Dr. Theall's Blog

Posts for tag: diabetes

By Dr. BruceTheall
August 06, 2016
Category: Diabetes
Tags: diabetes   footwear   Rashes  

The hottest month of the summer has started and everyone is out enjoying the beautiful weather with barbecues and trips down the shore. But what if you are diabetic?  Sandals or flip flops may be tempting to wear but it is always important to remember about taking care of your feet even if your diabetes is well controlled.

Small, unnoticeable wounds can start because your feet are not protected in your sandals whether it comes from burns from hot sand at the beach or running around in your back yard. Those with diabetic neuropathy should be especially careful of wearing sandals or flip flops because they are not supportive and do not protect the skin on your feet from potential threats. Always make sure your feet are protected with nice cotton sweat absorbing sock with a good supportive shoes during your trips outdoors.

Enjoy the beautiful weather and a well-deserved vacation but diabetes never rests! It’s easy to forget to take care of things during carefree summer days. If you noticed any pains or rashes call your podiatrist immediately.

A podiatrist is the only person that is trained in a specialized field in medicine for anything concerning the lower extremity, foot and ankle, that’s why it is important for you to visit your podiatrist if there are any problems concerning your feet.  In the case of diabetes, the most effective treatment is to eat healthy and wear nice, supportive shoes. If there are any other questions feel free to contact Dr. Theall’s Gentle Touch Foot Care office for all your foot and ankle needs and concerns at 973 673 – 3668.

               

 

By Dr. Bruce Theall
May 31, 2016
Category: Diabetes
Tags: diabetes   circulation   therapy  

The summer season is approaching us and many people will be ‘getting their feet wet’ whether it is in a pool, ocean, lake or river.  It is that time of year where we can all enjoy the outdoors after hibernating for winter.  Water has been shown to have immense advantageous effects on the body whether it is part of a work out, leisure activities, or for physical therapy.  Water is the most abundant natural resource this planet has to offer, and it offers a great deal more than previously thought.

The rationale for the use of hydrotherapy, water therapy, introduces an increase in resistance which causes more muscle activity, and most importantly to decrease weight-bearing on joints, especially in the feet.  While you are swimming or dipping your toes in the water, you are decreasing stress off of your joints without any effort.  Sometimes our feet need a break from the 10,000 steps we take per day.  Hydrotherapy is also beneficial to decrease recovery time from an injury, increases healing time, and to lower the risks for recovery injuries.  Hydrotherapy provides pain relief, increased strength, increase in range of motion, circulation, balance, while decreasing edema (swelling).  This provides pain relief, reduced muscle spasm, increase joint range of motion, strengthen weak muscles, increase circulation, improves balance and coordination, and re-educates paralyzed muscles. 

Hydrotherapy can be very helpful in patients with osteoarthritis to provide pain relief, patients with joint replacements in rehabilitation, patients afflicted with fibromyalgia to help improve sleep quality, patients with recent heart attacks for heart healthy rehab, and in patients with nerve disorders for improved balance/motion.  Hydrotherapy has been proven to help people with nerve pain in the lower back.  In addition, people suffering from arthritic pain, fibromyalgia, and diabetes, can benefit from waters’ qualities.  Be sure to check with your medical doctor and podiatrist first before trying any therapeutic options to see which one is best fit for you.

A podiatrist is the only person that is trained in a specialized field in medicine for anything concerning the foot and ankle.  If there are any other questions feel free to contact the office at 973  673 – 3668.

By Dr. Bruce Theall
May 14, 2016
Category: Orthotics
Tags: diabetes   orthotics   arch support  

“I have foot pain” is a very general and common statement in a podiatry office.  Most people go with pain their feet for months to  years before the problem is address and sometimes even longer until it is actually treated by the proper health care professional.  “Do I need orthotics” is probably the second most common question in a podiatry office because the patient has foot pain.  That is why it is very important to see your podiatrist if you have any kind of foot pain or ailment for proper evaluation and treatment. 

