Posts for: February, 2016

There are many things about the human body that we have yet to understand. One of those things is a strange condition called Raynaud’s disease. When some people's bodies overreact to stress or cold temperatures the small blood vessels in their toes and fingers spasm and narrow, causing color changes, numbness and tingling. Science isn’t exactly sure what the underlying cause of this disease (sometimes referred to as a syndrome or phenomenon) really is.

The disease manifests in episodes, called vasospasms, which can occur during exposure to cold temperatures or during times of high stress. All of the blood vessels in our skin are thermoregulatory, meaning they naturally react to changing temperatures by diverting blood to internal veins to maintain body temperature. For someone with Raynaud’s disease, this natural bodily function is intensified and the vessels narrow to a much larger degree even during simple events such as holding a cold glass or being exposed to air conditioning. Now the color show begins. First the digits will turn white (pallor) as the vessels narrow. Then, they turn blue (cyanosis) because they are not receiving ample oxygen rich blood. Lastly, as the blood vessels return to normal, the digits turn red and may hurt or tingle.

Doctors are able to diagnose Raynaud’s disease fairly easily, but identifying an underlying cause is much more difficult. With a full family history and physical examination, doctors can determine if they disease stands on its own (the most common form) or if a secondary factory is causing the symptoms. The disease usually affects women and manifests around the age of 30. It also runs in families, and most patients with the disease have at least one primary family member who is also affected.

The generally prescribed treatment is simple lifestyle changes such as avoiding cold weather and managing stress. For people with Primary Raynaud’s disease (aka not caused by an identifiable underlying cause) there is generally no tissue damage so non-prescription homeopathic remedies are best. If the phenomenon is linked to another illness, the doctor will focus on treating the cause and simply manage the symptoms in the meantime.

If you have ever had unexplained color or temperature changes in your fingers or toes during exposure to cold or stress, you could have symptoms of Raynaud’s disease. While this condition is not generally severe, if left untreated, permanent damage to bodily tissues could occur. Ask your podiatrist if you think you have these symptoms and they can help set up a treatment plan for you today.

Let’s face it, our veins are really important and when they aren’t flowing quite right it can cause all sorts of problems. Today we’re going to look at venous insufficiency, venous stasis ulcers, and edema (swelling) of the legs. Venous insufficiency is a condition cause by weakened valves in the veins of the legs. Normally, our veins pump blood back up to the heart, miraculously fighting gravity. But when the valves that pump our blood are damaged, either from a simple malfunction or complications from blood clots, they can’t get the blood back up to where it needs to be.

Factors that can contribute to venous insufficiency include advanced age, being female, obesity, sitting or standing for long periods of time, and even simply being tall. The symptoms are much the same as when we talked about artery diseases last week: pain in the legs when standing, a feeling of heaviness or cramping, swelling and redness, and wounds on the legs that won’t heal.

One type of wound that may occur is a venous stasis ulcer. These manifest on the skin of the legs, typically above the ankle and below the calf muscle. Because the blood is not moving through your legs, it pools in your veins and some fluid may leak out into surrounding tissues. The skin in these areas will turn dark red or purple and may become dry, thick, and itchy. Finally, an ulcer will develop.

If you have any symptoms of a venous stasis ulcer, call your podiatrist immediately. They may be able to help prevent an ulcer from forming or treat it before it becomes too large or infected. Your podiatrist can also help determine if your ulcer is a venous, arterial, or neuropathic ulcer. Diagnosis is mostly based on asking questions about your health and simple examination of the legs. A Doppler ultrasound may also be necessary.

Even if your only symptom of venous insufficiency is swelling (edema) of the legs, this is still a serious condition that needs treated. Luckily, there is an easy treatment for swelling that also helps with healing ulcers. The first step is to avoid sitting or standing for too long without movement. If you work at a desk most of the day, take five minutes every hour or so to do some simple leg exercises like the ones here: If you work standing, try elevating your legs on your lunch break and especially when you get home from work.

The other simple solution to leg swelling that can also help with the healing of ulcers is a CircAid. One of the best on the market is the Juxta-Lite legging. These thin compression sleeves can be worn under almost anything and feature adjustable straps that can target the best pressure needed for your particular condition. Features of this legging include: SILVERtech material to prevent odor and bacteria, built-in pressure system for easy compression targeting, inelastic compression (meaning they wont stretch out or lose compression over time), and they are machine washable. Available now from the FAAWC in any color (as long as it’s beige)!

If you have any symptoms of venous insufficiency, venous stasis ulcers, are just simple swelling in the legs, don’t wait to make an appointment. Early detection and treatment can save a lot of hassle, time, and healing down the road. If you have already been diagnosed with one of these conditions, drop by the office to try the Juxta-Lite compression aid. Every little step you can take toward bettering your foot and ankle health will give you the opportunity for many more (physical) steps in the future.

Wondering what P.A.D. is? Many of you probably know already, but P.A.D. stands for Peripheral Artery Disease. One in every 20 adults over the age of 50 has Peripheral Artery Disease. This occurs when fatty deposits, called plaque, clog the arteries of the legs. This can cause all sorts of problems with your legs and feet, not to mention the increased risk of heart attack or stroke.

