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Black Areas Under Toenails, Spreading to Toes

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faithfully300144

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I am a nurse in the US. My stepfather has type 2 diabetes. In September 2009 I noticed that he had a small black area under his toenail. His doctor said it was a blood blister, which I thought was not a proper diagnosis, as it hadn't disappeared by December of 2009. Haven't looked at his feet much until today. Now he has four blackened areas under four toenails and two small black areas on one toe toward the end of the toe by the foot. I know this is dead or dying tissue. I will be taking him to the doctor ASAP. Has anyone out there actually dealt with this condition before? What were your experiences?
 
Went to the doctor. Black spots, fortunately were related to scabs from blisters breaking open due to athelete's foot. The podiatrist will be seeing my stepfather on a regular basis, however, due to lack of sensation in his feet related to diabetic neuropathy.
 
Diabetic foot care is really important. He needs to see the podiatrist regularly.

Anyone living with your stepfather also needs to take their own foot health seriously. If they have things like athletes foot it needs to be treated promptly as it can spread rapidly.

Your stepfather needs to make sure his shoes are treated as well and try not to go barefoot if he has retinopathy and he should dry his feet properly after washing them.
 
Well thank heavens it was nothing worse, good that your stepfather is going to see a podiatrist from now on, he will now get good advice on foot care.

I am concerned re your first post when you said that you noticed the spots in September and by December they still had not healed also that he has neuropathy, has this been check out properly, is it diabetic neuropathy or are you assuming it is?

What is his bg control like, what is his Hb1ac, what does he eat? I have suffered from numb feet, legs and hands before but managed to reverse this condition eventually. Does your stepfather exercise at all, it is important to keep the circulation going.

Let us know if we can be of any help with any of these issues; it is so nice of you to care so much about your stepfather.

All the best

Karen
 
First, my stepfather does not have a good hgA1c and has no intentions of changing his lifestyle. Second, I can't make him. I am a nurse and have educated him about this for years. He chooses to ignore education and advice from everyone, including his own doctors. My stepfather has selective hearing and hears only what he wants to hear. Eg. The doctor told him that he needed to delete all sugar from his diet. My stepfather heard, "I need to adjust my insulin if I want sugars." You can lead a horse to water, but you can't make him drink. This fits my stepfather completely!!! He is making his life choices. All I can do is educate. He has been to several specialists regarding his neuropathy. The conclusion is that he has absolutely no feeling in his feet and legs when pricked with a needle. The neuropathy has now run its course and is rampant throughout his body, affecting his gastrointensinal system. His heart is, so far unaffected, as he passed his stress test. I don't think that this will last and that eventually his heart will also be affected. He has eye problems, specifically diabetic retinopathy, as well as a possibility of open angle glaucoma. He feels that he should live his life the way he wants to, darn the consequences. We have 5 family members that are in the medical field and we can't make him understand what he is doing to himself. Neither can the doctor's or nurses that he has seen over the last 10 years. In the meantime, we just keep plugging away at education and he keeps ignoring it. He is depressed and takes medication, but refuses to see a psychiatrist. We do the best we can. That's all we can do.
 
Education is not always a lot of fun for the one being educated. Education about healthy living can sound a lot like nagging.

I should imagine there is a significant loss of face involved in admitting that perhaps that you were wrong and someone else right. And this has to be viewed in the context of a very negative picture painted by the health professionals. If you believe that diabetes is a progressive condition, what is the point of making all those difficult and unpleasant changes if it will get you in the end? It is a depressing situation, and taking medication for depressin won't actually take the reasns for the depression away. I can see where he is coming from, sometimes depression is a normal and natural response to a situation.

People have a right to refuse advice and make bad decisions. It is really hard to stand back and watch someone do this, but you can't manage someone's condition for them (I know, I have tried this). They will eat secretly or when you are not with them. And saying "you can't/shouldn't have that" only creates ill-feeling - someone said that to me yesterday, I responded that I was a grown up and could make my own decisions.

I think, perhaps, that the best you can do is make sure he gets medical treatment when necessary and simply try to make healthy choices available. Some people need a real crisis to look at changing their behaviour, but even then is isn't garunteed. The people around them need a bit of support too, to help them to cope.
 
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