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HERTFORDSHIRE, England – A British court ruled that the death of a dietician who wrote about being possessed by aliens was an accident.
Hertfordshire deputy coroner Graham Danbury heard how Jennie Gosbell’s body was found floating in the tranquil waters of the Bahamas during a holiday.
While many retailers in New Providence are enjoying the holiday boom, other businesses have been feeling the pinch.The spike in business during this time of year doesn't come as a surprise to The Sports Centre. The company's operations manager said the store is braced for the late rush.
"We double our staff for Christmas Eve and we are very prepared for the wave that happens every year," Catriona Eldon told Guardian Business." Bahamians have a habit of waiting until the last minute to shop, and with Christmas Eve falling on a Saturday we are ready for what awaits us then."
Eldon mentioned that it's encouraging to see that sales are up year-on-year to this point despite the economic challenges that residents are faced with they are still able to squeeze some shopping into their budgets. Additionally, she added that the affordable prices and wide variety of items make The Sports Center a "go-to" location for consumer needs.
"The Sports Centre is a great brand, but we have reasonable prices on other things outside of athletic[items]and we have three locations so it's more convenient for our customers to shop with us," Eldon said. "We have a great cross-section of items and have developed a great reputation among our customers."
The Sports Centre is no stranger to the Christmas wave of shoppers, but a relatively new player in the retail business has also seen some success out of the gate. Quality Home Centre, located on Carmichael Road, has been open for about a month and is already reaping the benefits of having an all-around store in a heavily populated area.
Trevor Davis, the owner, told Guardian Business that the initial success his company is experiencing is a great start to what he envisions to be a staple in that community.
"I'm happy that a lot of persons are staying in New Providence and not traveling to the U.S. to shop and I'm grateful that they are choosing to patronize Quality Home Centre," Davis said. "Sales have been good and the support from the community has been great, and this is certainly a huge step in the right direction."
With Davis' business being fresh on the scene, he said having the first Christmas wave of shoppers arrive at his establishment is a "great feeling". His focus is not outperforming the competition, saying that everybody can equally benefit from the scrambling shoppers.
"As far as competing, I feel that there is enough for everybody and all of the similar business can do well during this period,"he said."Us being geographically located on Carmichael Road makes it easier for customers to access a store that sells specific goods they are looking for, and we are focused on maintaining this level of success."
Some newer businesses are not as fortunate to have high traffic like Davis, or are even eager to discuss how sales are going. Guardian Business can confirm that a well-known store that expanded in the Carmichael Road area refused to comment on its holiday performance after several attempts.
While some establishments are having a difficult time getting consumers to walk through the door, Eldon is encouraging customers not to hesitate to enter the doors of The Sports Centre, saying that they are confident that they will meet the demand of its customers in the coming days.
"We have items that are arriving daily so customers shouldn't have to worry about not finding something that they are looking for,"she said.
"Our hot items like the Air Jordan shoes and the basketball systems will be available up until Christmas Day, so our customers won't be disappointed at all."
The foot is the foundation of our entire body. Pain in the foot indicates that there is something wrong with either the structures or functioning of the foot. Foot pain should not be ignored. In fact, it is said that when your feet hurt, you hurt all over your body. How, when and where the pain occurs depends on what's causing the pain. When there is pain, the body reacts by changing the way it functions; it walks and stands differently, in an effort to decrease the pain. This change may prevent the normal movement and cause more injury to that foot or the other foot.
Causes of foot pain
Foot pain may be caused by many different diseases, biomechanical conditions or injuries. Acute trauma, disease, or combinations of these problems are the most common causes of foot pain, seen in sports and workplace environments that require a lot of physical activity. Poor biomechanical alignment and wearing tight shoes or very high heels may lead to foot pain.
Sprains, injuries to the ligaments of the foot, occur when ligaments are overstretched. Acute Injuries such as sprains, muscle strains, bruises, fractures and loosening of ligaments in the joints of the foot may also lead to foot pain. The foot muscles' bursa and fascia can be strained by over-stretching, overusing, overloading, or bruising; a cut may also cause foot pain. Achilles tendonitis is also a common and painful injury. Fractures or broken bones are painful and are caused by a single blow or twist to the foot, or by repeated trauma in the case of a stress fracture. The long term effects of foot deformities like bunions, and hammer toes, irritation of nerves and joints, damage to the skin and swelling can also lead to foot pain. Disease caused by viruses, fungi, and bacteria may also be the sources of foot pain.
