When little things turn big

Early steps can prevent life-threatening illnesses
WHAT DO BROKEN HIPS, amputations and dental infections have in common? They can all start with a seemingly small event that
rapidly escalates into life-threatening conditions. In many cases these serious health conditions could have been avoided with simple preventive measures.

Feet first
O’Grady, 59, didn’t know he had peripheral neuropathy, nerve damage that resulted in diminished sensation in his feet, a
common complication of diabetes. Because he never felt pain, the blister continued to rub against his shoe, and because diabetic wounds heal slowly, within three weeks the wound became infected. The infection worsened and then traveled to the bone and ultimately did not respond to antibiotics. A few months after the blister surfaced, doctors removed O’Grady’s leg from the knee down to save his life.

O’Grady’s story is not unusual. Improperly fitting shoes are the biggest cause of amputations in diabetic patients.

It’s frequently what starts the process. One out of four diabetic patients suffers from peripheral neuropathy. To avoid the problem, people with diabetes should wear only diabetic shoes fitted by a certified pedorthist, a specialist who designs, fits and/or modifies shoes and foot orthoses to alleviate foot problems. Other simple prevention strategies include turning shoes upside down to remove pebbles, inspecting your feet for sores or consulting with a caregiver or spouse if you can’t bend to inspect your entire foot. Those with diabetes who get a foot blister should immediately seek treatment from an orthopedic surgeon or podiatrist.

Clear the clutter
Hip fractures are another common medical condition that can quickly turn life threatening, and they usually begin with a simple fall. Of patients who break their hips, about 20 percent die within a year, according to the Centers for Disease Control and Prevention.

The increased risk of death is usually due to medical complications, such as heart attacks, urinary infections, blood clots, pneumonia or strokes. Roughly a third of those who break their hip lose at least one level of independence, such as going from independent walking to using a walker, or from using a walker to living in a nursing home.

The good news is that getting into a habit of walking or exercising, losing weight and reducing alcohol and cigarette consumption will reduce the chance of fracturing bones.

Women with certain health issues, such as kidney disease, use of steroid medications and past chemotherapy, should be evaluated and, if necessary, treated for osteoporosis; those without such health issues should be checked at age 65. Men of all ages who have had a fracture, such as a broken hip, should also be tested for osteoporosis.

Those who do break their hip should start rehabilitation as soon as their physician advises. Patients who don’t walk independently after a month of rehabilitation are unlikely to walk again. Of course, the easiest way to avoid the potential complications that follow breaking a hip is to not break it.

The most common reason why people break their hips is they simply fall. Eliminating clutter, extension cords and throw rugs, and installing grab bars and nonslippery bathroom mats can help. Shoes with non-slip rubber soles are also useful. Avoiding sleeping pills or pain medications before bed can prevent nighttime tripping due to grogginess.

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