Category Archives: Diabetes

Diabetes, Foot care, Foot Care Specialist, Foot Doctor, Foot Doctor Anthony Chionis, Neuropathy, Podiatrist

Gallery Of Foot Diseases / Abnormalities

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Diseases And Abnormalities

Please Note:  Some of these pictures may be disturbing to look at and may not be suitable for children.   These pictures are to serve, educate and compare conditions one may experience if left untreated by a professional Foot Doctor Specialist.  Parental Guidance is suggested!

This is a condition called Onychogryphosis or ram’s horn nails.

This is a condition that a Foot Doctor Specialist commonly treats and that is an ingrown toenail.

This is a patient who requires diabetic foot care.

Irritated corn on toe of foot.

Dry skin in the heel of the foot.

This is a front view of a bunion on the patient’s left foot.

This is a side view of a bunion on the patient’s left foot.

This is a foot condition called Raynauds Phenomenon.

The left toe of the foot condition called Raynauds Phenomenon.

This is the right foot of a foot condition called Raynauds Phenomenon.

This is the side view of the foot of a patient’s toes that are infected by fungi.

This is a picture of two toes that are infected by fungi that was untreated.

Neglected Fungal Foot Toenails.

Interesting callus formation.

Corn that may become ulcerated if untreated. The toe is bent and hits the shoe every time the person walks.

This condition is caused by allowing diabetes to take its course without treatment.

Painful calluses from hammer toe deformities.

Subungual hematoma from trauma to the toenail.

Infection of pinky toe is due by diabetic neuropathy by wearing improper slippers.

Another view of an infected pinky toe.

Infection under the nail that if left untreated causes increased pain and possible hospitalization. The nail needs to be cut down to expose the pus and remove it.

Decubitus Ulcers of the feet can increase rehabilitation time and a threat to the patient’s overall recovery. An early sign starts in the patient heel. Protection of the heel and avoiding breakdown in the skin is necessary.

This is what happens when people have the bone by the big toe (called the first metatarsal) is lower than the other part of the forefoot.

The patient did a great deal of walking with improper shoes. The area becomes hot and painful when the skin broke down and infection occur.

This simple cut from sock pressure on a severe bunion can easily be identified and treated by a Foot Doctor. Routine inspection of the patient’s feet can easily prevent this from becoming a significant problem.

This patient is bedridden, and their feet swell up. The slightest pressure can cause injury to skin that may result in a significant problem. In this case a cut.

This is the aftereffects of laser surgery on a wart. The laser treatment was incomplete which often happens with laser treatment. You can see the round burnt spot on the toe.

The Foot Doctor deals with diagnosis and treatment of a wart on the foot more routinely than other specialties. The treatment of a wart on the foot is complicated by the fact that the foot always bears weight, Certain treatment plans are not appropriate for the foot.

The picture is of a black spot on a patient’s foot. It was an incidental finding. The patient did not even know that it was there. We are trained to look at the whole foot and mark down anything suspicious.

The Foot Doctor examined and treated the lesion. It could have been anything from a mole to a nervous to something more suspicious like melanoma. Upon examining it, it was simply a blood blister that had dried up. The Foot Doctor found it on routine exam and upon further examination, found it to be benign.

The patient has a corn that developed between the toes of his foot causing pain and difficulties while walking.

Foot Doctor Specialist examining a corn between the patient’s toes that is causing much pain and discomfort.

This ingrown toenail is now infected by the patient who tried to threat it themselves.

The effects of ingrown toenail. The patient wanted to correct the problem themselves.

Black and Blue Big Toe
Is this a broken toe? Did someone smash the toe with a hammer? Did this person get their toe stuck some place?

Left Foot Swollen Big Toe
The toe condition is caused by medication. It is very important that the patient tells the Foot Doctor all medication or herbal supplements you’re taking.
Loss of sensation in the foot.(2)
The patient had their feet near an electric heater and fell asleep and that is the result. This required hospitalization and rehab and possible loss of limb.

