Non Healing Diabetic Foot Ulcer

Dr. Rahul GuptaMD-Ayurveda, BAMSSexologist

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Hello- signs are suggestive of sexually transmitted infection, most probably herpes. Its best to get it tested first before going into any kind of treatment or else it might affect your whole reproductive system badly. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Previous answer: mobility exercises standing arm swings to do this exercise: 1. Stand tall with your arms by your sides. 2. Engage your core and swing your arms forward until they’re as high as you can go. Make sure you don’t raise your shoulders. 3. Return your arms to the starting position and repeat. 4. Do this movement for 30 to 60 seconds. Shoulder pass-through to do this exercise: 1. Stand with your feet shoulder-width apart and your arms in front of your body. 2. Hold a stick, like a broomstick or pvc pipe, with an overhand grip. Your arms will be wider than shoulder-width. Make sure the stick or pipe is parallel to the floor. 3. Engage your core and slowly raise the broomstick or pipe above your head, keeping your arms straight. Only go as far as comfortable. 4. Hold the pose for a few seconds. 5. Return to the starting position. 6. Repeat 5 times. High-to-low rows to do this exercise: 1. Secure a resistance band to a sturdy object above shoulder height. 2. Kneel down on one knee and grab the band with the opposite hand. The other hand can rest at your side. 3. Pull the band toward your body while keeping your torso and arm straight. Focus on squeezing the shoulder blades together. 4. Return to the starting position and repeat. 5. Do 2–3 sets of 10 repetitions on each side. Reverse fly to do this exercise: 1. Hold a dumbbell in each hand. 2. Stand with your feet shoulder-width apart, knees slightly bent. 3. Engage your core and bend forward at the waist. Keep your back straight. Your arms will be extended. 4. Raise your arms away from your body. Focus on squeezing your shoulder blades together. Stop when you get to shoulder height. 5. Slowly return to the starting position and repeat. 6. Do 3 sets of 10 repetitions. Rotation with dumbbell o do this exercise: 1. Stand with your feet shoulder-width apart while holding a light dumbbell in your right hand. 2. Raise your arm so your elbow is at shoulder height. The front of your hand will be facing the ground. 3. Rotate your shoulder to bring your arm and weight up so your hand is raised toward the ceiling. 4. Slowly return to the starting position and repeat before changing sides. 5. Do 2–3 sets of 12 repetitions on each arm. Mobility stretches cross-arm stretch to do this stretch: 1. Stand with your feet slightly less than shoulder-width apart and bring your right arm up to a little less than shoulder height. 2. Place your left hand on your right elbow and gently pull your right arm across your body using the left hand to support your arm. 3. Hold this position for up to 30 seconds. 4. Repeat on the opposite side. 5. Do each side 3–5 times. Sleeper stretch to do this stretch: 1. Lie on the affected side. If you have no injury or pain, choose a side to start with. Your shoulder should be stacked underneath you. 2. Bring your elbow straight out from your shoulder and bend this arm, so your fingers are pointing toward the ceiling. This is the starting position. 3. Gently guide this arm toward the floor using the unaffected arm. Stop when you feel a stretch in the back of your affected shoulder. 4. Hold this position for up to 30 seconds. 5. Do 3 repetitions before changing sides. Doorway stretch to do this stretch: 1. Stand in a doorway with elbows and arms forming a 90-degree angle. Your feet should be in a split stance. 2. Bring your right arm up to shoulder height and place your palm and forearm on the doorway. 3. Gently lean into the stretch, only going as far as comfortable. 4. Hold the stretch for up to 30 seconds. 5. Change sides and repeat. Perform on each side 2–3 times. Chest expansion to do this stretch: 1. Stand tall with your feet together. 2. Hold the end of a towel or exercise band in each hand, with your arms behind your body. 3. Use the towel or band to help move your shoulder blades together and open your chest. This will cause you to look toward the ceiling. 4. Hold this pose for up to 30 seconds. 