Custom orthotics are devices that are placed inside shoes to help correct abnormal walking patterns, improve foot function, decrease pain/increase support, decrease the load with appropriate design features, increase ability for tissues to adapt to higher loads, and allow for better balance.  Many times people and advertisers confuse orthotics with arch supports, which are over-the-counter devices available in stores.  Arch supports claim to improve foot pain, but most have been found to be made of gels that may help with foot pain, but not with arch support. 

There are two types of orthotics, functional orthotics and accommodative orthotics.  Functional orthotics are designed to control abnormal motion that can help treat injury and are usually made with semi-rigid material.  Accommodative orthotics are softer and provide more cushioning and support in patients with painful calluses, diabetic foot ulcers, and severe foot deformities. 

A podiatrist is the only person that is trained in a specialized field in medicine for anything concerning the lower extremity, foot and ankle, that’s why it is vital for you to visit your podiatrist if there are any problems concerning your feet.  Custom orthotics can only be prescribed and purchased through your podiatrist, everything else is false advertisement.  Custom means “fit to only you, not to anyone else”, everyone’s foot type is unique.  If there are any other questions feel free to contact the office at 973  673 - 3668.

By Dr. Bruce Theall
December 22, 2015
Category: Diabetes
Tags: diabetes   smoking   pain in feet  

For many years now, everyone knows that smoking is bad for your health.  Smoking affects your lungs, heart, weight, skin, nails, hair, and it causes many different kinds of cancers.  Most people do not know that smoking can also affect your feet.  Smoking is linked to a disease called PAD, or peripheral arterial disease.  Most patients aged 50 years and older have a higher chance of developing peripheral arterial disease (PAD), especially if they have diabetes and they smoke, opposed to those who only smoke or only have diabetes.  Several risk factors for PAD associated with PAD, which include diabetes mellitus, hypertension, older age, and dyslipidemia.  A higher prevalence of PAD has also been found among older African Americans and Hispanics when compared with whites.  The inadequate recognition of PAD may place many patients at risk of its complications, including ischemic ulceration, gangrene, limb loss, and/or increased cardiovascular morbidity and mortality.

Peripheral arterial disease affects about 12 million people in the United States.  It is a condition that is caused due to the occlusion of arteries due to atherosclerosis, or the hardening of the arteries.  Often called peripheral arterial disease (PAD), this condition occurs due to a result of cholesterol and plaque buildup in the arteries of the lower extremities.  This causes decreased blood flow to the legs.  This condition commonly happens in elderly people as these deposits build up over a long period of time in their arteries.  This is the same type of problem that causes heart attacks and strokes when it affects the arteries to the heart or the arteries to the brain.  All can lead to serious consequences if not evaluated, treated, and monitored properly.

Age, sex, atherosclerosis, hypertension, Diabetes mellitus, smoking, hyperlipidemia, cardiovascular disease, poor diet, alcoholism, renal insufficiency, and family history.  Smokers are particularly at risk for poor peripheral arterial disease.  Every time a cigarette is smoked it causes constriction of the arteries reducing the blood flow.  It can take as long as 20 to 30 minutes after the cigarette for this process to reverse and if smoking goes on for a long enough period of time, sometimes damage is irreversible, meaning it can never go away.  People who are overweight and have high cholesterol levels also are prone to this significant disease.  Diabetics who have PAD from the above factors also have small blood vessels to the feet that are damaged when sugar is uncontrolled and too high over a long period of time.  This is an extra risk for diabetics and if they smoke and have high cholesterol now have three strikes against them.

The earliest symptom of the disease is muscular pain in the leg.  As the disease progresses, patients complain about pain at rest and pain that gets worse with elevation.  In later stages of the disease, arteries are not able to delivery blood to the tissue and this leads to tissue ischemia and eventually the patient is in extreme pain and the foot and toes will appear black from lack of oxygen.   In severe cases, PAD progresses to ulceration and gangrene.  About one third of the patients suffering from PAD require amputation which not only affects the quality of life in these patients, but also affects the life expectancy of the patient. 

