Injured toe, four days after the fact

Eli, my 18 year old son, sat at the kitchen table and paged through the local newspaper as he ate his breakfast.

“Mom, what are diabetic shoes?”

I looked over his shoulder at the classifieds and saw small ads, like the ones in the back of diabetes magazines, for ugly, practical shoes with thick heels and laces.

“Ah. Some people with diabetes, later in their life, experience circulation and nerve problems that affect their feet, and they need to wear solid shoes that will support and protect their feet and help them walk.”

I explained neuropathy to Eli, and I told him that one motivator for my vigilant self-care was to avoid its ravages. I mentioned my grandmother’s brother, long deceased, who at the end of his life had at least one foot amputated because of diabetes. (It may have been two, actually, but this is too horrifying to remember and dwell on.)

A few days after this conversation, I had my annual physical with Dr. H. Even though she does not oversee my diabetes care, she asks for an update. This time, she asked me a new question: “When was the last time you saw your podiatrist?”

“Never. I don’t have one. Do I need one?”

Dr. H. explained that many people with diabetes see a podiatrist regularly, not only for check-ups but for foot care. I explained that my diabetes doc and nurse always examine my feet and do the filament test.

“Plus, I’m so proud of my feet!” I looked down at them: no bunions, no bone spurs, no fungus, no cracking, no neuropathy. Very able.

She agreed that they looked healthy. “Still, look into it the next time you’re at the Joslin,” she concluded.

Flash forward two weeks, to last Thursday. Once again, I’m with Eli, and this time I’m helping him load the minivan with the stuff he’s taking to college. My husband is inside, washing the lunch dishes and shutting down the house in advance of our two-day road trip with our first college-bound child. I yank up the big suitcase — an old-style one that we’ve put aside in the attic expressly for this kind of occasion — and I feel a sudden, piercing pain in my left foot.

I look down. “Fuck,” I mutter under my breath. (When my kids were little and starting to experiment with naughty words, I whispered to them that the best time to use profanity is when one has stubbed a toe. It’s the only way to manage the pain, and the surprise.) The nail of my left toe had been pulled partly up by the wheel of the suitcase and a strip of skin peeled from the tip.

I hop into the house. Jimmy hands me a rag. I squeeze it around my toe to stop the blood and the intense burning. I peek; the blood was abating.

My diabetic mind kicked in. “Fill the sink with soapy water,” I said. I knew I had to clean and bandage it properly, to prevent infection. I sit on the counter and dip my foot in. “Ow!” It stings.

I dry it, dab it with anti-bacterial ointment, and wrap it with non-stick gauze pads and first aid tape.

I stand and test it. I can walk, and the sensation is more discomfort than pain.

“Okay, you guys finish packing the car,” I say. Inside, I’m calculating the risk. Should I stay home and see a doctor instead? Well, there’s a major teaching hospital on Eli’s new campus, and we’ll be back to Boston in 24 hours anyway. Once again, I’m in a situation where I’m weighing the demands of my diabetes with my desire for important life experiences.

“Let’s go. I’m ready.” As a precaution, I take Advil, pack some bandages, and have Jimmy fill a bag with ice. We lock the kitchen door. We go.

Day of injury, in the car with thermos of coffee and ice pack on left big toe


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