Everyone reading this commentary has surely faced the sad situation of having a patient require an amputation. That said, we all should be talking to our patients about the problem of amputations caused by peripheral artery disease (PAD), diabetes, and smoking. Too often these amputations are due in part to a late diagnosis of arterial disease, lack of aggressive revascularization, uncontrolled diabetes, poor offloading, and/or continued tobacco use. While not every amputation is avoidable, there are too many that occur without an attempt at limb salvage. This is why I joined The Save A Leg, Save A Life (SALSAL) Foundation. SALSAL is a national nonprofit organization dedicated to decreasing amputations. Our mission is to achieve this goal by educating both the general public and healthcare professionals about these important issues. We also strive to advocate for our patients and provide community outreach. Recently, our White Sock Campaign (www.thesalsal.org/white-sock-campaign) again kicked into high gear.
Sock It To Them
The public seems well aware of conditions including breast cancer and colon cancer; yet most don’t know what PAD is — let alone its symptoms, how to get screened, or the risk of death associated with it. This has to change. As part of our promotion of the White Sock Campaign, SALSAL members were encouraged to don a recognizable white sock that symbolizes PAD awareness while in the presence of patients during the month of September — aka PAD Awareness Month.
During one recent encounter I had with a patient while I was wearing my white sock (in support of my patients), this patient assumed that I had injured my foot. But the sock served it’s purpose and gave me a chance to explain that it symbolizes support for patients who’ve experienced an amputation while helping to raise awareness to those patients living with a chronic wound who can’t wear a shoe because of their dressing. This allowed me to elaborate on the importance of self-care and disease management in an attempt to avoid amputation.
How You Can Help
Awareness and education are the ways we can all make a difference. Teaching patients and family members about the importance of screening for PAD by their primary care physician, checking their feet daily, getting diabetic foot exams regularly, keeping their glucose well controlled, and stopping tobacco use will help prevent wound recurrence and improve overall health. Please, help educate your colleagues so they understand how early detection and early intervention for PAD will heal wounds quicker and lessen amputation rates. Don’t accept the old mantra of “Just do the below-the-knee amputation, it’s too much trouble to try to heal the wound.” With the high morbidity and mortality associated with major amputations, as well as their long-term cost (healthcare costs plus loss of income and independence), we should all be countering misinformed statements such as this one. It has been proven that a team approach can lower amputation rates. Build your team within your healthcare system. Speak up — your patient’s toe/foot/leg depends on it.
The white sock is also meant to raise awareness of the need for donations that SALSAL can utilize to impact PAD and diabetes treatment. Donated funds help to provide needed supplies for patients who may not be able to afford proper offloading devices, wound care products for healing, or diabetic shoes for prevention.
We invite all of those reading this commentary to join us in our awareness efforts (yes, we continue to promote the campaign year round) by wearing a white sock and posing for a picture with patients, staff members, friends, and families. Post your photos/videos on your hospital and personal social media pages with these hashtags: #WhiteSockCampaign and/or #DocsInSocks. We also invite you to share your photos and videos to SALSAL’s Facebook page, as well as with Today’s Wound Clinic. Be creative! Be goofy! (Or, be serious, if that’s more appropriate to you.) The idea is to get people looking, sharing, and talking about the campaign and the prevalence of the conditions associated with it. The more people we can reach, the more likely vital information is going to get to those in need of better care. If each video or photo can encourage one person to quit smoking or to stick to a dietary plan, or one family member to take a loved one to the doctor to get a foot exam, or one physician to investigate further why his or her patient has leg pain or a nonhealing ulcer — then we are one step closer to saving another leg and another life. Put on a white sock and start having these conversations.
Tay Sha Howell is medical director at Oklahoma Wound Center, Norman, and co-chapter leader of SALSAL’s Oklahoma metro region. She may be reached at email@example.com.