“Just doh make them cut my foot. If they cut my foot I will…!”
Unfortunately, we live in an age where the usual diet places us all at risk of developing diabetes. Even the most athletic, those who dance and play today, could be hobbling on crutches tomorrow. But there is a way to prevent that – and it is tantalizingly closer than you could ever imagine!
At the first medical visit, one is traditionally bombarded with a questionnaire that seems so long and boring. The average patient is thinking, “I just came to pick up some pills for that troublesome bow-bow on my leg. Why do I have to go into all that talala?!…No, I don’t have this; not that either…nope, nope, no, I tell you!” The magic of the medical profession is that this detailed review of symptoms actually provides a treasure trove of information more helpful than any test the physician can order. Among other things it can clue as to what is causing that particular kind of ulcer and the appropriate approach for effective treatment.
Chronic ulcers occur more in females and with age. They develop so gradually; people are surprised when it happens to them. Nurses and doctors are paid to look at these unpleasant things, so unless you really want to, do not click here https://www.google.dm/search?q=leg+ulcers+pictures&espv=2&biw=1093&bih=518&source=lnms&tbm=isch&sa=X&ved=0ahUKEwinsKiH3sfJAhUC6SYKHYA9BWsQ_AUIBigB .
These were once strong, sexy legs that may have won medals or even stopped traffic. Oh, the ravages of time! Much of it is wasted self-medicating with various lotions like cocoa butter, ‘something from the French countries’ or any potions from herbs and bush etc. If any of the following applies, close medical attention is needed to prevent a disastrous outcome:
1. Decreased sensation or numbness of the lower leg and foot
2. Decreased hair of the lower leg (indicates poor blood supply)
3. Edema (chronic swelling that leaves a dent when pressed)
4. Thickened and crumbly toenails
5. Previous blood clot in the leg (DVT)
6. Previous significant injury or fracture
7. Previous heart attack (with resultant congestive heart failure)
8. Lower leg skin becoming tight and shiny
9. Lower leg skin becoming darker
10. High blood pressure
This suggests a separate condition called venous stasis disease. As we age, we may notice more tiredness of the feet and tightness of the shoes after work. Swollen feet can snowball into something really ominous. History of varicose veins, overweight and lack of exercise all contribute to the problem. However, even if none of the above applies, one can be at increased risk if someone else in the family has been so afflicted.
Next thing you know, the skin becomes leathery, bumpy and breaks open. An ordinary sore should heal in couple weeks. Instead, months pass. Then it begins to define you. You are now that person with this leg bandaged up everyday from since whenever.
Your doctor should carefully perform MONOFILAMENT FOOT TESTING to check for decreased sensation. A small diabetic sore does not hurt as in a normal person. Consequently by the time they seek medical attention the condition is the proverbial horse is already out of the barn.
Every single adult and children of diabetics should have A1C blood test to check exactly how far along one is on the road to becoming diabetic. Patients should start on a REGULAR ASPIRIN DAILY (over-the-counter) to thin the blood. Patients with chronic ulcers should be on the prescription blood thinner Trental daily (pentoxyphylline 75 mg) and LASIX to decrease swelling. Proper medical evaluation involves VENOUS DOPPLER and ARTERIAL STUDIES. Legs should be elevated 30 minutes 3-4 times daily. This obviously is quite inconvenient for working people, but again, employers should understand.
International research confirms the best treatment for chronic leg ulcers is UNNA BOOT therapy. This consists of a ‘soft cast’ of Zinc paste bandage, which is then ace-wrapped. Patients come in every week to 10 days to change the dressing. As the ulcer finally heals, the doctor makes precise leg measurements and orders CUSTOM-MADE SUPPORT STOCKINGS. These must be worn religiously to prevent recurrence of the ulcer. Proper leg ulcer management cannot be done in quick, 5-minute, in-and-out appointments. The whole process is labour-intensive and time-consuming, but it is a valuable investment considering the alternative.
As a child, I knew of one amputee, a lady called ‘Bichie.’ She was an avid rounders player island-wide who probably lost her leg due to an accident. Today, amputees are, as they say, a dime-a-dozen. Thank God for the Keep Walking Association https://dominicanewsonline.com/news/homepage/news/general/four-amputees-receive-prosthesis-limbs/ in collaboration with Alliance Francaise. Nevertheless, all these prosthetic limbs also indicate how bad things have gotten, given that we actually have a smaller population now.
