Friday, October 23, 2015
Post-Op Ankle Surgery on Posterior Tibial Tendon with Dr. Wellens
Central Florida Foot and Ankle Center101 6th St Nw Winter Haven, Fl 33881Phone: (863) 299-4551www.FLFootandAnkle.com
Tuesday, June 28, 2011
The Role of Nutrition in Chronic Wounds
Chronic wounds can be extremely difficult to heal. Particularly in the diabetic patient, where a weakened immune system coupled with a loss of protective sensation, the risk of developing a chronic wound is compounded.
Diabetic foot ulcers have become a massive problem in the United States. Approximately 15% of diabetics are affected by chronic ulceration. They can become infected, and precede almost 90% of non-traumatic amputations. Because of the risks involved with open chronic ulcers in the diabetic patient, aggressive measures are often made at closing the wound. This generally involves at the very minimum a period of offloading the wound as well as strict control of blood sugars, in addition to local wound care.
Another area of concern that is often overlooked is the nutritional status of the patient. Simply managing the blood sugars of a diabetic patient is a good start, but many other nutrients are involved in the process of wound healing.
The single most important nutrient for healing is protein. A deficiency in protein has been linked to longer healing times, due to impaired steps in the healing process. In particular, the formation of new capillaries and the collagen fibers that assist in wound closure depend heavily on adequate supply of protein. Protein levels can be check with a blood test to look for albumin, the most abundant free protein in human blood. This level should be above 3.5g/dL for adequate levels. Protein deficiency can be the result of poor diet, or secondary to kidney disease or other metabolic dysfunction.
Omega-3 fatty acids have long been touted for their anti-inflammatory effects, and recent research suggests that they may play a role in the healing of chronic wounds. They may serve as building blocks for the healing wound, as well as control inflammation and promote the healing process.
Vitamins C, A, and E play an important role as antioxidants in the body, and contribute to wound healing as well. Vitamin C is particularly important in the formation of collagen. Without vitamin C, a crucial step in collagen synthesis is missed, and the resulting collagen is weaker than normal. This results in fragile capillaries, easy bleeding, and weakness of the newly synthesized collagen fibers that help the wound heal. Vitamin C deficiency was first described in Scurvy, a condition associated with poor wound healing. Vitamins A and E act as antioxidants, attacking free radicals in the wound that contribute to its chronicity.
The term micronutrients refers to minerals that are essential in small doses in the diet. This includes zinc, magnesium, copper, selenium, and iron. These nutrients all function as essential co-factors for enzymes that are critical for wound healing.
In summary, nutrition plays an essential and often overlooked role in the healing of chronic wounds. In diabetic patients susceptible to such wounds, or with those that have a chronic wound, their diet should be optimized for healing. Tight glycemic control is crucial to preventing the complications of diabetes, and proper nutrition is extremely important as well.
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
Tuesday, November 23, 2010
Socks, Socks, Socks!
With so many different types of socks out there, it can be difficult to decide which ones to get. Socks come in a variety of thickness, length, material, brand, and can be specialized for all different activities. So how do you know which ones to get?
The single most important thing to consider when picking out socks for yourself or someone else is the material that the socks are made of. Socks that are made of 100% cotton are the “gold standard” which all other are compared to. All cotton socks will absorb moisture, pulling it away from the skin. This can prevent conditions of the foot such as tinea pedis (athlete’s foot), hyperhidrosis (excessive sweating), and onychomycosis (fungal nail infections). They are the most versatile sock, and come in a variety of thickness.
But what happens to all of that moisture that the cotton socks pull off of the foot? In a very active person, or someone that will be on their feet for an entire day, that moisture has a tendency to just sit in the sock, right up against the skin. This is especially true for those who wear cotton socks with leather shoes or other types of shoes that don’t breathe easily. For this group of people, or for this type of activity, a moisture-wicking sock will be a better option.
Moisture-wicking socks come in tons of different forms, but most are made out of either a synthetic, acrylic-based material or a natural wool fiber. These socks, rather than absorbing the moisture from the feet, will spread the moisture out so that it can evaporate at a faster rate. The socks do not prevent sweating – they simply allow the sweat that is produced in the feet to evaporate faster. Moisture-wicking socks may be marketed as running socks, hiking socks, or other sport socks. Be forewarned, though – not all brands of socks are created equal. Many companies will use an inferior moisture-wicking material that may not work as well, and will be very warm against the skin during activity. Brands such as Smartwool, Bridgedale, Drymax, Balega, and Wrightsock are all good choices, but there are a number of other brands that make good moisture-wicking socks as well.
