My Rant About Men and Their Feet

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Disclaimer:  This is not a sexist rant.  I like men.  I married one.  I have sons.  Their feet are pretty good – they have no choice.  Some of my favourite people are men.  But…..

I’m a foot care nurse.  I look after alot of feet.  I really like my job.  I’m not picking on the guys.   We women have our own issues (read my high heels blog).  But men, really?  We need to talk.

  • You know those favourite shoes of yours – the ones you’ve had for 10 years or more?  Throw.  Them.  Out.  Now.  Get over it.  Before you buy new shoes, read my page on Socks and Shoes.
  • Stop tying knots all over those shoelaces that keep breaking.  Get new ones.
  • “These shoes were a great deal” is not a reason to keep wearing shoes that are way too big for you.  Again, read my page on Socks and Shoes.
  • Those cutters that electricians use to cut electrical wire?  They’re for electrical wire, not toenails.  (I’m not making this up)
  •  Same goes for the sander in your tool box.  Why are you using it for your dry heels and calluses??
  • Ingrown nails need to be dealt with before they become inflamed and infected.
  • Regarding those over-the-counter wart and callus removers – more is not better.  That’s why you’ve given yourself an acid burn and peeled off 3 layers of skin.
  • When drying yourself after a shower or bath, the towel needs to go lower than your knees.  Bacteria and fungus (athlete’s foot) breed in warm moist places like between your toes.
  • Moisturizer is not just for women.  Use it so your heels don’t look like baked, cracked clay.  If you don’t want to smell like a spring meadow, there are unscented ones.
  • Didn’t your mother ever tell you that socks need to be changed every day?  Gentlemen, this is not how to take a girl’s breath away.
  • It’s OK to have the foot care nurse look after your feet.  Don’t wait ’til your wife and/or daughter yells at you.  If you don’t have a wife/daughter, don’t wait ’til your feet are yelling at you.

I’m not saying that all men are hard on their feet, but this is some of what I see in my practice.  Regardless of gender, we all need to be kind to our feet.

To that end, stay tuned for McDermott Footcare Productions Definitely-Not-Ready-For-Primetime vlog on caring for winter weary feet.

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

Life Is What Happens

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Recently, a regular McDermott Footcare client told me that he’s moving to a retirement residence.  This is a surprise to me since he’s told me before that he doesn’t want to leave his house.

A retirement residence is for seniors who are mostly independent but may need minimal help to perform daily activities such as taking their medication and bathing.  Residents have their own suites but share some common areas such as the dining room.  It differs greatly from a nursing home or long-term care facility where people need greater assistance or complete care.

My client, Mr. X, is fiercely independent, generous and witty.  He lives alone, has trouble going up and down the stairs, difficulty bathing and cleaning his house.  He often forgets to eat and take his medications.  His closest relatives live out-of-town but they do the best they can to help him.  They worry about him all the time.

When I visit him for foot care, I ask him if he’s taken his pills that morning.  The usual answer is “no, I forgot.” I hand him his pills and remind him that since he’s diabetic, he can’t wash down his meds with the sugar-laden pop he likes to keep around.  I also remind him to eat.

So, why am I telling you this?  Well, it struck me how quickly my client’s life is changing.  Despite his earlier insistence that he can continue to function in his own home,  in one month his outlook is completely different.

Although we all experience many changes in our lives, I think the most significant shifts take place in old age.  The onset of illness, loss of independence and loss of loved ones take a hard toll on seniors.

I marvel at how my client is handling the impending move.  He’s given me a lesson in accepting life’s inevitable changes.   Instead of wasting time and energy fighting what he can’t control, he’s meeting his challenges head-on with a pragmatic, no-nonsense attitude.

That doesn’t mean he won’t struggle when he gets into his new place.  There will be major adjustments to make.  On top of all the other losses he’s experienced over the past few years, he’ll have to deal with the loss of the home he’s known for many years and the life he had in that home.  It won’t be easy but I believe he’ll be OK.

