How Oxygen Therapy Works | HBO Therapy

HBO Therapy
If you have a foot ulcer or leg wound that is linked to diabetes, you likely know how long these sores can linger. And, the longer they take to heal, the more vulnerable you are to infection and other risks. Speeding up the healing process is better for your health all around.

That’s where hyperbaric oxygen (HBO) therapy comes in. Research and clinical experiences show this therapy can reduce the presence of certain non-healing wounds. It can also speed up how quickly they improve. The key is increasing the amount of oxygen that reaches injured tissue.

How is HBO Therapy performed?

HBO therapy exposes patients to 100 percent oxygen inside a pressurized chamber that has up to three times the air pressure of our everyday environment. During the session, the lungs are able to take in more oxygen than they usually can, funneling it into the blood stream. That’s critical because more oxygen equals more healing.

What does oxygen do?

Your body’s tissues need oxygen to function properly, and they also need it to fix any problems, such as wounds or sores. During HBO therapy, oxygen dissolves into the body’s fluids, including blood, plasma, and central nervous system fluids. The oxygen can easily be transported through the circulatory system. Once it reaches a foot ulcer or leg wound, oxygen increases the ability of white blood cells to kill bacteria.  It also helps to fight infection, and reduce swelling. Additionally, it helps the body grow new blood vessels that will continue to help oxygen reach injured tissue.

How good are the results?

Recent clinical trials show HBOT can be an effective tool in improving the condition of long-lasting foot ulcers or leg wounds. The Journal of Anesthesiology Clinical Pharmacology conducted a study that followed 30 individuals with chronic non-healing wounds for 30 days. The participants treated with HBO therapy saw a 59% reduction in wound area. Patients treated with more conventional therapies only saw a 26% improvement.

Other studies also showed HBO therapy can improve the condition of these wounds. An additional 12 randomized trials involving 577 people, many of whom reported having diabetic foot ulcers, showed positive results. Based on the study outcomes, patients who received HBO therapy saw foot ulcer improvement at six weeks. HBO also reduced the size of leg vein wounds.

Contact the Amputation Prevention Centers of America if you have any questions regarding HBO therapy.

Causes for Leg Amputation

Leg Amputation

Having diabetes doesn’t mean you’ll definitely face a leg amputation, but it does increase your risk. In fact, nearly two-thirds of limb amputations in the United States are diabetes-related.

According to the American Diabetes Association, while the number of amputations has dropped by half over the past 20 years, there are still 73,000 amputations performed annually in adults with diabetes. Foot ulcers are largely the ultimate cause. Ulcers develop in 15 percent of diabetics, and, of that group, 24 percent end up losing a limb. The risk is two to three times higher for black, Hispanic, and Native American patients.

But, what causes the ulcers that lead to losing your leg? There are several factors that put you at risk, and being aware of these problems can help you minimize their impact.

High Blood Sugar

Blood sugar levels that are too high prompt nerve swelling and scarring. Damaged nerves have trouble sending messages, so you’ll eventually go numb in your lower extremities. Without feeling, you’re less likely to notice sores and wounds on your feet. Left untreated, these spots can become ulcers that develop infections that reach down into your bone and impact your entire foot and leg.

Peripheral Artery Disease (PAD)

PAD is more common in individuals with diabetes. The condition, also called atherosclerosis, clogs your arteries and decreases your blood circulation. Poor circulation makes it harder for any ulcers to heal. Without the proper blood supply, your ulcers will continue to worsen, opening the door that leads to infection and potential leg amputation.

Compromised Immune System

If your diabetes isn’t well controlled, your immune system can’t function properly to fight off the infections that lead to leg amputations. Without white blood cells and sufficient blood supply to attack infection, good, healthy tissue dies. At that point, a life-threatening infection can spread quickly to your bones and joints, making an amputation the only treatment option.

Skin Changes

Researchers from the University of Bristol recently discovered ulcers happen in the lower limbs of some diabetic patients because the connective tissue in the skin actually changes. The tissue renews at a faster rate, making collagen abnormal and skin weaker. Weaker skin breaks down faster and forms ulcers more easily.

