A woman with diabetes who has spent the last few years fighting to save her feet has urged others to be mindful of the risks.
Lesley, who is an urgent care nurse said: “About 10 years ago I was in Tenerife on holiday, I was walking along and felt a sharp excruciating pain in my right foot.
“It became red and swollen. Being a nurse, I did all the right things, resting it, keeping it upright when possible and so on.
“When I got back home I had x- rays and it was discovered that I had a condition called Charcot foot.”
Charcot is an issue which can affect the foot in people with neuropathy (nerve damage with numbness). The bones of the foot become very fragile and can start to break or dislocate in response to very minor forces such as standing or walking.
The most common cause of Charcot foot is diabetes, but it can occur in people who have a different cause of nerve damage. It is rare and affects only 1% of people with neuropathy in diabetes. However, when it occurs, it can lead to gross deformity or ulceration of the foot. It may even result in amputation of the lower part of the leg.
Lesley, who has worked at the trust previously as a neonatal nurse and as a health visitor, added: “Whenever it happened my foot needed to be put into a plaster cast. A couple of years later I also had it develop in my other foot. At one point both of my feet were in a cast – and I was still going to work. My doctor said it may need to be amputated, which was a shock. I’m an active person; I couldn’t imagine not being able to walk.”
Lesley started to develop more complications as a result of diabetes.
She said: “A couple of years ago I got really severe double vision. I had treatment for this and ended up wearing a patch on my eye for some time before having laser surgery which was a great success.
“On another occasion I have also ended up in the intensive care unit with kidney damage. My family were told to prepare for the worst. Luckily I am still here!
“Then just after Christmas I lost feeling in both my feet and I developed huge blisters in both feet. I woke up one morning and one of them had burst. I just had a hole in my foot. I was so upset. Since then I have been visiting the podiatrists every week to have them dressed.”
She explained: “I was sitting out in the sun and could feel my legs heating up. I put some sun cream on, including on my feet, but clearly I hadn’t covered my toes completely as they got burned.
“I am very careful. As a nurse and someone who has had diabetes many years, I know the risks. But I still get caught out sometimes.”
As well as taking insulin every day, Lesley also takes antibiotics and strong painkillers to treat her condition.
Luckily for her – and unlike some people in the same position – she has the support of her family who can help her when needed.
This is as well as having the help of an specialist team of doctors, nurses, podiatrists and dieticians who she regularly sees.
The help she has had has also included a week-long course run by the trust’s team of specialist diabetes nurses.
She added: “Every bit of your body is affected by diabetes. I just want to warn others in the same position to be cautious and mindful of what can happen.”
Claire O’Malley, a High Risk Specialist Podiatrist at the trust, said: “With the Charcot process, there is sadly no time frame for the active / destructive phase. The treatment plan requires the patient to be in a cast to support and protect the foot from further deformity.
“We must monitor the foot on a weekly basis and check the temperature difference – if there is more than two degrees difference between the feet this indicates the process remains active. Which means the foot is re-plastered again and the process continues, which can be anywhere between six to 18 months. This is clearly very frustrating for patients like Lesley who are doing everything they can to lower the risks.
“We ask our patients to be aware of the risks. Diabetes can cause problems with sensation and reduced blood flow to feet and legs, so people may not notice any issues with their feet until a problem has developed.
“They may not notice an issue until the end of the day. By then they may have developed the start of an ulcer which can cause further damage.
“Working together with the diabetes specialist nurses, consultants and dietitians, we treat and advise our patients. You can never be too careful. Our advice is to regularly check your feet. It’s about early intervention.”