I wish him all the best.  May you continue to accept life as it comes with grace and dignity, Mr. X.

High Heels vs. Foot Care

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This is my daughter taking great delight in her brand new , fashion-forward sandals.   With 4 inch heels.  And a teeny tiny platform.  I have to admit, she looks really good in them.

That’s the dilemma of high heels, don’t you think?  They make our legs look great, kick our outfit up a notch, and they make us feel confident, attractive, even  powerful.  On the other hand, high heels wreck our posture and eventually, our feet.

High heels pitch our posture forward and put most of our weight on the metatarsals, a.k.a. the forefoot or the ball of the foot.  Over time, this can result in metatarsalgia, a constant strain and pain over the forefoot.  Morton’s neuroma is a potential problem between the third and fourth toe that produces a sharp, burning pain over the ball of the foot and numbness in the toes.

As well, shearing friction along the ball of the foot creates calluses.  Pressure from weight concentrated on the forefoot creates corns.  Both conditions can be very painful.

Our hips, lower back and knees have to realign to maintain balance and posture.  This causes lower back, knee and hip pain because of the stress and strain on these areas.  We’ve all seen pictures of pregnant celebrities wearing stilettos……….do I really need to comment?

What happens to the toenails in high heels? Here’s my daughter again to illustrate the point.  Since the entire foot pushes forward in high heels, toenails are jammed against the top of the  narrow toe box.  The pressure on the toenails damages them and can lead to fungal, involuted, and/or ingrown toenails.

Toes crammed into a narrow toe box and pushed forward by the pitch of the shoe can develop hammer toes, claw toes and overlapping toes.   There’s also the potential for forming a bunion, a painful, bony prominence along the outside of the big toe.  The picture (not my daughter!) clearly shows these conditions.  Note the callus on the raised hammer toe.  This is due to the hammer toe rubbing against the top of the toe box.  Yes, it’s painful.

So, what’s a girl to do?  Give up high heels?  That’s unrealistic.  I don’t wear heels at work but, like most women, I have a wardrobe of high-heeled shoes and boots that I enjoy wearing when possible.  Admittedly, none of them have 4-inch heels.  My limit is 3 inches.

I think the key is moderation and common sense.  Leave the 4 -inch stilettos for very special occasions.  Don’t wear them every day – that’s just asking for trouble.

Wear a moderate high heel with a wider toe box on a daily basis.   A 2 -inch heel with a wider base is comfortable and fashionable.  Women who wear heels at work can change into them while sitting at their desk but can put on walking shoes or low-heeled dress shoes when commuting to and from the workplace.  I’ve recommended black, loafer-style nurse shoes to foot care clients who want something more fashionable than a typical walking shoe.  I wear them when I’m visiting McDermott Footcare clients.  Vary your heel heights from day-to-day by alternating low heels with moderate heels.

High heels are part of our culture and for many women, part of our self-image.  We will never give them up but that doesn’t mean we have to fall victim to their harmful effects.  We can continue to enjoy them as long as we take measures to reduce potential problems.

I would like to thank my daughter (and her stilettos) for inspiring this blog and for being such a good sport.  May you have many wonderful years enjoying your heels.

For more tips on proper footwear, read my McDermott Footcare page , above, on “Socks and Shoes.”  Let me know how you feel about high heels.

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

Foot Care and the Sandwich Generation

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“Mom has an ingrown toenail.  Can you come and see her?” 

“My uncle has diabetes.  Do you do foot care on diabetics?”

McDermott Footcare is often contacted by people in Toronto and the GTA who would like a foot care nurse to come and care for a relative’s feet –  mom, dad, uncle, aunt, grandparent – someone they love.  The people who call  McDermott Footcare are busy juggling kids, jobs, lives, but they are also extremely committed to providing the best care for at least one elderly relative.  This is the sandwich generation – responsible for their own immediate family on the one hand and elderly relatives on the other. 

