Diabetic Foot Files

Mercury Retrograde & The Reopened Ulcer: Unfinished Business, Cosmic Chaos, Biomechanics, and How to Stop the Cycle Before It Ends in Amputation

Dr. G uses the Mercury Retrograde analogy to explain why diabetic foot ulcers often recur, covering medical and mechanical causes like osteomyelitis, unresolved pressure, neuropathy, scar tissue, and poor footwear. He outlines common hotspot locations, signs of underlying bone infection, and why healed skin remains fragile.The episode emphasizes immediate reassessment for reopened wounds, essential tests (cultures, labs, X-ray/MRI), and proven prevention: timely offloading (TCC, boots, custom orthotics), footwear adjustments, surgical fixes when needed, daily foot checks, moisturizing, and close follow-up to stop the cycle and avoid amputation.

Being in A Situationship with Your Diabetic Foot Ulcer: breaking the toxic cycle

Dr. G compares diabetic foot ulcers to a "situationship"—a pattern of ignoring early warning signs, inconsistent care, and delayed follow-up that lets small wounds become serious. This episode explains how ulcers can appear suddenly, linger, and then worsen if not treated promptly.Dr. G covers the red flags (swelling, drainage, odor, persistent callus), the essentials of assessment and treatment (debridement, culture, x-ray, vascular checks, offloading), and clear prevention steps: daily foot checks, strict follow-up, glucose control, avoiding barefoot/pressure, and proper footwear. The takeaway: don’t ignore small problems—early action prevents complications and amputations.

Cutting the Culprit: How Removing a Peroneus Brevis Saved a Leg

Dr. G returns with a real-world diabetic foot case about exposed tendons, focusing on the peroneus brevis. This episode explains why exposed tendons resist healing, when tendon excision is necessary (infection, necrosis, persistent biofilm, or lack of granulation), and the trade-offs between biomechanics and limb salvage.
Practical tips covered include keeping exposed tendons moist, immobilization, fenestration, serial debridement, use of grafts or scaffolds, and postoperative rehabilitation including bracing and physical therapy. The episode emphasizes that saving the limb often means removing structures that prevent wound closure.

Why I believe Winter Time is Gas Gangrene Season- Frost, Flesh and Fermentation: A Deep Dive into Cold Weather Clostridial Infections

Dr. G returns to Diabetic Foot Files to explain why winter can increase the risk of aggressive diabetic foot infections, including gas gangrene. She reviews how cold-induced vasoconstriction, reduced oxygen, cracked skin, and warm boot environments create anaerobic conditions that favor Clostridium species.The episode covers warning signs to watch for—severe pain, discoloration, crepitus, foul odor, and systemic toxicity—along with recommended diagnostics (X-ray, CT/MRI, labs) and urgent treatments such as surgical debridement, IV antibiotics, and hyperbaric oxygen.Practical prevention tips are shared: daily foot checks, moisturize safely, keep footwear dry and rotated, avoid direct heat, maintain circulation, and follow up promptly with your clinician. The message: stay vigilant this winter and seek immediate care for suspicious wounds.

Offload First: The Antidote to Neuropathic Plantar Ulcers

In this episode Dr. G explains why offloading — removing pressure from the ulcer site — is the single most important intervention for neuropathic plantar diabetic foot ulcers. He reviews evidence and guidelines that favor non-removable total contact casts, practical offloading options, and how to integrate offloading into a full treatment plan.Key points include screening and treating infection and ischemia, sharp debridement, ensuring patient adherence through non-removable devices, and using adjunctive therapies when appropriate. The episode emphasizes multidisciplinary care, patient education, and frequent monitoring to optimize healing.

Please Grow for Me: The Photosynthesis of Diabetic Wound Healing

Dr. G examines how growth factors act as fertilizers, and how oxygen and light therapies function like sunlight and air to revive chronic diabetic foot ulcers. He explains key molecules (EGF, PDGF, VEGF, FGF, TGF‑β), the problem of growth factor resistance in diabetes, and bedside treatments including PRP, topical/recombinant growth factors, topical and hyperbaric oxygen, and photobiomodulation.Using clinical anecdotes and a “please grow for me” theme, the episode surveys current approaches and emerging technologies (smart dressings, nanoparticle delivery, adaptive LED devices) for actively cultivating wound healing.

Feed Me, Seymour: The Metabolic Appetite of Diabetic Wounds

Dr. G explores how wound healing is an active metabolic process — what wounds need (calories, protein, oxygen, vitamins and minerals), how hyperglycemia and malnutrition stall repair, and a case where nutritional repletion spurred granulation within 14 days.The episode emphasizes checking nutrition labs, optimizing protein and micronutrients, controlling glucose, and using a multidisciplinary team to prevent complications and amputation.

Diabetic Foot Abscesses: When Pus Hides Beneath the Skin

This episode of Diabetic Foot Files explains how abscesses form in diabetic feet, why they can develop quickly and silently, and the importance of identifying fluctuance, pain, odor, and signs of deeper infection.We cover pathophysiology, common pus types (including MRSA), recommended imaging, incision and drainage principles, antibiotic choices, aftercare, and prevention tips for people with diabetes.

The Vampire's Cure: Why Bleeding Can Mean Healing

In this Halloween edition of Diabetic Foot Files, Dr. G blends vampire lore with wound-care science to show how blood can signal healing—not horror. The episode covers the history linking myths to medicine, the stages of hemostasis, and why controlled bleeding during debridement often means viable tissue and good perfusion.Practical tips include debridement methods, when to seek vascular clearance, managing anticoagulants and bleeding disorders, moisture balance, offloading strategies, and therapies like hyperbaric oxygen. A quick Q&A reinforces key takeaways for clinicians and patients.

Don't Stop Early: Why Finishing Antibiotics Saves Feet

Dr. Gabrielle Hutcheson -Donaldson explains why completing prescribed antibiotic courses is critical for diabetic foot infections: early symptom relief doesn’t mean the infection is gone, and stopping treatment can lead to resistant bacteria, osteomyelitis, sepsis, or even amputation.
The episode also covers when to take antibiotics with or without food, common food and drug interactions (dairy, iron, antacids, alcohol, blood thinners, contraceptives), and practical tips for patients and clinicians — always finish the course, don’t share or save antibiotics, and ask your pharmacist if unsure.