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Barefooter giving advice to those with diabetes to go barefoot

Discussion in 'Diabetic Foot & Wound Management' started by Craig Payne, Apr 9, 2011.

  1. Craig Payne

    Craig Payne Moderator

    Articles:
    6

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    A question was asked at Yahoo! Answers:
    one of the answers was:
    How irresponsible is that! I have responded.
    They obviously have no idea how many amputations have resulted from the sequence of events due to trauma going barefoot around the home...
    http://answers.yahoo.com/question/i...guF3UEkjzKIX;_ylv=3?qid=20110408192602AAYRAtR
     
  2. DaVinci

    DaVinci Well-Known Member

    Good catch Paynie!

    I know we have a number of barefooters who are members here. I would love for one of them to come and justify the advice that was given to that person with diabetes or condemn it. If they want to be taken seriously as a group, they need to take a stand against this sort of nonsense.

    As far as I am concerned the advice given was incredibly irresponsible and dangerous.
     
  3. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    If they want to maintain any sense of credibility they would distance themselves from that advice.

    Kevin has now replied as well!
    http://answers.yahoo.com/question/i...guF3UEkjzKIX;_ylv=3?qid=20110408192602AAYRAtR
    Got to love this:
     
  4. DaVinci

    DaVinci Well-Known Member

    I hope KW comes back, either to defend what they said (which will be interesting) or apologise for the bad advice.
     
  5. Classic example of when the internet is bad.

    Get advice from 2 trained professionals but look to an internet site to get information. Take the advice they want to hear which in the worse case leads to a stick injury and then death.

    Sometimes you cant save people from themselves
     
  6. markjohconley

    markjohconley Well-Known Member

    Well said Craig and Kevin!
     
  7. DaVinci

    DaVinci Well-Known Member

    Some people just do not get it do they:
     
  8. William Fowler

    William Fowler Active Member

    They never miss an opportunity to plug their hyperbole, regardless of the consequences to the person with diabetes. Hopefully others will condemn the advice being given.

    I see one of the nutters is so blind, they think it has nothing to do with diabetes.
     
  9. blinda

    blinda MVP

    :good: Ditto
     
  10. Mike hit it on the head, you can't help some people. If it won't be barefoot running it will be MMS, or drinking wee, or cash4gold.com or something else.
     
  11. If you're doing it, we're filming it. The movies are getting more and more boring and youtube is getting more and more funny...
     
  12. JB1973

    JB1973 Active Member

    i see KW has seen the error of his ways!! his response now on the thread is below.

    "I removed my original response given the the mistake that I had made posting here. I did not realize at first that this question was posted in the Diabetes forum. As a person who has family that are diabetics, I would of course not recommend this lifestyle or any actions that would in any way aggravate ones condition. A mistake, but an honest mistake.
    Me, a person who is barefoot 95% of the time.
    http://www.thebarefootbook.com/
    http://www.primalfootalliance.org/
    http://www.barefooters.org/


    Cheers
    JB
     
  13. W J Liggins

    W J Liggins Well-Known Member

    I agree with Rob. Unfortunately Snake Oil salesmen (and obviously KW is a variation on a theme) will always find a ready stream of customers amongst the naive and credulous. There is nothing that can be done about this over and above that which Craig and Kevin have already done. Contrary to KWs belief system, we will be seeing a steady increase in patients with damage due to the current 'barefoot' ideology, so at least we will have the opportunity to re-educate.

    All the best

    Bill Liggins
     
  14. Chaaali

    Chaaali Welcome New Poster

    I'm a 4th year podiatry student, so am hesitant to bring up this point that most of the very well known contributers above have not pointed out as yet.

    The original quoted question was:
    "My podiatrist has advised me never to walk around the house or garden without wearing shoes or slippers. A second podiatrist I consulted offered the same advice. Does anyone know why this is so?"

    Having consulted two different podiatrists, this person *still* had no clear idea why they had to protect their feet even when indoors. In my mind, this is a failure of communication between the podiatrists and the client - a possibly catastrophic failure, if after spending a minimum of $60 per consultation for private podiatry, (or 2 of their 5 EPC visits a year) a client suffering from Diabetes is unable to understand why protecting their feet may save their life. Not having been at either consultation, I don't know what advice was provided by the podiatrists. However, if a client has to go to the internet to find information on footcare after consulting a podiatrist, something is very wrong.
    I respectfully suggest that approaching a consultation with the idea that "some people can't be helped" may contribute to poor dissemination of information.

    Just to make myself clear, I do not agree with the "barefooters". I realise I risk being labelled an idealistic novice but I feel strongly enough about patient education to post on Pod Arena for the first time.

    Kind regards,

    Chamali Egodagamage
    4th year podiatry
    Charles Sturt University
    Albury NSW.
     
  15. :welcome: to Podiatry Arena Chamali, it is a good point you make - but there is always a but while education is very very important.

