Showing posts with label CKPA. Show all posts
Showing posts with label CKPA. Show all posts

Thursday, December 24, 2015

Saints' Drew Brees day-to-day with torn plantar fascia

Saints quarterback Drew Brees became the fourth quarterback in NFL history with 60,000 passing yards on Monday night, but his ability to continue up the ladder in 2015 will be complicated by a foot injury.

After the loss to the Lions, Brees said that he would have an MRI on his right foot due to an injury suffered during the game that left him wearing a protective boot. Ed Werder of ESPN reports that the test showed a torn plantar fascia and that Brees wants to play in the final two games, but is still waiting an evaluation from Charlotte-based foot specialist Dr. Robert Anderson.

If the report is accurate, that would mean two of the four passers with more than 60,000 yards would be in contact with Anderson about similar injuries. Broncos quarterback Peyton Manning is dealing with a partially torn plantar fascia and may need surgery to repair the issue.

Injuries affect different people in different ways, but Manning’s been out for several weeks so there’s some chance that Brees may have played his last down for the Saints this season. With talk about Sean Payton’s future, or lack thereof, in New Orleans a background topic for much of the year and Brees carrying a huge cap number for a team that needs help at many positions this off season, some will likely wonder if he’ll play any for them next season.

Tuesday, April 23, 2013

Pregnant Feet Swelling Causes Permanent Foot Size Increase

Women’s feet swelling during pregnancy may not go away after they give birth, confirms a new study. What can you do about it?

Feet swelling while pregnant? It's a common problem for women during pregnancy, but new research brings the bad news that larger shoes may be necessary long after delivery.

Women often report flat feet while pregnant, a symptom that is probably caused by the extra baby weight bearing down to flatten the arches of the feet and increase feet size.

A new study published in the American Journal of Physical Medicine & Rehabilitation confirms that the swelling and loss of arch height that comes with pregnancy can be permanent, with the increase in foot size lasting long after pregnancy.

"I had heard women reporting changes in their shoe size with pregnancy, but found nothing about that in medical journals or textbooks," said Dr. Neil Segal, associate professor of orthopaedics and rehabilitation at the University of Iowa, in a statement.

Segal decided to scientifically measure the feet swelling of pregnant women in the first trimester of their pregnancy, and then five months after they gave birth. "We found that pregnancy does indeed lead to permanent changes in the feet." The study, supported by the American Geriatrics Society and the National Institute on Aging, included 49 pregnant women, collecting arch measurements at both time points before and after they gave birth.

The results showed that for between 60 and 70 percent of the women, swelling led to longer and wider feet five months after they gave birth. The average foot arch and arch rigidity of the women decreased markedly after they gave birth, causing a 2-10 millimeter increase in foot length and arch drop five months after being pregnant.

Feet swelling is likely to be greatest for women after a first pregnancy. The study findings suggest that second, third, or later pregnancies do not alter foot size much more than it increases the first time.

This study is corroborated by other experts. Dr. Bret Ribosky, president of the American College of Foot and Ankle Orthopedics and Medicine, told Parenting.com that a woman's foot size can increase by a half size or more during pregnancy.

"The same hormones that are released to relax the pelvic area also loosen the ligaments in the foot," said Ribotsky. "In addition, the increased body weight of pregnancy lowers the arches, further adding to the foot's length and width."
It's important for women to accept the growth of their shoe size while pregnant. Swelling feet should not be forced into uncomfortable shoes.

"Too-tight shoes weaken the muscles in the ball of the foot and the ligaments that hold the toes straight," Dr. Ronald Smith, associate professor of orthopedic surgery at Harbor-UCLA Medical Center, told Parenting. "And that can set the stage for foot problems."

Aside from feet swelling, those foot problems while pregnant can include ingrown nails, corns caused by pressure from tight shoes, and bunions, which are bumps at the base of the big toe that grow with friction from shoes. Higher heels mean a higher likelihood for foot problems later on.

In future research, Segal hopes to follow up with the 49 women in this study to see whether the changes in their feet size can lead to musculoskeletal problems like arthritis as they age.

"We know that women, and especially women who have had children, are disproportionately affected by musculoskeletal disorders," he said. Segal expects that foot size swelling can help explain why pregnant women are at a higher risk of developing arthritis pain in their feet, knees, hips, and spines later on. He plans to conduct further work on possible rehabilitation measures to prevent pregnancy-related arch drop.

The takeaway: pregnant feet swelling can lead to a permanently larger shoe size, and it's important to wear comfortable shoes during and after pregnancy in order to avoid foot problems later in life.

Friday, April 19, 2013

Kim Kardashian buys first flats: 'So uncomfortable!'



The pregnant reality star loves her high heels.

