Anxiety disorders may be a consequence of environmental, medical, genetical, brain chemistry or other reasons. The most common trigger is usually the stress in our lives. Very often anxiety is a response to outside factors, but it is possible that we make ourselves anxious with “negative talking to ourselves” - always saying ourselves that the worst will happen.
Outside factors that are known to cause anxiety include abuse, victimization, death of loved ones, stress in a personal relationship, marriage, friendship, and divorce, at work, from school, about finances and money, from a natural disaster. Anemia, asthma, infections, and several heart conditions are connected to different anxiety disorders. Some causes of anxiety include:
* Stress from a serious medical illness
* Side effects of medication
* Symptoms of a medical illness
* Lack of oxygen from emphysema, or pulmonary embolism (a blood clot in the lung)
Substance use and abuse
About half of patients who use mental health services for anxiety disorders such as GAD, panic disorder, or social phobia are doing so because of alcohol or benzodiazepine abuse. Other factors include:
* Cocaine or amphetamines use
* Withdrawal from such drugs or several prescription drugs
Some people may have a genetic predisposition that gives them a greater chance of suffering from anxiety disorders. Research has shown that people with strange levels of certain neurotransmitters in the brain are more likely to suffer from generalized anxiety disorder. When neurotransmitters are not working properly, the brain’s internal communication network breaks down, and the brain may react in an inappropriate way in some situations.
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What is a diabetic to do to protect their feet from a sore that can lead to infection and amputation?
1. Inspect your feet daily. If you can’t see your feet, have someone else look at them every day for redness, cuts, swelling, blisters, bruising, or nail problems.
2. Wash your feet daily. Sounds simple, but many people do not bathe their feet daily. Make sure to clean in between your toes and dry them thoroughly.
3. Moisturize your feet daily. Again, a simple habit to get in to, yet most people fail to upkeep their skin every day. Diabetes can cause very dry, flaky skin, so extra moisture is needed.
4. Cut nails very carefully, and straight across. If you can see and reach your toes, be careful to cut your toenails carefully, taking time not to nick yourself or cut them too short. When in doubt, visit the podiatrist at least every 8 to 10 weeks. The podiatrist would rather cut your toenails for you than treat an infection caused by your own handiwork!
5. Never trim corns and calluses. And absolutely no corn or callus remover! The package says, “Do not use if you are diabetic” for a reason. Have the podiatrist trim them when they are thickened or red.
6. Wear clean, dry socks. And change them daily…..sounds simple, but you would not believe how many people don’t.
7. Avoid tight or bulky socks. Tight socks can reduce circulation to you feet and bulky socks can bunch up and cause a blister or sore. Check your socks before you put them on and remember that they do shrink with age. Replace them periodically.
8. Wear socks to bed. If your feet are cold, wear clean socks to bed. Never use a heating pad or hot water bottle, you can burn yourself before you realize it! You can warm the bed with a heating blanket, but turn it off before you go to sleep!
9. Shake out your shoes and inspect them before you put them on. I have taken everything from a pebble, piece of basket and a doll house chair out of the bottom of diabetic feet after they walked on them all day. Easy thing to avoid!
10. Keep your feet clean and dry. No puddle splashing or snow drifts for your feet!
11. Never, never, never go barefoot. Not even at home on carpet. You can step on something easily and get an infected puncture wound. Think tacks, sewing needles, even wiry dog hair can be a problem!
12. Take care of your diabetes! Multiple studies have shown the complications of diabetes can be diminished by keeping your sugars under control. Keep that HgA1c under 6 if you can. This is hard to do by you. Work with your doctor and nutritionist for perfect care. Communicate many times with your medical team.
13. Don’t Smoke! Stop smoking if you do. Ever cigarette decreases the circulation to your feet and increases your chance of a non-healing wound.
14. Get periodic foot exams. The recommendations are to have a foot exam at least once a year by your doctor even if you have no foot symptioms. A trip to the podiatrist is recommended at least quarterly if you have neuropathy, a foot deformity, poor circulation, or have had a history of a foot ulcer.
Diabetes can be life’s annoyance or it can kill you. It is up to you! Take care of your feet so they will last a lifetime.
Dr Marybeth Crane is a board certified podiatric foot and ankle doctor with helpful tips to make your feet last a lifetime! For more foot and ankle health information and doctor-approved foot care products including safe pedicure instrument sets, visit her website or peruse her blog.
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