    The question remains how many times do you need to be told - don´t go barefoot outside ( we don´t know what was said after but maybe we can assume something like because if you get a stick injury and it gets infected you may get a serious infection etc etc )

    Diabetics in my limited treatment of them tend to be some of the worse group of patient at receiving information - maybe it is information overload. They might hear but not listen if you get my meaning.

    PS good luck with the future.
     
  16. W J Liggins

    W J Liggins Well-Known Member

    Hi Chamali

    Welcome - and what a fabulous name, much better than Bill Liggins!

    Mike is quite right. One of the most frustrating things I find in practice is the number of patients I see for 2nd opinions who really have no solid idea of what was said to them by the previous clinician. In many cases, I know for a fact that my colleague will have given them appropriate and timely advice, but after speaking to a 'friend' (like KW) - and sadly, very often a 'nurse' who may in fact be an auxiliary - they find it necessary to seek a further opinion. That's fine if it's another colleague, but sometimes it's the web, sometimes the aforesaid 'friend, 'nurse' or just someone who sounds plausible. I think that there are few Pods who do not dish out written information and hopefully none who approach a consultation with the thought that 'some people can't be helped'. However, unfortunately, some people do not listen or do not hear or do not read the material that is supplied to them. That's very sad, but it is a fact of life.

    All the best

    Bill
     
  17. Jacqui Walker

    Jacqui Walker Active Member

    maybe it is information overload. They might hear but not listen if you get my meaning.

    I overheard a comment the other day which might be worth pursuing - "perhaprs there's neuropathy of the brain" might be the reason of such high levels of non-compliance.
     
  18. Good point Chamali!

    There was obviously a breakdown in communication. Unfortunately, as you will find to your frustration, what a podiatrist says and what a patient hears are often two very different things. One does ones best.
     
  19. blinda

    blinda MVP

    Yep, quite a few studies have suggested a relationship with impaired cognitive reasoning and poor glycemic control. This is obviously a factor in low concordance in patients with diabetes. Hence, the need to repeatedly impress upon them the importance of self care and regular foot health checks. The majority are not being deliberately obtuse, there is a physiological element here.


    http://geronj.oxfordjournals.org/content/48/4/M117.short

    http://www.ingentaconnect.com/content/psych/jcen/2004/00000026/00000008/art00005

    Cheers,
    Bel
     
  20. JB1973

    JB1973 Active Member

    Hiya
    At our appointments with patients with diabetes we give out a leaflet according to their risk category ( low, medium, high) and go through the info in it with them, encourage questions etc. We write this all down on the record card and see them again accordingly. I'd say 8 out of 10 times at the return appointment they have forgotten/ ignored/ got 'better' advice from the friend/Internet and I find myself repeating the advice, depots them having the leaflet to refer to. Ironically, I have found the higher the risk category, the less compliant. As someone said before, it can be a challenging group of patients to work with. I got frustrated with one the other day and before u could stop myself I said "look I'm not your mum, take some responsibility". She was a bit taken aback but we will see if it works
    Cheers
    JB
     
  21. Jacqui Walker

    Jacqui Walker Active Member

    Reminds me of a patient whilst in my third year placement. Gentleman with a long standing neuropathic ulcer, just returned from a walking holiday! :confused: Mentor podiatrist had stopped talking to him months before because he ignored her. Apparently he was only SLIGHTLY DIABETIC because if I had seen his results before I would know that he was so much better now! :craig: After I had finished presenting my patient to the Podiatrist the classic response from him was "so if I rest more and watch what I eat the ulcer will heal?":bang:

    My husband has a fantastic quote for times like these - "you can't educate pork", a bit harsh but sometimes so true! Is it cynicism or realism?
     
  22. William Fowler

    William Fowler Active Member

    This thread throws up several things.

    Two podiatrists told this person to wear shoes around the home but they did not understand why or it was poorly explained them the reasons why.

    A barefooter was so quick to promote their world view with the propaganda, they did not stop to realize that the advice they were giving was dangerous (at least they showed some commonsense and withdrew their comments in face of the criticism).
     
  23. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    What it throws up for me is the continued misrepresentation, misuse and misquoting of research by the Evangelists from the Church of Barefoot Running.

    Part of KW's deleted message said:
    As I have repeatedly asked those in the other barefoot thread, please show us that research. Why have none of them come back to show us the research? ... especially the immune benefits. They making it up.
    No argument there. KW is obviously hanging out at Yahoo! Answers for no other reason than to promote an agenda (look at there posting history), rather than actually provide answers to peoples questions and they really dug a big hole for themselves on this one.

    DISCLAIMER: I have nothing against barefoot exercise; it is probably good for us. All I continue to object to is the continued misrepresentation, misuse and misquoting of research by the Evangelists from the Church of Barefoot Running.
     
  24. Freddy

    Freddy Member

    Hi, I agree that sometimes these group of patients can be difficult to give advice to. Some would appear to rather risk an amputation than follow your advice. Themselves, or the neighbour always knows best!