Loss of sensation in the foot
This happens with loss of sensation in the foot. It can also state what can happen when the foot has nerve damage. The patient had their feet near an electric heater and fell asleep.

This is a picture of a patient that developed a severe abscess secondary to diabetes with loss of sensation. Patient wore wrong shoes, and this was when I first saw him.

This image will show the current condition of the patient while being treated by the Foot Doctor. The abscess has been resolved and is now healing.

Diabetes, Foot care, Foot Care Specialist, Neuropathy, Podiatrist

Painful Toes

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“Painful Toes”

Left side of the foot with irritated sores on all toes.
The toes on the left foot are irritated and cut due to improper footwear. It’s very importance of having proper shoe size and width.

The right side of the foot with irritated sores on all toes.
If the shoe is tight or doesn’t have enough room, the toes may become irritated and develop sores.

One of the many problems I encounter in my office is the problems of painful toes.  Toes can hurt from any number of issues.  The problem I want to address today is one of the problems that tight shoes can cause in patients. I am often asked why shoe width is important.  One of the easiest answers for this is to have room for all the toes to function properly.  The width is important because an often complaint is that of the patient having “bumps” on their toes.  Often these bumps are either corns that form by the toes rubbing against each other or the bones of the toes having deviated from proper alignment.  The usual cause of corns between the toes or on the sides of the toe itself is tight shoes.  If the toe cannot move freely, then a problem will occur.  A simple corn on the side of a toe can cause intense pain especially if walking or running.  The foot doctor specialist can remove the corn via surgical debridement but the importance of a proper shoe cannot be underestimated.  Tight shoes can also cause other problems especially if the patient has diabetes or other diseases that can cause loss of sensation in the foot.

What caused this toe to get swollen?

Swollen Big Toe
The above picture shows what is surely viewed as a broken toe. However, that is not the case. When patients presents to Foot Doctor Specialist, it is very important that they bring a list of their medicines they are taking. Why is that important? Many patients take different types of medications that can change the diagnosis and treatment plan. So patients can be “blood thinners” that affects the appearance of trauma to the foot like in the above picture. Others take herbal supplements that can affect the foot. Others may use topical creams that can affect the foot. One cannot stress the importance of telling the Foot Doctor Specialist all the medications you are using.

 

Diabetes, Foot care, Foot Care Specialist, Foot Doctor, Foot Doctor Anthony Chionis, Neuropathy, Podiatrist

Frostbite And Your Feet

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What Is Frostbite Feet?

 

Is cold weather day after day good for your feet?  The answer is NO!  One must protect their feet when the temperature is freezing for days and weeks. Here is a few random thoughts as winter months is upon us regarding frostbite and your feet.

 

Beware Of Winter 
 
The winter months can adversely affect a person’s feet in a variety of ways. This winter has experience extreme cold severe temperatures.  If a person is exposed to the extreme cold, they may suffer frostbite.  The Foot Doctor-Specialist is able to evaluate the condition and determine the severity of the condition as it relates to the foot.  There are 3 degrees of frostbite and each degree has its own prognosis and treatment plan.  The Foot Doctor-Specialist is able to treat the condition depending on the degree of frostbite that the foot may have suffered.

 

Some Of The Conditions
 
Sometimes patients present to the Foot Doctor-Specialist with conditions that may be mistaken for many other diagnoses.  One type of condition that usually occurs in the winter months is called RAYNAUDS  phenomenon.  This phenomenon can occur when a person may develop problems with their toes.  The person may experience toes that are white in color than blue and finally red.  The Foot Doctor-Specialist is able to evaluate this condition and guide the patient towards diagnosis and treatment.
 
What Can We Do About Frostbite?
 
