Our second post in our Summer Series of Super People with diabetes living in Ireland is part one of a two-part post from Aileen O’Reilly from Dublin. Aileen was diagnosed with type 1 diabetes almost 40 years ago at age 10 years and is a travel, health and features writer (Travel Extra, Herald, Irish Times and Irish Examiner).
I first came across Aileen when she wrote this piece in July 2018 in the Irish Examiner in where she gave a very honest account of how health issues, both related to diabetes and unrelated to diabetes, affected her life and how she “never fully dealt with the fact that she was a diabetic”. This all changed around the time she had her first amputation which saw the removal of two of her toes.
Aileen has written previous posts for Thriveabetes, which details overcoming the diabetes related health issues and I’m happy to report her career has found its track again. You will find the links to those posts at the end of this one.
Running to Standstill talks about Aileen’s most recent experience with her feet and having been diagnosed with Charcot’s foot last December.
type 1 diabetes and Your Feet
I know it’s another thing to add to our diabetes to-do list but it is so important for ALL people with ALL types of diabetes have an annual foot check with a health professional to prevent serious foot health issues. Sometimes, this can be done as part of your diabetes clinic appointment saving you a ton of that extra work to organize a separate appointment, if done well.
The HSE’s Model of Care for the Diabetic Foot document states:
3.1 Foot Examination Frequency
All patients with diabetes should have their feet examined at a minimum on an annual basis whether they attend their primary care physician or a hospital based diabetes clinic. If the patient with diabetes attends their primary care physician or hospital diabetes clinic on a more frequent basis, the feet should also be examined as part of the routine clinical visit.
The confusing part of this is by who?
The HSE’s Model of Care for the Diabetic Foot is not clear about who should or is qualified to perform this exam and the community podiatry services are not even all over the country. BUT this should not stop you from asking for it at your diabetes clinic appointment.
The Model of Care for the Diabetic Foot is very clear that the person doing the foot exam should be “appropriately trained to examine foot pulses, vibration, and monofilament testing.”
3.2 Examiner
A practice nurse/primary care nurse in the patient’s general practice who usually reviews the patient’s general diabetes care and is appropriately trained to examine foot pulses, vibration, and monofilament testing. This clearly has resource implications both for nurse training and time for delivery of service.
I also wrote a post on BloodSugarTrampoline.com back in 2015 that was a review of a talk given my our community podiatrist on the why and what of a foot check. Link diabetes-foot-check” target=”_blank”>here. Here’s a another great webpage from diabetes UK on diabetes.org.uk/guide-to-diabetes/complications/feet/what-can-i-expect-at-my-annual-foot-check” target=”_blank”>what to expect at your annual foot exam
Running to Standstill – Part 1
By Aileen C. O’Reilly
I walk a lot.
From March of last year, it has been my chosen method of dealing with this cursed pandemic and the unceremonious halt to my (up to that point) blossoming career as a travel writer.
Walking has also helped immeasurably with the daily control of my type 1 diabetes. As a person who spent years running from acknowledging that I had the condition (I got it when I was 10 and have it 39 years now) feeling fit and healthy goes a long way towards helping me realise that there is precious little you can’t do with it when it’s well controlled (there are a growing number of international gymnasts, marathon runners, footballers and rowers who will vouch for this).
Having diabetes is far from the life sentence it was once deemed to be – we are not invalids, we have a condition that requires we mind ourselves and eat well.
Last year I returned from a foreshortened trip to Pittsburgh and, along with everybody else, stepped through some awful looking glass into a world of facemasks, elbow bumping (still ridiculous) and the bizarre practice of sneezing guiltily into the crooks of our arms.
Walking every day helped me cope as my normal life tilted precariously on its axis. It quickly became my “thing”, my Zen, my happy place, my way of dealing with stress – 8 am, sunshine or rain, I was out stomping along for 10 or 15 km.
There were no more travel events to rush off to photograph, no 5am trips to the airport to jet off to sunny climes and write about. Every day I continued my normal routine of pitching articles to features editors – every day less and less of them replied.
I felt useless.
While my initial goal in walking had been physical fitness this was quickly surpassed by the mental health benefits of communing daily with nature – there is nothing quite so soothing to a troubled mind as the cheep of ducks at your feet while the rain gently falls on lily pads at a quiet canal bank or the sun rising majestically on a frosty morning as you sit on the sweeping steps of Castletown House in Co. Kildare, the lichen covered facade blushed pink as if painted by Manet.
… and then in December I was unceremoniously stopped in my tracks…
All of a sudden, I had a pronounced limp, and the stairs was transformed into an extremely painful Kilimanjaro (going up was bad enough but coming back down was intolerable). I’m not a fan of painkillers either and suddenly I was desperately swallowing extra-strength Brufen and wondering why they didn’t appear to be working.
What the hell was wrong with my foot? I hadn’t fallen or hit it so it couldn’t possibly be broken (I had broken toes before, so I knew what that felt like).
Initially of course I was oblivious to how serious a matter this would turn out to be. I naturally consulted Dr. Google at 3 am when a visit to the bathroom elicited howls of pain as I tried to hobble the short distance.
An emergency appointment with my podiatrist followed quickly by x-rays and an MRI revealed not only that I had fractured 3 of my 5 metatarsals but that I had developed the diabetic condition known as Charcot foot.
For the uninitiated among you diabetes.org.uk/guide-to-diabetes/complications/feet/charcot-foot” target=”_blank”>Charcot foot is a serious complication that can affect people with diabetes with peripheral neuropathy. Charcot affects the bones, joints, and soft tissues of the foot or ankle. The bones become soft and can break and the joints in the foot or ankle can dislocate.
