Bob VogelQ. I met a C7 quadriplegic who had returned to the hospital to have two of his toes removed because they had become infected and the infection had gotten into the bone. He said the whole thing started when he was wheeling around without shoes on a hot summer day and got a minor scrape on them. He didn’t think it was a big deal, but it really freaked me out. Is this something that happens often? What can I do to prevent it?
— Chris

A. Chris, I wasn’t able to find statistics on how often this happens, but I know friends who’ve had toes amputated for the same reason. Because SCI often results in reduced blood flow to legs and feet, a minor scrape or cut on a heel or toe heals slower, which leaves an opening for bacteria to cause serious infection that can spread to the bone — osteomyelitis. Although the thought of losing a toe is bad enough, if the infection spreads, more area may need to be amputated. The best and easiest way to avoid this is by wearing shoes — something we often overlook, especially during summer.

In his younger years, Eric Stampfli. 53, now in his 36th year as a T11 para, lost two toes on his right foot and four on his left foot this way. “I used to go barefoot a lot and would stub or scrape a toe. It would get infected and eventually would get into the bone and require amputation. Usually the amputation was just the tip of the toe which left a stub, but sometimes it was