Home Care for Sensation Loss

home-careYour doctor has detected a critical loss of sensation in your feet. The finding represents a “loss of protective threshold,” meaning your feet no longer have enough sensation to protect you from problems such as foot ulcers, serious infection, and disfiguring joint dislocation, call Charcot Joints. Because of this critical finding, you must now use the sensation in your finger tips, your eyesight, and a heightened awareness of prevention as substitutes for the failing sensation in your feet. Please follow these instructions, so that you can prevent the serious complications mentioned above.

Follow the shoe recommendations given to you by your doctor. You may be prescribed custom-made shoes, if the doctor feels you need extra protection. If you do not receive these special shoes:

  • Never wear shoes longer than two hours at a time.
  • After shoes are broken in, never wear one pair of shoes longer than five hours. Use one pair for the morning hours, one pair for the afternoon hours, and one pair for the evening hours.
  • Always inspect the inside of your shoe with your hand for sharp or loose objects before putting the shoe on your foot.
  • Buy shoes made of soft leather uppers that are able to adapt to the shape of your foot.
  • Never wear open toed shoes, open heeled shoes, or sandals.
  • Always have the shoe clerk properly fit the shoe to your foot when purchasing new shoes.
  • Let your doctor inspect your shoes, new or old, for fit and acceptability.
  • Buy new shoes at the end of the day, when the foot is slightly larger than at the beginning of the day.

If your doctor has prescribed custom-made shoes

  • Wear them at all times, including in the house.
  • Do not substitute any other shoe without discussing it with your doctor.
  • Keep in mind that for the prescription shoe to have the best results, the entire shoe, or the special insole made need to be replaced periodically, and should be inspected by your doctor regularly.
  • Always inspect the inside of your shoe with you hand for sharp or loose objects before putting the shoe on your foot.

Never go barefoot. This includes inside the house.

  • House shoes or house slippers, if allowed by your doctor should have a thick enough sole on it to resist pin punctures of glass fragment punctures.
  • Especially avoid going barefoot in warmer weather around the pool or at the beach.

Socks should be worn with shoes at all times because they reduce friction, provide insulation, reduce soiling of the foot, and absorb perspiration.

  • Do not wear socks with holes in them.
  • Do not wear mended socks.
  • Avoid socks or stockings with seams in them.
  • Socks should be made of cotton, wool, or a blend, but never a 100 percent synthetic material.
  • Preferably the socks should be white. At the end of the day, the socks can be removed, turned inside out, and inspected for signs of blood or pus.
  • Do not hold up the socks or stockings with a circular garter or elastic band. This can cause unwanted swelling, or even worse, serious circulation problems in the feet.

Avoid exposing your feet to temperature extremes.

  • Always check bath water with thermometer or your hand (if the sensation is good in your hands) before placing your foot in the water.
  • Do not attempt to warm cold feet with a hot water bottle, heating pad, or next to a fire.
  • Beware of the floor or the car heating your feet excessively on long trips.
  • Protect your feet from sunburn with sun block whenever you might sunbathe.
  • Snow skiing is a very high risk activity with your feet, because of the cold exposure and problems created by the ski boot.
  • Do not “ice down” your feet if they feel like they are burning.

Do not attempt to treat corns, calluses, toenails, or other foot problems yourself, unless specifically directed by your doctor.

  • Never us a razor or other corn or callus removing device.
  • Never use any chemical agent or medicated pad (corn remedies) for the removal of corns, calluses, or warts. These agents almost always contain an acid designed to erode the skin.
  • Avoid pads and arch supports that can be bought in the store. Not being custom-made for your foot shape, these devices may place excessive pressure on certain areas of the foot, leading to an ulcer.
  • Do not attempt to cut back the corners of your toenails. It is better to use an emery board to file this area, if the need arises.

You must inspect your feet every night. This will be the only way for you to catch developing problems early, so that serious problems can be prevented.

  • You must be able to see and touch the following areas: around the toenail, toes, between the toes, soles in the area of the ball of the foot, and heels. You might find you need a mirror to help you. If you feel you can’t inspect your feet adequately, first, let your doctor know, and second, get a family member to help you.
  • Look for blisters, cracks, redness, swelling, discolorations, or fluid drainage.
  • Feel, with your fingertips, for areas that seem warmer than the same area on the other foot.
  • Report any of the above findings to your doctor immediately.

If you do have any breaks in the skin, whether it be from an ulceration, ingrown, toenail, recent but or scrape, callus or corn treatment, blister, heel crack, or surgery, be observant for the signs of infection. If you do think you have an infection, take your temperature and call your doctor immediately. Do not take any old antibiotics that you may have in the medicine cabinet before seeing the doctor.

Discuss with Dr. Shumate

It is important to discuss your mobility and foot care problems with Dr. Shumate. He can advise which service or professional support is most appropriate to your needs. Dr. Shumate, after assessing your foot function, may recommend orthoses or insoles to help relieve foot pain and discomfort.