Don’t be afraid to visit the Foot Doctor-Specialist if you suspect any of these serious conditions. During the winter months, it is very important for patients with systemic conditions like diabetes or neuropathy to maintain their foot health.  The patient should wear waterproof shoe gear to deal with snowy conditions, and proper socks to maintain adequate warmth for their feet.  Also,  feet should be inspected on a daily basis to check for symptoms that may cause problems.  For your own well being, make an appointment with your Foot Doctor-Specialist.
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Diabetes, Foot care, Foot Doctor, Podiatrist

Neuropathy Of The Feet

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Neuropathy Of The Feet

 

What is neuropathy?

 

The word neuropathy is derived from 2 Greek words and it simply means pathology of the nerve, or the losing of your feelings in the nerves of your feet.  Every year many patients who have diabetes develop neuropathy, and this may cause problems with their feet. 

 

The symptoms of diabetic neuropathy are many, and among the most common is a feeling of numbness across the foot, and sometimes pain that comes and goes for no apparent reasons.  In the patient with diabetes, the numbness starts with the toes and then proceeds toward the rest of the foot. 

 

The Foot Doctor ( Podiatrist ) plays a vital role in dealing with this condition.  The person with diabetes should be evaluated by the Foot Doctor who will perform a few simple tests on the patient to determine if the patient has neuropathy.  The Foot Doctor then notifies the primary care doctor and then schedules the patient for quarterly visits for routine foot care. 

 

The purpose of this is to examine the patient’s feet for any sores, and to careful cut the nails and trim any corn or calluses. The patient with neuropathy is unable to feel any sores, cuts, and may trim the nails to the point of bleeding.  The patient cannot sense things as well as someone without neuropathy.

 

Patients with diabetes who develops neuropathy usually seeks out “cures” for this condition.  The patient may seek over the counter remedies that may work.  They may seek prescription medication to combat this problem or topical creams.  One of the newer treatment option is the use of laser therapy but this is not yet a proven treatment plan.

Diabetes, Foot care, Foot Care Specialist, Foot Doctor, Foot Doctor Anthony Chionis, Podiatrist

The Gout, A Painful Foot Condition.

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What is The Gout?

Gout is simply a big pain in the foot!  The Gout is a disease that is affecting more people lately, and I would like to discuss this disease as it pertains to podiatry.  Many patients walk in to the office on a daily basis with the following statement: “Oh Doctor, I have the gout!”

Gout is a very simple disease in terms of what it is precisely.  Your body will produce uric acid. The problem will start if your body either has an over production of uric acid or the under secretion of uric acid. The Foot Doctor  does not treat the systemic aspect of gout but rather the attack that occurs in the foot.

Gout affects about one in a 100 people and is much more common in men over 60.  Some developing factors of gout include obesity, high alcohol intake, high intake of rich foods, some high blood pressure medicine, kidney decease, diabetes, and genetic predisposition.

How Does Gout Affect The Foot?

Gout affects the big toe over 50 percent of the time and causes the toe to become very inflamed and painful.  The big toe becomes very red and hot.  The patient usually enters the office in severe pain and mostly with the same complaint of being unable to sleep due to the pain. Sometimes the patient has difficulties in walking due to the intensity of pain in the big toe. The Foot Doctor will start treatment immediately with a strong anti-inflammatory medicine and an injection into the big toe area.

The Foot Doctor will also order the patient to have a blood test in order to assess the uric acid level.  The patient’s Medical Doctor will then be advised and they will treat the patient systemically.  There are numerous medications that the medical doctor may prescribe and treat the patient with accordingly. Gout can be destructive of all your joints throughout your body and can disable you if left untreated.

Why So Much Pain With Gout?

Why is there so much pain involved with a gouty attack? The uric acid that is high in the blood will crystallize out at cooler temperatures.  When a patient sleeps, the lower part of the body receives less blood than the upper part.  Thus the foot cools down, and the crystals form in the joints.  The crystals usually attach to the  big toe  joint and the body reacts to the crystals and responds with a severe inflammatory reaction. Ouch, that hurts!

