Doctor helps patients put best foot forward

Published on November 1, 2009

by Dr. Crystal Holmes

Dr. Crystal Holmes

Bugs, dirt and gory movies gross out some little girls, but not me. I was a tomboy. Still am.

When I was 6, I had heart surgery to correct a congenital defect. That sparked my interest in science. Naturally, I found the hospital a fascinating place, and I learned one person could change another's fate in a single encounter.

In college, I shadowed doctors and tried different specialties on for size: pediatrics, cardiovascular surgery, internal medicine and podiatry. I even worked at a dental office for a year.

I loved surgery, but I didn't care to stick my hands into people — not into their mouths, ears, noses, and certainly nowhere else. So feet were a great compromise.

Around the time I was learning about different medical specialties, several family members developed diabetes. They didn't manage their disease well and suffered the consequences — heart attacks, strokes, limb amputations and premature death. Each was horrible, but amputation was, to me, the worst complication.

Diabetes is the leading cause of non-traumatic amputations in the U.S., resulting in about 84,000 lower limb amputations each year and it's almost completely preventable. Elevated blood glucose levels can decrease circulation and lead to nerve damage in feet. Because of this, a sore is more likely to go unnoticed and poor circulation slows healing, which can lead to infection.

Witnessing the physical deterioration coupled with personal anguish and frustration my family went through was almost unbearable. Right then, I set a goal to help others avoid such needless suffering.

At my podiatric practice in the University of Michigan Health System, I treat and help prevent diabetes-related foot complications, such as diabetic neuropathy, or nerve damage, wounds and infection. Education and early intervention is critical.

I work to empower patients so they can take care of themselves and manage their disease — choosing the right foods, exercising, taking medications properly, and following up with doctors regularly.

Barbara Fayroian-Roth, a patient of mine since 2006, has had diabetes for more than 50 years. She has suffered major complications from diabetes, including kidney failure for which she received her sister's donated kidney.

Last year, she contracted a foot infection so severe it appeared one of her toes would have to be amputated. But we decided to try to save it, and she took my instruction to heart.

She kept the wound on her foot clean, wore a special boot to keep pressure off of her foot and followed up with other specialists, who are part of the diabetic management team. It took several months, but she recovered and the toe healed.

She and I share stories about our canine companions during visits, and I'm happy to say she's back walking and caring for her beloved dogs.

Having the opportunity to take patients like Mrs. Fayroian-Roth from the brink of amputation to healthy and walking is as rewarding for me as it is for them. It's the reason I became a podiatrist.

So whenever I'm asked, "How can you look at feet all day?" I reply with a smile "one foot at a time."

Dr. Crystal Holmes is a board certified podiatrist and wound care specialist and a clinical instructor with the highly rated University of Michigan Health System. The Ohio College of Podiatric Medicine graduate completed her residency in podiatric medicine and surgery at the University of Texas at San Antonio. She is a member of the American Podiatric Medical Association's public education committee.