6 B
SIUSLAW NEWS ❚ SATURDAY, JANUARY 16, 2016
TO YOUR
GOOD HEALTH
Diabetic foot
ulcers deservedly
feared
DEAR DR. ROACH: My father is
an 84-year-old diabetic. He has had a
wound on his foot (on the inner side of
his right foot, near his big toe) for
about five months. He has been treat-
ed by a podiatrist, who has debrided
the wound every week. He prescribed
antibiotics when the wound has
looked infected. A visiting nurse and
my mother have changed and dressed
the wound regularly during these
months.
This week, the podiatrist said he
could see the bone in my dad’s foot,
and recommended hyperbaric treat-
ment. Could you tell me what your
opinion is of this treatment in my
father’s case? Do you know if it has a
high percentage of success? — C.O.
ANSWER: Foot ulcers in diabetes
are common and feared. Diabetes
SALOME’S STARS
ARIES (March 21 to April 19)
Single Lambs looking for romance
could find Cupid especially accommo-
dating this week. Paired partners also
find their relationships benefiting from
the chubby cherub’s attention.
TAURUS (April 20 to May 20)
Keep your keen Bull’s eye focused on
your target, and shake off any attempt
to turn your attention elsewhere. You
should get some news later in the week
that might answer some questions.
GEMINI (May 21 to June 20) Your
early enthusiasm for a project might
have been somewhat premature.
Although you feel positive about it,
you might need more information in
order to make an informed decision.
CANCER (June 21 to July 22)
Taking on a new responsibility might
seem like the politically correct thing
to do. But even with the promise of
damages blood vessels, both large and
small. Also, longstanding diabetes
decreases the effectiveness of the
inflammatory response and immune
system. Finally, poor nerve function in
people with diabetes combines with
these other factors to predispose one
to developing breakdown of the skin
and development of ulcers. These
ulcers can get large and deep, and
when the bone is visible (and some-
times even when it’s not), the bone is
infected. In this case, there is a high
risk of the need for amputation.
By far, the best way to deal with
diabetic foot ulcers is to not get them
in the first place. Good control of dia-
betes, proper footwear, regular checks
by a professional and daily self-
checks of the feet for people at high
risk can reduce the likelihood of
developing ulcers. Early and aggres-
sive treatment of precursor lesions,
even mild redness of the skin,
ingrown toenails or fungal infection of
the feet, should prompt urgent evalua-
tion by a podiatrist.
Once the ulcer has progressed to
the point where your dad’s is now,
aggressive measures are called for. In
addition to care by a podiatrist or
orthopedic surgeon, evaluation by a
vascular surgeon and a wound-man-
agement specialist may be limb- and
even life-saving.
While hyperbaric oxygen has
indeed been shown to be beneficial in
several studies (reducing amputation
rate from 33 percent to 9 percent in
one study), only an expert with
detailed knowledge of your dad’s case
can decide whether this is appropriate
treatment. If you trust your podiatrist,
I think it may well be a useful treat-
ment. However, I would be sure that
he, or a vascular surgeon, has looked
at the quality of blood flow to the foot.
DEAR DR. ROACH: What is your
position on the shingles vaccine for
people in their 70s? We have been told
that some doctors do not approve of it.
Yet we know of so many people who
suffered terribly from shingles. Thank
you. — J.T.
ANSWER: I’ve written about the
vaccine lots of times. I am a strong
believer in it and think anyone over 60
should get it unless they have a med-
ical reason not to. The older you are,
the more important it is to get the shot,
since the complication of pain (pos-
therpetic neuralgia) is so devastating
and tends to lasts longer the older you
are.
support, was it the wisest? Consider
reassessing your upcoming decision.
LEO (July 23 to August 22) Apply
yourself to completing your task
despite all the distractions that might
be interfering with your work. Then
reward yourself with a weekend of fun
shared with people who are close to
you.
VIRGO (August 23 to September
22) A business agreement from the
past might need to be looked at again.
Use this unexpected development to
check out other matters related to it. A
weekend venture proves to be reward-
ing.
LIBRA (September 23 to October
22) Don’t ignore that uneasy feeling
about making a commitment. It could
be a case of understandably cold feet,
or a warning that something isn’t as
right as it should be.
SCORPIO (October 23 to
November 21) A colleague could be
more supporting of one of your efforts.
But it’s up to you to make the case for
it, and that could mean opening up a
secret or two, which might be a prob-
lem for you.
SAGITTARIUS (November 22 to
December 21) Expect some good news
about a relative you’ve been worried
about. But don’t expect the full story to
be told — at least not yet. A workplace
matter might face shifting priorities.
CAPRICORN (December 22 to
January 19) Despite some anxious
moments, you could have good reason
to be pleased with how things are turn-
ing out. An end-of-the-week call might
hold some interesting information.
AQUARIUS (January 20 to
February 18) A long-overdue expres-
sion of appreciation could be offered
soon. But admit it: You never really
expected it would happen, right?
Meanwhile, keep your weekend
options open.
PISCES (February 19 to March 20)
It’s a good time to dive right into a new
challenge, whether it’s learning a com-
puter app, or how to drive a stick shift,
or making a new friend. Whatever it is,
good luck.
Siuslaw N ews
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