Getting A Safe Manicure/Pedicure

 In the interest of researching how thoroughly mani-pedi establishments sterilize their instruments, I donned my very best undercover-I-am-not-a-foot-care-nurse disguise and conducted an informal survey.  I walked a distance of about 1.5km on a busy Toronto street and counted 12 mani-pedi places and 2 more that had closed down. 

Bacterial, viral and fungal infection risks are present with any procedure that can potentially break skin, such as accidentally cutting a client with improperly sterilized nail or cuticle nippers.  Transmission may also occur between client-technician through improper glove use by the technician.  Infection risks are even greater and have more serious effects for diabetics and anyone with lower immunity or circulation issues.

At all 12 places, staff were happy to answer my questions about how they clean their instruments and soaking tubs.  Each place said they use bleach or isopropyl alcohol to soak instruments and soaking tubs.  About half use a UV light machine after chemical soak, a couple of places have an ultrasonic machine to soak instruments, a few just use soaking, and only one establishment has an autoclave sterilizer. 

 All establishments claim to have been passed by the Toronto Public Health.  Although I didn’t ask to see documented proof of this, no one voluntarily showed me any documentation and no one has a certificate of approval on display. 

In preparation for this survey, I did some preliminary reading of Canadian sources.  The first study I read was the Survey of Infection Control Procedures at Manicure and Pedicure Establishments in North York, published in the Canadian Journal of Public Health, March – April, 2001.  The second study was Personal Service Establishments:  Looking at Infections Risks, by Prabjil Barn and Tina Chen at the National Collaborating Centre for Environmental Health Seminar, October 27, 2011 for the British Columbia Centre for Disease Control.

Disinfection is not the same as sterilizing. Disinfection eliminates all pathogenic organisms except bacterial spores.  Bacterial spores may revert back to the multiplying form of the bacteria and cause infection.

Sterilizing destroys all pathogenic organisms, including spores.

Isopropyl alcohol and solutions that contain quaternary ammonium materials are used in mani-pedi places as a chemical cleaner. According to both studies,  they are all classified as low-level disinfectants and should not be the only method of cleaning instruments which can pierce the skin, such as nail and cuticle nippers.  Their efficacy also depends on the amount of time instruments are soaked or how well tubs are wiped down.

 UV light machines and a glass bead sterilizers are not approved methods of sterilization and should be discouraged, according to the North York survey of mani-pedi establishments, and seconded by the Barn and Chen study.  

The only establishment that properly sterilizes their tools is the one with the autoclave sterilizer.   At McDermott Footcare, autoclave sterilization is the method we use as well.

Each place claimed that the method they use thoroughly sterilizes their instruments and soaking tubs.  It seems that the people I spoke with don’t know the difference between disinfecting and sterilizing, which indicates a lack of knowledge in this area.

How can we be assured of a safe manicure/pedicure?

  • find a place that uses an autoclave sterilizer, not a UV light machine or glass bead sterilizer and not an ultrasonic machine for soaking.  Only an autoclave will eliminate all pathogenic organisms including spores.
  • find out if all tools, files and sponges used on you are autoclaved between clients
  • make sure the technician uses gloves while working with you.  If he/she attends to another client at the same time, make sure the gloves get changed between clients.
  • Do not let the technician push back your cuticles or cut them.  Cuticles are the main line of defense that prevent bacteria and fungus from infecting the nail bed.  Read about fungal infections, here.
  • ask if you can bring your own tools to use.  If using your own personal tools, there is no need to autoclave because you are not sharing them with anyone else.

In Toronto, Canada, mani-pedi establishments are not regulated; there is no set protocol or best practice guideline for disinfecting and sterilizing.  It might be the same where you live.  Check with your Department of Health.

I went back to the only establishment that had an autoclave sterilizer and got a pedicure.  It was the one place where I felt that I could get a safe pedicure. The technician honoured my request to not push back or cut my cuticles after I explained that cuticles protect the nails from bacterial and fungal infections.  I never did tell them that I’m a certified foot care nurse. 