Pain and tenderness are the immediate indicators that something is wrong in a part of the foot. The onset of pain, whether suddenly or over time, is an important indicator of the cause of the problem. The following questions are also important to answer for a doctor to treat the pain correctly: Where is the pain? When did it start? Is there pain with movement of the affected area? Does walking or standing on the foot make it worse? Does it change the way you walk? Is the pain there all the time or does it come and go? Is it better or worse at any particular time of the day or during any particular activity? For example, sharp sudden pain to the foot after twisting may indicate a sprain or fracture, whereas pain and redness at the edge of a toenail may indicate an ingrown toenail or numbness and burning pain may indicate neuropathy.
Proper evaluation and diagnosis of foot pain is essential in planning a treatment. A good general guideline is to compare the injured side to the uninjured side. The doctor will ask you several questions to determine how the problem began. It can be helpful to tell the physician about how and when it started, how it affects you, when it bothers you and what you may or may not have done to make the pain better or worse. A physical exam will be conducted to determine the cause of the pain, and if there are any other injuries. Depending on the pain, the feet will be physically and visually examined at rest, with weight, and non-weight-bearing movement. The foot and arch will be touched and manipulated and inspected to identify obvious deformities, tender spots, or any differences in the bones and shape of the foot and arch. Then the muscles and joints of your foot will be tested. The nerves in the foot will be tested to make sure no injury has occurred there. An X-ray, MRI, or bone scan of the foot and arch may be taken to determine if there are injuries or abnormalities of the bone and/or soft tissues.
When you first notice discomfort or pain in the area, you can try to treat yourself at home with rest, ice, compression, and elevation (RICE) to relieve the symptoms. Rest will allow the tissues to heal by preventing any further stress to the affected area. Crutches should be used if you have difficulty putting weight on the foot. Using ankle and foot supports may also provide rest, comfort, and support to the affected area. Ice should be applied to the area for no longer than 20 minutes. The ice may be put in a plastic bag or wrapped in a towel but not directly on the skin. If more discomfort occurs, stop icing immediately. Compression and elevation will help prevent any swelling of the affected tissues.
Over-the-counter medications can also be used to reduce discomfort and pain. There are two types of over-the-counter medications that may help with the pain and swelling of foot pain. Acetaminophen (Tylenol) will help reduce the pain, while a non-steroidal anti-inflammatory such as aspirin, ibuprofen (Motrin), or naproxen (Naprosyn) can help lessen the pain as well as reduce the inflammatory response. Caution should be taken when using these drugs; dosage should not exceed the labeled directions, and medications may need to be taken with food.
When to seek help for foot pain
When the pain begins to interfere with your daily activities, or if you cannot perform your activities without pain, you should consider seeking medical attention. Other signs that you should seek medical care are if the area looks deformed, you have loss of function, change of sensation, a large amount of swelling with the pain, prolonged change of skin or toenail, the affected area becomes warmer than the
surrounding area or if symptoms increase or worsen.
Treatments are directed toward the specific cause of the pain. Once the severity and cause of foot pain is determined treatment can begin to correct and or treat the cause.
Therapies may be used to treat foot pain, including electrical medical devices such as ultrasound, various forms of electrical stimulation, LED light therapy (laser), and/or manual therapies to reduce pain and increase circulation to the area to promote healing.
The podiatrist may order rest or modification of your exercise routine to maintain your fitness level, such as doing alternate activities that can be performed so the injured area is not made worse. For example, instead of running, he or she may suggest that you cycle, use elliptical trainers, step machines, swim or use ski machines to minimize impact and allow you to maintain and improve your fitness.
Corrective prophylactic measures
New shoes or the replacement of shoe insoles or orthotics can help prevent and treat foot pain. Proper footwear fitting, including lacing and socks are important when purchasing shoes. Additional supports can be added to the shoes such as heel pads or cushions, arch supports, and various wedges to help maintain the foot in a proper position. Remember, athletic shoes wear out after a while. A good rule of thumb is to replace your shoes every six months or more often if you wear them a lot.
Muscle strengthening and flexibility
You may be given exercises to increase the strength, flexibility and stability of the affected area, and to correct muscles that may not be balanced. Flexibility helps to make muscles stronger and less likely to be injured.
