www.diabeticmctoday.com
David G. Armstrong, PhD, DPM

Dr. Armstrong was selected as one of the first six International Wound Care Ambassadors.
1. What made you choose podiatry, and specifically the diabetic foot, as your specialty?
I grew up with podiatry. My father, who passed away 2 years ago, was a foot doctor. I spent as much time in the office and at symposia as I did in class. My interest in the diabetic foot is another matter and was not specifically piqued until (literally) my first week of my surgical residency. I had just participated in a surgery on an elite athlete and wanted to visit with him in clinic for his first postoperative visit. The basketball player, who was pushing 7 feet tall, was writhing in pain in his treatment chair. Another clinic patient, a 4-foot, 8-inch woman from South Asia with a neuropathic diabetic foot ulcer, sat serenely with her family, waiting for debridement of her wound. She was completely peaceful despite the infected wound on her foot, while this mountain of a man, sitting just one room over, was in agony. This I suppose was my first clinical epiphany. I stepped back into the hallway — looking at this remarkable therapeutic juxtaposition before me, and I remember saying to myself, “Treating the presence of pain is a challenge, but treating the absence of pain is a calling.” Much of the work we have done has been directed toward that very effort.

2. What has been the biggest single development or advance in the treatment of the diabetic foot, in your career?
While there have been monumental advances in the understanding of neuropathy, infectious diseases, vascular surgery and wound healing, I believe the most significant has been the systematic classification of risk for ulceration and amputation. This, in my opinion, forms the foundation for everything else we do. My close friend and mentor, Professor Andrew J.M. Boulton, along with a few others of his ilk, developed a subspecialty where one did not previously exist. I think to make this area of medicine successful, development of a therapeutic lingua franca is essential so that everyone isn’t speaking in tongues. That is what is now occurring. It is very exciting.

3. What research are you currently involved in?
There is much work now going on in our unit in several areas. I think the three that most intrigue us are wound healing, infectious diseases and prevention. On the first two ends, we believe there are devices and pharmaceuticals either available or shortly to be available, that show great promise in healing the wound and the infection. On the prevention end, we are working hard to develop what we believe are personal local area health networks or home health portals, that can identify abnormal physiologic patterns and empower both the patient and doctor to immediately take action to prevent a catastrophic complication.

4. What’s your secret for balancing your professional life and your family?
I am not sure I have a secret. I must confess that I believe that I am quite bad at it. The only tip I could offer is for one to win the nuptial lottery and have a better half that is far more intelligent and talented than one’s partner. Tania, my wife, is everything that I am not. In that way, I suppose we have always complemented one another. Our three girls, Alexandria, Natalie and Nina, are simply spectacular.

5. What is your favorite family activity?
I love traveling with my wife and daughters. There is something that I can’t articulate that occurs the very fleeting moment one of our daughters sees something new and internalizes it. I see that most when we are far from home. Justice Oliver Wendell Holmes was fond of saying that, “Man’s mind, once expanded by a new idea, never regains its original proportions.” Seeing that happen is nothing short of magical.
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