Buyer beware.  A representative from Toronto Public Health told me that since they do not regulate mani-pedi establishments, the onus is on the consumer to ensure their health and safety.   Know the risks.  Ask questions.  Protect yourself.

*I’m linking this post to http://www.findafootnurse.com/.  Find A Foot Nurse.  Check it out!

Foot Care for Bunions (Hallux Valgus)

A bunion (or hallux valgus deformity) occurs when a bony growth develops at the base of the big toe.  As the growth becomes bigger, the toe becomes misaligned and starts to lean into the other toes.   The second toe often develops into a hammer toe due to impingement from the big toe.  The joint between the base of the big toe and the ball of the foot, called the first metatarsophalangeal joint, becomes inflamed and painful.  The bursa, which is the fluid-filled sac next to the joint, can also become inflamed, leading to swelling, redness and pain.  This condition is known as bursitis. 

Although bunions most often develop at the base of the big toe, smaller bunions sometimes develop at the base of the small toe.  This is a Tailor’s bunion.

What causes bunions?

Some statistics claim that the ratio of women to men who develop bunions is 10:1.  The biggest cause is footwear.  More specifically,  the shoes in question have a narrow toe box that push the toes together and high heels that put stress on the metatarsophalangeal joints.  For more information on the effects of high heels, read here.  Heredity can be a factor.  Medical conditions that affect the joints, such as arthritis, cause it as well.

Caring for bunions:

Shoes that accommodate the bunion are a must.  The toe box should be wide enough to comfortably fit the width of the forefoot and there must be wiggle-room for the toes.

It is never a good idea to cut a hole at the side of the shoe to provide more room for the bunion.  A hole in the side of the shoe can irritate the skin around the bunion or cause herniation of the inflamed bursa – ouch!

Padding can be cut to protect the bunion and make walking more comfortable.  At McDermott Footcare, I cut special padding specific to the size and location of the bunion that cushions it inside the shoe.

Toe spacers placed between the first and second toes keep them from rubbing against each other and realign the big toe.  A bunion brace or splint may be worn at night for realignment.

A person who has bunions often benefits from custom-fitted orthotics.  A podiatrist or chiropodist provides this service.

Medical Treatment of Bunions:

The pain and discomfort from an inflamed bursa next to the metatarsophalangeal joint may be relieved by oral anti-inflammatory medication such as ibuprofen.  Before taking anti-inflammatories,  check with your doctor first if you are taking any other prescription medication.  And always take them as directed.  Ice packs provide relief as well.

For persistent bunion pain, surgery is an option to discuss with your doctor.  An osteotomy realigns the joint.  Arthrodesis surgery removes damaged parts of the joint.  The most common procedure is a bunionectomy which shaves off the bony growth.  This surgery is not always successful and the big toe may return to its deviated position post-surgery.

Preventing bunions:

The best way to care for bunions is also the best way to prevent bunions.  Proper footwear is the first line of prevention.  A wide toe box, wiggle room for the toes, a low heel; these are what to look for in an everyday shoe (read here for more on shoes and socks).   While this advice applies mostly to women, men would do well to use the same guidelines for footwear.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Care of Corns and Calluses

Corns and calluses can cause much discomfort and frustration for clients seen by McDermott Footcare.  Clients often say that the pain caused by corns and calluses limits their participation in daily and social activities.

What is a corn?

A corn, or heloma, is a thickened area of dry skin that has a visible centre, or nucleus, at the area of greatest pressure.  It is caused by direct pressure from shoes upon a bony surface of the foot.  The centre, or nucleus, presses on nerve endings in the skin.  If it is large enough, it can be quite painful.

Soft corns form between toes, caused by direct pressure from neighbouring toes.
In this case, the skin between the toes is moist.

In the picture, two large, painful corns are visible – one on the ball of the foot underneath the third toe and one on the tip of the fourth toe.

What is a callus?

A callus (tyloma) is an area of hardened skin caused by shearing friction – a constant rubbing back and forth – over the heels, balls of the foot and along the sides of bony areas of the foot.  The hardened areas may be whitish, yellowish or brownish in colour.  The picture shows callus formation around the corn on the ball of the foot, on the area underneath the big toe, and on the side of the big toe.