The podiatrist will also order medications to control inflammation or symptoms. In some cases, based on the cause of the pain, surgery may be necessary.
To prevent injuries and pain, a general physical exam and a foot exam may be recommended before starting any exercise program. If you have conditions such as gout, diabetes, certain types of arthritis, and neuropathies, they should be treated before beginning any exercise program. If you have had an injury to your foot or ankle, it is best to have the area evaluated by the podiatrist to get the okay to resume exercise. Proper technique and a gradual increase in activity can help you develop good biomechanics that can prevent foot injury and pain. Properly fitting shoes and proper foot hygiene can also prevent foot pain.
Remember, if you feel pain when working out or walking, try decreasing the intensity of the workout or walking less. If the pain persists, stop immediately and see a podiatrist to discover the source of the pain. Pushing through pain often results in injury. Foot pain is not normal and is there to tell you something is wrong. Get help.
Women who love to wear high heels, especially shoes with pointed toes, this is for you. Especially if you have noticed the bending of your toes, corns or pale or darker spots on the toes. If you have to grin and bear it when wearing your favorite high heel and can't wait to take them off because your little toe is "killing" you, you may have hammertoes.
Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.
Hammertoes usually start out as mild bending or deformities and get worse over time. In the early stages, hammertoes are flexible and the toe can be straightened out to its original shape. But if left untreated, hammertoes can become stiff or rigid and will stay in the bent position permanently.
Hammertoes seldom get better without some kind of intervention. Because of the progressive nature of hammertoes, they should be treated early.
Hammertoe is caused by an imbalance in the muscle and tendon around the toe. Because of the way some people walk, mechanical (structural) changes can occur in the foot leading to this imbalance and bending of the toe.
Hammertoes are often made worse by shoes that don't fit properly. It may also result if a long toe is forced into a cramped position when a tight shoe is worn. In some people, hammertoes are inherited and occasionally, they can develop from an earlier trauma to the toe.
Common symptoms of hammertoes include:
o Pain or irritation of the affected toe when wearing shoes - especially tight or pointed toe shoes.
o The tops of the toes may have skin that is darker that the rest of the toe. Sometimes, the area may be lighter in color that the rest of the toe especially if medicated corn pads were used.
o Corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.
o Inflammation, redness, or a burning sensation.
o Contracture (permanent bending) of the toe.
o In more severe cases of hammertoe, open sores may form.
To diagnose a hammertoe the podiatrist will obtain a history of your symptoms and examine your foot. During the physical exam, the podiatrist may try to straighten and manipulate your toes to study the contractures. In addition, x-rays of the foot will be taken to determine the extent of deformity in the toe. Hammertoes are progressive so they will not go away by themselves and will usually get worse over time. Some hammertoes progress quickly while others take a longer time.
There are a variety of treatment options for hammertoe. The podiatrist will choose a treatment based on the severity of your hammertoe and how it is impacting your feet and life. These may include any or all of the following.
o Padding corns and calluses. Your podiatrist can provide or prescribe pads designed to protect corns from irritation. There are also over-the-counter pads that can be used to avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. They can cause the color to change on the toe (darker or lighter) and may cause ulcers/sores to the toes. This is especially true for people with diabetes. They must never use medicated corn pads.
o Changes in shoe wear. Avoid shoes with pointed toes, shoes that are too short or shoes with high heels. All these conditions can force your toe against the front of the shoes and encourage or aggravate hammer toes. Instead, wear comfortable shoes with a deep, roomy toe box and heels no higher than two inches.
o Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance and prevent or delay the hammertoes.
o Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
o Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation in the toe.
o Splinting/strapping. Splints or small straps may be applied by the podiatrist to realign and straighten the bent toe.
When surgery is required
In some cases, when the hammertoe has become more rigid and painful, when the conservative treatment has not helped or when an open sore has developed, surgery is needed to treat the hammertoe.
The podiatrist will choose the best procedure to fix your hammertoe based on the extent of the deformity, the number of toes involved, your age, your activity level and other factors about your general health. The procedure can be performed to fix one or multiple toes at the same time. The recovery time will vary, depending on the procedure or procedures performed but can be between three to six weeks.
oFor more information on hammertoes visit www.foothealth.com or www.apma.org. To see a podiatrist visit Bahamas Foot Centre, Rosetta Street telephone, 325-2996 or Bahamas Surgical Associates, Albury Lane, telephone 394-5820.