 The internet is full of articles and resources on this phenomenon.  Just Google “sandwich generation Toronto” and you’ll get too many sites for me to link on this blog. 

I am a member of the Sandwich Generation.  My balancing act consists of 8 kids ranging from grade school to a university graduate on one side of the scale and my mom, who is almost as much work, on the other side.  Before dad passed away from complications of Parkinson’s Disease, he was on the scale too.   I still haven’t managed to find the right balance and I know I’m not alone.

People who contact me on behalf of a relative share the common trait of being  dedicated to improving  mom’s and dad’s comfort and well-being.  One daughter schedules her mother’s  foot care appointments over her lunch hour so she can come home from work when I visit her mom.   A son whose father has recently been admitted to a long- term care facility insists that McDermott Footcare be allowed to continue caring  for his dad even though the facility  has their own foot care nurse.   Someone schedules visits for aunt, mom and dad to be seen all at the same time – that’s organized!  Others make sure that visits are regularly booked.   Of course, I look after my mom’s feet.

It’s not easy.   Some days we can’t tell right from left.  Unexpected events can be challenging.    But lovingly giving back to the people who gave so much for us makes everything worthwhile.

 

Tea, Cookies and Potpourri

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On Thursday, Dec. 8, I spent a wonderful afternoon making Christmas potpourri and having tea and cookies with a lovely and lively group of seniors.  We were at a community resource centre.   McDermott Footcare had been invited to come and see what they’re all about.

Amidst tea served in porcelain cups, hot mulled cider and an abundance of Christmas cookies, we crafted our individual potpourri.  The resource room smelled of Christmas – cloves, ginger, cinnamon.  Kimberley Davies, Community Relations Manager of Amica at Bayview, guided us through our craft projects.

Some of the seniors reminisced about Christmases past, childhood winter adventures and a simpler time.   For me, that was the best part of the afternoon – getting to know the guests and listening to their stories. 

Thank you to the staff of the community resource centre for your hospitality.  Most of all, thank you to Jack, John, Lorna and the other guests who shared part of your lives with me over afternoon tea, cookies and potpourri.  What a great reminder that foot care is not just about feet 🙂

Why I Became A Foot Care Nurse

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 It’s funny how seemingly random, unrelated events all come together to influence a major career decision.  Former patients, past incidents, personal circumstances all played a role in getting me where I am today.

As an RN working in both acute care and continuing care, I often cared for patients with different conditions.  My focus was always on the medical issues, the post-op complications, the controlled chaos of a busy unit.  Even though I sometimes encountered patients with foot issues, I was unprepared to do anything about them.  Even if I did feel compelled to address their overgrown nails and other problems, I didn’t have the time.

I still remember the first time I saw onychogryphosis nails (toenails that look like curled ram’s horns).  I was a brand new RN working on an orthopedic floor and I was so shocked I stared at the patient’s feet.  I didn’t know nails could do that! They were extremely fungal as well.  That disturbing image has stayed with me all these years. 

Fast forward to about 5 years ago.  My dad had Parkinson’s Disease.  He only allowed my mom to care for him and refused all of my pleading to bring in home care.  Dad’s feet were not as bad as that onychogryphotic patient of years ago, but he needed foot care badly.  Unfortunately, he refused all efforts to have his feet problems addressed and we were powerless to convince him otherwise.

On Christmas Day one year before he passed away, dad slipped and fell on the ice after Christmas Day Mass and ended up in the Emergency Room.  As I was prepping him to be seen by the doctor on call, I took off his socks and he became very upset.  He begged me to cover his feet because he was ashamed of  their appearance. 

When dad was in palliative care in the hospital, two weeks before he died, mom overheard a nurse remark on the awful condition of his feet.  She was certain my dad was neglected at home because his feet were horrendous.  The nurse’s unfair assessment hurt my entire family, most of all my mom.