Common Causes of Corns and Calluses

  • ill-fitting shoes are the biggest culprit – shoes that are too tight, too small, too big, too high, squish the toes, lack cushioning, have seams that rub against the foot
  • structural deformities of the foot such as hammertoes and bunions that rub against the inside of the shoe.  Part of the problem are shoes that don’t accommodate the deformity.
  • walking too much on the outside of the foot (oversupination)
  • walking too much on the inside of the foot (overpronation)

Preventing Corns and Calluses

  • wear supportive, well cushioned shoes that fit well.  Wear socks that absorb moisture.  For tips on buying shoes and socks, read here.
  • daily washing, exfoliating and moisturizing the feet
  • if overpronation or oversupination is a concern, a chiropodist or pedorthist can fit you with corrective orthotics

Home Remedies for Corns and Calluses

Home remedies for treating dry, cracked heels work well for getting rid of corns and calluses since both are caused by a build-up of dry skin.   Read 8 tips for dry, cracked heels here.

Avoid over-the-counter medicated corn and callus pads since the acid in these pads can irritate healthy skin around the affected area.  A u-shaped, unmedicated pad is fine for corns since it avoids putting direct pressure on the area. Using razor blades and other sharp objects to cut away corns or calluses is just plain unsafe…..enough said.

Corns and Calluses in Diabetics

Diabetics must be extra careful with corns and calluses.  Because of poor circulation and decreased nerve functioning in the feet, diabetics have an increased risk of infection from corns and calluses.  The same applies to anyone who is not diabetic but has poor circulation or decreased nerve sensitivity in the feet.   Self-care of corns, calluses and other foot problems could put you at risk for infections and trauma.  Seek out the care of a certified foot care nurse who is trained in diabetic foot care such as at McDermott Footcare.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Tennis Ball Foot Massage

We’ve all had those days…………….on our feet all day, shoes feeling two sizes too small by the afternoon, feet throbbing in pain………can’t wait to get those shoes off and give our feet a little lovin’.

There are 26 bones and 2 sesamoid bones in each foot.  Along with that, more than 100 ligaments, muscles, tendons and 33 joints are in each foot.  Add to that an abundant nerve supply. Now, take all those various parts and cram them into shoes that pinch our toes together, don’t give enough support or cushioning, don’t breathe, and abuse our feet in so many ways.  On any given day, our feet absorb about 1000 tons of force, mostly from hard surfaces.  No wonder they hurt at the end of the day!

All McDermott Footcare clients get a soothing foot massage. They love it!  In a perfect world, there would be an incredibly gifted masseuse waiting for me after a long day with the sole purpose of giving me a soothing foot massage.  Alas, I don’t live in a perfect world and I’ll bet most of you don’t either.

What do you do if there’s no one to give you a much-needed foot massage or if the person who’s rubbing your feet can’t get it right?  Enter the tennis ball.  Yup, the common, green, fuzzy staple of tennis courts and school yards everywhere is an excellent piece of foot care equipment. 

Soothe your overworked arches and caress the balls of your feet and heels by placing your foot on the ball and rolling the ball back and forth and side to side.  You can easily adjust the amount of pressure you put on your foot.  And, it’s convenient.  Give yourself a foot rub while eating, going online, watching TV, anytime you’re sitting or standing in one place.  Did I mention how inexpensive it is?

The tennis ball foot massage is great for runners, hikers, all sports enthusiasts who are hard on their feet.  Anyone whose job requires standing and/or walking for long periods will find it helpful.  People with plantar fasciaitis will find it very soothing.  All sizes of feet can use it.  It’s a must-have for anyone whose feet need a little TLC.  As the weather warms up, I’ll be spending less time on my elliptical and more time walking outside.  My trusty tennis ball, along with really good walking shoes and socks that wick away moisture, will not be far away. 

Give it a try.  I think you’ll like it. There is one caution, though:  don’t share your tennis ball if you have Athlete’s Foot (read this) or fungal toenails (here).  In fact, don’t share it at all.  Tell them to get their own tennis ball 😉

All About Toenail Fungus

Fungal toenails were the main concern of everyone seen by McDermott Footcare this week.  Everyone from the 30-year-old professional to the octogenarian needed help with toenail fungus, a.k.a. onychomycosis.  Toenail fungus doesn’t discriminate against age and there are many causes for it.

