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November 22, 2019

Put your feet up

By Kaelanne Jordan
Twitter: @kaelanne1

One certified foot health practitioner believes just like seeing a general physician, a foot health practitioner should be among the list of specialists, diabetics and even the general public see regularly.

Keith Nancoo, owner of KYN Foot Care told Catholic News 80 per cent of his patient’s problems stem from self-neglect. Because feet are greatly impacted by diabetes, he stressed everyone, especially diabetics ought to check their feet daily for splits between toes, blisters, cuts and even broken skin.

Why daily? Nancoo, a specialist for 12 years explained, “…that little cut can turn into a sore, that could start to get pus, that could start to get discoloured, then it starts to smell….”

Serious complications can lead to gangrene and amputation.

He explained while diabetic foot problems vary from person to person, most diabetics suffer from diabetic neuropathy—a type of nerve damage that can range from pain and numbness in the lower limbs. With diabetic neuropathy, persons may be unaware of an existing cut or bruise.

“So that’s where the checking every day comes in,” he reiterated.

Nancoo shared that the profession came into existence for diabetics. He specialises in foot health services including removal of calluses and treatment of corns, ingrown toenails, athlete’s foot and toenail fungal infections. His expertise also involves recommending proper footwear and the appropriate way to clip toenails. He has close to 500 patients with clients from St Lucia and Grenada.

On how often a diabetic should see a foot health practitioner, Nancoo said it depends on the patient’s problem. He said some of his patients will see him every month or every three weeks. For instance, a client with an ingrown toenail may be scheduled to return two weeks, then a month later following their first procedure. All in all, he affirmed, if the patient is doing what they need to do, it will be 6–8 weeks.

Lack of foot care knowledge

Having a podiatrist or a foot health practitioner attend to your feet is a very different thing from having a pedicure. According to Nancoo, a pedicurist’s “focus” is different. “Our focus is on health and well-being. When you go to a pedicurist it’s more aesthetic, it’s more on the surface. So, they focus on the polish, we don’t deal with polish,” he said.

He observed, “The education is not out there enough. And I think that’s one of the problems Trinidad [and Tobago] has…people don’t know where to go. A lot of people have a lot of issues with their feet and they don’t know what they have…. It’s just a lack of knowledge,” he said.

Some common foot problems range from nail bed fungus, a fungus that affects 85 per cent of the world’s population to issues related to inappropriate footwear. “A very real, common problem that I see. If I see ten people for the day, probably ten of them have the fungus,” he asserted.

Symptoms include a discoloured nail plate, which is sometimes thick and brittle that begins to “pry” on the sides of the toe.

Showing images of treatment performed for his clients, Nancoo cleared up some common misconceptions, corns and calluses. Corns usually occur on surfaces which are exposed to a concentration of pressure. They are usually small and circular with a clearly defined centre that can be hard or soft. Calluses, however, are dry dead skin cells caused by impact and friction, for example using slippers, any backless footwear or footwear that is too big or too tight. They can also be caused by continuous wearing of very high heels.

Nancoo also stated another misconception that diabetics take longer to heal. He said while some heal faster, some don’t at all. It has to do with circulation to the extremities.

“So when people come and say ‘It’s not working, I watch them…and then they start to laugh… a lot of things I can detect as well…I know when you wear a new [pair of] shoes, you did this, you did that, that happen and they just can’t lie to me because I know,” he said.

General tips and advice

  1. Bacteria strives in moisture. After showering, use paper towels to dry between toes, then discard. Avoid using bath towels as you are only reapplying bacteria from the towel to the skin.
  2. Never wear shoes that are too tight or too big. Nancoo explained the biomechanics of the feet involves walking heel to toe. When you are trying to make that heel-to-toe motion with a pair of shoes that are too big, you are forcing the toes to grip to keep the shoes on.
  3. Avoid shoes with straps that go in between toes. Straps that run between the big and second toe places pressure on the joints. Rather, wear sandals with straps that go horizontally.
  4. Toenails should be clipped horizontally. Nails should be filed using an emery board. Avoid using metal files.
  5. Diabetics should wear shoes that are pliable and flexible. Shoes should be soft, comfortable with no seams or ridges on the insides.
  6. All should avoid using corn removal plasters, especially diabetics as they contain acid which is harmful to diabetics.