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Re: Diabetic Neurophathy (was: I am really scared..)

From: Renee (anonymous@obgyn.net)
Thu, 17 Jan 2002 07:54:09 -0800


Panacea,

I'm a stickler for terminology. ;-> To me, constriction is a muscular action temporarily making the vessel walls smaller in diameter. Athersclerosis plugs up the lumen "permanently" (except surgery, certain diets make the claim to reverse, plaques may loosen and move on--bad news). And, it's not the circulation loss itself causing the pain. It's the effect on the nerve of long-term circulation loss.

For someone who was a med tech for that long, it would depend on the person. Are they flexible enough to reach the toes easily and see the entire work area? Dextrous enough to control the hands precisely? With retinopathy, that would be tough. Being a med tech may give experience in the area, it may not. It would depend in what context the person worked. I don't believe med techs do much with toenail trimming, though. Even RNs often won't do it because of the risk involved. In nursing homes, for example, nurses are not allowed to do it, even an RN. They have to have a podiatrist come in to do it. Only nurses working with podiatrists, or those in nail or diabetes clinics do it. It is up to the individual, though I can rarely recommend it. If you do do it yourself, cut straight across, not curved. That reduces the risk of ingrown nails and cutting yourself. Also, using an emery board is safer than scissors.

I've seen too many patient with poorly healing wounds, and amputations, because of home nail clipping (and home corn/callus removal) to recommend it for anyone. Most insurances pay for it for diabetics, so why take the risk to do it yourself? Leave it to a professional.

Renee

Panacea wrote: >
> At Wed, 16 Jan 2002, Renee wrote:
> >
> >This isn't exactly correct.
> >
> >Neuropathy is damage to the nerves. It is usually caused by a decrease in
> >blood flow (arterial=from the heart to the limbs, venous=out of the limbs to
> >the heart).
>
> I say it's a constriction in blood flow, you say it's a decrease. ;)
> Okay. Guess I was wrong. ;)
>
> >Both these problems result in a higher risk of foot problems. Anyone with
> >diabetes, or arterial insufficiency, should see a podiatrist every 2 months,
> >as cutting your own toenails can be harmful.
>
> Even if you were a medical technician for 30+ years? :) It's true she
> does have retinopathy as well.
>
> --
> Panacea
>

--
Renee Cordrey, MSPT, MPH, CWS
---

Don't follow in the footsteps of the masters. Seek what they sought. --Zen saying




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