Anatomy of a nail:

To understand how a nail becomes fungal, we need to know the structure of a nail.  Anatomically, a toenail and a fingernail are the same.  The nail plate is the part that needs clipping every 6 weeks or so.  Underneath is the nail bed which is protected by the nail plate. The cuticle (eponychium) is the narrow band of skin at the base of the nail plate; it is a protective barrier, preventing  fungus and bacteria from entering the nail bed.  The  nail root (matrix), at the base of the nail bed underneath the cuticle,  is where nail cells form.  The end of the matrix is the white, half-moon shaped area (lunula) at the base of the nail.

How nails become fungal:

Onychomycosis is caused by the same dermatophyte as Athlete’s Foot.   Athlete’s Foot and Onychomycosis can be caused by the same factors (read here). 

Anyone with poor circulation to the feet, including diabetics and people with heart and vascular conditions are more susceptible.  People with weakened immune systems because of illness or medication use are at a greater risk.

Anyone who has regular pedicures may be at risk.  During a pedicure, the cuticle is pushed back.  This damages the cuticle and makes it easier for fungus and bacteria to infect the matrix where new nail cells form.  Are the pedicure and manicure instruments sterilized (read here) by autoclave?  Nail fungus is very contagious.  The Ontario Ministry of Health and Long-Term Care mandates that these instruments be autoclaved.  Ask the salon if they autoclave – buyer beware.

What does toenail fungus look like?

Onychomycosis starts off as a small area of whitish or yellowish discolouration in one corner of the toenail. This picture shows mild toenail fungus.  As it spreads, the area of discolouration becomes larger and the nail becomes rough and thickened.  You may notice a darker colour under the nail because of debris that has collected.  The nail plate may separate from the nail bed. If bacteria are involved in the infection, there will be a slight odour. 

Treatment:

 Over-the-counter topical medications may or may not work.  Your doctor may prescribe a stronger topical medication but even that will take months of regular use.  Oral medications may be prescribed for diabetics or those with other medical conditions.

The vinegar – water soak I talked about in (this) previous blog  is a home remedy that has been shown to work if used constantly over many months.  Eating a healthy diet will boost immunity and help to fight the infection.  Probiotics which are added to certain foods such as yogurt may help.

Tea tree oil applied to a piece of cotton and used to clean under the nail plate may show results over time.

As a certified foot care nurse, I treat fungal nails by clipping away as much of the infected nail as possible.  For thickened nails, I use a special file that thins out and removes pieces of the damaged nails.  Regular nursing foot care halts the spread of infection.  A McDermott Footcare client is looking forward to being able to wear sandals this summer for the first time in years since I have treated her fungal toenails for the past 6 months and we are now seeing favourable results.

Preventing fungal toenails:

  • The measures used to prevent Athlete’s Foot (here) will also prevent fungal toenails. 
  • Try to avoid wearing shoes that are tight in the toe box. Squashing the toes together damages the matrix and increases the likelihood of infection.
  • If you get regular pedicures, do not let the esthetician push back the nail cuticle.  Find a salon that will honour your request to leave your cuticles alone.  It may be tempting to cover fungal nails with nail polish but this will trap moisture and worsen an existing infection.
  •  A fungal toenail infection is contagious.  Again, use the same prevention measures as with Athlete’s Foot.

Toenail fungus, or onychomycosis, may be frustrating and embarrassing.  Diligence and patience are needed to end the problem and prevent it from recurring.

Vinegar is Good for Your Feet!

A mainstay at McDermott Footcare, white distilled vinegar is reliable and inexpensive.  If you google the many uses of vinegar, you’ll see claims for everything from cleaning windows to controlling blood glucose.  I don’t know about its use in controlling blood glucose, weight loss or other medical conditions,  but  from my experience,  I know that vinegar is helpful in treating certain foot care concerns.  

