I thought I’d drop a very quick line to shed a bit of light on what to expect when you attend for your annual diabetic foot screen, particularly if you’ve never had one before.
The whole point of an annual Diabetic Foot Screen is to ‘screen’ you for foot complications caused by your condition and then if we find them- to send you to someone who can help manage these problems and advise you on how to protect your feet. We are actively looking for disease related to your diabetes (and hoping not to find any of course!).
So firstly, when you visit an NHS Podiatrist your foot check will be very similar to what we do. We all have to meet a minimum standard as per government guidelines, which means that you must have your foot pulses checked, your sensation checked with a 10g monofilament and your foot shape examined to assess for any deformity. There will also be some questions around symptoms of pain in your feet and legs. Your Podiatrist will then advise you of the outcome of this assessment and tell you what your risk is for developing diabetic foot ulceration in the future. You should also be provided with any relevant patient information leaflets so that you can refer to this for advice in the event of a problem or to prevent a problem from occurring.
So what do we do that’s slightly different?
We do all of the above… and a little more, because we like to provide a super whizzy service for our patient’s and theres little point in having a Diabetes Specialist Podiatrist on hand if we don’t make use of her!
So basically, the difference at Peveril Podiatry is that if we cant find a pulse or we think you DO have circulation related pain, we can provide an advanced arterial assessment right there in the clinic. NHS services would need to send you to a Vascular Consultant in a hospital for this type of assessment usually, unless of course you’re very fortunate and you live in Manchester where there are 4 centres of excellence for this type of assessment in the Community. Michelle works in one of these departments as part of her other role in the NHS so we can make use of these skills in our private practice and our patient’s can benefit from that extra special care.
If we find a serious problem we can organise rapid access to the Vascular Consultant via your GP but if we don’t, you can happily avoid a hospital appointment altogether.
When we check your sensation with a 10g monofilament as per the government guidelines, we are looking for severe neuropathy (loss of sensation). We like to make a few additions to this test and use a 28 mHz tuning fork to perform a vibration perception test (basically a metal fork that we tap firmly to generate a vibration). This test detects early signs of loss of sensation so while you might not have severe damage, you will have a heads up if you’re developing problems so you can start making crucial changes to your diabetes control if this needs addressing. We also test to see if you can feel the difference between sharp and blunt. None of these tests are painful so rest assured! We are basically trying to find out- “If I stand on something sharp, will I feel it??”.
After all this is complete we send you off with a copy of our detailed report which you can keep for your records or take to any of your other health related appointments to ensure your foot risk is communicated to all relevant health professionals who are looking after you.
If you are interested in this service, you can contact our reception team and they will be happy to book you in and answer any questions you might have.
If you have an URGENT concern about your foot you can email us from the website and a Podiatrist will respond within 24 hours to help you or you can contact your GP. If the foot problem is very serious such as spreading infection, go to A&E.
Hope this helps!
Peveril Podiatry Team