Although more research is needed to figure out how common the problem is, the researchers said maintaining low blood pressure, blood sugar, and cholesterol levels is a good way to treat the skin changes. The skin alterations can be undetectable for a long time, though, so don’t wait to control your levels until you see problems.

Reduce Your Risk, Control Your Blood Sugar

There are things you can do to limit your amputation risk, however. The biggest step is controlling your blood sugar — keep it at 80-130 mg/dL before meals and 180 mg/dL after eating. Include lean meats, fruits, vegetables, fiber, and whole grains in your diet, and avoid sugar-sweetened juice and soda. Exercise 30 minutes daily. Maintain a healthy weight and blood pressure (less than 120/80), and take your diabetes medications as directed.

Contact Us to Learn More on Causes for a Leg Amputation

Overall, remember that having diabetes doesn’t mean you will lose a limb. Work with your doctor to keep your diabetes under control and ensure your feet are as healthy as possible. If you have any questions or concerns, you can also contact us at Amputation Prevention Centers of America.

Get Your Blood Flowing: Improving Circulation with Diabetes

improving circulation
Your first thought about managing your diabetes might be controlling your blood sugar. But, don’t forget about improving circulation. Your blood needs to pump smoothly so your feet and legs stay as healthy as possible.

If you’re feeling numbness, tingling, or cramping in your feet, peripheral arterial disease (PAD) could be to blame. This condition, that narrows and hardens arteries due to fatty plaque build-up, affects between 8-12 million Americans, and approximately one-third of individuals with diabetes over age 50 live with it.

Poor blood flow plays a large role in the 73,000 amputations that occur among people with diabetes annually, so improving circulation could not only improve how your legs and feet feel, but it could also save you from losing an extremity.

Consider taking these steps to improving circulation:

Exercise: Engage in some form of cardiovascular activity for 30 minutes five days a week to keep your blood pumping. Biking, walking, running, swimming, and aerobics are good options. The most important thing is to be sure you’re moving your toes, feet, ankles, and legs.

Quit smoking: Smoking hardens your arteries, much like PAD, and decreases your circulation. Stopping can help improve how well your blood reaches your legs and feet.

Control your cholesterol: High cholesterol can narrow and harden your arteries, limiting your circulation. Talk with your doctor about what your optimal cholesterol numbers are and shoot for lower.

Keep blood sugar low: Managing your blood sugar levels is also important to maintaining healthy blood flow. Keep your levels between 80-130 mg/dL before eating and under 180 mg/dL after eating. Pay attention to your A1C levels, too, though. The target level for people with diabetes is 6.5 percent.

De-stress: Not only does stress increase your heart rate, blood pressure, and blood sugar levels, but it also sends more blood to your brain, heart, and skeletal muscles. Conscious muscle relaxation, deep breathing, and visualizing comfortable situations, such as using the WarmFeet technique, can lower your heart rate and blood pressure, increase your body temperature, and route blood to more areas of the body, including your extremities. In fact, WarmFeet has been clinically proven to increase circulation and heal foot ulcers.

Wear diabetic compression socks: Compression socks apply pressure to your calves and feet, straightening out your veins so the valves work better and let more blood flow through. Be sure any socks you choose won’t wrinkle and offer extra padding and flat seams. Socks made from acrylic, merino wool, bamboo, and charcoal mixed with spandex minimize the abrasiveness on your feet and decrease the amount of moisture that could come in contact with any foot sores you might develop. Compression socks range from extra-light to extra-firm pressure. Talk with your doctor about what would be best for you.

Take medications correctly: If your doctor prescribes blood thinners, take it as directed. It can’t stop the build-up of plaque on your arteries, but it can improve your circulation.

 

Following these suggestions could help you avoid the negative impacts of poor circulation. The more freely your blood flows, the less pain, discomfort, numbness, and cold temperatures you’ll experience in your feet and legs.

Contact the Amputation Prevention Centers of America for more information on how to improve your circulation.

Low Blood Flow: The Cold Truth About Poor Circulation Leading to Diabetes

Poor Circulation

If your hands and feet stay cold, perhaps even numb, it’s an almost sure sign you have poor circulation. While decreased blood flow can be a symptom of several medical problems, one of the most common is diabetes.