Some people like to use apple cider vinegar, organic vinegar or  flavour-infused vinegar.  If you want to use fancier vinegar, go for it.  But for me, a big  jug of simple, plain, white vinegar is just fine.

Athlete’s Foot:

For mild, uncomplicated Athlete’s Foot a.k.a. Tinea Pedis,  a daily vinegar and water soak works well.  For more detailed information on Athlete’s Foot, read my blog on this topic.  Uncomplicated Athlete’s Foot looks like this picture.   There is slight peeling and scaling between the toes, especially the 4th and 5th toes.  It may spread to the back of the toes.   It may  be itchy or have a burning sensation.

Mix up a solution of  1/4 cup white vinegar in a basin of warm water, enough to cover the affected foot.   Soak daily for 15 minutes until the peeling, scaling, itching and burning sensation are gone. 

If your Athlete’s Foot is more complicated –  if the itching, scaling and redness have spread all over the bottom and maybe the sides of your foot –  it’s a good idea to see your doctor for a prescription anti-fungal cream or lotion and use it along with the vinegar and water foot soak.

Dry, cracked heels:

The same 1/4 cup white vinegar-water soak as above is also great for treating those rough, dry, cracking heels so many of us have.  Here’s my blog on dry, cracked heels.   The acid in vinegar, acetic acid, is very gentle and softens rough heels really well.  Gently scrub the feet while soaking for 10 – 15 minutes, 3 times a week.  You can scrub existing calluses at the same time.  Soaking too often or for too long will dry out your skin.

Smelly Feet:

Admit it.  This happens to you.  It happens to me.  Especially in the summer when my feet sweat during hiking.  Or after a long day at work.  Even in my breathable socks and shoes.  Smelly feet, or bromhidrosis,  is caused by a mixture of sweat and bacteria. 

Our all-purpose vinegar and water foot soak works here as well.  Vinegar has disinfecting properties that help to get rid of the bacteria.  Of course, proper foot hygiene is important too.  Wash your feet with warm, soapy water first, then soak.  

 Take a closer look at that humble bottle of white vinegar lurking in the back of your kitchen cupboard before going out and spending  your hard-earned money on fancy foot products.  I think you’ll be pleasantly surprised at how vinegar can help your feet.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

 

 

  

Athlete’s Foot: What Is It? What To Do About It?

At McDermott Footcare, I see Athlete’s Foot on a fairly regular basis.  Here is a primer on what it is, how you get it, how to prevent it and how to get rid of it.

Athlete’s foot (a.k.a. tinea pedis) is caused by a skin fungus.  The skin fungus or dermatophyte is known as trichophyton rubrom.  A common name is ringworm, although it’s not a worm. Here’s what it looks like under a seriously high-powered microscope:

Tinea doesn’t limit itself to the feet.  Variations of tinea infections can show up on other parts of the body.  It is very contagious and can even be caught from cats and dogs.

What does Athlete’s Foot (Tinea Pedis) look like:

  • Most of the time, Athlete’s Foot is found between the toes, especially between the fourth and fifth toes.  It looks like scaling, flaky skin and you may notice some cracking (fissures) in the skin between the toes.  It may be itchy.   The flaking and itching may extend to the bottom of the feet.
  • It may progress to a moccasin-type outline, covering the same area that a moccasin shoe would cover.  You’ll see scaling, flaking, redness, a rash.  It may be itchy.
  • Much less common is Athlete’s Foot with open sores.  This may occur in people with immune – deficient conditions or diabetes.

How do I get Athlete’s Foot?

  • Tinea thrives on hot, sweaty feet that spend a lot of time in covered footwear, especially non-breathable shoes and socks.
  • Athlete’s Foot fungus is found on the floors of public swimming pools, saunas, locker rooms, washrooms, shower stalls.  Walking barefoot in any of these areas increases the chances of picking up the fungus.
  • Poor basic hygiene of the feet is another  cause.

How do I prevent Athlete’s Foot?