New research shows that breadfruit is very good for diabetes. People who live a thousand miles from the nearest breadfruit tree know more about its benefits that we do. Is it just me, or do you too see something wrong with this picture? Click here for video. https://www.youtube.com/watch?v=sKq0oVzCk t0 Dominicans of my generation grew up with a mortar/pestle in the house. Try as I may, I’m yet to find one to buy. I miss my tortor!
We ramping up to roll back the scourge of diabetes in Dominica. In fact, it is slowly happening already. In a previous article, I highlighted the noble efforts by Dominicans in the Diaspora who teamed up with the son Marcus Garvey to donate hundreds of new varieties of short breadfruit plants. Readers have caught the vision: In just 5-10 years, you will be able to stand on the ground and pick breadfruit like guavas. U doh have to joogooloo it with a long, heavy bamboo that damages the fruit when it falls from a height.
So much so, people are stopping me on the road, “Make sure you give me my breadfruit plant you know!” Well, that’s not for me to decide. Interested persons have to join the Breadfruit society to qualify. There are those wiser than I in charge of these matters. They have teamed up with the Ministry of Agriculture to teach us the fundamentals and distribute the plants.
Breadfruit is high in complex carbohydrates and is an excellent source of fiber, vitamins and minerals. Somebody reading this article is going to seize this idea and run with it. In time, our new buy-local supercenter will be bursting at the seams with breadfruit products: fries, chips, as a flour substitute for bread and pastries. As for breadfruit juice, OMG, that’s to die for…um, to live for!
Look at your legs. Ah! All that good stuff from the humble yampere woti I just bought yesterday? Unbelievable! Where do you get yours?
Dr. Sam Christian is a surgeon who runs the Urgent Care on 137 Bath Road. He is Medical Adviser to the Dominica Cancer Society and heads the Dominica Cadet Corps Top Lifesaver Country (TLC) CPR outreach program. Dr. Christian can be reached at 440-9133 or clicking on the Urgent Care website http://urgentcareda.weebly.com/
Good food, bad food!
Thank you Dr. Christian for this information that most of us would never take the time to dig out for ourselves. I am a diabetic in Canada. When I was told I was a diabetic I was sent to a counselor to be educated but I did not hear half of this.
The one thing I have learned is this. What we like and crave is usually not what is good for us.
We like soda pop, and sweats from candy to cakes. We patronize fast food restaurants indulging in their
deep fried products, red meats, and processed meats.
We were doing these things before we knew of the dangers of the fast food lifestyle. Now we need to make some positive changes. Hopefully these restaurants will get the message and start offering us a healthier choice.
The way to abundant living is to know the truth and crucify our desire for harmful things. This applies in every department of life, not only in matters of diet and physical health.
Sincerely, Rev. Donald Hill. Evangelist.
If some of us just reminisce about the way that our ancestors ate and continue to follow their footsteps, our health would be better. They did not have the luxuries that we now have, such as refridgerators, microwaves, telephones, etc., but they lived better lives and had more longevity. They exercised naturally by walking long distances, socialised every day instead of texting and being on the phone, they ate what they grew and hardly ate imported foods, they used natural herbs instead of using pills and most of all they were filled with wisdom and many of them were seers, meaning they had a relationship with, and communed with nature.
Today, there are many distractions and we are not in harmony with nature and with each other as we are supposed to be. As a result of these gadgets, a sense of disharmony, confusion, and imbalance take place causing us to be become weak and confused individuals. We have to be very careful of the amount of radiation that these gadgets emit as well.
Haha!
I never hear a doctor say that before. But seriously, diabetic foot ulcer, venous stasis ulcer, are they one and the same? If so, is the treatment different.
Appreciate your support of local agriculture and industry. Very positive. Its like you were talking to me…
Positive vibes as always. Thank you.
Great article again
Excellent article doc. I learned a lot. We definitely need to eat more of our local food especially breadfruit.
Dr Sam you have done a great service by blending your excellent rendition of the symptoms of diabetes, with local breadfruit use and the wonders of the Dominica Manufacturers having opened their own store. It is such positive articles we need.
kudos Dr. Excellent stuff. more of the same.