JACKSON, Miss. (AP) -- Take off your shoes. Empty your pockets. Walk through a metal detector, or get an embarrassing pat-down from a Transportation Security Administration agent.
It's all part of the routine for airline passengers in the United States since the terrorist attacks of Sept. 11, 2001.
The top Democrat on the House Homeland Security Committee feels your pain.
U.S. Rep. Bennie Thompson of Mississippi said he and other members of Congress go through the same procedures as every other passenger.
"Same lines, same inconvenience," said Thompson, who flies several times a month.
"We have had to get off a plane because some anomaly occurred that didn't get picked up,...
Orange top with purple tights
Green earring and bracelet
Ya lipstick white
Rainbow weave wit blue eye shadow
Red belt and yellow stilettos
Gal go do what ya wanna do
I can' tell ya who to sock it to
Spread ya joy gal if das your ting
But Ine ga be no fool
Jus' gee me back my ring
- Geno D "Jungaless"
In the popular mind, when we say "Looka da Jungaless" (cause let's face it, we enjoy looking at them, can't take our eyes of them) we are talking about a young woman who is dressed and behaving in a fashion middle class respectable folk would consider tacky, brazen, slack or unladylike. And in The Bahamas we are very concerned with female behavior. Male behavior we don't give a damn about.
Poompoom shorts, bright colors, bras as outerwear, bright wigs, same-color eye shadow, nails, bracelets, shoes. Gold, blue, red or yellow contacts maybe. And they're loud. Will cuss you stink. They at every dancehall concert, every sail away; and most of all - they dance. They dance like they workin' in a strip club; they dance like they're in the videos they watch on Tempo. Pull out your cell phone camera an' it's on. YouTube or nuttin'.
Usually, when we say "Look da Jungless" it's because we feel better, smarter, more sensible, more decent than she is. She's not quite the same as the sissy or the 'Highshun', but we definitely feel better than her.
She's a whore after all. Showing her wares, droppin' it like it's hot for all to see. No doubt in exchange for some rum and Red Bull, a conch snack and a ride home in somebody's Maxima. Or on the back of somebody's Kawasaki. But in this country good people don't exchange sex for money or assorted services. We just don't do that. Right?
Are we better than the jungaless, though? How many respectable, professional men wouldn't marry that big boongie girl in the fluorescent green shorts and white stilettos but they'd spend the night (or at least 15 minutes) with her somewhere where no one can see and then go back to the wife and kids?
"Looka da jungaless?" When you look what do you see externalized: what you want, what you fear, what you hate about yourself?
The jungaless is making herself the center of attention. Men stop and stare. And though some might wish she could find another way to gain an edge in this man's world, aren't most young women playing the same game, albeit with less color and a little more cloth? The push-up bras. The tights that look like jeans? The thongs. The too small blouses? So, the hair ain't aqua, but aren't you still investing in that weave down to your back in an effort to attract the same man the jungaless has got mesmerized? And is the business suit wearing woman, with her college degrees, doing her dirt behind closed doors, really better cause she ain't touchin' her toes at a beach bash? What about the church going, working that 9 to 5, sweetheart with two kids for someone else man? Can you always tell character by attire and demeanor?
Being a jungaless in this country means you are crass, loud, you drink and brawl, party hard and have sex with too much people. Well, minus the lace front, isn't that thousands of Bahamian men? What's our name for a man like that? O, right, "man".
Comin' out your house as a jungaless is a performance. It's assuming an identity. Wearing a mask, masquerading as some bolder, more awesome version of yourself. You are being audacious; no less audacious than if you were on Bay Street Boxing Day morning whinin' in a costume for Roots or Saxons or One Family or Da Valley. No less audacious than if you were whinin' in a dusty school yard, 10 years old, singin' "Sauchiss in Dere".
Scholar Carolyn Cooper describes jungaless performance this way (and yes, we borrowed some of this from the Jamaicans, sort of): "Jamaican dancehall culture at home and in the diaspora is best understood as an erogenous zone in which the celebration of female sexuality and fertility is ritualized... The dancehall is a liberating space in which working class women and their more timid middle class sisters play out eroticized roles that may not ordinarily be available to them in the rigid social conventions of the everyday... This self-conscious female assertion of control over the representation of identity is misunderstood... Indeed, the joyous display of the female body in the dance is misperceived as a pornographic devaluation of female sexuality. But the fantastic un/dress code of the dancehall (in the original Greek sense of the word 'fantastic', meaning 'to make visible', 'to show') is the visualization of a distinctive cultural style that allows women the liberty to demonstrate the seductive appeal of the imaginary - and their own bodies... Indeed, the elaborate styling of the body is a permissive expression of the pleasures of disguise."
