How’s your diabetes foot care?

[Deleted member 18634]

In the next few weeks Diabetes UK is hosting an event with health care professionals to talk about diabetes foot care. So we’d love to get thoughts from all of you on your own experience of foot care.

Particularly if you’ve had problems with your feet yourself, it would to be great to hear what did, or would have, helped you deal with these problems at an early stage.

If you have had problems, it would also be interesting to hear if you were told you were at risk of diabetes foot problems before those problems developed.

But whether your care has been bad or good, and whether you’ve had problems or not, it would be really useful to hear what is good about your diabetes foot care, and what is not.

Your thoughts will help the health care professionals we’re meeting next week understand what good diabetes foot care really means for someone living with the condition.

If you would like to share anything more privately then you can email diabetesvoices@diabetes.org.uk with any feedback as well.

 

[Ditto]

Nobody's mentioned my feet. In fact, nobody's mentioned anything at all about anything! No wonder I was in denial so long.

 

[Wirrallass]

Hi Emma. I recently saw my DSN to check my feet - I suffer with painful toes at night so she carried out the usual pin cushion test & dopler - both of which passed with flying colours I'm pleased to say. The pain was put down to possibly arthritis with which I do suffer in other joints & lumbar region. I am fortunate in so much that I don't suffer with the same extreme feet problems that many here do.My feet are checked regularly at my reviews by my DSN so I'm happy with this.
Good luck.
WL

Dx Type 2 April 2016
Diet and exercise only

 

[Grannylorraine]

I have had the pin cushion test, but ironically asthma nurse did it when she realised I had recently been diagnosed with D.

 

[Steff]

Hi Emma,
I must admit when i was first diagnosed they wasnt really alot of emphasis on my feet but admittedly thats become alot better over the last few years, whenever i have my annual MOT the nurse always checks my feet with the doppler and checks in between my toes for fungus or any issues.

 

[Robin]

I get my feet checked every year by my surgery nurse, who is the Diabtetes 'specialist' but also runs the asthma clinic, the flu jab clinic, the travel jab clinic, etc etc! One year she said to me, 'I don't need to check your feet, do I? As long as you think they're OK? And last time, I asked her specifically to check the pulses, because I'm developing varicose veins in one leg, and was worried about blood supply. She found the pulse in the foot I was concerned about, but couldn't find a pulse in the other. 'But don't worry' she said cheerfully ' We were told on the course that it's very difficult to find them'
I'm sure she'd refer me on pronto if I had a problem, but as I've said to her generally in the past, I may not know that I've got a problem!

 

[Ljc]

When I was first diagnosed until I was transferred to gp care for my diabetes the foot checks were very good. Then many years it was just a quick look at the tops and soles.
At the practice I am at now , I will not let the foot person anywhere near my feet, because I had a battle with her wanting to clean my toes, remove a scab that has formed after parts of toes had been amputated, when I'd been clearly told to keep my foot dry till it had healed at the hospital.
she also told me their was no infection in my foot , even though I clearly had Cellulitis in it, this was confirmed by the gp who she called in to back her up.
(The infection was not in my toes)

Now I'm under the NHS podiatrists for all my foot care and foot tickling sessions.

 

[Pumper_Sue]

I've never had any checks on my feet, then come to think about it I don't go to any reviews, esp after being told by the person masquerading as a nurse at my surgery that she knew nothing about them new fangled things (pump) and didn't want to know anyway oh and the silly cow also told a newly diagnosed type2 that her pancreas would disintegrate after a couple of years and she would have to have nasty injections for the rest of her life.