The symptom might seem mild, but if left unchecked, poor circulation puts you at risk for limb, heart, kidney, brain, and eye damage.

Consequently, it’s important to know how your poor circulation developed and how you can improve the condition.

How Does Diabetes-Related Poor Circulation Happen?

  1. Diabetes can lead to poor circulation in several ways. In many cases, high glucose levels can be the culprit. Over time, high glucose levels in your blood can cause damage to the lining of your small blood vessels, impeding your circulation.
  1. Diabetes also increases your risk of peripheral arterial disease (PAD). Based on data from the American Diabetes Association, 1 in 3 people over age 50 with diabetes has PAD. The fatty deposits common to this condition narrow the blood vessels, mainly in your legs and feet. As this happens, your chances of having a stroke or heart attack rise significantly.

 

Identifying Poor Circulation

Diabetic neuropathy — cold or numb hands or feet — is a common sign of poor circulation in diabetes. However, according to United Kingdom-based Global Diabetes Community, you should alert your doctor if you experience these symptoms, as well:

  • Pain when walking, particularly in calves, thighs, and buttocks
  • Chest pain during exertion
  • High blood pressure
  • Infections in your feet
  • Trouble seeing
  • Hair loss on legs or feet
  • Dry, cracked skin on feet
  • Slow-healing wounds on feet
  • Brittle toenails
  • Erectile dysfunction

 

Can You Improve Your Circulation?

Yes, you can. According to The Diabetes Council, there are several things you can to do improve your blood flow.

  • Exercise is one of the best ways to improve blood flow to your hands, feet, legs, and other parts of the body. At least five days a week, try to bike, run, walk, swim, or get some other type of aerobic exercise for 30 minutes. In fact, according to the United Kingdom’s National Health Service, exercising consistently for 6 months can produce a 20-percent improvement in ankle blood pressure. This reduction points to PAD improvement, as well as increased circulation.
  • Keep your blood sugar levels under control. Aim for keeping your blood sugar at the levels recommended by the American Diabetes Association for both before and after meals.
  • Control your blood pressure and cholesterol levels, trying to maintain levels recommended by the American Heart Association. Take medication, if necessary.
  • Wear warm diabetic (compression) socks. If your feet can’t feel temperature, avoid putting them in a hot bath.
  • Check your feet daily for any injuries.
  • Lose weight.
  • Stop smoking.

Pay attention to what your body tells you. If you start to develop symptoms of poor circulation, talk with your doctor or contact the Amputation Prevention Centers of America. Addressing the problem early could prevent infections, amputations, and worsening cardiovascular health issues.

What’s Behind that Non-Healing Wound? | Living with Diabetes

non-healing wound

A non-healing wound that lingers can be annoying, but it should also be cause for great concern — especially if you have diabetes or are in the early steps of developing the disease. Chronic non-healing wounds, especially those that won’t heal within three months, can impact you more frequently and more significantly.

According to the Centers for Disease Control & Prevention, chronic wounds affect approximately 5.7 million adults, leading to nearly $20 billion in medical care costs. Knowing why these long-lasting sores develop can not only improve your health, but it could also reduce your medical expenses.

How Diabetes Puts You at Risk with a Non-Healing Wound

Diabetes does increase the likelihood that you’ll develop a chronic wound at some point. These sores frequently start small, such as a small pimple or scratch. However, even after repeatedly scabbing over, they won’t heal. If you notice this type of wound, contact your doctor for medical attention immediately.

According to the Cleveland Clinic, there are three factors that increase your risk for developing a chronic wound:

  1. Neuropathy: Having limited feeling in your feet makes it harder to notice any small cuts or trauma to your feet. This increases your infection risk and can lead to a chronic wound.
  2. Poor blood flow: Poor circulation limits how well your blood can bring the cells to your wound that can increase your likelihood of healing.
  3. Infection: With diabetes, it’s harder for you to fight off infection. If your wound becomes infected, it could progressively worsen, putting you at risk for amputation.

 

Reducing Your Risk with Non-Healing Wounds

Although having diabetes makes you more vulnerable to chronic wounds, you can take steps to decrease your chances or bolster your healing abilities.