It's hard to be a woman in this man's world. Some women pop pills to cope. Some keep sweetheart. Some whine on their head top. Walk a mile in them stilettos before you judge.
As I returned to Nassau recently from London, I heard on the radio more of the notion that we, as a country, need to be 'tuff on crime' and incarcerate offenders. This debate made me ponder where it is we live and what we are saying about ourselves as a nation.
In the aftermath of the London, Tottenham riots, a number of issues have become more glaringly obvious. Young men are rapidly being criminalized as the ring leaders if not the sole cause of violence and crime in our societies. This trend is not just a fact for the U.K., but also in other countries, both white and non-white. It has been a fact for years, especially during the 2007 riots, that young, black and brown men in France were seen as the cause of all problems and the system sought to exclude them from many aspects of French life, while insisting that they fit in and become French through its assimilation policy.
The recent riots in England have shown an entirely new side to this. As the footage was played in homes world-wide, the public saw young people, many hooded, looting and shooting, not to mention committing other random acts of violence against their fellow countrymen and women.
Of course, the government's answer has been that these youth are criminals - they have turned against a benevolent system that has done its best to provide for them. The U.K. prime minister and his ministers have declared that the disaffected youth are problems and their actions were unprovoked transgressions. Never mind that community and youth programs and centers have been closing at the speed of knots. They are criminals and must be treated as such; the heavy and swift hand of the law has been loosened from its constraints and is inflicting justice in warp speed. The community has become a problem and the government bears no responsibility for any of its problems.
The U.S. Troy Davis matter, a more recent case of a black man being "thrown away" by the state, provides more evidence of the way non-whites are disposed of even under questionable circumstances. Davis' execution speaks to the 'accepted' or internalized perception of black males as dangerous, which may lead to this sort of legal injustice.
Class and the response to young people
Meanwhile in the Caribbean, the language is much the same. The politicians and leaders all declare that young males are a problem. The laws must be strengthened to deal with the vicious underbelly that is bursting out and inflicting crime on the safe and happy, idyllic country. Public opinion is that all these young men should be locked away for decades not to see the light of day. Sadly, according to the people, the law does not work like this. The answer then must be vigilante justice. Much like the purported result of the Dudus debacle in Kingston, Jamaica where it is rumored that dozens, if not hundreds, of young black males who were going to be mischief-makers were relieved of their potential to create havoc. The system simply encouraged their disappearance.
Many celebrate this as foresight in housekeeping before the problem destroys the country. What did we say about Haiti when so many were being killed under Jean Claude Duvalier and then the interim government of the early 1990s? And what of the Dominican Republic? And what of Bosnia and Serbia? Yet we celebrate such violence when it comes to protect us?
Where does this lead us? The issues that have been glaringly revealed much to no one's surprise unless they were unaware that this fact was existent prior to the postcolonial thrust, is that class matters. In Britain if you riotously destroy a pub in an Oxbridge brawl then the criminal act of destruction of property is forgiven because the fathers of those in question have trotted off to the pub, paid the owner damages and then off to the constabulary and sprung their promising youngsters from the bowels of holding cells. That only required a few thousand pounds. Is there a difference in The Bahamas? Could a similar fact not be offered of those who can afford it? In the case of the sods who have run amuck during the riots, their parents cannot trot off to the pub owner and pay to have the building righted.
And sadly, the damage was often done to those who could least afford it too. The large companies whose premises were ransacked and merchandise looted, were up and running within days of the inconveniences. The others had to either go into debt or close down. However, the disaffected youth's parents or guardians, despite arguable cash-richness, could not afford to even spring their youngsters, so the system would have to deal with them.
In the case of France, swift attacks on the blacks and browns were apparently okay, because they were non-white lads and lasses who were disturbing French civility. The French have a penchant for dismissing assimilation when it suits them and relegating the other to the junk heap of history. But the acrimony between the French and the Arabs and blacks from its former or present-day colonies is renowned. What was not so 'apparently apparent' was this relationship in Britain, though this seems odd, given the history of race riots in that country. However, the ministers can forget historical fights and damages because they were never left on their records and because the situation was quickly corrected. They are, however, quick to gloatingly reveal that the youth involved in the riots were overwhelmingly known to Her Majesty's forces. The system has them carded. There is a certain flavor of class divide in this debate that sours upon close examination; the same class divide that was arguably dismantled decades ago when the north-south divide was taken down.
