Soon we will be enjoying spring, but still with cooler temperatures and in spite of heavy socks and shoes, the feet still get cold. Individuals who are diabetic sometimes don’t feel pain or other stimuli in their lower extremities which is called peripheral neuropathy. This can even occur in folks without diabetes. Every year many diabetic patients must be admitted to the burn unit who get cold feet, but end up with serious foot and leg burns after they try to warm themselves up. This happened in a number of ways. One by laying down in front of a space heater, another sitting beside an open fire (no chestnuts roasting, only their feet that were protected with boots), and another who started the shower and did not know the water was scalding hot. All required long inpatient stays that included burn care, surgical removal of dead and damaged tissue, hyperbaric oxygen therapy, skin grafts and even amputation.
The saying that “an ounce of prevention is worth a pound of cure” is very appropriate here. First, be aware of heat sources that could damage the soles or feet (including hot pavement and campfires in the summer). Second, when around hot water, use the inside of your wrist to test the water temperature just like testing bath water for infants. If the water is too hot to touch with your wrist, it is too hot for your feet. Third, never, ever expose bare feet to a high heat source. As mentioned above, heat can even travel through the bottom of a boot. The moral is if you are diabetic, don’t heat the feet!
Feel free to copy this for your health information notices at you clinic! It was written for patient education.
George Wolf, MD
59 Medical Wing
Hyperbaric Medicine Department
Lackland AFB, TX