I have a ulcer on heel of my right foot.

by Larry
(Chicago,IL)

As I said I have a ulcer on the heel of my right foot I am wearing a boot shoe at home but when I go to work I can't wear the boot so I was wondering is there some way that I can raise my arch in my every day shoe so that my heel won't get any pressure to it.

RESPONSE

Hi Larry,

Let me start off by making a very important point. Your doctor who is treating you for this condition, should be the one answering this question. Simply because he or she is much more familiar with your situation, including the severity of the ulcer (there are varying degrees of foot ulcers), whether or not you are diabetic, your weight, your age, other medical issues that you may have, are you a smoker, the type of work that you do and on and on.
So as you can see it is a more complicated picture than just having an ulcer.
Having said all that I would like to give you some guidance and hopefully reinforce what your doctor has already told you. It has been my experience that those who do not take this medical problem seriously, are the ones who end up with the most complications.
Let me start off by saying that foot ulcers can be very hard to close. There are people walking around with ulcers for months, if not years, in spite of medical treatment.
Every day that your ulcer remains open is another day that it may get infected and lead to more severe complications. So, obviously the goal is to get the foot ulcer closed as quickly as possible.
There is a saying about foot ulcers and that is "it is not so much what you put on it (medicine and dressings), but rather what you keep off of it (nonweightbearing)."
The more pressure you put directly on the ulcer, the less likely the ulcer is going to close. You do not mention how long you have had the ulcer but in general, the longer you have suffered from a foot ulcer, the harder it is to close.
Understanding that, I also understand that some people simply cannot stay off their feet and many people have to work.
The problem that is occurring is just wearing your boot at home and not at work defeats the whole concept of not bearing weight on the ulcer.
You do not mention what kind of work you do but I am assuming you are not seated most of the day and you are on your feet all day, which is why there is a problem in the first place.
I do not have a simple answer for you, but you have to weigh getting this ulcer closed as quickly as possible and returning to a normal life versus dragging on with this problem and being either partially or totally disabled as a result of this ulcer.
Again, since I do not know what kind of work you do, whether you are self employed or work for someone else and not knowing the severity of your ulcer, I cannot offer specific advice, but what I can tell you is your smartest move is to speak to your doctor.
Explain the whole situation to your doctor and ask the doctor to start thinking "outside the box" in terms of concocting some kind of foot wear that will take pressure off the ulcer and allow you to work. Every thing in life is a trade-off and a foot ulcer in an individual that has to work is no different.
Assuming your doctor comes up with some sort of compromise, the next step would be to follow the progression of the ulcer healing, with the understanding that if the lesion does not show progress you may be forced to go on disability in order to stay off your foot.
When we evaluate ulcer progress we have certain benchmarks that have to be met in order to determine if the ulcer is actually healing or not. If you do not meet these benchmarks in healing while trying to also work, then you are increasing your risk of complications which can include loss of limb.
So you have to consider how your life and your employment would be impacted in a worse case scenario and this too should be part of the equation in treating the ulcer that you have right now.
So, even though I cannot give you specific advice I hope I have pointed out or at least reinforced what I hope your doctor has already told you. An ulcer on the foot is nothing to fool around with.

Marc Mitnick DPM
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