This is what the Foot Doctor treats. The Foot Doctor examines the patient in order to rule out other possibilities such as infection, fractures, or many other foot conditions that may look like an acute gouty attack.  You should see a Foot Care Specialist if the gout conditions is present before its develops into something worse and much more painful.

Diabetes, Foot care, Foot Care Specialist, Foot Doctor, Foot Doctor Anthony Chionis, Podiatrist

Diabetes And Foot Care.

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Diabetic Foot Care
Foot Doctor checking toe from a diabetes patient.
Foot Doctor checking toe from a diabetes patient experiencing discomfort.
Do people with diabetes require foot care?  The answer is yes.  A person with diabetes needs an evaluation from a Foot Doctor at least every three to six months. The foot doctor examines the patient with diabetes and looks at 4 key areas—the circulation of the foot, the neurological condition of the foot, the musculus oskeletal condition of the foot and the dermatological condition of the foot. The patient’s foot must have good blood circulation to avoid complications such as amputation.  Some of the signs would be hair loss of the foot, numbness of the foot and toes, and difficultly walking.  For this reason it is important for a diabetes patient to visit a Foot Doctor – Podiatrist.
Neurological and Musculoskeletal Condition
Foot Doctor treating a toe from a diabetes patient.
Foot Doctor treating a toe from a diabetes patient in pain with a tube foam to elevate toe discomfort.

 

The Foot Doctor checks the pedal pulses of the person with diabetes and looks at certain key points of the foot.  The Foot Doctor looks at simple things in order to assess vascular status, and then examines the neurological system of the foot.  The person with diabetes that has blood flow problems usually develops dry skin.  They may also have thin or shiny skin.  They usually start to lose hair from their toes or legs.  They also may develop thickened nails that are hard to maintain. The nails may be crumbly, misshaped or ingrown.Then the Foot Doctor examines the muscle function of all of the major muscle groups of the foot and determines if there is muscle pathology.  The Foot Doctor then examines the skeletal structure of the foot for various deformities such as hammer toes, hallux valgus, bunion and bunionettes. 
 
The person with diabetes that develops neurological problems may develop many symptoms.  The first sign is usually numbness or tingling of the toes.  They also may have extreme burning sensations especially when sleeping that awakens them.  They may develop sores or cuts on their feet and do not recall any trauma.  They must always be on the lookout for problems due to micro trauma.  These skeletal deformities may become sites of irritation and possible ulcerations in the future.

This is the result of having arthritis of the big toe and the loss of sensation to the foot. This often occurs in people that have diabetes with loss of sensation. The medical doctor recommends that patients with diabetes go to the foot specialist to avoid situations like this from occurring.
Dermatological Condition
The foot doctor also must take extra care when dealing with dermatological conditions that often affect the person with diabetes.  Onychomycosis or fungal nails may pose a very serious risk to the person with diabetes.  The person with diabetes also is at high risk for tinea pedis and possible super infection of the foot. The patient with diabetes developing infections may also have an increased healing time.  They may develop a cut or sore that takes a long time to heal.   The ingrown nail on the person with diabetes may develop into cellulitis (skin infection) that spreads to the rest of their foot.  Majority of people with diabetes are usually admitted to hospitals with foot infections. So we can conclude that a Foot Care Specialist (Podiatrist) assess the foot care of a person with diabetes like no other doctor. 

Decreased Nerve Sensation

This picture will show the effects of nerve damage from diabetes on the patients foot. The patient has decreased nerve sensation and didn’t feel the nail being loose from the nail bed. The nail kept catching on the shoe gear and tore off the bed. The patient didn’t feel the nail being torn off from the nail bed.
 
If you are suffering from any of the above conditions, you will need a foot care specialist.  Why not call Foot  Doctor Anthony Chionis – Podiatrist at one of his locations for free consultation by phone or email him at www.doctorchionis@aol.com.