Members do not see these Ads. Sign Up.

I have recently seen a self referred 72yr old female with stable type 2 dm no sensory neuropathy complaining of difficulty managing her feet lately due to reduced mobililty .
She has bilateral hav with medial hd on right foot both 5 pipj hd plantar 1 mtp left which are being aggravated by footwear, slight oedema and pvd. she is reluctant to change from a slip on with narrow toebox as an injury to the right dorsum years ago after dropping “something” on it makes it uncomfortable to wear footwear which extends proximally.
I see a sleeve which has gel in the dorsum on the simply feet catalog

http://www.simplyfeet.co.uk/p-2240-gelx-gel-double-protector-sleeve-1.aspx


and wonder whether this might be helpful to get her into more accommodative shoes? Does anyone have any experience with this dressing or could recommend alternatives please

 

l have not used this idea/product before but l like it, provided the top line elastic does not cause any problems, something to keep an eye on.

After a week or two of wearing that she made be more inclined to look at a real shoe

Good luck

 

Hi Magda

Sometimes people are very stubborn, especially the elderly! They often the see going into "Old Lady"shoes" as another step toward decrepitude; but when they have "Old Lady" feet then there is no other answer. But who wants to wear frumpy styles when you have been used to something with a bit more about it, specially women?

Perhaps a bit of psychology is needed here. You could obtain as many wider fit shoes catalogues as possible ( Hotter DB Widerfit which are the more conventional or Baer shoes which are exquisite german made footwear etc) . Let her have the catalogues and she can come to her own decision, with very subtle pressure from you.

Let her see the sort of "sensible" shoes you wear, and emphasise the bliss of being comfortable.

There are plenty of shoes around with low vamps and spacious toe boxes. Many have a velcro fastening which would accomodate the various degrees of oedema through the day.

However having said all that I find many patients moan about their feet and seem to enjoy that much more than doing something about their footwear, even diabetics.

Good Luck

 

Why not try and orthopedic shoe (extra depth) with a stretchable vamp. There are brands that make these that are slip on, clog style. I have never used this specific gel sleeve, but have seen patients that wear gel socks. You have to be careful with these products because they can cause the shoe to fit tighter.

The other thing to think about is if this patient has edema secondary to PVD, you don't want something to tight around the ankle to cause increased edema above the gel sleeve. Some of these products fit pretty snug.


Joe Eads, C.Ped

 

hi itchyfeet

thanks for that i'd like to get some baer catalogs but google comes up with india when i google "baer shoes" tried "baer shoes and german" but that comes up with bar shoes- trainers. are those what you mean? i'm interested in them for myself, however she's a little old lady who goes to church every day and has never worn trousers so i don't think i'd have a chance of going down that road with her.
mayre

 

hi joe
thanks for replying. the tightness was what was of concern to me too, but i liked the look of it as it doesn't extend down into the toebox which is where she has the lesions.i wondered whether maybe people had tried it sucessfully or not before i proceeded to recommend it to her, hence the posting.
"Why not try and orthopedic shoe (extra depth) with a stretchable vamp" do you mean something like the cosyfeet stretchy shoe dominic or susan? or is there any other you'd advise

mayre collins bsc hons podiatry

 

The cosey feet shoe will do. It will conform nicely to the patients foot unlike a leather shoe. So if you try the gel sleeve and the shoe fits snug thats the way to go as long as the patient is ok with the look of the shoe. :D


Joe Eads, C.Ped