Socks with a nylon blend or polyester fabrics should be avoided at all costs. These socks tend to be very hot, and make the feet sweat excessively. This can be a very uncomfortable situation, and will lead to hyperhidrosis, which can then lead to fungal infections of the nail and foot.
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
Tuesday, July 6, 2010
USDA To Release New Dietary Guidelines
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The United States Department of Agriculture recently announced plans to update dietary guidelines for Americans for 2010. The report is currently open to the public for comment, and a public hearing is to be held in Washington, D.C. on July 8. Written comments are being accepted at www.DietaryGuidelines.gov until July 15, 2010.
As expected, the new guidelines emphasize a plant-based diet rich in whole grains, fruits, vegetables, beans, peas, nuts and seeds. Also included are low-fat dairy products and more seafood, and moderate consumption of lean meats, eggs, and poultry. The reduction of fats, oils, and refined sugars has been emphasized as well.
The guidelines are something that many are already familiar with, but is based on the findings of the report provided by the USDA and the Department of Health and Human Services. In this report, it was found that although Amercians continue to eat calorie-rich foods, many of these foods are low in nutrients, and resultant deficits in essential nutrients has been observed. In particular, low intake of calcium, potassium, dietary fiber, and vitamin D has been reported.
The report addresses supplementation of these nutrients as being insufficient, except for in cases of known risk factors for disease, such as osteoporosis, pregnancy, and other conditions involving an increased need of nutrients.
As a solution to obesity and nutrition-related health problems, the report calls for more education in the areas of nutrition and fitness, as well as an advancement of cooking skills. In particular, this education is to be provided in schools, preferably at a young age. Improved access to healthy and fresh foods as well as financial incentives to purchase these foods is seen as essential to the guidelines and their implementation.
The report also calls upon the food industry to improve the nutrition of the foods produced, including low-sodium and low-fat foods, as well as a reduction in the use of refined sugars. Smaller portions are also encouraged, as well as a move towards environmentally friendly and sustainable agriculture techniques.
These guidelines, according to the USDA and HHS, are seen as essential to the well-being of the American people. The way that these guidelines have evolved over the years is a far cry from the original food pyramid that was established in 1994, and the four essential food groups that were used in the 1950’s. Over the years, these different variations have been deemed obsolete, due to flaws in their presentation and interpretation. To read more about the 2010 guidelines and to leave your comments, visit www.DietaryGuidelines.gov
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
Tuesday, March 23, 2010
Go Green With Your Socks
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Looking for eco-friendly socks? They can be hard to come by, especially when compared to how easy it is to find eco-friendly t-shirts, pants, shoes and other clothing articles. Here are a few brands that we found on the Internet:
· Devmir – These socks are made in North Carolina, and are endorsed by the Sierra Club. The socks are made from organic cotton and bamboo, and serve a social cause too. For every pair purchased, Devmir will donate a pair to the homeless. Also, 10% of the proceeds go right back to the not-for-profit Sierra Club.
· Teko Socks – This brand specializes in highly functional, highly earth-conscious socks made from either merino wool or from recycled polyester. They offer a number of different styles, from hiking and backpacking socks to running socks to skiing socks. You can read all about their commitment to the environment at their website, http://www.tekosocks.com
· Patagonia – one of the first outdoor clothing brands to have a strong eco-friendly mission, Patagonia socks are not only good for the environment, but good for your feet, too. They offer a number of different moisture-wicking socks made with organic and recycled synthetic materials. The company also donates a large amount of money to sustainability projects throughout the world. Check out their website, www.patagonia.com
· SmartWool – known for their luxurious yet durable socks, SmartWool uses merino wool from free range New Zealand sheep. The socks can be quite expensive, but do hold up well under pressure. The natural fibers make great wicking material, and the company invests not only in sustainability projects, but in advocacy programs such as breast cancer awareness. Their website is https://www.smartwool.com/default.cfm#
· REI – the outdoor gear co-op makes some great eco-friendly socks that are usually about half the price of other brands. Their hiking socks are mostly made of merino wool, and running socks are made with synthetic, earth-conscious materials.
If you’re into earth-friendly products, there are plenty of items to look at. Many brands are creating socks and other clothing products that are both earth-friendly and functional. If you’re looking for cotton socks and want to find something sustainable, look for something made with organic cotton. Organic cottons aren’t treated with harsh chemicals, so the impact on the environment is reduced.
You can also look at the packaging that the socks come in. Is the paper or cardboard made from recycled material? If it is, it will say so right on the packaging.
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com
Thursday, September 24, 2009
Nutrition and Health Care
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Many of the most common health problems have a strong correlation with a poor diet. There is a very strong link between obesity and the incidence of type-two diabetes, and many cardiac problems can be attributed to a diet high in saturated fat and cholesterol. Nutrition can play a vital role in the health of a patient, down to the details of wound care and post-operative healing.