After dad passed away, I convinced mom to let me hire a foot care nurse for her.  She hesitated at first, even argued and yelled at me the morning of the nurse’s first visit, but eventually she began to enjoy the wonderful care.  I was always present when mom was having her foot care appointments and would watch with fascination while the nurse did her thing.

So what do all these experiences have to do with my career move?  I needed a change from my increasingly demanding job as a visiting nurse in community.  While I loved my work seeing patients in their homes, the pace and hours of my job left me with little time and energy for the most important people in my life, my family.  I wanted to work; I needed to work, but I needed balance most of all.  So, I handed in my resignation despite that fact that I had no other position to go to.

After much thought, and even more prayer, I felt that foot care nursing was something I should pursue.  I went back to school and realized that I really enjoyed my course.  Because I was striving for balance between my professional and personal life, I decided that my best course of action was to be an RN in independent practise – start my own nursing business – as a foot care nurse.

I am very much aware of all the foot care episodes of the past when I visit my clients.  I remember all the patients who would have benefited from foot care; dad’s shame when his feet were exposed; mom’s initial reluctance and eventual pleasure from good foot care. 

My dad has taught me to be aware that some people are embarassed when they first show me their feet.  Many clients are certain that I have never seen anything worse!  (oh yes, I have) Feet are very intimate and people need to feel they won’t be judged if they place this part of their body in my hands.  A level of trust develops between my client and myself as I spend 30 minutes or more talking and listening to them as I do their foot care.  Many times, I will be the only person they see that day.  I may be the only one  to remind them to take their pills, make sure they eat on time and just ask them how they are. 

I enjoy my work – I really do.  The people who hire me,  either for themselves or for a family member, seem to like my work.  They arrange regular foot care visits with me every 4 to 7 weeks. That’s a pretty good indicator!  It’s a privilege to be allowed into clients’ homes and an even greater privilege to be asked to care for their feet.

 

About Nursing Foot Care

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 In the world of foot care options, nursing foot care is a trusted, professional, convenient choice for discerning healthcare consumers.   Among the various alternatives available, only Registered Nurses possess considerable nursing knowledge and expertise  in order to provide timely,  holistic care which considers the well-being of the entire person.

As a Registered Nurse specializing in foot care, I hold a Certificate in Advanced Nursing Foot Care from an accredited educational institution.  As well, I update my skills and knowledge through continuing education for Foot Care Nurses.  The College of Nurses of Ontario, the Canadian Nurses Association and the Registered Nurses Association of Ontario regulate my practice as a Certified Foot Care Nurse and require that I adhere to Standards of Practice that apply to Registered Nurses,  Certified Foot Care Nurses and Registered Nurses in independent practice.

As a Certified Foot Care Nurse, I believe in the importance of quality foot care as an integral aspect of my clients’ health.  I recognize that my clients may face certain challenges that make it difficult for them to care for their own feet.  Changes in vision, flexibility, hand strength, coordination and mental acuity may make personal foot care onerous. 

 Conditions such as diabetes, rheumatoid arthritis, osteoarthritis, vascular disease and other degenerative conditions affect the health of the feet.  These conditions will often cause pain, nerve damage, skin problems, as well as circulation deficits.  All of these affect the health  and appearance of the feet as well as a person’s ability to use them.  I am able to address, in a non-invasive way, problems which  may develop.  I typically address concerns regarding thickened and fungal nails, corns, callouses, bunions, nerve and circulation deficits, athlete’s foot and other matters.

As a Registered Nurse, I strive to prevent further foot problems for my clients and to address current issues.  To that end, part of my care consists of providing  clear and simple health teaching which allows my clients or their families to better care for their feet between nursing visits.  If needed, I can also make referrals to other healthcare providers.

Clients who regularly receive nursing foot care express an increased sense of comfort and well-being.  The health and appearance of the feet are restored so that the client may once again participate in social activities and activities of daily living because their feet no longer cause discomfort,  pain and embarassment.  The client or their family is empowered and satisified.