  • Proper footwear: Choose properly-fitted shoes that won’t create sores on your feet. Avoid pointed-toe shoes or ones that are too flat or high heels because they make it harder to distribute your foot pressure. Soft insole leather, canvas, or suede shoes will let your feet breathe, and laces, buckles, or Velcro will make adjusting shoes easier.
  • Manicure your toenails: Be sure to keep your toenails cut short. Longer nails put you at risk for scratches you might not be able to feel. Visit a podiatrist for foot care.
  • Control your blood sugar level: Actively monitor your glucose. If you’re pre-diabetic, make healthy food choices and exercise to control your weight and blood sugar levels. Your doctor could conduct an A1C test, measuring the percent of blood sugar attached to your red blood cells, to determine your blood sugar level over the past 2-3 months.
  • Eat well: Stay hydrated, and eat complex carbohydrates that help control your blood sugar, such as whole grains and vegetables. Also, be sure to eat enough protein because it supports new cell and tissue growth needed for wound healing. Chicken, fish, turkey, eggs, yogurt, peanut butter, and cheese are good options. Limiting your fat intake can also improve your immune system.

Ultimately, you need to take a chronic wound seriously. Don’t delay treatment — see your doctor or contact the Amputation Prevention Centers of America as soon as you notice a non-healing wound or sore.

Treatment for Wounds: Breathe in Healing | Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy

If you have diabetes, chances are you’re struggling with several factors affecting the health of your lower extremities.  You could have vascular disease, peripheral neuropathy, or swelling.  In addition, you could be dealing with poor nutrition.

All of these complications can damage the healthy tissues in your legs and feet, potentially leading to chronic wounds that don’t heal and increase your risk of amputation.  Getting more oxygen to those tissues can be an effective weapon in battling those wounds.  Among other therapies your doctor might suggest, hyperbaric oxygen therapy (HBOT) that increases your blood oxygen level can be a useful treatment option that can promote natural-healing.

What is HBOT?
HBOT is an outpatient therapy during which you breathe 100-percent oxygen in a pressurized room or chamber. Air pressure is up to three times higher than normal, increasing the amount of oxygen transported to the blood stream.

How does HBOT work?
The increased pressure forces oxygen to dissolve into your blood — up to 10-13 fold increase. With more oxygen in your blood, your body can fight off infection better, stimulate the production of stem cells for greater healing, and can prompt the growth of new blood vessels to wounded tissues.

During the treatment, you might feel a fullness in your ears similar to being in a plane or in a high elevator. Yawn to alleviate the pressure.

How long does hyperbaric oxygen therapy last?
Most sessions last between 90-120 minutes. During the first 5-15 minutes, your hyperbaric technician will change the atmospheric pressure in the chamber to feel like you’re between 33 and 45 feet under water. You’ll stay at that pressure for roughly 60-90 minutes, and your doctor will return the pressure to normal during the session’s final 5-15 minutes.

How many HBOT treatments will you need?
The number of sessions depends on the condition you’re treating. For non-healing wounds, you’ll likely need somewhere between 20-40 sessions.

How will you feel after HBOT treatment?
Post-treatment, you might feel tired and hungry; however, it’s safe for you to return to your normal activities.

What are the risks of HBOT?
Prior to your hyperbaric oxygen therapy, your physician will discuss with you potential risks and side effects. Most patients experience no side effects from HBO therapy. However, some patients may feel ear discomfort or sinus pressure.

What are the benefits of HBOT?
HBOT increases the amount of oxygen delivered to your tissues that don’t get enough, and it can reduce swelling. This can be helpful if you have poor circulation due to diabetes. Additionally, higher oxygen levels help your body produce more white blood cells to kill bacteria, and it can maximize the effect of some antibiotics.

To learn more about hyperbaric oxygen therapy or about the Amputation Prevention Center of America, please contact us today.

 

Sources:
1 https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380

Side-Stepping Amputation: It’s All In Your Feet | Diabetes

Amputation Prevention with Diabetes

Diabetes Amputation Prevention

Amputation is a serious risk when you have diabetes. In fact, your risk is 28 times higher than someone without the condition.

