EDITOR’S NOTE: Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in HEALTHWISE MAUI, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.

Q: How do I know when it’s time to seek care for a diabetic wound?

Barron Elleby, DPM, Podiatrist and Wound Care Provider, Maui Memorial Medical Center Wound Care and Hyperbaric Therapy: If you have diabetes, you’re at a higher risk for sores and ulcers; these wounds are also more likely to become infected or have trouble healing. That’s why it’s important to check your skin regularly and notify your doctor right away if you spot any signs of a diabetic wound. Early detection allows for timely treatment.

Diabetes can lead to wounds for several reasons, such as poor blood flow and numbness, which can make it hard to feel injuries or ulcers. These wounds often appear on your feet and legs but can also develop on other parts of your body. Early warning signs of a diabetic wound include red, dry, cracked, or scaly patches on the skin. If an ulcer becomes discolored, emits a foul odor, has drainage, or develops a hard, calloused area, these could be signs that it’s becoming more advanced.

Catching and treating wounds early, before they progress, can help reduce the risk of infection and complications. Always consult your care team when you notice a diabetic wound. They’ll guide you on how to clean and dress it, apply any necessary topical medications, and prescribe antibiotics if needed. It’s also essential to keep pressure off the wound, such as by using crutches if necessary.

If the wound doesn’t heal, additional treatments like hyperbaric oxygen therapy may be recommended to promote healing by increasing oxygen levels in your blood.

Untreated advanced diabetic wounds can lead to serious complications, including infections and even amputation, so don’t delay care. Contact your doctor immediately if you suspect you have a diabetic wound

The Maui Health wound clinic is fully equipped to heal diabetic wounds quickly, with a hyperbaric oxygen chamber and other advanced treatments all in one place. For more information or to make an appointment, call 808-986-4500 or visit mauihealth.org/woundcare.

Q: How high is too high for a child to fall? When does a fall become dangerous?

Cameron Rogers, Trauma Injury Prevention & Outreach Coordinator, Maui Health: There’s no height limit that’s considered “safe” for falls. However, the risk to children increases as the fall gets higher and the surface they fall onto gets harder.

Many parents are surprised to learn that falling is one of the most common causes of injury in children. In fact, it’s the number one cause of pediatric visits to Maui Memorial Medical Center due to traumatic injury. One reason falls are so dangerous for children is because they are top heavy; they have big heads, so they are more likely than adults to fall headfirst. This can cause concussion or other serious head injuries, including bleeding in the brain.

Falls from great heights and onto hard surfaces tend to result in the most serious injuries. You can protect your child by being extra cautious when they are sitting or standing on something taller than them.

Windows, high furniture, and shopping carts are three problem areas where children’s falls can result in more serious injuries. Remember that screens are meant to keep bugs out, not keiki in. Move climbable furniture away from windows or install guards on any window a child can reach. Add padding or soft rugs on surfaces where children are likely to fall, like at the bottom of stairs or around beds, and in areas where they regularly play.

Keep kids safe in shopping carts by having them ride in the designated seat area with the seat belt, and never leave them unattended while they are in a shopping cart. Buckle babies and toddlers into highchairs, and always supervise children when they are climbing or sitting on a high surface.

If a child does fall, and the fall was significant or you are at all concerned about the fall, they should see a doctor. The US Centers for Disease Control and Prevention (CDC) publishes valuable information about concussions, how to prevent them, signs and symptoms, as well as how to respond to a potential concussion on their website at www.cdc.gov/headsup.

According to the CDC’s Head’s Up website, if a child has unusual behavior, increased confusion, restlessness, agitation, is not able to recognize people or places, has repeated nausea or vomiting, loss of consciousness with increasing drowsiness, inability to wake up or inability to stay awake, slurred speech, weakness, numbness, decreased coordination, a headache that gets worse and does not go away, one pupil larger than the other or double vision, will not stop crying and cannot be consoled, will not eat or nurse, or has convulsions or seizure (shaking or twitching) you should call 9-1-1 and seek emergency care right away.*

Falls can be dangerous for children, but by taking precautions you can reduce the risk and help keep keiki healthy and safe. For more child safety tips, visit cdc.gov/headsup.

*Signs and Symptoms of Concussion, CDC Heads Up, updated as of Aug. 23.