Tuesday, March 26, 2013

Footsies

"You need to make sure you're watching her feet!"
"It's important for you to inspect her feet carefully."
"Make sure you are wearing good shoes because you have to take good care of you feet."

We hear this all the time from people!

WHY is it so important to care for a diabetic's feet?

Proper foot care is very important when you have diabetes. Poor foot care could lead to amputation of a foot or leg. People with diabetes are more vulnerable to foot problems because diabetes can damage the nerves and reduce blood flow to your feet. The American Diabetes Association estimates that one in five people with diabetes seek care for foot problems. By taking proper care of your feet, most serious health problems associated with diabetes can be prevented.

I found this interesting information while surfing the internet about diabetic feet:

Wash and Dry Your Feet Daily

  • Use mild soaps
  • Use warm water
  • Pat your skin dry; do not rub. Thoroughly dry your feet.
  • After washing, use lotion on your feet to prevent cracking. Do not put lotion between your toes.

Examine Your Feet Each Day

  • Check the tops and bottoms of your feet. Have someone else look at your feet if you cannot see them.
  • Check for dry, cracked skin.
  • Look for blisters, cuts, scratches, or other sores.
  • Check for redness, increased warmth, or tenderness when touching any area of your feet.
  • Check for ingrown toenails, corns, and calluses.
  • If you get a blister or sore from your shoes, do not "pop" it. Apply a bandage and wear a different pair of shoes.

Take Care of Your Toenails

  • Cut toenails after bathing, when they are soft.
  • Cut toenails straight across and smooth with a nail file.
  • Avoid cutting into the corners of toes.
  • Do not cut cuticles.
  • You may want a podiatrist (foot doctor) to cut your toenails.

Be Careful When Exercising

  • Walk and exercise in comfortable shoes.
  • Do not exercise when you have open sores on your feet.

Protect Your Feet With Shoes and Socks

  • Never go barefoot. Always protect your feet by wearing shoes or hard-soled slippers or footwear.
  • Avoid shoes with high heels and pointed toes.
  • Avoid shoes that expose your toes or heels (such as open-toed shoes or sandals). These types of shoes increase your risk for injury and potential infections.
  • Try on new footwear with the type of socks you usually wear.
  • Do not wear new shoes for more than an hour at a time.
  • Change your socks daily.
  • Look and feel inside your shoes before putting them on to make sure there are no foreign objects or rough areas.
  • Avoid tight socks.
  • Wear natural-fiber socks (cotton, wool, or a cotton-wool blend).
  • Wear special shoes if your health care provider recommends them.
  • Wear shoes/boots that will protect your feet from various weather conditions (cold, moisture, etc.).
  • Make sure your shoes fit properly. If you have neuropathy (nerve damage), you may not notice that your shoes are too tight. Perform the "footwear test" described below.

Footwear Test

Use this simple test to see if your shoes fit correctly:
  • Stand on a piece of paper. (Make sure you are standing and not sitting, because your foot changes shape when you stand.)
  • Trace the outline of your foot.
  • Trace the outline of your shoe.
  • Compare the tracings: Is the shoe too narrow? Is your foot crammed into the shoe? The shoe should be at least 1/2 inch longer than your longest toe and as wide as your foot.

Proper Shoe Choices

The following types of shoes are best for people with diabetes:
  • Closed toes and heels
  • Leather uppers without a seam inside
  • At least 1/2 inch extra space at the end of your longest toe
  • Inside of shoe should be soft with no rough areas
  • Outer sole should be made of stiff material
  • Shoes should be at least as wide as your feet

Tips for Foot Care in Diabetes

  • Don't wait to treat a minor foot problem if you have diabetes. Follow your health care provider's guidelines and first aid guidelines.
  • Report foot injuries and infections to your health care provider immediately.
  • Check water temperature with your elbow, not your foot.
  • Do not use a heating pad on your feet.
  • Do not cross your legs.
  • Do not self-treat your corns, calluses, or other foot problems. Go to your health care provider or podiatrist to treat these conditions.

When to Talk to Your Doctor About Foot Care

Your health care provider should examine your feet at each visit. In addition, see your health care provider if you have any of the following problems with your feet:
  • Athlete's foot (cracking between the toes)
  • Sores or wounds on your feet
  • Ingrown toenails
  • Increasing numbness or pain
  • Calluses
  • Redness
  • Blackening of skin
  • Bunions
  • Infection
  • Hammer toes (when the middle joint of toes is permanently bent downward)
Interesting stuff, huh?