Our disaffected youth
On this side of the Atlantic, the same discourse is used to frame the same people in the same way. The state has not failed the people by leaving them in poverty or allowing them to become poorer while the upper crust flourishes. These disaffected youth have failed the state and the latter can take no responsibility for anything therein. Not to mention that the failing average in education is a D. How many millions does government spend on education annually? How is it that they are not held at all responsible for the masses of young people that they are encouraging to fail? How is it that they are not challenged for inappropriate handling of money? Is there no accountability for misspent funds? Notwithstanding this deviation, the fact remains that the working class youth, overwhelmingly black, are the problem in the country and must be dealt with severely. Woe to the young man who cannot afford to call up his parents and have them trot to the police station to pay his bail and secure a 'good' lawyer to get the charges dropped.
The parallels in meaning and implication in these trans-Atlantic debates are alarming and the racism and classism they espouse are tragic, given the color of the leaders of most Caribbean countries. However, we seem to be following a perfect example set out by France and Britain. The country will be safer if we simply criminalize all young, working class people, especially males. Why not follow Jonathan Swift who suggested that the working class youth be eaten or used as shoes and clothes for the wealthy? Or, perhaps we could begin to discuss more preventative and proactive ways of working through social problems before they begin.
Diabetes is a chronic disease that is best treated by a team of healthcare professionals including family physicians, diabetes educators, wound care specialists, nurses, podiatrists, surgeons, orthopedists, prosthetists, nutritionists and many others. However, the person with diabetes remains the center of this team.
They are the recipient of the care and the entire reason the team was assembled. This does not take away the diabetic's responsibility to do their part, to control their diabetes and take care of their feet preventing complications such as ulcers and amputations. One of the simplest and most important things someone with diabetes can do to protect their feet is to examine their feet every day. The good news is that you don't need any special tool or be an athlete or super flexible to do a foot self exam.
It is recommended that all persons with diabetes check/examine their feet daily. The purpose of checking the feet is to identify any active or potential foot problems that may lead to ulcers.
Getting an ulcer or wound on the foot puts the diabetic at high risk for getting an amputation. To prevent an amputation we must do all we can to prevent an ulcer.
Looking at your feet regularly can prevent an ulcer as well as alert you to the presence of an ulcer which can be treated and healed quickly before it becomes infected. If any problems or potential problems are identified they can be prevented or treated early by the podiatrist to prevent ulcers and amputations.
A number of challenges such as a poor vision, blindness, limited flexibility, arthritis, foot deformity and a large belly can make doing a foot self exams difficult. If you are unable to check your own feet, ask a friend, family member or caretaker to help. Here are some simple steps to follow to give yourself a good foot exam.
Get into position to
check your feet
After cleaning and drying your feet, after a bath for example, sit on a bed, chair, or toilet in a well-lit room. Both legs should hang comfortably in front of you. Bend one foot at the knee and place it over the opposite knee so you can easily see the foot. The supporting leg should be bent and relaxed in front of your body.
Look at your feet
o Look carefully at your feet, do a visual inspection. Search for anything abnormal on the foot -- on the top, on the bottom and between the toes.
o When looking at your feet you are looking for any signs of irritation, or a break in the skin that may indicate an ulcer. These may include dryness, scaling, redness, swelling, pain, a break in the skin, build up of hard skin, scratches, cuts, scabs, sores, bruises, or corns, etc.
o Changes in the shape of the foot -- flattening of the middle part of the foot, curling up of the toes (hammer toes) and large bump on the side of the foot (bunions)
o Signs of infection -- redness, swelling, heat, pain, drainage (blood or pus) on the foot, socks or on the ground, bad smell (odor), etc. A really bad infection may also cause you to have symptoms in your whole body, like fever, chill, high blood sugar, etc. If any of these occur, you must see the doctor immediately.