5. Repeat 3–5 times. Strenghtening exercises 1.pendulum stretch do this exercise first. Relax your shoulders. Stand and lean over slightly, allowing the affected arm to hang down. Swing the arm in a small circle — about a foot in diameter. Perform 10 revolutions in each direction, once a day. As your symptoms improve, increase the diameter of your swing, but never force it. When you're ready for more, increase the stretch by holding a light weight (three to five pounds) in the swinging arm. 2. Towel stretch hold one end of a three-foot-long towel behind your back and grab the opposite end with your other hand. Hold the towel in a horizontal position. Use your good arm to pull the affected arm upward to stretch it. You can also do an advanced version of this exercise with the towel draped over your good shoulder. Hold the bottom of the towel with the affected arm and pull it toward the lower back with the unaffected arm. Do this 10 to 20 times a day. 3. Finger walk face a wall three-quarters of an arm's length away. Reach out and touch the wall at waist level with the fingertips of the affected arm. With your elbow slightly bent, slowly walk your fingers up the wall, spider-like, until you've raised your arm as far as you comfortably can. Your fingers should be doing the work, not your shoulder muscles. Slowly lower the arm (with the help of the good arm, if necessary) and repeat. Perform this exercise 10 to 20 times a day. 4. Cross-body reachsit or stand. Use your good arm to lift your affected arm at the elbow, and bring it up and across your body, exerting gentle pressure to stretch the shoulder. Hold the stretch for 15 to 20 seconds. Do this 10 to 20 times per day. 5. Armpit stretch using your good arm, lift the affected arm onto a shelf about breast-high. Gently bend your knees, opening up the armpit. Deepen your knee bend slightly, gently stretching the armpit, and then straighten. With each knee bend, stretch a little further, but don't force it. Do this 10 to 20 times each day. Starting to strengthen as your range of motion improves, add rotator cuff–strengthening exercises. Be sure to warm up your shoulder and do your stretching exercises before you perform strengthening exercises. 6. Outward rotationhold a rubber exercise band between your hands with your elbows at a 90-degree angle close to your sides. Rotate the lower part of the affected arm outward two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day. 7. Inward rotation stand next to a closed door, and hook one end of a rubber exercise band around the doorknob. Hold the other end with the hand of the affected arm, holding your elbow at a 90-degree angle. Pull the band toward your body two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day. Shoulder exercises and stretches regular exercises and stretches can keep your shoulder strong and flexible. A few things to remember before swinging in to exercises: •stop any exercise if you have more shoulder pain. It may be too soon for you to try. •watch your form. Exercising incorrectly can also cause or worsen shoulder problems. •warm up, even before deep stretching. Light shoulder rolls, gentle movements, or even a warm shower are all ways to warm up your muscles before exercise and stretching. Pendulum stretch for range of motion•stand and bend at the waist. •let your arm on the injured side hang straight down. •keep your neck relaxed. •move your arm in a circle up to 20 times. •do once or more times in a day. Overhead shoulder stretch•sit or stand to do this shoulder stretch. •intertwine your fingers in front of you. •bend your elbows and raise your arms above your head. You can also place your hands on your head or behind it. •gently squeeze your shoulder blades together to move your elbows back. •continue for up to 20 repetitions. Repeat 5 to 10 times a day. Do’s and don’ts for shoulder pain do’s do the prescribed exercise regularly to maintain strength, flexibility and range of motion. Do keep the affected arm supported. Use an ice pack for pain relief. Apply the ice pack 3-4 times a day for 10 minutes. Don’ts don't sleep on the affected side. Don't lift heavyweight with the affected arm. Don't jerk your shoulder to avoid stress. Don't use the arm to push yourself up in bed or from a chair. Don't participate in contact sports or do any repetitive heavy lifting. We suggest you to wear shoulder support brace which is available in two different sizes which makes the patient to feel comfortable as it maintains the shoulder in anatomical position and the short lever is maintained. The reason to maintain the short lever in the shoulder joint is it helps the shoulder to prevent the movements which itself is the key to have better progression of healing in the shoulder region. This is suggested for the following conditions. This shoulder support brace what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. 

