A March 22 story in the Los Angeles Times about the increasing number of foot amputations in people with diabetes led to an outpouring of ideas, information and comments from readers. About 100,000 Americans -- and many thousands more worldwide -- undergo foot amputations each year due to complications from diabetes. Doctors, however, believe that more limbs could be saved with better preventive care and aggressive medical treatment. Below, I'm sharing some of the many thoughtful comments and suggestions for people with diabetes that were sent in after the story appeared.
--St. John's Well Child & Family Center Clinics will open a new building at Hoover and 57th streets in Los Angeles in May that will house a Diabetes Center. The center will give the organization more ability to meet the needs of diabetics in under-served communities and who lack the ability to pay for care. The S. Mark Taper Foundation building will also house medical exam rooms, exercise and fitness rooms, a classroom/demonstration kitchen, gymnasium, mental health rooms and offices. The clinic is equipped to handle at least 7,000 new primary care visits for patients with chronic diseases and a minimum of 5,000 preventive care visits.
--The American Podiatric Medical Assn. has a Web page for the public with information on diabetes and amputation prevention. The information is in English and Spanish. www.apma.org/diabetes
--A comment from Jeff Everson, Woodland Hills: "Reading your March 22 article, "Doctors Target Diabetic Foot Loss," in 1971, as my father was wheeled out of surgery after his diabetic-induced amputation for a gangrenous (posterior surface) foot ulcer infection, he turned to mom and sarcastically harrumphed, “Well, at least you can’t nag me now when I lose one of my socks in the laundry.” Problem was 3 years later his other leg had to be amputated too. While medicine may now be ‘targeting’ foot loss with diabetics, I am sure that my father would have preferred they had started that more than 40 years ago."
--One reader notes that researchers at the U.S. Department of Veterans Affairs are using a system called Health Buddy "that keeps patients in touch with health care providers every day, letting doctors catch problems and intervene before they become costly hospitalizations ... they have seen substantially lower hospitalization and mortality rates in diabetic patients who use a small electronic device in their homes to check in with their doctors every morning. What the doctors are finding is that by having patients answer some basic health questions every day, they are able to jump in early before small problems like foot wounds become full blown crises. They are also finding that patients who know they are going to have to report their blood sugar and answer questions about their self-care each day also end up staying healthier because they have better habits."
--Suggestion from a reader: "I have a problem with calluses on my heals. I have seen a podiatrist and she uses a scalpel to cut away the calluses making my feet very sore and requires medication to prevent infection. I found a much better way to keep the calluses down to the minimum. It is called a Pet Egg Professional. Cost about $10.00 and 3 replacement blades $10.00. You hold this device in your hand and remove the callus. The callus that is scrapped off collects in the hand holding device. Check it out. (TELE Brands Fairfield NJ 07004 www.TeleBrands.com) This device eliminates many trips to the podiatrist that want to cut on you ... The last time I have seen my doctor he remarked how good my feet looked."
--From Marilyn Zeitz Norwood, registered nurse practitioner, Los Angeles: "The costs, both human and financial, are ludicrous in the presence of our ability to save the patients limbs ... I am proud to say that I am one of eight women volunteers and one man, a wonderful, generous ,trusting volunteer M.D. who founded the T.H.E. Clinic Inc. in South L.A. 35 years ago. Thanks to the outstanding stewardship and leadership of Jamesina Henderson C.E.O, and the excellent, dedicated medical, educational and ancillary staff, T.H.E. Clinic is alive and well, and taking care of hundreds of patients each and every week. Please take time to look us up on www.theclinicinc.org. It may be of benefit to those you know who need low cost, excellent health care ... The majority of our patients are low income, uninsured African American, African from other countries, Hispanic and South East Asian. Included in our medical services is a comprehensive program for diabetic patients. This includes a monthly class conducted by a dedicated corps of volunteer registered nurses and specialists in various disciplines. Anyone is free to attend at no charge.They do not have to be a patient but they have to contact the program coordinator to reserve a space."
--From Dr. Jack E. Rubin, medical director, Los Angeles Vascular Access Center. "I read with great interest your article on diabetic foot amputations in last Sunday's Los Angeles Times. I would suggest to you that another way to treat the problem of peripheral arterial disease (PAD) is having an angiogram done of the limb that has a non-healing wound or symptoms of claudication, cramping of the calf muscles whilst walking. ... The Los Angeles Vascular Access Center has been doing angiograms and angioplasties on the limbs of patients with PAD since 2007. Most of our patients have had their limbs saved due to correction of the PAD present in their legs. This is done without general anesthesia, is cheaper than an in-hospital admission and has fewer complications than in patient surgery."
--From Dorothy Liener, Orange County: "I have just started a Kidney For Life organization in Newport Beach. Diabetes and kidney disease usually go hand-in-hand. Kidney for Life is a nonprofit organization that focuses on improving patient care and quality of life for anyone suffering from kidney disease. Our goal is to raise awareness of kidney health and prevent the need for dialysis." For more information, call (949) 759-0622.
-- Shari Roan
Photo: An exercise class in the new S. Mark Taper Foundation Building of the St. John's Well Child & Family Center. Credit: St. John's Well Child & Family Center