IT is with a heavy heart that I write this article. I recently treated a patient where I was so disturbed by what I found, I had to share the experience with you. I implore those of you who are capable and able-bodied to check older relatives, the disabled, friends, and associates to ensure they are not hiding dreadful problems inside their shoes.

Because feet are usually covered, we often ignore them, especially if they are not our own. If a problem is visible we are more likely to deal with it. Most people will visit their dentist twice a year or have their eyes checked annually, just to ensure that all is well. We have regular physicals to be sure our blood pressure is stable and we are generally fit. Unfortunately, the part of our bodies that we most neglect is the part that takes the majority of the bashing every day, the feet.

I received a call from the relative of a 95-year-old woman. They said she was bed-bound and that her nails hadn’t been cut for a long time and that she also had corns. This is a standard request, so I packed the necessary instruments and medicaments and went to her home. On arrival, it was apparent that the patient had advanced dementia and was unable to communicate well. She was also incontinent, but besides those ailments, her family assured me that she had no other relevant medical history and was doing very well ” for an old girl”.

Her toenails were very thick (onychogryphosis) and at least four inches long. They had curled underneath the soles of her feet and some had pierced the flesh. Unfortunately, I see this type of neglect regularly. Contrary to belief, these are often the easiest nails to remove once the podiatrist has the correct instruments and good technique.

So, I got to work. However, as I attempted to reduce the nail of her right great toe, I was horrified to discover an ant’s nest – yes an ant’s nest – living underneath the nail. I had disturbed hundreds of sweet ants ran up her legs, onto the sheets and onto my surgical gloves. This was a first for me in more than 20 years of practice.

The patient lay oblivious to what was happening. Remember, she is very old and infirm with severe dementia. She would not have been capable to communicate any discomfort. That day I found two other ant’s nests living underneath her nails, resulting in the same horrific swarms of ants expelling from her toes. I was able to continue my work and treat this lady accordingly. All nails were reduced to their normal length, the ants were removed and her wounds dressed. She will need regular medical attention for at least the next few months to sort out her problems. This may even result in an amputation which, at her age, is very risky.

This lady had a loving, attentive family, but her feet had been neglected. They thought that as she was not mobile, no harm could come to her feet, but how wrong they were. They had never noticed any ants before, just the odd one or two. They were just as shocked as I was when they saw what had been living underneath her nails.

Podiatry has a lot of similarities to dentistry. Years ago people went to the dentist only when they had a bad toothache. By this time the dentist could only extract the tooth as it was so badly damaged. It is the same with podiatry. People only tend to go when there is a severe problem which can lead to long, drawn-out rehabilitative care or amputation. Most amputations start out as an ingrown toenail, a blister, discoloration, a small cut or swelling in the feet or ankles. This can all look so innocuous.

Tackle these issues early on, and a lot of heartache can be avoided. Treat your feet like your hair or teeth. You have your teeth cleaned by a dentist or hygienist; if you damage a tooth you have it repaired. Annual check-ups for your feet are exactly the same. Everyone should have some level of professional care when it comes to their feet. This is even more important when it comes to the vulnerable in our society, like the elderly and disabled.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293-7119), Mandeville (962-2100), Ocho Rios (974-6339), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.