Diabetic foot is one of the most neglected subjects in geriatric medicine, says Dr. Alexander Olshanyetsky, a vascular expert who came on aliya 13 years ago from Estonia. The condition is a great burden not only upon the patient, who is suddenly less than whole, but on their families, who feel as if they were sliding down a slippery slope to watch their loved ones growing disability and provide major nursing care. After years of diabetes, the smaller arteries in the extremities become obstructed and close up, severely reducing the amount of blood that can reach the feet and toes. Peripheral neuropathy results in a burning sensation and often much pain. Bacteria enter the skin, causing the development of small wounds that fail to repair under the bodys natural healing process.
More infections occur, and doctors prescribe antibiotic salves.
As infections nibble away at the bone, osteoporosis can develop as well. The patient, one day independent and active, can overnight become weak and helpless, hospitalized so he can receive antibiotics intravenously. But, explains Olshanyetsky, if the small arteries in the foot only a 10th to a half of a millimeter wide and only a few centimeters long are impassable, the blood and the antibiotics it should carry cannot reach the area to promote healing. Patients are forced to wander from one doctor to another without finding a solution. These want just to get rid of them, because in the most chronic and serious cases, they really havent much to offer.