The Mayer Institute has developed a personalized system of care that identifies clients’ needs and matches them with the appropriate care. The categories listed below give brief overview and insight to the work we advocate and perform.
Diabetic Treatment & Management
Insulin Starts:
Addressing root causes, as the beginning of healing and health, is foundational to our work. Our approach identifies present and future needs concurrently, creating a holistic approach that reduces the chances of increased diabetic complications.
Dietary and Activity Advice:
With every visit to the center, we offer dietary and activity advice in addition to ongoing monitoring of daily blood sugar readings. This repetitive practice serves to reinforce the critical importance of lifestyle modification in the battle against diabetes.
Medication Reviews:
We partner with a team of talented pharmacists who provide ongoing medication reviews for our patients in-between their foot care appointments. This collaboration provides a well-informed and resourced treatment and anticipates medical conflicts and challenges.
Foot & Wound – Non Ulcer
Comprehensive Advanced Care:
- Regular blood work
- Physical exam
- Dystrophic nail and callus debridement
- Assessment of skin integrity
- Assessment of biomechanical change
Vascular Neurological Assessment:
Microvascular and macrovascular testing using laser
Doppler and pulse volume recording
Neurological assessment with vibration perception thresholds and formal nerve conduction studies when necessary
Review Lab Work:
Aggressive diabetic target control with every visit
Preventative Care:
Frequent reinforcement of the message…
Response vs. Reaction
Risk Assessment:
All points are stratified according to the University of Texas Diabetic foot risk index.
Category Assignment: Frequency of preventative care visits based on risk.
Foot & Wound – Diagnosis and Maintenance
The mainstay of treatment of diabetic wounds is offloading. We work tirelessly to find innovative ways to offload the affected diabetic foot. Diabetic foot care involves a complex series of examinations and integration of the data that is derived form these examinations. Using this information we are able to move the wound healing process in a logical and systematic direction.
Diabetic foot goes beyond mere toenail clipping and towards an ongoing, careful follow-up, education and risk management. Part of the care for the high-risk diabetic foot involves dealing with dystrophic or abnormally shaped toenails that are thick and cut into the skin. By using a specialized tool that grinds and debrides, we are able to shape these multi laminated nails into a thinner and flexible form. This treatment minimizes the risk, and injury to the adjacent tissue.
An additional concern is the buildup of thickened skin on the foot. Thickened calluses are usually accompanied by pain, but this is not the case for the diabetic foot. High sugar levels lead to damaged nerves and cause diabetics lose the ability to sense pain. This is a condition, also known as neuropathy, is the reason that diabetics unknowingly develop severe wounds to their feet.
The treatment of diabetic foot wounds involves offloading but also debridement. This is the process by which the dead or devitalized tissue in the foot wound is removed from the wound bed. In addition, the surrounding tissue is also removed in order to allow healthy cells on the periphery to move onto the healthy wound bed. Once the wound has been properly debrided and prepared, we apply the latest in advanced wound treatment modalities to facilitate the healing process.