Most amputations are lower limb — toes, feet, below the knee, and above the knee. And, the risk is greatest for men, older adults, and non-Hispanic black males.

Fortunately, you can limit your risk. Control your blood sugar, exercise daily, and take your medications correctly. But, the most important thing you can do is take care of your feet.

Inspect your feet: Check your feet daily for sores, redness, blisters, calluses, ingrown toenails, numbness, open sores, or any temperature changes or hair loss. If you can’t see the bottom of your feet easily, use a mirror.

Wash your feet: Use a mild soap and warm (not hot) water. Dry your feet well, especially between your toes, and apply a non-alcoholic lotion to your feet. It keeps your feet soft and prevents cracks that let bacteria into your skin. Don’t put lotion between your toes as it can cause blisters, and don’t soak your feet because it can dry out your skin.

Cut your toenails: Cut your toenails straight across with straight clippers, and file down sharp edges. Apply foot powder, such as talcum or corn starch, to your feet, if desired.

Wear socks: Choose soft, seamless, padded socks to avoid sores and blisters. Make sure they don’t pinch or rub. They should be loose enough around the top so they don’t cut off circulation. Also, choose socks that pull sweat away from your skin, such as cotton or special acrylic. Avoid nylon.

Pay attention to shoes: Change shoes at least once daily to side-step pressure points. Check your shoes regularly for pebbles or sharp objects, and make sure they have enough cushioning for the heel, arch, and ball of your foot. Select shoes with enough room for your toes, and if your feet are two different sizes, buy the larger shoes. Don’t wear sandals or flip flops, and don’t go barefoot — even at home.

Leave calluses alone: Don’t attempt to remove calluses or foot lesions by yourself. Avoid using nail files, nail clippers, or scissors, and don’t apply chemical wart removers. Instead, see a podiatrist for expert care.

Quit smoking: Smoking constricts your blood vessels and limits oxygen to your extremities. Poor circulation is a large contributing factor to amputation risk.

These steps go a long way toward helping you avoid amputation, but know when to seek medical care. Contact your doctor if you develop these signs of trouble:

  • Ingrown toenails
  • Blisters
  • Plantar warts on the soles of your feet (flesh colored bumps with dark specks)
  • Athlete’s foot
  • Swelling
  • Redness
  • Discolored skin
  • Warmth in one area
  • Pain
  • Foul odor
  • Ulcer lasting longer than 2 weeks
  • Ulcer bigger than ¾ inch
  • Ulcer so deep it exposes bone
  • Sores than don’t heal quickly

Following these steps and seeking care when needed can improve your long-term mobility, increase your quality of life, and, potentially, increase your life expectancy.

Contact us today to learn more about Amputation Prevention Centers of America.

 

Sources:
1 https://www.thediabetescouncil.com/diabetes-and-amputation-everything-you-need-to-know-to-avoid-amputation/
2 https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5043a3.htm

How Eating Well Keeps Your Feet Healthy

We all know that eating well is good for us. Consuming more leafy greens, colorful fruits and vegetables, salmon and sardines, beans, legumes, and whole grains improves our health and well-being. So does eating lean protein, good fats, and limiting sugar.

But what does that have to do with our feet? A lot, it turns out. Eating nutrient dense foods can help protect our feet from one of the most serious complications of diabetes — foot ulcers.

Maintaining a Healthy Weight Matters

Why, you ask? Good nutrition helps you lose and keep off excess pounds. And that helps prevent nerve damage, blood sugar fluctuations, obesity, and high blood pressure — all of which put you at greater risk for foot ulcers and impairs your body’s ability to heal itself.

The Role of Nerve Damage in Diabetic Foot Ulcers

Prolonged high blood sugar can cause nerve damage (neuropathy). Carefully monitor your blood sugar keeping it as close to normal as possible. Keeping it at a safe level protects the nerves throughout your body including your feet.

Nerve damage is a major cause of diabetic foot ulcers. It often occurs when your blood sugar is not controlled, you have high blood fats, high blood pressure (hypertension), and are overweight. It can start as tingling and progress to pain. Then you can lose feeling. Blisters and sores can go unnoticed if your foot is numb.

