Putting feet first

[JoeFreeman]

Good morning - hope you're all well.

I'm at the Diabetes UK Professional Healthcare conference this week, and we launched our new campaign this morning. It's had some good coverage across the BBC, which is good to see.

Just thought I'd share a link to the story with the information about the campaign:

"Call for an end to "national disgrace" of diabetes-related amputations"

We're aiming to half the number of diabetes related amputations in 5 years. A big ask!

 

[cherrypie]

Alan did start this off this morning with the BBC article.

http://www.diabetessupport.co.uk/boards/showthread.php?t=26197

My area has a high rate but if you read what I posted, whose fault is it please.

 

[Northerner]

Interestingly, I attended a meeting recently with representatives of my PCT, who have a poor record on amputations. I was encouraged to hear the recognition of the problem, the fact that it is more expensive in the long run to have expensive operations instead of regular care and prompt attention where required, and some of the proposals to improve the situation.

The main problems were identified as (in no particular order):

• Some surgeries lacking any clinical staff with an interest in diabetes.
• Surgeries meeting their QOF targets for doing only 50% of checks
• Reluctance to refer due to quotas
• Patients not attending for checks or when problems appear

I also agree with cherrypie, that so many people do not take their diabetes seriously, and this beggars belief that they continue in this mindset even when they have lost a limb due to it!

So it strikes me that you can improve education, both of staff and patients, and also provide more incentive (higher QOF targets), or fewer barriers (less restriction on quotas for referrals), but I suspect that there will always be a big element of patients not taking responsibility for their health.

 

[Pumper_Sue]

I suspect that there will always be a big element of patients not taking responsibility for their health.
__________________

Would be interesting to know if it's don't want to or don't know how to.

From many post on here and other forums the HCP's have very little knowledge or even inclination to help patients.

Even in this day and age many do not have computers so can not do their own research. Many of the older generation still think that Dr's and nurses know best and would never dream of questioning any info given.

 

[everydayupsanddowns]

Oops! Looks like I'm living in a bit of a hotspot!

http://www.bbc.co.uk/news/health-17270379

 

[Pumper_Sue]

Oops! Looks like I'm living in a bit of a hotspot!

http://www.bbc.co.uk/news/health-17270379

I live in the South West and acording to that map it's a very hot spot. I know the care down this end isn't that great, so thinking a bit more about it made me realise that a lot of elderly people come down here to retire. Thus the problem prob looks a lot worse than it actually is.

 

[cherrypie]

Would be interesting to know if it's don't want to or don't know how to.

From many post on here and other forums the HCP's have very little knowledge or even inclination to help patients.

Even in this day and age many do not have computers so can not do their own research. Many of the older generation still think that Dr's and nurses know best and would never dream of questioning any info given.

Whilst I agree that care is a postcode lottery it seems to me that even a good HCP cannot get everything across that needs to be said.
I quoted what I see personally. This particular surgery has monthly meeting for Type2's where they can discuss anything that is troubling them. The facilitator has gone out of her way to make tools to help people get a better understanding, Charts and diagrams that a child could understand. So many of the participants will not accept that their readings are too high because they do not like the feeling of a false hypo. One even said that if she wakes up in the night and her reading is below 10 then her husband gets up and prepares her a meal. Eyes glaze over when they are asked to participate or understand what high readings can do to the body. One even thought that neuropathies were only for alcoholics and you couldn't get foot problems with diabetes. She still refused to believe it when it was explained to her as her neighbour had told her so and he had an alcoholic cousin. I swear some of them only go there to enjoy a cup of tea and meet other people. They have made up their minds that diabetes is a progressive illness and you can get help with DLA and some can even get a car if it gets too bad!!!!!!!!
I don't bother to go anymore as I find it too depressing and I want to shout out in defence of the Nurse.

