Early steps can prevent
By Susan Glairon
WHAT DO BROKEN HIPS, amputations
and dental infections have in common? They
can all start with a seemingly small event that
rapidly escalates into life-threatening conditions. In many cases these serious health conditions could have been avoided with simple
For New Jersey Costco member Ray
O’Grady, the loss of his leg began with an ordinary foot blister. O’Grady, 59, didn’t know he
had peripheral neuropathy, nerve damage that
resulted in diminished sensation in his feet, a
common complication of diabetes. Because he
never felt pain, the blister continued to rub
against his shoe, and because diabetic wounds
heal slowly, within three weeks the wound
became infected. The infection worsened and
then traveled to the bone and ultimately did
not respond to antibiotics. A few months after
the blister surfaced, doctors removed O’Grady’s
leg from the knee down to save his life.
O’Grady’s story is not unusual. Improperly
fitting shoes are the biggest cause of amputations in diabetic patients.
“It’s frequently what starts the process,”
says Dr. Michael Pinzur, a professor of
orthopedic surgery with the Maywood,
Illinois–based Loyola University Health
System. One out of four diabetic patients
suffers from peripheral neuropathy, he adds.
To avoid the problem, people with diabetes should wear only diabetic shoes fitted by a
certified pedorthist, a specialist who designs,
fits and/or modifies shoes and foot orthoses
to alleviate foot problems, says Pinzur, a
Costco member. (To locate a nearby pedorthist, visit
www.pedorthics.org.) Other simple
prevention strategies include turning shoes
upside down to remove pebbles, inspecting
your feet for sores or consulting with a care-giver or spouse if you can’t bend to inspect
your entire foot. Those with diabetes who get
a foot blister should immediately seek treatment from an orthopedic surgeon or podiatrist, says Pinzur.
fall. Of patients who break their hips, about
20 percent die within a year, according to the
Centers for Disease Control and Prevention.
The increased risk of death is usually due
to medical complications, such as heart
attacks, urinary infections, blood clots, pneumonia or strokes. Roughly a third of those
who break their hip lose at least one level of
independence, such as going from independent walking to using a walker, or from using
a walker to living in a nursing home.
The good news is that getting into a habit
of walking or exercising, losing weight and
reducing alcohol and cigarette consumption
will reduce the chance of fracturing bones,
says Dr. Adam S. Bright, a Sarasota, Florida–
based orthopedic surgeon, who is also a
spokesperson for the American Academy of
Women with certain health issues, such as
kidney disease, use of steroid medications and
past chemotherapy, should be evaluated and, if
necessary, treated for osteoporosis; those without such health issues should be checked at
age 65. Men of all ages who have had a fracture, such as a broken hip, should also be
tested for osteoporosis.
Bright also recommends choosing an
orthopedic surgeon who is a fellow of the
American Academy of Orthopaedic Surgeons.
To choose an orthopedist in your area, visit
And those who do break their hip should
start rehabilitation as soon as their physician
advises, Bright says. Patients who don’t walk
independently after a month of rehabilitation
are unlikely to walk again, he notes.
Of course, the easiest way to avoid the
potential complications that follow breaking a
hip is to not break it.
“The most common reason why people
break their hips is they simply fall,” Bright
says. Eliminating clutter, extension cords and
throw rugs, and installing grab bars and nonslippery bathroom mats can help. Shoes with
non-slip rubber soles are also useful. Avoiding
sleeping pills or pain medications before bed
can prevent nighttime tripping due to grogginess. For more tips on fall prevention, visit
CONTINUED ON PAGE 46
Clear the clutter
Hip fractures are another common medical condition that can quickly turn life threatening, and they usually begin with a simple
Costco members can manage their diabetes
and osteoporosis with Costco Pharmacy-sponsored osteoporosis clinics (see Special
Events on page 88), prescription and over-the-counter medications, nutrition and weight-management products, and exercise equipment available at Costco and Costco.com. They
can maintain oral health with toothbrushes,
floss, rinse and toothpaste. Costco also offers
organizer products to manage clutter.