The first thing to remember is that pain is not normal! Many people with P.A.D. either exhibit no symptoms or ignore them, writing them off as the general pains of aging. You should not feel pain in your feet or legs at any time. Some of the most common symptoms include pain, cramping, heaviness, or tiredness when walking or climbing stairs, pain that disrupts sleep, color changes in feet or legs, poor nail growth, and sores or wounds that heal slowly or poorly. Even if you don’t exhibit symptoms, people with P.A.D. may notice that they cannot walk as fast or as far as they used to.

So how do we diagnose P.A.D. if most people don’t have clear symptoms? First, discuss your risk factors with your podiatrist or primary care physician. Your risk of P.A.D. is increased if you smoke or used to smoke, have diabetes, have chronic high blood pressure or high cholesterol, or a personal history of heart disease. Your doctor can perform several simple tests to see if you have Peripheral Artery Disease. 

They may check the pulse in both your legs, comparing them to each other and the pulse in your arms. If the pulse is weaker in your legs or your legs are different temperatures, this is a good indication that you may have blocked arteries.

Treatment for P.A.D. is usually based on lifestyle changes and managing other conditions such as your blood pressure or cholesterol. Eat healthier, get out and exercise, and quit smoking. Sometimes medications may be prescribed to help eliminate pain or reduce the chance of blood clots. In extreme cases, special procedures or surgeries may be required.

If you think you have or have risk factors for P.A.D., call your podiatrist today. It’s never too early to start yourself on a healthier path and get yourself checked. Don’t block yourself from an active future with blocked arteries!

If you follow the news at all, I’m sure you’ve heard by now that the legendary Punxsutawney Phil did not see his shadow and predicts an early spring. His findings were independently verified by his Canadian counterpart Shubenacadie Sam. However, Mother Nature seems to have missed the memo and temperatures around the US have dropped this week after reaching rather high temperatures last week. If our groundhog friends are wrong, which let’s face it, they very well may be, we can look forward to lots more chilly temperatures before our spring flowers start to bloom.

Either way, it’s still winter and you still need to be wary of all that comes with it, specifically frostbite. There are no solid statistics on how many people are treated for frostnip or frostbite every year, but you can bet that it’s quite a few. Exposure to temperatures even as high as 40 degrees Fahrenheit with minimal wind chill can bring on the early stages of frostbite in just 30 minutes. It should be obvious that frostbite happens when your skin is exposed to cold temperatures without adequate protection. Most commonly affected are the toes, fingers, nose, and lips. There is a lot to know about frostbite, but let’s just stick with the basics:

How does it occur?

When your body gets cold, your blood vessels constrict and limit blood flow to your extremities, diverting the much-needed blood to maintain the temperature and function of your core organs. As this happens, the skin and tissues of your feet and hands have no ability to re-warm themselves after becoming chilled by the ambient conditions. The severity of frostbite is classified in degrees (1st degree frostbite, etc.) with fourth degree frostbite being the most dangerous. Your particular degree of frostbite is determined by how much of the skin and tissue has been frozen and how long it has stayed frozen.

During 1st and 2nd degree frostbite, the affected area becomes white or pale and painful, often with a pins and needles or burning feeling. Numbness can set in quickly and when pressed, the skin will show some resistance. This is called superficial frostbite. Deep frostbite (3rd and 4th degree) manifests with complete loss of feeling in the affected area, swelling, white or yellowish skin that turns black or purple upon re-warming, and when touched, the skin will feel solid.

What happens if I get frostbite?

If you think you have frostbite (even frostnip!) you need to immediately seek emergency medical attention. Every minute of lost warmth could mean permanent damage to skin and tissues and even result in the need for amputation. While you are waiting for emergency care, remove any wet or restrictive clothing and wrap loosely in a blanket. Do not place the area on or over any direct heat sources such as radiators or fires. Avoid refreezing at all costs!! At the hospital, doctors will re-warm the area rapidly in a hot water immersion, apply aloe vera, then wrap and elevate the area. A hospital stay of a few days can be expected, even in mild cases.

How do I prevent it?

Preventing frostbite is easy if you just stay indoors when it’s cold out. However, this isn’t always a possibility so if you do need to go out into the cold, make sure that you are properly dressed in loose layers. Warm socks (sweat wicking preferably), mittens, scarves, and hats will help protect the most at risk areas of the body. If any of your clothing (especially your socks) becomes damp or wet, seek warmth and remove them immediately. Children tend to lose body heat faster than adults so watch them closely and limit their time outdoors. People with circulatory issues (the elderly, diabetics, etc.) need to be particularly careful and attentive. Although children and senior citizens have the highest risk factors for frostbite, most cases actually affect men ages 25-40. This is most likely due to the increased homeless population in the United States. So the next time you go out to buy your family socks to keep them warm this winter, pick up an extra pack to donate. Someone else’s toes will thank you for it.