photo by Jonathan Fitch

If you ever think about it, the feet support us, can get us around, and take a lot of abuse. However according to the American Podiatric Medical Association, 75% of Americans will have some type of foot problem in their lives. The feet are a very important but often neglected part of our body and often when I see patients, it is the feet that they are having issues with. When the feet are not well, it can cause pain, interfere with mobility, and thus your freedom.

Some common problems include athlete’s foot, warts, bunions, plantar facititis (heel pain) corns and calluses, gout, blisters, bunions, hammertoes, ingrown nails, nail fungus, neuromas (pinched nerves), and warts. So this begs the question – how can we take better care of our feet before a problem starts? First of all, wear shoes that fit properly. Wash your feet daily if possible, and keep your feet dry, including in between the toes. Have clean socks (not just because your mother said so), but to avoid inviting fungi. If you have a condition such as diabetes, daily foot checks are necessary by you or a family member. Invest in a telescoping self-examination mirror so you can see the bottom of your feet. Examining your feet should be included in your daily ritual just like brushing your teeth. If you notice any redness, swelling, cracks in the skin or sores, contact your doctor or podiatrist.

Luckily, many foot problems can be treated successfully if found and dealt with. The bottom line is, don’t neglect your feet! Give them the attention they need and deserve. Your feet will thank you for it. So let’s avoid the agony of “defeet”. There, I said it. Corny, I know – whoa! another one! OK I’ll stop now.

Be well.

Photo by: graur razvan ionut / FreeDigitalPhotos.net

When you are in the midst of a busy holiday season, getting enough sleep is something that can be hard to obtain. Yet for others, this is a year round problem if they have sleep apnea. It has been estimated that this condition, where a person has episodes of stopped breathing during sleep, affects about 18 million Americans (1 in 15 people) yearly. Not only does it contribute to daytime drowsiness and lack of energy, but could be potentially dangerous and affect ones health. Many suffer from this condition without even knowing it.

I once had a patient who had uncontrolled high blood pressure, and even though he was taking his medications the way his doctor told him, it was always too high. One weekend, his sister and her family came into town and stayed with him. It wasn’t until his younger nephew told him the next day that he snored so loudly it nearly scared him, that he went to get it checked. Eventually it was discovered he had obstructive sleep apnea (OSA), and now that he uses a CPAP machine at night, his quality of sleep improved along with his blood pressure.

Months later I told a girlfriend his story when we went on a trip together and I found her snoring to be disturbing. After having a sleep study done, she too found out she had sleep apnea and wears the CPAP at night. She recently told me she now gets the best sleep ever. Although snoring does not mean a person has this condition, speak to your doctor about your sleep patterns and your energy during the day. If you believe you or someone you know may have this, have it checked out. Good sleep is something we all need! Be well.

photo by Maggie Smith

Arthritis affects the joints and muscles of the body and can affect people at different ages and stages of their life. It limits a person’s mobility and creates an emotional toll from losing the ability of fully participating in the things once enjoyed. It is this aspect of the illness that can cause another problem and is one of the hardest to deal with — depression. At times putting feelings of loss and hopelessness into words is difficult, and having others understand what you are going through can be one of the greatest challenges.

Recently, a patient spoke to me of the emotional roller-coaster ride this illness was taking on him. Not only was the pain intolerable at times, but he stated he was becoming very depressed because of it, causing him to dwell more on his illness and what he could no longer do. When he was speaking to me, I thought of the problems my grandfather had to face with his rheumatoid arthritis. As far as I could see as a child, it only affected his knees causing him to walk with a cane. Some days he was fine, but on others he was downright miserable and I would try to help him as best as a child could. Yet now that I am older and thinking of what my patient was telling me, I wondered how much more the pain had affected my grandfather’s mood, and if he too was somehow suffering with depression. For my patient, he is about to start going to a pain clinic, and is also thinking about counseling to help with the feeling of helplessness and loss he sometimes encounters.

Studies have now shown that treating depression can very well help with the symptoms and problems with arthritis. Whether a person is treated with medication or psychotherapy, it not only helps with the symptoms of depression, but also the symptoms of arthritis. By treating one issue can help with the other. Is this something you or someone you know has had to deal with? And if so, was there a treatment that helped? Share with us your stories, and be well.

