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Dr. Jim Marks Needs Your Help
By Lois Thomson

Dr. Jim Marks' goal is to "always save a limb whenever possible," but he needs your help. If you are a diabetic, he encourages you to take some of the responsibility.
As he said, "The adage really is true, that an ounce of prevention is worth a pound of cure, and that's especially true when discussing patients who have diabetic foot disease. The real key to what we call limb salvage is prevention. In other words, the responsibility is not just on the health care provider, it's getting the patient to buy in on that preventive concept."
Dr. Marks is medical director of The Washington Hospital's Wound & Skin Healing Center, and a podiatrist with his partner, Dr. Nick Lowery, in Penn Foot & Ankle Specialists. He said, "One of the things we have consciously focused on is patients who have what is called diabetic foot disease.
"We know for a fact what causes a diabetic foot ulcer. Normally they start out very incidental, just a callus or blister. Unfortunately, the patient either can't feel it because they have what's called neuropathy, or they just think they'll take care of it themselves. The problem is that it typically breaks down and creates an ulcer, and that ulcer leads to a diabetic foot infection, and that causes the high incidence of amputations. For example, we know that a callous on a diabetic foot is potentially the cause of an amputation 30 percent of the time."
That's why Dr. Marks strongly believes that "every diabetic, whether controlled or uncontrolled, type 1 or type 2, really needs to have a podiatrist as part of their team." He said that with early recognition, the overall amputation rate in adults 40-and-older has been declining—by more than 65 percent between 1996 and 2008. "A big part of it is that everybody, especially the patients who are well-educated, is buying into this concept that if they have better sugar control, and they have a podiatrist as part of their health care team, then the rate of amputations can decrease."
Dr. Marks said a diabetic's biggest fear is amputation, and with good reason, because statistics show that about half of diabetic patients only live three to five years after an amputation. That's why there's such an emphasis on preventing amputation, and it all goes back to a very simple, comprehensive diabetic exam.
He added that recent studies indicate that podiatrists have proved to be the best at being able to identify those complications associated with diabetes in amputation prevention. He clarified that not all diabetic patients need to be seen every three or four months; some who are low-risk can schedule a comprehensive foot exam annually. But it definitely should be done.
So do your part, and make sure a podiatrist like Dr. Marks is on your care team.
For more information, call (724) 225-7000 or visit www.washingtonhospital.org

Podiatrist Dr. Jim Marks has several recommendations for people with diabetes:
• Never walk barefoot
• Be careful that your shoes don't create any friction or irritation that could cause blisters
• Use caution when soaking your feet, don't use water that is too hot as it could cause severe burns
• Don't use sharp instruments to try to trim corns or calluses
• Simply look at your feet, between your toes, to see if there are any cracks, rash, swelling, redness, anything that doesn't look right; it could mean an ulcer is forming
Dr. Marks also says that more deaths are attributed to diabetic foot disease than some other prominent diseases. "You see pink ribbons for breast cancer, but I think we need a ribbon for diabetic foot disease. More people die from diabetic foot infections and ulcers and amputations than from breast cancer, colorectal cancer and several other diseases."

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