Sunday, January 18, 2015

Important Thoughts Concerning Your Feet and Preparedness

( Rendering from: )

            Many of us don't think much about our feet. Men buy the shoes they like or that are dictated by work, and the socks they like and then, beyond that, they don't think much about them.  Many women own shoes that actually produce challenges for their feet and legs, and they also don't give consideration to socks, tights or panty hose which actually should protect their feet from the friction of many of today's shoes. Many of the most popular shoes for men and for women, don't protect feet at all.  Man-made "plether" shoes may also exacerbate the problem.   Either sex should never wear shoes which would make running impossible.

                   If an emergency were to occur, then all of us could be faced with a situation in which we needed to walk a number of miles in which to gain safety. Remember that many of the bystanders who survived the collapse of the World Trade Center were people who were able to put distance between the building and themselves, quickly.  This leads me to my next question.  How are your feet ? Keep in mind that if you found yourself in an emergency that lasted several weeks (like a weather emergency in which your living arrangement changed drastically for a time) that your feet would endure some challenges more quickly than it could compensate for them.

                   Most people mistakenly think that foot callus formation is a positive thing.  They mistakenly believe that a callus will protect their foot from friction and additional discomfort.  The first group of people for whom this is absolutely not true are diabetics.  Both Type I (autoimmune/juvenile) Diabetes Mellitus patients, and Type II Diabetes Mellitus (usually acquired in adulthood) should take great care not to develop calluses on their feet.  (These as two different disorders with differing pathophysiologies and causes)  In diabetics, the callus can prevent the patients noting ulcerations and injuries below the callus. Since many diabetics don't have the foot sensitivity they should due to gradual nerve damage due to higher blood sugars, they may not realize that they have a foot ulceration which threatens their foot. This may occur during an emergency when they are least able to obtain a hospitalization and intravenous antibiotics. A blister near a callus on a diabetic individual this morning, can be an infected ulcer with red lines on it, this afternoon.   Prevention is key, especially for this particular group of people. 

                 The second group of people who may have difficulties with runaway callus formation are those with hypothyroidism.  Women in middle age who may be experiencing a decrease in thyroid function may find they have foot callus formation to a degree to which they never have previously. This is an important sign.  If you have unexplained foot callus formation and you never had this before, then you should ask your primary care physician to run a TSH on you to rule out a failing thyroid gland.   Secondly, new and severe foot callus formation is not a normal part of aging.  Please look for what has changed which is contributing to such formation.

Dr. Scholl's Product Line for Calluses
                If your need to use your feet in a manner in which you had not prior, occurred during an actual emergency, you could develop calluses rather quickly.   Calluses are hard material and as you walk or hike, they can cause pain, irritation, actual bruising, and actual injury to the fragile skin below the callus.  Cracked heels are also an important and potentially painful problem which can lead to infection.   If you and your family had to walk forty miles to get out of an area in an impending disaster, could you ?   Do each of you own the correct socks, the correct boots ?     Do you have adequate padding, gauze, moleskin etc. to treat the minor irritations which clearly would occur even with healthy feet on an impromptu but protracted hike ?

               Diabetics should have their feet inspected by a podiatrist who will give them guidelines as to how best to maintain their own feet and prevent calluses.  Some endocrinologists will do this also.     The rest of us should make sure that our feet are as smooth and as callus free as is possible.   If you do develop a foot callus, Flexitol cream might be an important investment in your emergency kit.  It should be used as a preventive measure in keeping your feet mission ready at a moment's notice.   Flexitol    ( is marketed as Flexitol heel balm ) an over the counter urea preparation which softens calluses and allows you to soak them or scrape them off over time. It is available at almost any US and Canadian pharmacy and is available at Wal-Mart and online.    Diabetics or those with resistant calluses can buy a prescription strength urea based callus cream if ordered by your general or your podiatric physician.

I receive absolutely no personal benefit from mentioning or in essence, advertising Flexitol.  It simply works when used exactly as directed.

               When using Flexitol, it is important to keep it away from faces and eyes.  I apply it using vinyl gloves to avoid irritation to my hands.  You should wash your hands after application, particularly if you could not use vinyl gloves for application.  Children should have this applied for them.  It may sting deep cracks in heels.

   Important points for your entire family:

1.  Make sure that each member of your family has ankle boots or longer types which are well fitting and comfortable enough to endure a five mile "emergency hike".  These should be in close proximity to your evacuation kit.
2. Make sure that if a tornado is imminent that each of you put on clean socks and the boots mentioned above.  Walking through broken glass with the correct footwear is very important.
3. Consider white cotton socks for everyone in your evacuation kit.  These are more likely to wick moisture away, and less likely to result in athlete's foot (a fungal infection of the feet and toes) if you had to wear your boots for a protracted period in an emergency.
4. Attend to any difficulties, calluses, corns, etc. well in advance of an emergency.  Learn to care for your feet before you have a problem.
5. Consider creating a "Foot Kit" in your emergency evacuation kit.
    It should contain:
                   A.) One or two tubes of Flexitol.
                   B.) Package of Molefoam Padding*
                   C.) Package of Molefoam Cushion*                     *All sold by Dr. Scholl's and online
                    D.) Package of Moleskin Plus Padding Roll *
 6. The formation of new calluses can be a sign of a new health problem.  Mention this to your doctor.
7. Make properly fitting comfortable shoes and socks a priority.
8. Don't surgically or semi-surgically remove calluses.  Gradual removal using Flexitol or prescription urea creams will do the job without giving you a nasty infection where you, or the scissors slipped !
9. Manage diabetes well.  The better your blood glucose levels are managed, the less of a problem this is likely to be.
10. Investigate orthotic inserts for your shoes that will help distribute weight better over your entire foot rather than selected areas which eventually form calluses.  Traditional orthotic shoe inserts are provided by podiatrists or sports medicine physicians or orthopedists.  Increasingly, partially customized orthotic inserts are available over-the-counter and these will help and awful lot of patients, not only with walking and longer term comfort in their shoes, but with reducing foor callus formation as well.

                    Your survival from certain disasters may well hinge on the health of your feet.