A diagnosis of PAD could be a barrier to preventing further cardiovascular risk.18 Increasing physicians’ awareness of the importance of screening patients at high risk for PAD has important benefits. Patients treated early for PAD could have a significantly improved quality of life as well as the decreased likelihood of future cardiovascular morbidity and mortality.

A podiatrist is the only person that is trained in a specialized field in medicine for anything concerning the lower extremity, foot and ankle, that’s why it is vital for you to visit your podiatrist if there are any problems concerning your feet.  In the case of PAD, the most effective treatment is to stop smoking immediately. If there are any other questions feel free to contact Dr. Theall’s Gentle Touch Foot Care office for all your foot and ankle needs and concerns at 973 673 – 3668.

By Dr. Bruce Theall
November 11, 2015
Category: Diabetes
Tags: diabetes   infection   skin conditions  

Within the past week we have learned that NY Giants football tight end Daniel Fells was hospitalized with an infection in his foot.  He was diagnosed with having MRSA, or methicillin-resistant staphylococcus aureus, which is a serious potentially life-threatening infection.  MRSA is caused by the bacteria staphylococcus aureus and it is most commonly found on the skin and in the nasopharynx or the back of throat.  Methicillin-resistant Staphylococcus aureus (MRSA) has become the leading cause of healthcare associated infections since the 1970s while just as recently as the 1990s has it emerged as a of infection in the community setting.  It has been suspected that the infection in Daniel Fells case came from the locker room or training rooms, but the source is still not definitive.  Methicillin-resistant Staphylococcus aureus is a type of bacterial infection that is resistant to certain antibiotics.  Over the past several decades, MRSA has gone from being a controllable condition limited mostly to hospitals and healthcare facilities to a serious public health concern.

There are 2 major categories of infections with the transferring of a MRSA; it can come from community acquired infections (CA-MRSA), these infections of MRSA in patients who lack risk factors, can be linked with those in urban areas children in day care and prison inmates.  Most infections manifest as skin and soft tissue infections or dermatological lesions.  The second type of MRSA infections can occur by hospital acquired (H-MRSA) infections with MRSA, mostly from tobacco use and diabetes.   In the hospital setting, patients that have been hospitalized for long-term care, have had surgery, have indwelling devices, have had dialysis, or have a history of MRSA are at greater risk of acquiring an infection.   In the community (CA-MRSA) we can see spread through a wide range of activities, but usually occurring when in crowded or more densely populated areas.  Some examples are playing sports that have close contact, in correctional facilities, daycares, individuals who have received tattoos.

MRSA and CA-MRSA are transmitted by direct contact with someone who has an active infection, someone who is a carrier, or a contaminated object.  MRSA can occur in a few different ways, touching skin of a person who is already colonized or has an active infection, breathing droplets from a cough or sneeze of an infected individual, or even touching a contaminated surface.  Some common contaminated surfaces in the hospital include bed side rails, blood pressure cuffs, toilet seats, and remote controls. Spread via contaminated surfaces is usually more commonly seen in CA-MRSA.  These occur with the use of shared items, such as towels, bedding, and sports equipment.

Once infected, signs and symptoms do not usually have an immediate onset.  It usually takes 1 to 10 days for symptoms to start.  It will appear as a skin infection and is often mistaken for a spider bite.  The site of infection usually appears red, swollen, warm, and painful.  The infected sites are commonly at sites on that skin that have already encountered skin trauma.  These sites allow the infection to adhere and colonize easier since the skin surface is exposed.

The treatment of MRSA depends on severity.  In less severe cases,  the patient will be placed on oral antibiotic treatment and if it doesn’t seem to be responding then the MRSA strain may be resistant to the antibiotic, or the infection may be more severe then it appears.  In more severe cases of MRSA, the patient may be admitted to the hospital and started on IV antibiotics.

A podiatrist is the only person that is trained in a specialized field in medicine for anything concerning the lower extremity, foot and ankle, that’s why it is vital for you to visit your podiatrist if there are any problems concerning your feet.  If there are any other questions feel free to contact Dr. Theall’s Gentle Touch Foot Care office for all your foot and ankle needs and concerns at 973 – 673 – 3668.