Where to look.
o Look at the bottom of your feet. Turn your foot to the side, so that the bottom of the foot is visible. If you are unable to do so, put one foot on the other knee to see the bottom of your foot, use a handheld mirror to view its reflection. You can also place the mirror on a foot stool or on the ground so you can just hold your foot over the mirror and see it without having to lift up your feet. You must be very careful not to walk on the mirror because it can break and cut you. Ask a family member to look at your feet for you if you are unable to do so yourself. I recently heard some good advice about looking at your feet. A colleague said he tells his diabetic patients, just as they look at their faces in the mirror every day, they should also look at their feet in the mirror every day.
o Look at the bottom of your feet, under the toes for any bumps, raised areas and irregular textures. Because this area receives a lot of pressure when walking, calluses (thick, hard skin) or corns may develop here. Proper-fitting shoes can reduce your risk of developing this.
o Look at the soles of the feet, and look and feel for bumps and lumps, which can be signs of injuries or changes in the shape of the underlying muscles or bones of the feet. Look for any opening in the skin, scratches, fissures, or open wounds. Again, a thick callus may develop here as a result of high pressure.
o Check your heels, by feeling for dry, rough, or cracked skin. Even small fissures can become infected by bacteria (germs) on the skin. To treat this, moisturize your feet daily with moisturizing lotion or cream. Don't apply moisturizers between toes because bacteria love to grow in warm, moist places.
o Check the tops of the feet looking for scabs, scratches, sores, and bruises. Look for signs of decreased blood flow, such as no hair on the toes, cold feet, pale color, thin or shiny skin. Blood glucose control and physical activity like walking can help boost blood flow to the feet.
o Examine your toes carefully. Spread toes apart with your fingers so that you can look between your toes. Look under the toes and check each toenail as well as the fleshy area surrounding it. Toes with normal blood flow will be pink and warm. Pale or grayish blue looking toes indicate possible circulation problems. Look between the toes for cuts, scratches or fissures, which can be signs of an ulcer developing. Soft white tissue or dry scaly skin may be an indication of a fungal infection between the toes.
Checking your toenails are important as well. Remove the polish and examine your toenails for proper nail color (clear or pink), length, shape, texture and thickness. Discolored (yellowing, brown, even black), thick, crumbling or flaking nails may indicate signs of nail fungus. This must be treated by a podiatrist.
The toenails should also not be neglected. Look for signs of ingrown toe nails. Look for red, puffy skin on the sides of the nails, drainage, pain and swelling. Ingrown nails may require surgery if ignored for too long.
Feel your foot
Feel both feet with your hands, check the bottom and top for any bumps, or temperature changes from one part of the foot to another. Check your feet for feeling -- does it feel the same on all parts of the foot? If the foot feels numb or "different" from the leg, or on top of the foot, you may have neuropathy. This makes it even more important for you to examine your feet regularly.
Check your shoes
Check your shoes to make sure they fit properly, and that they are in good condition, not worn out, are without holes or rough edges. Any shoe that causes foot injury and are worn out should not be worn and should be replaced.
Track your foot self-exams over time. It is very common that persons with diabetes do not remember how long they have had a problem with their feet, so making a record of your foot exams can help you remember when a ulcer or other foot condition started. This will alarm you, and encourage you to seek medical care earlier and you will be able to tell the podiatrist when the condition started. On a piece of paper, or in a book, record the date, make a note of anything out of the ordinary such as cuts, blisters, corns, unusual temperatures, injury, etc., and describe it, how it looks, feels, and smells. Compare your notes from exam to exam, maybe weekly or monthly. If any area of concern continues or gets worse, or if you notice any new issues, contact your podiatrist as soon as possible.
There are a number of tools out there that may help you examine your feet, including a foot exam mirror or even a thermometer that can identify areas of high temperature on your feet indicating places where ulcers will develop. These tools are great if you have them, but you already have all the tools you need to examine your feet -- your eyes, your nose and your hands. Now that you have the tools, examine your feet regularly and see a podiatrist if you have any concerns.
This information on how to examine your feet is intended to help the person with diabetes to have the knowledge and skills to look at their feet and identify any problems that may indicate an ulcer. If a concern or problem is identified you must see a podiatrist right away.
For more information or to see a podiatrist, visit Bahamas Foot Centre, Rosetta Street or telephone 325-2996; Bahamas Surgical Associates, Albury Lane or telephone 394-5820 or the Foot & Ankle Institute, Dean's Lane 326-5402 or email us at email@example.com or visit www.apma.org or heal2gether.org.
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