Thursday, February 12, 2015

Foot Care and Why It's Important

In times of crisis, you are very likely to be relying on your own two feet for transportation. Roads and streets can be torn up by tornadoes, earthquakes, hurricanes, or man-made disasters, or blocked with debris and dead, unmoving vehicles from same. Cars can run out of gas in all kinds of weather and conditions. There are countless ways that you could be forced to travel by foot, and so it makes sense to look at your most basic form of transportation.

Our feet are a complicated mix of bones, tendons, muscles, ligaments, and various other tissues. They are also the part of our body furthest from our heads and are often covered by shoes, so they tend to get less attention than other extremities. Taking care of your feet and footwear breaks down into several important parts.

Proper selection of socks is based on the type of boots and the type of activity you plan on engaging in.
  • Hiking and long distance walking require a set of socks that will provide cushioning and prevent friction from causing blisters. A normal hiking set is silk or nylon socks (for preventing friction) inside wool socks (for cushioning and insulation). 
  • Cold weather will require insulated or heated socks to keep your feet warm. Carry extra socks and change them as often as you need to in order to keep your feet dry. 
  • Cotton is not the best choice for socks, but can work if you change them out often and keep them clean.

Selecting Footwear
Weather and terrain should influence your selection of footwear.
  • The sandals you might be able to get away with on the beach will not work anywhere else. 
  • Those insulated snow boots you'll need to walk around in knee-deep snow will be dangerous to wear in the summer. 
  • Waterproof boots work both ways -- while they keep water off of your feet, they also keep your foot-sweat from evaporating and can lead to some very unique odors at the end of the day. 
  • Select your footwear based on your expected use of it and try to remember to have a back-up pair.
I'm old-school (some say I'm just old), so I prefer leather for my footwear. Leather is easy to care for, easy to waterproof, comfortable, renewable, and affordable. I prefer laces on my boots to zippers or slip-on styles, since they provide the ability to vary foot compression depending on the thickness of my socks and possible swelling of my feet.

Buying Footwear
Poorly fitting shoes and brand new shoes are hard on your feet, so learning how to shop for shoes is an essential step in taking care of your feet.
  • Wear the type of socks you intend to use with the shoes when you shop for them to ensure a good fit. 
  • Proper footwear should be snug, but not tight, and must support the sole of your foot to prevent breaking your arches. 
  • I place quality boots below only food and water on my list of preps, mainly because if I can't walk then I can't gather more food or water. Spend as much as you need to in order to get good boots. That neat pack is nothing more than a pillow if you can't walk, your tacticool carbine will make a rather poor crutch, and unless you have someone willing to carry you around, your caches are just buried treasure.

Care For Your Footwear
Your feet will sweat regardless of the temperature outside. You may have to walk through water or wet areas, getting your boots wet. 
  • If your boots are waterproofed or made of one of the breathable fabrics, your feet might stay dry but the boot itself will get damp. 
  • When you are done walking for the day, take off your boots and find a way to dry them inside and out. 
  • Campfires can work, but never set your boots closer to the fire than you can leave your hand. 
  • Leather dries best with gentle heat, and plastics will melt if placed too close to a heat source.
  • Brush the dirt and mud off of the outside of your footwear whenever you get time. This removes water trapped next to the surface and lets the fabric breathe on untreated boots. Spend a few extra minutes cleaning your footwear at the end of the day.
  • Unless you're in IDLH (Immediate Danger to Life or Health) conditions, never sleep in your shoes/boots. Your feet need a chance to decompress and your footwear needs a chance to dry before the next day's challenges.

Care For Your Feet After Walking
Blisters form from friction between your skin and your footwear. Keeping your feet and footwear clean and dry will minimize the friction and blisters as well as reduce the chances of picking up any of the varieties of fungi that like to grow in dark, damp places.
  • At the end of the day, wash and dry your feet, if you can, to get rid of dead skin and anything that may have started growing over the course of the day. 
  • Change out of the boots you've worn all day and rest your feet if you can.
  • Learn how to prevent and treat blisters before you get them and do what you can to avoid them. 
  • Learn how to use moleskin. 
  • Frostbite is a danger up here is the frozen North. Learn how to identify it and prevent it. Treatment of frostbite is advanced medicine and best left to professionals, but you should learn as much as you can.

Keeping your toenails clean and trimmed prevents them from catching on clothing, keeps them from being forced back into the cuticle when hit, and removes a breeding ground for bacteria/fungi. You don't need to get a pedicure every week, but spend a little time trimming your nails after washing your feet (nails cut better when damp).

What Inspired This Post
A friend of mine damaged his right knee at work last fall. He already has light nerve damage from a separate medical issue and has limited feeling in his feet, so he pays attention to his feet to avoid damaging them. He developed a blister on the top of his right foot from his shoe not fitting right, and because he couldn't bend his knee all of the way, he couldn't take proper care of a simple blister. After two weeks, this poorly-treated blister became infected, and the bacteria from the infection spread and moved down into his foot. 

These are pictures from a week after his surgery -- the kind of surgery where he wasn't sure if he'd still have his foot when he woke up. I must warn you that the pictures are not pleasant to look at. If you have a weak stomach or are easily grossed-out, don't click on the links below, and for heaven's sake never open a real medical book. That is about as close to a “trigger warning” as you're ever going to get out of me. I'm a firm believer that bad things happen and turning away from or ignoring them doesn't make them go away. 

For those of you with limited medical training, that yellowish-green tint is a sign of gangrene. Gangrene is one of the “old” diseases that used to kill people before the invention of antibiotics. When the tissues of your body stop getting sufficient blood flow, and therefore oxygen, they start to die and break down. When the tissue breaks down, it creates a nutrient-rich environment for bacteria and the damage spreads. If you look at the pictures close enough, you'll notice that he is missing several layers of “meat” on the side and top of his foot. This is called “debridement “, which is the process of removing dead tissue in an attempt to limit the spread of the infection. The tissue may or may not grow back to fill in the hole; only time will tell.

With access to a modern American hospital and well-trained doctors, my friend is going to survive. He is currently limited to standing no more than 5 minutes at a time, not carrying anything that could put weight on his right foot, and no walking more than 30 feet. A trip to the bathroom is an Olympic event that involves hopping and balancing, and usually leaves him worn out. He is taking large doses of antibiotics chosen for the specific bacteria he was infected with, and is taking pain pills for the effects of having his foot flayed to the bones and somewhat put back together. 

Recovery time is estimated at 12 weeks. That's three months of no work, no play, and no walking.

If this had happened anywhere or anywhen without the medical support facilities of a modern city, the best he could have hoped for was an amputation below the knee. Untreated, it would have killed him.

Take care of your damn feet, people.

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