 

[Donald]

Oops! Looks like I'm living in a bit of a hotspot!

http://www.bbc.co.uk/news/health-17270379

This has Just Been on the BBC One o clock News

 

[Northerner]

A neighbour told me of a man (a friend of hers) who had been diagnosed a few years, had had very poor control and was told he would need to go on insulin, but his wife had said 'oh no, he won't go on insulin' - so what does he think is going to happen to him? Sometimes it's not optional. Along similar lines, no doubt there is an awful lot of non-compliance with medication regimes - people simply not taking their pills because maybe they get some side-effects, but feeling OK and ignoring what might be insidiously sneaking up on them

 

[Abi]

Ironic cherrypie's statement about some not controlling D so they can get complications and DLA and ? motability car
I know I'm not alone as an insulin user being terrified of either complications or severe hypos leading to loss of independance and livelihood and having to walk that tightrope. Strange that some are punished for looking after themselves while others are rewarded for abusing their condition. But I suspect the latter group are a very small minority and that the ins and outs of blood sugar control appear too complex for most people to deal with rather than them deliberately manipulating the condition. Our culture has a subgroup that think the state, NHS etc should be reponsible for everything i/e/ give then a pill so they don't have to think for themselves about lifestyle etc but there is also a group which believe the doctor is a "god" and their opinion or advice is to be deferred to at all times and must be completely 100% correct. Don't kow which subtype annoys me most

 

[trophywench]

Went to a talk by a local podiatrist about 12 months ago. Most interesting all in all, generally. And illuminating too.

She bemoaned the fact that she sees far too many people with just AWFUL feet in terms of they clearly haven't had any TLC ever, by the looks of it.

And when asked 'What have you been doing about your nails/hard skin/cracked heels/bunion/corns/whatever' - the answer is basically, 'Nothing whatsoever - that's YOUR job - YOU sort it'.

Whaaaaaaaaaaaaaaaaaaaaaat ?

Do they go to the barber/hairdresser with their hair like a rat's nest and say they haven't combed it for 6 months - YOU sort it ?

 

[Northerner]

..Do they go to the barber/hairdresser with their hair like a rat's nest and say they haven't combed it for 6 months - YOU sort it ?

'Number 1, sir?' 😉

I've actually got quite nice feet, especially considering I've been a runner for 30 years. They never blister and I've just got one toenail that started trying to grow in a bit 25 years ago, but I've always been good at keeping it properly cut. They do get very cold at times though, but the foot woman said my pulses etc. were fine 🙂`

 

[Vicsetter]

It would be good to see an overlay map of postcodes that are reluctant to supply test strips!

I was appalled at the amputee on the news who had trodden on a thorn in his bare feet and done nothing until he needed to have his leg amputated. Is this just another instance of people unable to think for themselves? if you don't complain to your GP, having an annual inspection of your feet is not going to catch these sort of people.

A friend of mine, same age, walks around the house all day in bare feet, and knows he should take more care but just doesn't like wearing anything on his feet. At least he regularly sees a podiatrist about his feet.

 

[HOBIE]

I was in hospital when i was about 11 & remember this really nice old guy having to have an amputation. It scared me because he had big D ! Keep up good work Joe !

 

[everydayupsanddowns]

I was in hospital when i was about 11 & remember this really nice old guy having to have an amputation. It scared me because he had big D ! Keep up good work Joe !

Very similar experience when in the Diabetes ward after Dx Hobie. Several people pottering around without any feet certainly gave me as a 20-something a pretty graphic illustration of the importance of trying to maintain good control!

 

[trophywench]

Just as depressing in a general medical ward I'm afraid - quite a few stroke victims. And a very very nasty, mean-minded Auxiliary. Who made me cry a couple of times.

My saviour was the woman in the next bed, who'd had a heart attack and was in there when she came out of ITU - she used to live locally and was visiting friends at the time she was taken ill, but now lived oop north so they wouldn't let her out 'yet'. Intelligent, with just as batty a sense of humour as me and far worse foot and mouth disease. Like some poor hapless lady one day said 'she was going into Powick for a little while for a rest' and my mate immediately comes out with 'Powick? - that's the Loony Bin, isn't it?'

Ooopsy.

Or when she regaled us with eg They do everything for you in ITU you know - marvellous. Every night they came to try and take my teeth out for me to go to sleep - you try telling someone you've got all your own still, when they have their hand in your mouth!

 

[Northerner]

...Or when she regaled us with eg They do everything for you in ITU you know - marvellous. Every night they came to try and take my teeth out for me to go to sleep - you try telling someone you've got all your own still, when they have their hand in your mouth!

Hahaha!