 

[trophywench]

Always had the foot exam at the docs with all the usual range of monofilament testing, pulse checking, tuning fork tests and Doppler and a cursory 'look' - never saw a Podiatrist until I was diagnosed with intermittent claudication about 2 years ago when I was referred and they went potty that I hadn't been before - with longstanding diabetes and a bunion I apparently class as having 'high risk' feet according to their degrees of risk - I said don't moan at me - if you want to moan, moan at the GP who told me ages ago that as long as a person is able to cut their own toenails there was absolutely no need whatsoever for anyone to see anyone else about their feet - and that piece of info was delivered 'in no uncertain terms' and made me feel about 3 years old, at the time! Yet - you both work for the same CCG, so as far as I'm concerned you should both be operating under the same rules, so explain that then?

Now - they keep saying I shouldn't cut my own toenails and to see them again in 6 weeks when usually the first available appointment is 4 if not 5 months hence! And then tell me off for cutting them when I get there - well yeah actually, I sometimes need to wear shoes instead of sandals/my oldest pair of trainers, not going to eg the christening of a grandchild in church looking like a rag bag, thanks! Would you? LOL

Plenty for them to attack with the clippers next Monday as since I've been more in sandals anyway for weeks, I've managed to stop myself attacking them for a number of weeks now!

 

[Ipsi]

In the next few weeks Diabetes UK is hosting an event with health care professionals to talk about diabetes foot care. So we’d love to get thoughts from all of you on your own experience of foot care.

I've never been given the option and, when I asked my doc about it he said, "are your feet giving you problems?" . I've got plantar fasciitis in my left heel, so the answer was yes. He put that down to "walking" and dismissed any need for foot care. I should have told him I never walk, that I'd flown to the surgery on my magic carpet.

 

[Flower]

Hi Emma,

My current foot care is excellent and if I ring up with a problem I am usually seen the same day. I cannot fault the care the diabetes podiatry team take with my feet. I am classed as high risk and have a print out of all contact numbers to call and pathways to follow in an emergency.

Sadly my previous experiences at a different hospital were not good resulting in me developing Charcot foot and ankle. I went to A & E with a hot swollen foot. The Doctor I saw said I was too young for complications and it was just a sprain. I had never heard of Charcot foot at this point and although I knew I hadn't injured myself I accepted his diagnosis. Within a week the bones in my foot and ankle had all collapsed and deformed. I have been living with this devastating, life changing condition ever since. After 3 failed ankle fusions, and about 15 years in casts I have all but run out of options to try and save my leg.

The one thing I would stress to professionals discussing diabetic foot care is that I really hope Charcot foot is flagged up as a potential diagnosis to be ruled out - rather than overlooked -when somebody with diabetes whatever their age,presents with a swollen, painful foot and no obvious reason for the problem. I am so sad that my life has been sent off in this direction when my foot and ankle could potentially have been saved. I had an intact foot in A & E but 7 days later I had massive bone destruction and had to fight to prevent amputation at that point. It makes me so sad thinking back to what could potentially have been avoided by the medic in A&E asking for another opinion or for a scan.

I write about Charcot foot when I can in the hope it will make more people aware of this devastating complication and might just prevent someone else being dismissed with similar symptoms whilst the precious opportunity to intervene goes begging.

 

[Lindarose]

My feet get a very quick look over yearly if I make an appt to be seen by the nurse. I always have hba1c done but tend to miss out nurse follow up because I'm not sure there's anything to discuss if bloods ok. She advises eatwell plate and statins!
But I see a very knowledgeable chiropodist who does a thorough check which is very reassuring. Much more than the nurse does.

 

[Deleted member 18634]

Thank you everyone for the feedback so far, it's great to hear all your different experiences!

 

[happydog]

I've had D T2 for over four years now and in that time have only had one foot examination and that was cursory. At first my husband paid for me to go to see a podiatrist every six months but since he has been ill for the last eighteen months or so I have not been. It was £35 each time and as I had to give up work to care for him I have to be more careful with the pennies now. I do my own every day because I have learnt on this forum how important it is 🙂

 

[Contused]

I was diagnosed Type 2 in Nov 2008 and, initially, received what appeared to be adequate attention. Following the diagnosis and a consultation with my doctor, continuing care was entrusted to a practice nurse, who gave good support during the initial consultation and arranged further consultations with a dietitian and a podiatrist. When I was finally able to consult the podiatrist at the local health centre in early 2009, she gave good advice, noted my ingrowing toenails, assessed the condition of my feet as 'low risk' and suggested the next visit should be no sooner than January 2010. I believe it's fair to say that the podiatry service appeared to be under some considerable pressure.

