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All about the feet

April 12, 2012
By KELLY FOSNESS - DMG writer (kfosness@mininggazette.com) , The Daily Mining Gazette

LAURIUM - Aspirus Keweenaw Hospital's Foot Clinic offers care for a variety of problems ranging from thick and discolored nails to peripheral neuropathy.

"We take care of calluses and corns, too," Certified Diabetes Educator Elaine Parks said. "Patients with bunions or conditions that need further evaluation, we refer to a podiatrist."

Parks said the clinic opened at Aspirus Keweenaw Hospital in September 2010 and currently they have between 75 and 100 patients.

Article Photos

Kelly Fosness/Daily Mining Gazette
Aspirus Keweenaw Hospital Family Nurse Practitioner Deborah Gruver demonstrates using a small, hand-held tool to shave calluses off a patient’s foot. The device is also used to sand down thick nails.

Family Nurse Practitioner Deborah Gruver said in addition to peripheral neuropathy, (damage to sensory nerves affecting sensation or feeling in the feet) other conditions the clinic sees are foot ulcers and infections.

Foot ulcers and infections can be caused by diabetes, Gruver said, and the severity of the problem can range from minor sores to permanent damage.

"Sometimes there's an open lesion underneath the callus, an open sore that they can't feel, with an infection going on so we try to take the callus off to see what's underneath," she said.

"Some people will get an infection right to the bone. It's called Osteomyelitis."

A dark ring around a callus can be a sign it's ulcerated, Parks added.

People who have concerns about their feet, be it sores or loss of sensation, can self-refer themselves to the clinic, Parks said, and appointments are similar to a regular doctor visit.

After registering at the front desk, the clinic's medical assistant records the patient's height, weight and vitals. Next, patients are brought into a private room where they remove their socks and shoes.

"Then what I'll do is come in and do a foot inspection," Parks said. "I check their pulses (in their feet), check for corns, calluses, cracks - anything that needs to be addressed."

Following the inspection, Parks performs a sensitivity test.

"It's a monofilament test, which tests for the loss of sensation on the bottom of their feet," she said. "It's a nylon kind of fiber that I touch to the skin until it bends to see if they can feel it."

If the patient is unable to feel the filament, it can mean the patient has nerve damage caused by diabetes.

"Then we really have to emphasize proper foot care of their feet and watch that they don't get sores," she said.

Loss of feeling in the feet does not mean people should walk barefoot, Gruver noted, because they could suffer an injury without their knowing. They should also avoid using a pedicure foot file that shaves dead skin.

Instead, Parks said a bath towel can be somewhat effective.

"After a bath or shower, rub the calluses in one direction with a towel," Parks said. "That will help remove some of the dead skin."

Diagnosing patients with loss of feeling can be challenging, Gruver said.

"If they don't have feeling and they don't have a pulse (in their feet) it's hard to tell if they don't have a blockage somewhere," she said. "We'll do different studies to make sure they don't have a blockage."

While foot ulcers and infections, including fungal infections in the toenails are among the most common cases she sees, Gruver said they also care for Athlete's foot, gout and warts.

Parks, who is also a registered nurse, provides patients with helpful information pertaining to their diagnosis. In addition, she informs them of proper foot care and footwear.

According to Aspirus Keweenaw Hospital's website foot and nail care is a service covered by insurance and Medicare. Diagnoses that are covered include: Diabetes, onychomycosis, peripheral vascular disease or peripheral neuropathy.

For more information about the foot clinic, call Cathy Taskila at 337-6587. To make an appointment, call 337-6560.

 
 

 

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