My primary sent me to a podiatrist for a new foot pain, who sent me to clinic for diabetic shoes and orthotics. Medicare pays for proper shoes for diabetic foot care. Feet get numb, resulting often in skin damage, leading to infections, and worst case followed by amputations. Those were quite common for diabetics when I was a kid. I remember a neighbor we got our eggs from who had it and there were concerns about those and blindness. Medicine has since improved.
I got diagnosed as pre-diabetic something like 15 years ago. I never bothered to make an exact note of when, but it was before we moved south. My treatment was to watch my carbs, with lots of information, and sources for more, on how to do that. I'm still doing that... sort of. It's not exactly religiously followed. But my A1C is monitored, and first AM fasting blood sugars taken with finger jabs, about 28 days a month. Stuff happens, like suddenly realizing one has started breakfast without doing that poke. So far I haven't had to go on any kind of medications for it. It's going pretty well. At some recent point my official diagnosis changed from "pre" to just plain diabetic. Far as I can tell, the only change has been additional birthdays.
Maybe I'm doing too well, which I'd never complain about.
Today was the initial consult for orthopedic / diabetic shoes. I got a lesson on how strict Medicare is on what actually qualifies feet for what's about $2,200 worth of footwear. Is my diabetes controlled? Yep. Do I have any skin lesions in my feet? Nope. Any numb spots? Nope. Testing with my eyes closed verified I felt everything he touched with a little filament, except a spot near one of my replaced knees. Not all the nerves reconnected after those surgeries, even now. It didn't count. I'm just not diabetic enough to qualify for special shoes.
Yet. The expectation is always it will get worse.
We had a discussion on the things that have gone wrong with my feet over the years, what hurts now (which is mostly barefooting on hard surfaces.) What have I done for those issues? I explained about the arch supports, now doubles rather than singles, all the time now except in bed, including in the shower with a pool shoe on one foot with supports inside. I explained how walking on our lumpy yard outside hurts when the lump presses on the one sore spot. Also how hard it has been to find the right kind of supports for my arches recently. And how I had to resort to snowmobile boots for several winters - no snowmobile, just boots - when the first arch damage had been done, resulting in bone spurs in '85, lasting a few years, now an issue long past so long as I wear the arch supports.
With a lecture on things like pronation, for which I should thank my genetics, and metatarsals becoming affected, he explained what's happening and precisely why none of those qualify as a diabetic reason for special shoes and orthotics. He also explained why what he offers wouldn't fix my feet even if I chose to pay the bills myself, and why the orthotics only last a few months and would have to be replaced annually... at my expense.
He knows exactly who developed the kind of arch supports I wear, knows they're coming off the market because the plastic is hard to work with, and advised me if I still have a source to go out and stock up on them from, get as many as I can. I also need to go find shoes with lots of room inside (yes, men's wide!) and very thick, firm soles. Unfortunately, while thick soles are "in" right now. "firm" has been bypassed for "soft". So he wished me luck.
Before we parted, he commented on the Olympics this last summer. He takes a professional interest in the footwear used by the runners. Or in previous years, the lack of it. He was greatly encouraged, from his professional viewpoint, by what looks like much better footwear to support feet during competitions. To make his point he mentioned that this last year, even the Kenyans, long noted for running even marathons barefoot, were now wearing shoes.
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