    From experience, getting a partner or family member imvolved and use shock tactics showing graphic images of the consequences of not following advice. this has worked for me in the past. It either scares the patient into realisation or they get bullied into taking care of themselves by their family.
     
  25. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    or in this case, KW knows better!

    I noted an interesting observation in the UK thread on HPC regulation on Blogs & Networking sites in which it appears that the HPC will be watching online sites for things posted by those registered under what the HPC might say that imply are issues with "if it raised concerns about their fitness to practise". William made reference to this thread here, that KW can get away with giving advice that has potentially life threatening consequences, but if he was a heath professional registered with the HPC and gave that advice, he would probably soon no longer be allowed to practice.
     
  26. DrPod

    DrPod Active Member

    I just came across this thread from a link on another site. Why did no one from the barefoot community take responsibility and condemn this person for the the medical advice they were giving?
     
  27. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    Yes. The barefoot bloggers have been notoriously silent on the dangers of going barefoot in this context. Similar to the potentially life long disabling advice given to a runner who developed posterior tibial tendon dysfunction that I commented on in this thread: The Barefoot Running Injury Epidemic
     
  28. RobinP

    RobinP Well-Known Member

    In most of my consultations, I would reckon that I spend more than 50 % of the time explaining the patient's diagnosis, treatment plan and self help mechanisms (appropriate footwear, good care routines etc). I spend relatively little time actually doing the assessment and a reasonable while documenting all the things I have told them.

    How much does the patient actually absorb?

    Somtimes the grasp it well and understand. Other times they don't "get it" but they are prepared to listen and blindly follow the instructions given. Sometimes they just aren't following and that much is obvious. *cue writing down everything for the patient to take away*

    The most dangerous ones are the ones who nod at all the right points, repeat what you have told them parrot fashion and would appear to be taking it all in. Then they ask the question that they have been waiting to ask for the last 5 mins whilst you have been talking to them. And so busy are they trying to remember and practice the question that they are going to ask, that they have not been listening to a word you said and had they listened would realisee that the answer to the question they were desperate to ask had just been given.

    How do I know this. Because I did the very same thing when I took my son to the doctor the other week.

    We all do it.

    What we are told and what hear can be worlds apart.

    Robin

    "she wrote me a John Deere letter. Said something about me not listening.....I don't really know, I wasn't paying attention" - Dumb and Dumber - Jeff Daniels
     
  29. Boots n all

    Boots n all Well-Known Member

    We make our Diabetic clients getting new shoes sign a "Wearing agreement" that we also read to them, all diabetic clients sign two copies, one for us/records and one to go on their fridge at home.

    Maybe you need to introduce one for your clients, most carers love the idea, the message is in hand and gets home this way, it may end up in the bin but hey it did get home and you never know they may have even glanced at it before tossing it.
     
  30. MyFootCrisis

    MyFootCrisis Welcome New Poster

    Can someone please let me know the pros of going barefoot if you are diabetic. Now I understand from an entirely holistic standpoint meaning that there are many parents that let their children walk around barefoot outside because they are closer to nature, but we are talking about diabetic foot here and there are many great shoes out there to improve those that suffer from it so I just want a quick well rounded argument for going barefoot for those suffering from diabetic foot.
     
  31. David Wedemeyer

    David Wedemeyer Well-Known Member

    There is NO upside, the risk of injury from being barefoot in the at-risk diabetic population and subsequent complications is too grave to even consider this notion. The entire reason that Medicare adopted the Therapeutic Shoe Bill was to educate and protect the at-risk diabetic from potential complications that could result in amputation, so to even consider suggesting going barefoot to at-risk diabetics is ludicrous.
     
  32. DaVinci

    DaVinci Well-Known Member

    Which clearly indicates the idiocy of the advice that was given in this case. It is clear that KW was so blinded by the propaganda of his/her agenda that they did not think through the potentially fatal consequence of their foolishness.
     
  33. Boots n all

    Boots n all Well-Known Member

    Well you could be cold and say there is an upside, another injured foot, another new client, no that wont work either, sorry as stated no upside at all.

    But l would like to point out your statement
    "..great shoes out there to improve those that suffer.."

    Its not so much the shoe as it is the fit of the shoe
     
  34. OneFoot

    OneFoot Active Member

    I dont agree with barefoot walking (or standing, running etc) at all for those with Chronic illnesses and who have high risk feet...

    But....

    Do people find that Pts in Australia seem to always to prefer barefoot walking simply due to heat :( :hammer:
     
  35. Pros and cons of going barefoot if diabetic you say.

    Pros,
    You do this list. I'm all out.

    Cons
    Injury, infection, ulceration, cellulitis, necrosis and amputation would top the list for me.
     
  36. Orthican

    Orthican Active Member

    I think the only "pros" to going barefoot all the time and suffering diabetes is the "prose" that is written in your chart at the first assessment....
     
  37. Craig Payne

    Craig Payne Moderator

    Articles:
    6

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