The focus of nutrition and its impact on health care has come into the national spotlight recently because of the connection between the two. Several documentaries have addressed the issue. Robert Kenner’s documentary “Food, Inc.”, which came out this summer, addresses the issue. On a related note, the documentary “The Future of Food” discusses the ramifications of genetically engineered crops, and the impact that it has on the food industry. The landmark film “Super Size Me” also tackles the issue of health and the fast food industry. There are dozens of books written on the subject of nutrition and its impact on our health, including Michael Pollan’s The Omnivore’s Dilemma.
With the state of food prices and availability of fresh food in America, unfortunately, many go without proper nutrition. This situation can exacerbate the problems associated with diabetes and heart disease, ultimately adding to the cost of health care. This issue of poor nutrition and prevention of disease is at the very core of the health care reform bill, which is still under heavy assault from its opponents.
In Detroit, a city that has been described as a “Nutritional Desert”, one company has tried to bring fresh fruits and vegetables to areas that do not have a grocery store nearby. That company is Peaches and Greens, a fresh food delivery service. The concept is simple; much like an ice cream truck brings sweets to kids with a carnival music-playing van, Peaches and Greens brings around fresh veggies and fruit in a green painted delivery van.
The neighborhoods that Peaches and Greens delivers to in Detroit are much like the urban neighborhoods found across the country. They are areas where the residents may pass several convenience stores before finding a market that sells fresh foods. This is a common problem in poor urban areas, and many feel as though it contributes to a significant increase in health problems in the populations of these areas.
So far, the reception of Peaches and Greens has been very positive. The community appreciates the availability of fresh foods, and many outside of the community are impressed with the efforts of the company’s owners.
The issue of nutritional foods often being more expensive and less convenient than junk food for urban residents is a serious and multifaceted issue. If proper nutrition is made available to everyone at a reasonable price, and education is included in the classroom at an early age about the advantages of proper nutrition, it may be possible to ward off a great deal of preventable disease.
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com
Tuesday, September 22, 2009
Smoking vs. Circulation
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The process of smoking directly involves your respiratory tract: nose, mouth, throat, and lungs – you inhale the smoke and exhale it out; so it makes sense when you hear that smoking causes breathing and lung-related problems such as cough, wheezing, emphysema, and lung cancer. However, smoking also affects circulatory ability and hence the body’s process to heal!
In a non-smoker, healing of a bone fracture by growing 1 cm of new bone takes 69.6 days. Yet, that same physiological process takes 89.4 days in smokers. Why is there a difference in healing rates? Healing rates are directly affected by blood flow and in smokers blood flow is impaired.
Smoking-induced circulatory disease (which is essentially damage to the blood flow systems of the body) actually causes more deaths than lung-associated diseases. Another alarming fact is that circulatory system damage starts early on in the course of smoking!
What is the circulatory system? The circulatory system is composed of our heart and all the associated pipelines that transport blood to tissues of the body and then bring them back to the heart (arteries, veins and capillaries). Blood is an important component because it carries oxygen and vital nutrients to tissues and organs. The blood vessels (pipelines) need to be clean and unobstructed on the inside to transport blood through them.
The smoke from cigarettes has a molecule called carbon monoxide that damages the smooth inside walls of these vessels and as a result substances such as plaques and fat can start to stick onto them. These adherent substances start to build up in the vessels and slow the transport of blood. However, carbon monoxide is not the only culprit in smoking causing circulatory disease. Nicotine is another compound that worsens circulatory disease.
Nicotine plays two roles that can greatly exacerbate circulatory disease. 1) It activates the sympathetic nervous system which is the “fight or flight” mode in our bodies – this increases blood flow and now this blood has to be forced through the clogged vessels and 2) the “fight or flight” mode triggers a release of stored fats as a mechanism for instant energy. This increase in fats has a greater probability of attaching themselves into our blood vessels damaged by carbon monoxide and further impeding blood flow!
If only the damage to the circulatory system caused by smoking stopped here! Not only does nicotine increase blood flow and mobilization of fats into the bloodstream, nicotine has been found to promote angiogenesis (the growth of new blood vessels) to supply nutrients and oxygen to the blobs of fat that have attached themselves to our blood vessels! In other words, nicotine basically causes growth of vessels within vessels!