  • Daily washing and thorough drying of the feet, especially between the toes, is the first step.  Avoid moisturizer between the toes.
  • Wear sandals or other appropriate footwear in public swimming pools, saunas, locker rooms, shower stalls, washrooms.
  • Wear breathable shoes and socks.  See my McDermott Footcare page (above) on Socks and Shoes for some pointers.
  • Don’t share shoes.
  • Avoid sharing towels if you have Athlete’s Foot or with someone who has Athlete’s Foot.
  • Wash your hands thoroughly – at least 15 seconds – if you touch an infected area.  Be careful not to touch your face or any other part of your body or anyone else before thorough hand washing.

How do I get rid of Athlete’s Foot?

  • Mild, uncomplicated Athlete’s Foot can usually be cleared up without prescription medications.
  • Try a foot soak of 1/4 cup white vinegar with enough warm water just to cover your feet.  Soak for 15 minutes daily until the scaling, flaking, redness, itching are gone.  If you’d like, add a couple of drops of tea tree oil to the solution.  Dry your feet thoroughly after soaking, including between the toes.
  • Over-the-counter Athlete’s Foot powders work well.  Using a cotton ball,  lightly dust the powder over the affected areas.
  • Wear breathable, moisture-wicking cotton socks and breathable canvas or leather shoes.
  • As much as possible, avoid wearing nylon pantyhose.
  • You don’t have to get rid of your shoes.  Spray a solution of a few drops of tea tree oil or white vinegar and 1 or 2 ounces of water inside the shoes.  Air out the shoes.
  • If none of these suggestions solve the problem after a couple of weeks, or if the condition worsens, see your doctor.  She/he can prescribe an anti-fungal cream.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Why Assessment is Important in Foot Care

When a potential client phones or emails McDermott Footcare to ask about available services, I briefly explain that since I offer a nursing procedure, my first visit includes a very short assessment to find out what medications the person is taking and any medical conditions that affect the feet and toenails (and there are many).  Most people are fine with this.  On rare occasions, a person doesn’t want  the assessment  and decides not to have me come in.  That’s OK.  However, here’s why the strictly confidential assessment is so important:

  • As a Registered Nurse, it’s necessary to know what’s going on medically so I can give the best care possible.  Anyone who’s diabetic, has a heart, lung, blood pressure or circulation condition, is arthritic, has low immunity,  has difficulty walking, bending or seeing is going to be concerned about more foot care issues than overgrown  toenails.
  • Some commonly prescribed medications for the above conditions will cause changes to the health of the feet and toenails.  For example, long-term antibiotic use increases fungal infections to the toenails and skin of the feet.  Different types of steroids used in conditions of the lungs, the joints and cancer treatments make nails brittle and increase fungal infections of the feet and nails.
  • Past surgeries to the lower limbs and hips may cause poor circulation to the feet.  Fungal, thickened, discoloured toenails, lack of feeling in the feet (known as neuropathy) and poor skin condition are the result.  These surgeries may cause a change in the way we walk and the way we carry our weight.   In turn, corns and calluses may develop, making walking painful.

It seems to me that most of us don’t see the connection between what goes on in our feet and the rest of our body, but everything is connected very intricately.  That’s why conscientious, properly trained, certified foot care nurses get to know the whole person – not just their feet.

In my experience, not everyone wants a nursing assessment and decide that their needs are better addressed elsewhere.  On the other hand,  those who take the few minutes needed to answer the confidential assessment questions receive personalized, holistic, quality nursing foot care.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

8 Tips for Dry, Cracked Heels

With the colder weather, I have seen an increase in very dry feet when visiting McDermott Footcare clients.  Dry, cracked heels are the most frequent concern.  If these cracks, called fissures,  become severe, they may cause bleeding, infection and pain when standing or walking.

What causes dry, cracked heels?