Over the next few years my further podiatry visits were made on an 'as required' basis, when I was experiencing difficulty with foot-care. I made no more than three further visits and received good care, advice and encouragement. When I needed further treatment during May 2015, I discovered that the podiatry service had been withdrawn from the local health centre and was instead being provided by Sirona, a private contractor. However, the service offered amounted to nothing more than surgery, which was not what I wanted as I'd already had a bad experience at the hands of the NHS at a local hospital. I suspect and fear that I shall have to 'go private' to receive further chiropody and podiatry treatment.

In addition to the problems outlined above, I suffer from varicose eczema in both shins and, most recently, oedema of the feet and ankles. The varicose eczema is treated with Betnovate, which contains the condition rather than cures it. The oedema of the feet and ankles is treated by wearing very fetching support hosiery.

The routine diabetes foot care appears adequate. I'm not confident, however, that emergency diabetes foot care will be adequate, bearing in mind how difficult it is to get a timely appointment at the local practice and even less likely at the Sirona clinic.

 

[Lilian]

Practically non existent in my area. I think (but only think not sure) if there was a sudden emergency a patient would be seen by somebody. All I get is an annual pricking all over the foot, stethoscope round the ankles and a quick look to see if there is any fungal or other infection by the health care worker.

 

[mikeyB]

I have noticed a NHS podiatry ad in the surgery- the clinic is in Oban. They state quite baldly this is not a nail cutting service. Oh well. I don't have any problem with my feet, apart from the fact they are attached to useless legs. Mind you, I've discovered the best cure for hard skin on the heels - don't walk anywhere. My heels are like the after pictures on those Scholl ads.

I will have to start using a private foot fettler on the island, because I just can't find any way to cut my toenails at the moment. I'm not bothered about the money, I just hope the service is sound.

 

[Lucy Honeychurch]

There is a foot clinic at the hospital I go to and when I asked if could have a consultation I was told no 🙄

 

[Ljc]

When I phone for a routine nail cutting at NHS podiatrist I've never had to wait more than a week. When I have problems I've been told by one podiatrist if its mon-wed just turn up and she will fit me in at other times I'm to phone up and say it's urgent .

 

[TheClockworkDodo]

I'm shocked how hit and miss foot care seems to be 😱

At Addenbrookes, the consultant used to prod my feet once a year, and when I mentioned I had a split toenail they called in a podiatrist immediately to have a look at it, so that was very good.

Not so good was the fact that when I was first diagnosed they told me to check my feet every day, but didn't tell me how to check them or what I was looking for. In view of the fact that they kept prodding them I thought they meant I should do that, so I said "I don't have anything to prod them with" . Consultant told me in a shocked, no uncertain terms tone of voice "Oh, I shouldn't advise you to prod them!" and left me none the wiser and feeling distinctly patronised and too upset to ask anything further. Had to ask my lovely GP later to find out what I was checking for and how I should do it.

Here the consultant doesn't do it, but the diabetes nurse at my local surgery not only prods my feet once a year, she also takes the pulse in them. Recently, because she'd had trouble organising my annual appointment (I have to have afternoons, and she couldn't find a free room) I suggested we do my review by email or Skype - I always do my own blood pressure and work out my own BMI anyway, so the only thing she needs to see me face to face for is the feet, the rest is just me asking questions. I asked whether she could teach R to check my feet? - and she said no, she'd be failing in her duty to me if she didn't do it herself. So it's good that she takes it seriously and does it properly, even if slightly irritating that I can't do the appointment by Skype thing, which would be much easier for me!