Sugar Matters
March 26, 2010
A quick interruption: Meet my Patient Ms M

Along these lines of good diabetic foot care, I would like to introduce you this week to one of my favourite patients, Ms M.

Ms M is a lady in her 60s. I met her four years ago when I first started in my clinic. I had read her chart history prior to seeing her and thought to myself she is going to be a tough one. Why?{{more}} Her medical history was quite complicated. Ms M has had diabetes for many years, but it only recently came under better control. Prior to that time, she had not taken very good care of herself, and her medical history showed proof. When I walked into my clinic room, I saw an older-looking lady, holding onto a cane. She needed a cane for help balancing, because she had been fitted for her new leg prosthesis a few months prior and had not yet become fully used to walking with the aid of prosthesis. This was actually her second prosthesis, or “fake leg” as you may know it. You see Ms M had a below the knee amputation on one leg first, then some time later had a second amputation on the other leg. She wears two prostheses and is able to walk. She also has kidney failure and receives dialysis three times a week. She admitted to me that early on in her life with diabetes she had not really take good care of herself, and not taken her medication etc. She had developed ulcers on her feet, which led to the amputations.

By now you are asking yourselves WHY this woman is one of my favourite patients, why when her story is so sad? I agree her story is sad, because she has suffered two of the most serious complications of diabetes: amputations and kidney failure. But she has survived, and now has excellent control of her diabetes. Why does it even matter now? You might be thinking. It does matter, quite a bit actually. Since we are focusing on foot care, I will expand on that aspect. Ms M had leg surgery for her amputations obviously, and those areas needed to heal. If the surgical site did not heal, she could not wear prosthesis and get around the way she does now. In fact she may have instead ended up needing more surgery and having amputation procedure further up her legs. She has worked well with therapy so that she looks like any older woman who needs a cane for a bit of balance but you cannot tell she wears prostheses at all unless you get a close look.

She is one of my favourites because even though she initially failed, she literally got back up and started walking this road again, and right now even though she has suffered serious consequences, she has regained control of the situation. So this week’s article is devoted to those of you who have lost something already to diabetes, and may feel like there is no point to trying anymore. There IS reason to get up after falling and keep working at it. You can save more from being lost, and with some help may be able to salvage from what you thought was lost. Do not give up.

Until next week stay safe and healthy Vincies!

Anita Ramsetty, MD [email protected]
Medical Director Endocrine Care Group
Tel: 843-798-4227