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Saving lives, one foot at a time

DPT student Kristi Hoff conducting a diabetic foot screen—a filament is used to test a patients sensitivy to touch.
DPT student Kristi Hoff conducting a diabetic foot screen—a filament is used to test a patients sensitivy to touch.
Photo by Pauline Oo.

Ill-fitting shoes are not only uncomfortable and can cause nasty corns and bunions, they can actually harm your feet if you’re diabetic. According to the U.S. Department of Health and Human Services, two-thirds of all lower extremity amputations in the United States are directly linked to diabetes.

“Diabetes causes blood vessels of the foot and leg to narrow,” says MarySue Ingman, assistant professor of physical therapy at St. Catherine University. “So a person with diabetes gets less blood flow to those areas and also experiences a loss of sensation, which means rubbing from an ill-fitting shoe goes unnoticed.”

Without proper care, the skin breaks down and becomes infected. The risk, then, of losing is limb becomes all too real.

Ingman oversees a group of students from St. Kate’s Doctor of Physical Therapy (DPT) program that volunteers one Thursday a month at the Minneapolis Indian Health Services Diabetic Foot Clinic in the Phillips neighborhood.

Typically, between three to five students show up each time for the outreach experience, which runs 2:30 to 5 p.m. One DPT faculty preceptor or advisor is there as well to answer student questions and co-sign documentation that goes into a patient’s medical records. An exam room at the clinic serves as home base — until a patient requests a consultation. One or two students, along with the preceptor, then head over to the patient’s exam room. A purple St. Kate’s folder with foot care and exercise information in hand.

“This place is a one-stop shop,” says Kristi Hoff, one of the three student coordinators. “Patients can see a dietician, nurse, nutritionist and even a podiatrist. They can have their blood drawn or just come in for regular check-ups.”

And they can get their feet cleaned and thoroughly checked for bumps, bruises and sores by friendly Katies.

“Their role is to provide education about foot care for diabetic and pre-diabetic patients,” Ingman explains. “They do a foot soak and teach the patients a lot about how to protect their feet and what to look for. Patients love it, and some schedule their appointments on days that our students are there—just so that they can see the students again.”

Feet on their minds

The DPT program at St. Kate’s runs 33 months and, at a given time, has a total of 90 students. (It accepts a maximum of 30 students per cohort). Its curriculum integrates basic and clinical sciences within each course to encourage self-reflection and experiential learning.

“Our students learn a little bit about a lot of things along the way,” Ingman says. “For example, they learn about diabetes and the risk factors with diabetes, and this starts in the first year of their education.”

Diabetes is a chronic condition that affects 18.2 million people—nearly six percent of children and adults nationwide. American Indians are more than twice as likely to develop it than the rest of the population, according to the U.S. Department of Health and Human Services.

St. Kate’s students start volunteering at the Indian Health Services Clinic at the end of their first year. Students who came before them mentor or teach them the ropes. The same type of hand-off takes place with the student coordinators when they enter their last year.

“It’s nice to be able to volunteer in any way,” says DPT student Cole Kampen. “I don’t have a lot of experience with [the American Indian] community, but I’m getting the experience. And helping at this clinic is reinforcing what’s taught in class.”

Kampen’s classmate Becky Henderson, a student clinic coordinator, agrees.

Henderson says the monthly patient interaction allows them “to keep our personal skills up-to-date.”

Aug. 13, 2010 by Pauline Oo

See also: Healthcare, Students