I traveled to Europe, a continent with a lot of history and cobblestone streets. I was aware of the amount of walking I was going to do and reminded myself of what we teach, or should be teaching, our patients: Do not travel with new shoes only. Always bring a pair of tried and true. And when you do buy new shoes, buy them later in the day, make sure they fit well, and break them in before wearing for long periods at a time. Wear them about a half hour a day, then slowly increase the time you wear your shoes to avoid foot problems.
Before the trip, I went shopping, bought a well-known brand of walking shoes, and broke them in. I thought I had it made. They seemed like that ‘tried and true’ pair of shoes I could wear. That is, until I walked on the cobblestone streets. In a short time, I realized the soles were not right for that type of pavement and the soles of my feet hurt, to the point of numbness. I remembered how pain is our friend, a sign that something is wrong and to do something about it. I was also reminded of my patients who, due to peripheral neuropathy, can’t feel pain and end up with wounds, many of which do not heal, and and could end up with an amputation.
I listened to my friends, pain and numbness. I told my husband I must get shoes with a different sole, no matter the cost. I went back to the hotel, got the weight off my feet for a few hours, and went to buy a pair of shoes that worked. I bought a brand I knew and has worked for me in the past, broke them in and all’s good now. I am grateful for my knowledge as a diabetes educator, and as a certified foot care nurse.
- Teach your patients about foot care when teaching travel tips.
- Teach the importance of wearing the “right” shoes whether they have intact sensation or impaired sensation. This does not mean all have to wear specially prescribed shoes or custom-made shoes, but shoes that work for the task. Recommend they talk with their foot care health professional for advice. Avoid salespeople out there who profess to be foot care/shoe care specialists but are not.
- Listen to pain. It’s sending a message that something is not right. Don’t just mask it with pain meds, but look, listen, and consider the cause and change it.
- Check (look at) your feet (tops/bottoms/on top of and in between toes) every day, twice a day for redness or other problems for prevention. If you can’t see, ask someone else to look. If there is no one else, get a long-handled-held mirror.
- Don’t forget to manage your glucose, blood pressure, cholesterol levels, it all works together to help you save your feet for a lifetime. It is possible to do so.
Joy Pape, FNP-, CDE, CFCN
Medical Editor, Diabetes In Control
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