LHC sees significant increase in foot amputations during COVID-19 pandemic

Hospital authorities concerned over patients no-show at diabetic foot clinic  

The Diabetic Foot Clinic at the Linden Hospital Complex (LHC),  has seen a drastic decline in the number of patients accessing its services since the start of the deadly Coronavirus (COVID-19) pandemic here in Guyana, according to Dr. Joseph London, Medical Superintendent (ag). As a result, there has been a significant increase in foot  amputations in 2020.

For the period January to September – a total of 18 amputations were done at the LHC. This figure, Dr. London said, is significantly higher when compared to the same period in 2019. 

London said this downward trend is a strong indication that Diabetic Foot patients are not receiving the necessary treatment and care required to prevent amputation.

“We have noticed a decrease in visits of diabetics to the foot clinic; a decrease in interaction between diabetics and primary healthcare service (screening and education) since the focus has shifted. Persons started to take care of their feet at home [but] this is not as effective, if the person is not educated on diabetic foot management,” Dr London explained during an exclusive interview with INFO 10.

He said more and more patients are turning up at the clinic when their infections are long advanced, making it difficult to prevent amputation. 

“Worst case scenario for any diabetic complication is amputation. It is always the objective to try to save the foot and to save the pressure points on the foot so that the person can ambulate. The more a person can move around, can increase the quality of life and their length of life. It has been scientifically proven that the higher up you go with an amputation, the shorter is that person’s lifespan,” the Medical Superintendent explained.

He said while the Ministry of Health, in an attempt to avert the spread of COVID-19, has advised persons to only visit health facilities unless it’s absolutely necessary – such a measure hinders the ability of the clinic personnel to effectively educate and screen the patients. Dr. London, is therefore, advising diabetic patients to visit the Diabetic Foot Clinic as soon as possible for a consultation.

“We have implemented a system where the stable patients extend the time between visits and we have included the health centers more in this activity since it is easier to access a health center during the pandemic,” Dr London detailed.

He added: “Should a diabetic person experience complication with their foot, it is recommended that they visit the foot clinic to get a consultation. Do not stay at home to see how it’s gonna go. Even if it’s a nail stick, a cut or a bruise; visit the foot clinic.”

DIABETICS ARE MORE PRONE TO EXPERIENCE COMPLICATIONS WITH THEIR FEET

Persistently high blood sugar levels affect the nerves in the feet which in turn, affects a person’s ability to feel in that area. Without being able to feel, then the mechanism of defense from pain and injury gets taken away. For example, a diabetic with a small pebble in their shoe can walk around with that pebble all day without noticing, until that pebble creates an ulcer. Whereas, another person would instantly feel the pebble in the shoe when they put it on and remove it.  Most diabetics carry on with injuries unnoticed, unless they pay close attention.

The nerves that innovate the small muscles of the foot are sometimes destroyed as well and some of those muscles are responsible for giving shape to the foot which helps us with balance, our arch and also distributing pressure throughout the foot.

LHC has dedicated a specialized area of care for diabetics since 2011. To date, the Diabetic Foot Clinic is the only clinic of its kind within Region 10. 

This clinic plays a major role in the screening and education of diabetic patients. These patients require close follow-up and daily evaluation. The clinic takes a team-approach when it comes to the management of its patients. With the general surgery team, internal medicine team and specialized nurses, the department works tirelessly to ensure that patients are well cared for.

The clinic works daily from 8:00hrs to 14:00hrs.