Tuesday, May 09, 2006


There are times throughout the day during which newFNP sees her patient and immediately senses a "what the fuck" coming on. What newFNP would like to do is gingerly tiptoe backwards out of the exam room, hoping that the patient never noticed that she was there.

Given the state of affairs of one patient today, newFNP could have probably succeeded in the aforementioned exit strategy.

Before continuing, can newFNP just make one more plea to prevent frigging Type 2 diabetes? Yes, yes, we can't save them all, but newFNP is sure as shit saving herself. And if a gaggle of patients want to set sail in the health boat with newFNP, they can hop on board. Ahoy!

Here is why "Develop Type 2 DM" is not on newFNP's to-do list.

A) Renal failure.
B) Proliferative retinopathy/blindness.
C) Peripheral neuropathy/amputation.

And if that weren't enough, newFNP has a new reason to add to her list: Charcot's Foot - a complication of neuropathy that leads to fractures of the bones without having experienced major trauma. Because of the neuropathy, the fracture isn't felt by the patient who continues to walk on the affected foot. This, in turn, leads to severe deformities, sometimes intractable ulceration and the potential for amputation.

If you haven't seen Charcot's Foot before, conjure images of Kathy Bates' character hobbling James Caan in "Misery." That is what Charcot's looks like. It's swollen, warmer than surrounding skin and looks like someone took a sledgehammer to it.

And if that wasn't incentive enough, just think of this: Charcot's Feet cannot wear cute shoes.

1 comment:

Nurse Practitioners Save Lives said...

I take care of a lot of diabetics. They often don't understand the ramifications of the disease. They are shocked to find that their kidneys, eyes, heart and small vessels are affected. Diabetes is pure hell. My husband is an insulin dependent one himself.. It sucks... Cheers from The Nurse Practitioner's Place and Nurse Practitioner News