Just a Little Callus

Because calluses can break down and turn into ulcers, preventing and treating them should be a part of the diabetic’s daily foot monitoring and regular visits to the podiatrist. I try to examine my feet at a set time each day and schedule routine podiatrist visits every four to six weeks. While diabetics can help avoid or eliminate calluses by applying specialized creams and ointments, the more troublesome ones require podiatric attention.  Podiatrists treat calluses by safely sanding or filing down the callused skin or, in some cases, by debriding them—trimming or excising the callus with a blade or scalpel. Both methods are normally safe, relatively painless, and generally successful.  However, even this simple procedure can prove problematic for people suffering from diabetic foot disease. My case in point.

During a routine visit late last year, my podiatrist debrided what he described as a “little callus” on the bottom of my midfoot (interestingly in an area where I do not normally experience ulcers).  The incision was small and unremarkable. He told me to keep it covered with a fresh Band-Aid.  Because this was the only problem he discovered during the visit, he told me that, unless I noticed signs of infection or other issues, I did not need to return for six weeks. (Signs of infection include a foul smell, pus, swelling, pain, and warmth around the wound).

Consistent with the podiatrist’s advice, I changed the Band-Aid daily, tried to avoid walking without shoes or otherwise exposing my foot to sources of infection, inspected the callused area periodically, and monitored it for signs of infection. Regrettably, these steps proved inadequate.  Four weeks later, I woke up one morning with pain and swelling in my midfoot and observed that the area around the wound was red, contained pus, and was warm to the touch.  More alarming yet, I had a 101+ degree fever—an ominous sign of a potentially serious systemic infection. I was rushed to the emergency room of a nearby medical center, diagnosed with a Staph infection, spent five days in the hospital and, despite state-of-the-art wound care (that I will describe in the next installment), am not fully healed and remain mostly non-weight-bearing six months later.

Although at the time the use of a Band-Aid and the precautions that I took seemed to be a reasonable treatment for “a little callous”, in retrospect, they did not protect me from what otherwise might have been potentially avoidable complications.

Next time: Finding state-of-the art wound prevention and treatment.

This content was originally published here.