I was also recommended another site to purchase shoes, Dr. Comfort at www.drcomfort.com. I see these shoes can be very pricey but could be covered by insurance. Has anyone heard about this company or bought special "diabetic" shoes before? Is wearing special shoes necessary? Maybe one day we could afford to buy these kinds of shoes but for now we'll just wait!

I've always bought Kacey good sneakers. Most of the time we get the from Reebok (she has a wide foot and wears a ladies size 10) but when we looked into special shoes before I couldn't spend nearly $200 for a pair of shoes. She is very hard on her shoes and so we are buying a new pair every 6 months or so.

How about you all....anything else to add about "Diabetic Footsies"?

Wednesday, March 6, 2013

Endo Report Card

It's that time again....REPORT CARD TIME! Time to see how good we're doing as a pancreas. Kacey hates this visit because it always falls the week of her birthday and that always means lab work for her. She says, "It's my birthday present from the Diabetes Center!"

We got to see Nurse SJ this time and we LOVE her. We haven't been able to see her the last 2 visits so it was nice to catch up. She was surprised at how tall Kacey had gotten. She's 5'4" and still growing!


I had a chance to talk with SJ about the jump in copay for insulin and test strips. She couldn't believe they went from $60 to $125...EACH! We continued to talk about options and she told me she would like to switch Kacey to Apidra from the Novolog. They've seen some really good results with it and teens especially. She also told me that Apidra was running a special for the rest of 2013 on the insulin...$100 off your copay! So thats nearly FREE for us!! All I had to do was sign up and get the card with the number along with the new prescription. AWESOME!

Kacey's A1c hasn't changed....still 8.6% but she expects there to be a big change next visit. So like I said, this time it meant lab work for Kacey. Unfortunately we got a Lab Lady that was having a rotten day and wasn't friendly at all.


Other than that, Kacey is doing great! She wants her to try and work hard to get that A1c back into the 7's but she said she was confident that switching up the insulin was going to work.

Any Apidra users out there that can offer advice....good or bad?

Monday, March 4, 2013

Low, LOW, LOWWWWWWWWWW!

While we are fighting all of these puberty battles, it's not too often that we have many lows or even lows that last very long. But occassionally, Kacey body goes into "working" mode and it's almost as if she has a complete and functioning pancreas. Diabetes seems to rear it's ugly face most at night. This night that I am speaking of was a typical evening for us. She didn't have any extra activity or over correction of insulin. We came home from church youth group and both girls got cleaned up and got their jammies on. It was about 9:45pm and both of them went on to bed. Kacey checked her blood sugar and she was sitting at a 389 with a headache and feeling pretty crappy. She corrected and I got her some Motrin and off to sleep she went. The house was quiet and I decided to get myself cleaned up and got my jammies on. I settled down in bed watching the news and I don't even remember falling asleep. And what does that mean?!?! That means the 2am alarm never got set!!

I felt like I'd only been asleep for a few minutes when a scream came from the other room. A scream like nothing I've heard before. It was Kacey! I stumbled out of bed, arrived at her doorway still trying to focus and there she was crying hysterically and screaming out that her whole body was numb. She had her meter in her hand but she couldn't function to test her blood sugar. As I scrambled to test her, my eyes tried to focus on the time.... 4:15am! WHAT?!?! It was then that I realized the clock never got set. Panic set in as I tested her... 63.... I pulled out Dexcom as I pushed her to drink TWO full glasses of juice. My eyes welled up as I looked at the screen....


She had been low for over TWO HOURS!!! She layed there with her eyes closed as she waited for her blood sugar to come up. Silent tears rolled down my face as that sinking feeling set in. All the "what if's" started to flood my tired brain. What if she had not of called out to me? I would have continued sleeping and then when my internal clock decided to wake me up then how would I have found her? It scares me and makes me sick to my stomach to even think about it. "Dead In The Bed Syndrome" is one of my biggest fears. I hold my breath every morning at 2am and again at 6am when I wake her for school...so to know that she was low for those two hours and it was MY fault for not setting the alarm...scared me so bad! I felt guilty and beat myself up for a few days. I made sure to set alarms on my iPhone instead that way I know they will always go off and I don't ever have to worry about missing that 2am check. Thank you God for allowing us to have the Dexcom G4 (even though we wish the low alarm was louder like the high alarm). Thank you God for protecting her and giving her just enough strength to call out to me. Thank you God for allowing me to hear her when she did call out.

After her blood sugar came up to a 156, I went back to my room to lay down. I was so scared and couldn't go back to sleep.

We NEED a cure!