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Dr. Karuna ChawlaBHMSHomeopathy Doctor

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1. Avoid spicy and sour foods, drinking hot liquids like tea, coffee and avoid oily, spicy food until the ulcers heal. 2. Drink plenty of fluids. 3. Regularly rinse your mouth out with warm, slightly salted water or baking soda. 4. Keep your mouth clean. 5. Apply ice to your canker sores by allowing ice chips to slowly dissolve over the sores 6. Apply toothpaste over the sores to treat them 7. Apply little honey onto the mouth ulcer or mix in a little turmeric to make a paste that can be applied to the affected area.Honey helps to retain moisture and prevent dehydration. 8. Brush your teeth gently, using a soft brush For this homeopathic treatment is very effective. For more details you can consult me. 

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Dr. Karuna ChawlaBHMSHomeopathy Doctor

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This medicine (proton pump inhibitor (ppi).) will not cure problem. It only works by reducing the amount of acid in the stomach. The day you do not take medicine normal acid production will be there n you will have symptoms. Do this 1. Don't take tea empty stomach. Eat something like a banana (if you are not diabetic) or any seasonal fruit or soaked almonds and a glass of water first thing in the morning (within 10 mins of waking up). No only biscuits or rusk will not do. 2. Don't overeat 3. Take your breakfast every day. Don't skip it. U can eat whatever your mother or grandparent eat in bfast. I mean to say whatever is your traditional food. If punjabi eat paratha, if belongs to south then take idli/ dosa etc. 4. Have light meals every 2 hours (in addition to your breakfast, lunch n dinner) e.g. Nariyal paani, chaach, a handful of dry fruits, a handful of peanuts, any fresh n seasonal fruit (eat whole fruit not juice), a cup of curd/milk etc 5. Finish your dinner at least 2 hours before going to sleep. Take simple food like rice n dal in dinner. 6. Maintain active life style7. Avoid fast foods, spicy n fried foods, carbonated beverages 8. Take a lot of green vegetables n fruit. It contains a lot of fiber which will help reduce tendency for constipation 9. Drink lot of water.10. Everyday preferably sleep on same time 11. Take half cup of cold milk when you feel acidity, it will help. Curd is good for u. 12. If its very severe then elevate your bed raising the head of your bed six to eight inches can help gravity keep gastric acid down in your stomach. This is for long term results but for now to bring your digestive system back on track you need to take medicines. For that I need more details, you can consult me. 

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Dr. Karuna ChawlaBHMSHomeopathy Doctor

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Follow this 1. Don't take tea empty stomach. Eat something like a banana (if you are not diabetic) or any seasonal fruit or soaked almonds and a glass of water first thing in the morning (within 10 mins of waking up). No only biscuits or rusk will not do. 2. Don't overeat 3. Take your breakfast every day. Don't skip it. U should eat whatever your mother or grandparent eat in bfast. I mean to say whatever is your traditional food. If punjabi eat paratha, if belongs to south then take idli/ dosa etc. 4. Have light meals every 2 hours (in addition to your breakfast, lunch n dinner) e.g. Nariyal paani, chaach, a handful of dry fruits, a handful of peanuts, any fresh n seasonal fruit, a cup of curd/milk etc 5. Finish your dinner at least 2 hours before going to sleep. 6. Maintain active life style7. Avoid fast foods, spicy n fried foods, carbonated beverages 8. Take a lot of green vegetables n fruit. 9. Drink lot of water.10. Everyday preferably sleep on same time exercise in the form of yoga, cycling, swimming, gym etc.Till lock down do suryanamaskar every day. for this homeopathy offers good results. Consult online. 

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Dr. Prakhar SinghMBBS, Basic Life Support (B.L.S), Advanced Cardiac Life Support, Fellow of Academy of General Education (FAGE)General Physician

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I am sorry to hear about your concern but will be happy to assist you. If a diabetic foot ulcer does occur, it's important to seek medical care as soon as possible; this is not a wound you should attempt to treat at home on your own. The faster a foot ulcer is properly treated, the greater chance it will heal completely and without infection or complications. Let's connect over a call so that we can discuss your concern in details and make a suitable treatment plan for you. 

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Dr. Prakhar SinghMBBS, Basic Life Support (B.L.S), Advanced Cardiac Life Support, Fellow of Academy of General Education (FAGE)General Physician

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I am sorry to hear about your concern but will be happy to assist you. Allergic reaction to certain foods. Stomach acid that makes its way into the mouth from conditions such as gastroesophageal reflux disease (gerd) medications, such as those used for high blood pressure. Diabetes, hypothyroidism, and other endocrine disorders. Let's connect over a call so that we can discuss your concern in details and make a suitable treatment plan for you. 

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Dr. Yasmin Asma ZoharaMDS - Oral & Maxillofacial SurgeryDentist

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Eat lot of fruits & green leafy vegetables & drink plenty of water. Avoid drinking anything hot. You may need coronoplasty (smoothening of teeth edges). Hexigel ointment can be applied over the ulcerative area on the tongue. T. Rebagen 10, morning one tab & one night for 5 days, along with c. Becosules 5 cap, for five days in the morning after meals. Rinse it thoroughly with the mouthwash. Advance procedures can be done with laser. Kindly consult a dentist in person if ulcer doesn't heal. You may consult me in person. 

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Dr. Bhushan KantaleMD Internal Medicine, MBBS Bachelor of Medicine and Bachelor of Surgery, DM - CardiologyCardiologist

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What was the last time you checked your blood sugar level? Are you on any medication for diabetes? Better to check sugar and show to doctor for controlling and care of wound. 

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Dr. Varsha Kandewad JakkalMBBS.MS.FMAS.FIAGES.DIPMAS, Fellowship in AnoproctologyGeneral Surgeon

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Pressure sores require frequent change in position, also offloading of ulcer you can use silver impregnated foams for dressing for early healing. 

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