On the other end of the spectum however, is anorexia nervosa. Anorexia is simply a loss of appetite, yet anorexia nervosa is a disorder characterized by a fear of becoming fat, leading to a refusal of eating food, or at least eating enough for a person to remain healthy. Even though many cases are seen in adolescence, it has been found in children as young as seven. This (and other eating disorders) have a physical, behavioral and emotional component. Some symptoms to look for in those with anorexia include the following:

• being 15% below ideal weight
• fear of becoming overweight even though they may be normal weight for their age and height
• a distorted body image
• unusual avoidance of food, monitoring what is being eaten or eating in very small amounts
• excessive exercising
• menstrual cycle may be irregular or stop (missing at least three in a row)
• frequently feeling cold
• dry skin, thinning hair

Where children are concerned, it’s especially difficult to determine if the child is just a “fussy eater”, or perhaps just going through a growth spurt. Yet if you suspect your child or someone you know may be anorexic, it is important to speak to the parent and/or pediatrician right away. Sometimes a parent may suspect, but are not sure until someone else observes signs that there may be a problem too. If it’s discovered a child does have a problem, professional treatment may include a medical doctor, nutritionist as well as a psychotherapist. For more information about anorexia nervosa, contact the National Association of Anorexia Nervosa and Associated Disorders.

However at times the tables are turned and it’s the patient who ends up helping us. I cared for an 80 year old woman this weekend, and we had a great time talking about her life, hopes and dreams for the future.  She has been a widow for a number of years and we talked about her life with her husband with all the happiness and heartache that you would expect with a life together. In terms of dealing with her loss, she talked about finding that quiet place within and finding strength there when life throws her a curve.

The following day I discovered that an amazing friend/neighbor passed away suddenly.  I had spent an enjoyable summer evening with him, his wife and some of our friends two nights before. After hearing the news, the neighborhood gathered around to try to make sense of what we had just learned. We cried and grieved together, and are doing what we can to help his wife and daughter celebrate and honor the life of this most charismatic fellow.  Through our tremendous grief and tears I remember the words told to me the day before by my patient: find the quiet place within. It is not easy, but I’m trying.

There is a long and ardurous road ahead, but as my patient taught me, this is the time to find that stillness in you. Listen, and let the universe heal you.

Yet in terms of  just exercise in general, any activity that gets you moving and active is a positive one. Not only is it good not for your health and well being, but it can also benefit some physical conditions. In particular, arthritis is a condition that may actually improve with movement. As it happens, May is National Arthritis Awareness month. According to the Centers for Disease Control and Prevention (CDC), arthritis affects 50 million U.S., adults mostly over the age of 65 and is the most common cause of disability. One way to manage symptoms is through physical activity for 30 minutes a day, five days a week, which can be done in 10-minute blocks throughout the day. There are stretching, weight training and water exercises that can decrease stress on joints. Even yoga can help. The Arthritis Foundation has some good information on what people can do to help alleviate the symptoms of arthritis, reduce joint pain and decrease stiffness.

Share with us what you do to get up and get moving. Have a great May!

Every situation is different. But, for some caregivers, there is the added stress of worrying about the brother or sister who is caring for the parent. I have one girlfriend who is so concerned about how her sister is handling their mother’s affairs, it sometimes keeps her awake at night. She told me that although she is concerned about her mother’s health, she has come to terms with her mom’s illness and what can or cannot be done for her. It is the concern about her sister and her health that is most bothersome. The role that I, and our other friends, play is to do whatever we can to support her here and the sister, though she’s miles away. Simple things, like phone calls, social network sites and even Skype helps to keep a connection.

Recently, I saw a gentleman at a store who I had as a patient a few months ago. It is not common that I get to see someone again out of the home, so it was a surprise. What was more surprising however, was the weight Mr. C. had lost. I remembered he had told me he would start exercising when he got better, and he had. He started slowly and over time he was able to do more. It was difficult at first, but eventually he felt stronger and more flexible. Mr. C. said he now thinks he’ll be able to “take on” his young grandson this summer playing ball. I told him how proud I was, and what an inspiration he’s become, too!

The benefits of exercise may include improved blood pressure and lipid profile. Others are improved flexibility, better quality of sleep and improved mood. And, of course, the ability to play ball with the grandkids! Places to start may be “walking clubs” with friends, gardening or joining a center that hosts classes such as yoga and tai chi. Any small change can make a difference. Share with us what you have done.