What is the outcome of this vessel growth phenomenon? The arteries and veins of a smoker become more clogged, narrowed and now become less elastic. The damage becomes more profound when these events occur within the coronary arteries (the arteries that supply the muscles of the heart). Remember, the heart is a muscle that also requires oxygen and nutrients so that it can pump blood to oxygen and nutrients to organs and tissues to other areas of the body. If the muscles of the heart do not receive enough oxygen, they will start to die and this causes heart attacks (also known as a myocardial infarction). If a certain area of the brain is deprived of oxygen due to impaired blood flow, a stroke can occur!
Smokers are always considered risky surgical candidates because of their poor healing ability. In terms of healing, an injury such as a cut or fracture at the foot is less likely to heal completely with there is circulatory disease present. So many signs and symptoms of smoking can be attributed to the impaired blood vessel flow: tooth loss, hair loss, wrinkles in the skin and early aging.
The foot is affected by poor circulation because medical conditions such as ulcerations, sores or infections and has reduced ability to heal. In some cases, circulatory disease is so bad special intervention is required for proper healing. Your podiatrist can assess your circulation status by evaluating your health and habits. In addition, your doctor will advise you on proper footwear to prevent trauma and accidents. If footwear produces excess pressure in an area, your skin can breakdown causing more problems. Your podiatrist will also provide foot care such as trimming calluses and toenails! Prevention of injury is of the utmost importance in a smoker since healing is a challenge due to circulatory disease.
Remember, the best way to stop circulatory disease is to stop smoking!
Central Florida Foot & Ankle Center, LLC
101 6th Street N.W.Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com
Monday, August 24, 2009
Sunday, July 19, 2009
Greening Your Footwear
Having trouble going green and maintaining your wardrobe? Want to add some eco-friendliness to your routine? Try swapping out your old kicks for a new pair of earth-friendly shoes!
Now that sustainability is the focus of many consumers, it is easier than you may realize to find footwear that is not only comfortable and cool, but earth-friendly as well. Brands like Keen and
Earlier this year, Payless released a new line of green footwear. The shoes feature organic cotton and linen, hemp, recycled outsoles, and eco-friendly packaging. With over four-thousand stores across the
Sustainability and environmentalism are growing concerns for everyone, and this is apparent from the response from the business sector. Companies are more than ever focusing on reducing emissions, and limiting pollutants from manufacturing.
Brands like
Even running shoes are getting an earth-friendly makeover. An industry that was once dominated by synthetic materials is becoming more earth-conscious through design. We’ve mentioned Brooks’ Green Silence in past posts – it’s the shoe with BioMoGo, a compound used for the midsoles that biodegrades at a much faster rate than other synthetics. Earth Neutral Design, or END, is a shoe brand based out of
Plenty of green products, including footwear, are now available. If you’ve been meaning to go green, let green footwear be your first step forward. You can check out any of these brands or retailers online, or go to your local shoe store and ask about environmentally-sound footwear.
Central Florida Foot & Ankle Center, LLC101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com
Saturday, July 18, 2009
Hand-Foot-and-Mouth Disease
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Hand-foot-and-mouth disease is a viral infection commonly found in children that is very easily spread. The culprit in this disease is the Coxsackie virus. The transmissible nature of this disease is due to person to person contact with the unwashed hands of an individual with the virus and contaminated surfaces.
This disease usually arises in the summer or early fall in the northern hemisphere. The signs of this disease include a child with fever, rashes, and mouth sores – however, all three do not have to be present!
Some indications that your child may have hand-foot-and-mouth disease include:
- Decreased appetite for solids
- Fever and/or sore throat
- Mouth sores in and around the mouth – the sores may appear on the mucous membranes, gums, or tongue
- Non-itchy spotted skin rashes on the palms of hands, soles of the feet and/or on the buttocks
The disease is much more severe in infants and children than in adults and usually the disease has a mild course. Hand-foot-and-mouth disease is a condition that may be confused with chickenpox because they both have blisters; however, the rashes in this disease are not itchy unlike chickenpox. The virus that causes hand-foot-and-mouth disease is found in both respiratory secretions and stool. Therefore the virus may be spread via fecal-oral transmission, airborne droplet transmission, direct contact with an infected person, and contact with contaminated surfaces. The virus may be present in the patient’s stool for over 1 month and to reduce the incidence of the virus spreading, do not rupture the raised lesions.
The best way to reduce the transmission of this disease is to practice a good hand washing routine especially after diapering children and before eating.
Since this disease is caused by a virus, antibiotics will be ineffective in treating it! In most instances, medical care is not necessary. The most important factors to treat would be the fever and sore throat. Tylenol is a good fever reducer and popsicles and cold liquids are soothing to the sore throat. Ensure that the affected individual is adequately hydrated during the course of the disease.
101 6th Street N.W.
Winter Haven, FL 33881
Phone: 863-299-4551
http://www.FLFootandAnkle.com
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