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Posts for tag: circulation issues

Let’s go back to high school Anatomy class. The human heart has four chambers that beat in rhythm. Blood is pumped into the heart by your veins and pumped out of your heart by your arteries. If you have poor circulation in your legs and feet, it could be caused by a problem with either your veins or your arteries. Both have very different symptoms, but they are equally bad for your health.

Here is a quick rundown on the two main culprits: Venous Insufficiency and Peripheral Artery Disease.

Venous Insufficiency

Your veins carry blood back to the heart. If they are not functioning properly, your circulation becomes an uphill battle, literally. Veins are equipped with valves that open and shut and keep the blood flowing in the correct direction. When these valves have trouble opening and closing it can lead to Venous Insufficiency. Signs of venous insufficiency include swelling, varicose veins, feeling of heaviness in the foot, and could eventually lead to leg ulcers. You are more likely to develop venous insufficiency if you are over the age of 60, you smoke, you are obese or lead a sedentary lifestyle, or if you have high cholesterol.

Peripheral Artery Disease

Arteries carry freshly pumped blood away from the heart to your extremities. When your arteries are constricted, narrowed, or blocked, you may experience symptoms of Peripheral Artery Disease. Contributors to PAD include smoking, high blood pressure, high cholesterol, diabetes, and leading a sedentary lifestyle. Persons suffering from PAD may have mild symptoms such as persistently cold hands and feet, or more serious issues like chronic leg cramping, burning sensation, or numbness.

Wearing compression hose or elevating your feet are good home remedies to help alleviate symptoms. But that’s not enough; stop smoking, get your cholesterol to a healthy level, and increase your exercise. Treating the underlying causes of either condition is the only way to ensure long-term relief. If these conditions are left untreated for too long, they both can lead to life threatening issues that go way beyond your feet. If you experience any of these symptoms, talk to your podiatrist about your circulation today.

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: http://goo.gl/YSR6wM. 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!

On March 17th every year, millions of people gather to join in the celebration of Saint Patrick’s Day. St. Patrick is considered the patron saint of Ireland and is credited with bringing Christianity there. March 17th was the day of St. Patrick’s death. For the devoutly religious, church services and a temporary reprieve from Lenten promises is the perfect way to celebrate. For the rest of us, it’s pinching people not wearing green clothing and drinking oddly-colored green beer.  In fact, I only own one green shirt and I keep it solely for the purpose of wearing on St. Patrick’s Day.

Although it is an uncommon condition, one type of green you don’t want to be seen wearing is gangrene. Gangrene arises from restricted blood flow, usually to the lower extremities. The skin and underlying tissue are not receiving adequate amounts of oxygen and they slowly begin to necrotize (die). This is a serious and potentially life threatening ailment. Gangrene is generally not something that will “just spring up”. There are risk factors and warning signs and knowing these will help you avoid complications.

 

WHO IS AT RISK?

Gangrene has two primary causes: lack of blood supply and infection. Lack of blood supply can develop from many pre-existing conditions including: diabetes, atherosclerosis (blood vessel disease), vascular disease, Reynaud’s disease, smoking, obesity, injury, immunosuppression, and certain medications. Gangrene resulting from infection usually occurs after a bad injury that isn’t treated properly or from a wound following a medical procedure or as a complication of another injury such as a burn or frostbite.

 

TYPES OF GANGRENE

There are two major types of gangrene and a couple of more rare ones. The most common type is dry gangrene. This type of gangrene takes days or even months to develop and generally stems from a preexisting vascular condition. Signs of dry gangrene vary with severity and location, but generally start with a cool and numb feeling in the affected area. Skin will change from healthy to brown, blue, or black accompanied by evidence of excessive dryness and shrinkage.  Eventually the body will slough off the affected area (meaning the tissue will fall off completely). While fatalities from dry gangrene are rare, it is still important to get treatment immediately because as tissue death progresses, more extreme measures may have to be taken to correct it. It is also not uncommon for dry gangrene areas to become infected and progress to wet gangrene, which is much worse.

“Wet (also sometimes termed "moist") gangrene is the most dangerous type of gangrene because if it is left untreated, the patient usually develops sepsis and dies within a few hours or days. Wet gangrene results from an untreated (or inadequately treated) infection in the body where the local blood supply has been reduced or stopped by tissue swelling, gas production in tissue, bacterial toxins, or all of these factors in combination.” (http://www.medicinenet.com/gangrene/article.htm) Early symptoms of wet gangrene start with aching pain and swelling. A foul smelling discharge or pus will appear around ulcerations and the dying tissue takes on a moist, black appearance. Infection can also lead to gas buildup inside the body tissues, so you may feel a crackling under the skin where gas is trapped.

 

HOW IS GANGRENE DIAGNOSED?

If you see any discoloration of the skin accompanied by numbness, get yourself to the doctor right away. If dry gangrene is suspected, your doctor will perform an angiography, which will show them how much blood is flowing in the affected tissues. For wet gangrene, blood cultures are used to determine the type of infection and MRIs are used to show the extent of damaged tissue or spread of gas. Removal (debridement or amputation) of the affected area is often necessary along with antibiotic treatment. Wounds can also be treated with hyperbaric oxygen treatment in conjunction to other methods.

HOW DO I AVOID GANGRENE?

Avoiding gangrene is generally easy. For diabetics this means maintaining steady glucose levels and checking your feet regularly. This should be a daily activity for those with vascular conditions affecting the feet. If you have any injury to an extremity (such as your toes), especially if it is a burn or cut, get treatment right away. Preventing infection is an important step to preventing gangrene. In short, as I have said many times before, just pay attention to your feet.

If you suspect that you have signs of gangrene, contact our doctors immediately to make an appointment. Early diagnosis and treatment is important to reduce complications and speed healing time.