Reduce Your Risk Factors

Smoking, excess alcohol, high blood pressure, and poor circulation in your legs and feet (peripheral arterial disease) also increase your risk for diabetic foot ulcers.

If you smoke, quit. It’s the only solution if you want to protect your feet. Here’s why. Smoking depletes the body of essential nutrients: vitamins, minerals, and antioxidants that help prevent disease.

What’s more, smoking narrows small blood vessels and hardens them. That means your feet do not get enough blood and nourishment they need, so they are less able to fight infection and heal.

Many people with diabetes who require foot amputation are smokers.

Limit alcohol consumption. Excess alcohol damages your nerves and blood vessels — two major risk factors for foot ulcers — and greatly increases the likelihood that you will get an infection.

If you have high blood pressure (hypertension), work with your doctor to lower it. High blood pressure damages your blood vessels. They thicken, stiffen, and build up fat reducing blood flow and healing nutrients to your feet. Eating less animal protein and eating more plant-based, nutrient rich meals helps reduce blood pressure.

If you have poor circulation in your legs (peripheral arterial disease or PAD), the large vessels in your legs are partially blocked limiting blood flow to your feet. Eating a healthy diet, quitting smoking, and exercising can help treat poor circulation.

The Bottom Line

Eating a nutrient rich diet can save your feet — and your life. Half of all people with diabetes who require foot amputation are dead within two years of losing their feet.

Luckily, you can train your brain and your taste buds to adopt a nutritious diet.

Need help inventing nutrient dense menus that you will enjoy? Talk with a registered dietician to create delicious, nutritious meal plans that match your tastes and lifestyle.

Your feet will thank you.

Diabetes

What are diabetic foot ulcers?
Often people ask me, “What are diabetic foot ulcers and why are they so harmful?” So I am here to help you understand what they are, why they occur, and why they can be dangerous.

What is a diabetic foot ulcer?
A diabetic foot ulcer is an open sore on your foot that fails to heal. They often occur on the bottom of your feet but can occur anywhere skin or tissue breaks down or is cut open.

Why do diabetic foot ulcers occur?
Normally, if you injure your foot, you feel pain that alerts you to the injury. You then take steps to treat it: clean the wound, apply a bandage and perhaps ointment, and replace poor fitting shoes if that is the underlying problem. Your body continues the healing process and your foot heals well.

But when you have diabetes, your natural healing process and pain reflexes can be disrupted. If you develop poor circulation in your legs and feet (peripheral arterial disease or PAD), have high blood sugar, or both, healing slows down.

If you have nerve damage (peripheral neuropathy), your feet may feel numb. Or you may have no feeling at all. In either case, the injury may be painless. When that happens, blisters, cuts, and sores can go unnoticed. That’s when serious problems can begin.

Why are diabetic foot ulcers so harmful to me?
Diabetic foot ulcers can be downright dangerous. They are the leading cause of amputation and hospitalization when you have diabetes.

If infection spreads throughout your body, or severe ligament, muscle, and bone damage occurs, amputation may be necessary. In less severe cases, you may need surgery to remove tissue that has died.

In the best circumstances, it takes weeks to several months for a diabetic foot ulcer to heal.

Having diabetes puts you a much greater risk for a foot ulcer. Once you have had one, you are more likely to develop another.

What can I do to prevent them?
Although preventing a diabetic foot ulcer is not always possible, you can take steps to reduce your risk.

Here are my 6 basic rules to help prevent diabetic foot ulcers:

  1. Keep your blood sugar at your target level throughout the day.
  2. Practice daily foot care. Wash, thoroughly dry, moisturize (except between toes), and carefully inspect your feet every day. Use a mirror or helper if needed.
  3. Eat a healthy diet as advised by your doctor and dietician.
  4. Keep your toenails trimmed, cutting straight across.
  5. Have a podiatrist remove corns and calluses.
  6. Always wear well-fitting shoes and clean, dry socks indoors and out.

Most important, talk to your doctor right away if you have any foot sore or foot problem that does not heal promptly. Report any breaks in your skin and any changes in the feeling, shape, or color of your feet.

Early treatment is key to preventing infections and serious complications.