1. A Lifetime of Quality Care That’s Convenient & Complete Love your feet (and they’ll love you) Robert Grimshaw MD FACP A Lifetime of Quality Care That’s Convenient & Complete

2. Quick: What Has... 26 bones 33 joints 20 muscles 150 ligaments 250,000 sweat glands that release a cup of moisture a day daily endures the cumulative force of hundreds of tons trudges about 115,000 miles in a lifetime? You’re right – your foot!

3. A Lifetime of Quality Care That’s Convenient & Complete Our Feet Our feet are important to all of us, but are especially at risk in those with poor blood flow or diabetes. Of some 16 million diabetics, 15% will be hospitalized for foot problems.

4. A Lifetime of Quality Care That’s Convenient & Complete The Reasons: Poor Sensation: Neuropathy (due to diabetes or other causes) leads to injuries because you don’t know you’ve been hurt, can cause toes to curl up and other deformities. Poor Circulation: Lessened arterial blood flow means that feet can’t fight infection and injuries are slow to heal. If you’re getting pain in your calves on walking, we should check your blood flow – there’s a lot we can (and should) do! From callus to ulcer - what you don't want

5. A Lifetime of Quality Care That’s Convenient & Complete What WE’LL Do: At your physical, we’ll ask about your feet; alert us to any issues. We’ll check your feet for sensation, Pulses, and ulcers.

6. A Lifetime of Quality Care That’s Convenient & Complete If you’re diabetic: Get our foot guide Get our foot guide We’ll check your feet more often. We’ll discuss a podiatrist (foot specialist). For more information, see the "Diabetic Foot Guide" in the Our Guide section. Other resources are the American Diabetic Association (www.diabetes.org ).www.diabetes.org

7. A Lifetime of Quality Care That’s Convenient & Complete What YOU Should Do: Wash every day, and dry carefully between toes Check daily for cuts, sores, calluses, & blisters Test the water first - don’t make the temperature too hot CHANGE YOUR SHOES 2-3 times during the day – they lose resilience Wear socks if cold, and choose them carefully: well padded, ½" longer than your longest toe Do not use hot water bottles, heating pads, or electric blankets (you can be burned) No garters! (they cut off blood flow) Cut toenails straight Don’t rip hangnails

8. A Lifetime of Quality Care That’s Convenient & Complete What YOU Should Do (continued) : Wear comfortable, flat shoes that fit, and break them in slowly Buy shoes at the END of the day, when your feet are swollen (if they’re comfortable then, they’ll likely be so all day!) Check shoes daily for pebbles, tears, etc Never walk barefoot! Keep your feet dry by dusting with non-medicated powder If your feet are too dry and the skin is cracking, moisten with Nivea, Eucerin, or Alpha-Keri (NO PERFUMES!) If you’re diabetic, control your sugar DON’T SMOKE!!! If you lose sensation, tell us! See us at the FIRST sign of infection or inflammation.