Siren Provider near them and begin the enrollment process by clickinghere.