Sometimes, ulcers on the lower extremities last for years. In the end, we all pay for it, but the suffering is reserved for the patient. However, when the patient is a young mother that have little ones at home, the picture is more tragical for the patient and the family. Patients that have diabetes usually do know that they should never go for pedicures. However, it is nice and pampering to go. One of my patients, a very young woman, went for a pedicure in her late teen years. A small cut on the heel on the right side was all she got initially. No big deal. Except that she had diabetes. It got infected. She went to the doctor and small cut became a large ulcer. After months of trying to heal the ulcer, she had an autologous graft (skin taken from her from one part and try to cover the defect in the heel). The graft got infected. It was followed by infection in the bone. Weeks in the hospital with IV antibiotics and partial calcaneal removal and external fixator finally controlled the infection. However, the ulcer did not close. Now, twenty years later, the ulcer is still not closed completely. Due to the fact patient had to ambulate and distribute the weight only in one foot, the “good foot” also got a condition termed “Charcot foot” where the bones just break. Multiple surgeries followed complicated by infection in the heel bone in the good foot. Now she has two ulcers, one in each foot, two partial calcaneal amputations- one in each foot. That was a horrible outcome for something that was suppose to be a pampering experience….