  • cold weather and indoor heating
  • ill-fitting shoes and boots
  • improper daily care of the feet
  • standing on your feet all day

It’s not just my clients who are asking for help.  Their caregivers and family members want advice too.  Since this is such a common problem, here are some tips that may help:

8 tips for dry, cracked heels:

  1. Heels will move around in shoes and boots that are too big.  This causes friction which forms dry calluses around the ridges and surface of the heels.  Make sure your shoes and boots are properly sized so that heels don’t move but at the same time, toes have wiggle room.
  2. Wash feet daily with warm, soapy water.  Don’t use hot water because it dries out skin.  Hot water is also harmful to diabetics and anyone else with impaired circulation to the feet.
  3. Exfoliate the feet, especially the heels, while washing.  Use a wash cloth, pumice stone, or loofah and rub the skin gently to slough off dead skin.
  4. Dry the feet thoroughly.  Dry well  between the toes since fungus and bacteria like to grow in warm, moist, dark places.
  5. Moisturize daily with body lotion.  If you feel you need something more emollient, ask the pharmacist to recommend an over-the-counter body lotion that contains urea.  Urea is naturally present in skin cells, but in dry skin, urea levels are lower.  Using a lotion that has urea increases the skin’s ability to hold in moisture.  Avoid moisturizer between the toes.  Put on cotton  socks.
  6. Foot soaks are relaxing and helpful if done properly.  Limit foot soaks to 10 – 15 minutes, 3 times a week.  Soaking for long periods dries out the skin.  Use a solution of  1/4 cup white vinegar and enough warm, never hot, water to cover the feet up to the ankles.  Mild acetic acid in vinegar softens dry skin.  Exfoliate.  Dry thoroughly.  Moisturize.  Put on clean cotton socks.
  7. For an overnight treatment, try the following:  massage olive oil mixed with a bit of white vinegar or lemon juice over the feet, concentrating on the heels.  Honey is a natural moisturizer so if you want, put some in your mixture.  Put on cotton socks.   In the morning, wash it off.  Exfoliate.  Dry thoroughly.  Moisturize.
  8. Over-the-counter callus softeners often contain ingredients that irritate the skin.

If dryness and fissures are severe with no noticeable improvement in a couple of weeks, see your family doctor.

Some factors that affect the skin on our feet can’t be helped, like the climate or a job that requires standing for long periods.  However, the tips I’ve given you are all easy and don’t take much time.  Try them and start seeing an improvement in the health of your feet.

Related post: 9 Tips For Moisturizing Your Feet

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

Advocating for Those Who Can’t

Even though my business is  nursing foot care, I am a registered nurse and when something isn’t right with one of my clients, I need to address it.  While doing foot care for one of my McDermott Footcare clients, I noticed that the symptoms of her chronic medical condition were more pronounced.  I convinced Mrs. X to make an appointment with her doctor then I wrote the doctor a note outlining my observations and concerns.  This is something I do for my clients when I see a change in their health status.  It usually works well.

Two days later, Mrs. X phoned to tell me that the doctor’s response was “well, we all know you’re deteriorating.”  At the present stage of my client’s condition, there are medications that will ease her symptoms but none were prescribed.  I was hoping the doctor would finally give her a prescription, but he didn’t.   Mrs. X didn’t question the doctor, but she was disappointed.

Registered nurses are bound by very strict laws of client/patient confidentiality.  Even though I wanted to talk to her family about the doctor’s response, I couldn’t since Mrs. X didn’t give me her permission.  The only thing I could do was urge her to tell them what happened and ask them to talk to the doctor with her and on her behalf. 

Sometimes, the people we love need our help when dealing with difficult issues such as illness.  They may not know how to discuss their concerns with the doctor.  Or they are so overwhelmed that they don’t know what to ask.  It’s up to family members or trusted friends to step in and advocate for them.  You’ll still need to get their permission if they are capable of making their own decisions.  

If you don’t like the answers your relative or friend is getting, there are some things you can do to help.

  • be aware of what is happening to them medically
  • do your research about the medical condition and current treatment options
  • if they are of sound mind, you need to get their permission first before you can discuss the issues with the medical team
  • offer to take them to the doctor
  • if you don’t like what you’re hearing, ask questions and don’t leave until you get answers
  • discuss the treatment options you’ve researched with the medical team
  • if your loved one does not have a Power of Attorney for Care and for Property (2 separate documents), talk to them about naming a P of A now before they need one.  The same goes for a Living Will and Last Will and Testament.   Having these documents before you need them gives everyone peace of mind.

In my experience, what happened to my client is not the norm.  The majority of doctors would have begun treating her symptoms by now.  But don’t you think that one story like hers is one too many?