Kim Kardashian, out and about to promote her newTyler Perry's Temptation movie, hid her bump under a poufy, short beige dress as she visited Live with Kelly and Michael today. Kristin Chenoweth, who was filling in for Kelly Ripa, asked about her maternity outfits and why there's so much chatter about the reality star's pregnancy style.

"My sister Kourtney warned me when I wasn't pregnant," said Kim. "She said all of the criticism you get when you're pregnant or a new mom is insane. Just wait." She went on to say, "I wore this black leather skirt the other day. People are like why are you wearing black? Are you ashamed? Are you trying to hide it? It was tight! I was trying to show the bump. (They said) You're trying to suffocate the baby. I had this maternity skirt made for me, like specially!"
She added, "Everything I do it seems to be crazy."

What's really crazy is what she said next: "I just bought my first pair of flats the other day. And I wore them. They are SO uncomfortable. Like, my heels are so comfortable," she said, acknowledging that at 5-feet-2 she likes the added height.

When Chenoweth noted the beautiful high heels she was wearing on the show, Kardashian admitted, "My foot is so swollen. I will say. It really is. And I'm sad. You know, 'cuz all my shoes doen't really fit me anymore. But I heard it goes back. Hopefully."

Wednesday, April 17, 2013

Lakers trainer: Kobe aiming for start of season return



So much for all that premature talk about Kobe Bryant retiring.

The morning after the Achilles tendon pop heard 'round Laker Nation, team trainer Gary Vitti said the timetable for Bryant's return is six to nine months and that he is aiming to return for the start of the 2013-14 regular season.
"That's the plan," Vitti said, according to the team's Twitter account.

Bryant, who shared his deepest thoughts on the matter by way of Facebook late Friday night, tweeted a picture of his MRI today as well.

Vitti, who is in his 30th season with the team, said Bryant suffered a third-degree rupture of the tendon. Surgery is scheduled for today at 1 p.m.

Vitti was also quick to dispute the much talked-about notion that Bryant's excessive playing time may have led to the injury.

"Some of its just bad luck," Vitti said. "The stuff out there about Kobe… to say he was injured because he played 48 (minutes) is a stretch."

Lakers general manager Mitch Kupchak was also quick to address questions about whether the team might use its amnesty clause on Bryant's contract, saying it was something that had not been discussed. If they didn't anticipate him playing for most of next season, it would be a way to preserve $30.4 million in salary cap space while planning for his possible re-signing when he becomes a free agent in summer 2014. Bryant would still be paid on his contract.

Bryant averaged 45.6 minutes in the last seven games, with the Lakers going 6-1 and Bryant averaging 28.9 points (42.4% shooting), 8.4 assists, 7.3 rebounds and 3.4 turnovers. The Lakers, who are one game up on Utah for the eighth and final playoff spot in the Western Conference but don't have the tiebreaker with the Jazz, still have a playoff push to finish without Bryant.

They host San Antonio on Sunday and then host Houston on Wednesday in the regular-season finale. The Jazz play at Minnesota on Monday and at Memphis on Wednesday.

EVERYTHING THAT'S GONE WRONG FOR THE LAKERS IN 2012-13

Monday, April 15, 2013

What Kobe's probable Achilles tear means for his future


Kobe Bryant was in no mood to answer the only question that mattered, and no one — not even a Boston Celtics fan — could blame him.

Yet as the Los Angeles Lakers star stood there in the Staples Center locker room with teary eyes discussing his night of ill fortune, how he heard his Achilles tendon pop late in the fourth quarter and how this was the toughest moment of his transcendent career, the question eventually came.

"So this isn't the last game that we'll see you play?" a reporter asked after the Lakers downed Golden State to keep their playoff hopes alive.

"Really? Really?" he shot back before making light of the moment.
Yes, Kobe, this is really happening.

Bryant will have an MRI on Saturday to, as the Lakers put it in the news release, "confirm the diagnosis" before later having surgery. The timing, make no mistake, couldn't be more torturous for the 34-year-old who had hinted so many times next season would likely be his last. As one could predict when it comes to Bryant, he hardly sounded like someone who was entertaining the notion that this could be the end.

"(I was) upset and dejected and thinking about this mountain, man, to overcome," he told reporters. "I mean this is a long process. I wasn't sure I could do it. Then your kids walk in, and you're like, 'You know, I've got to set an example. Daddy's going to be fine. I'm going to do it.'

"I can hear (the doubters) already, and it's pissing me off right now thinking about it."
Beyond the fact that the Lakers will now attempt to sneak into the playoffs without him, there's the reality that — based on a brutal body of evidence from NBA players in the past — he may not return until midway through the season that was his supposed swan song. As the Miami Heat's LeBron James tweeted late Friday night, Bryant has played through so much pain that a comeback wouldn't surprise.

But given that Bryant is as diligent a worker and quick a healer as there is in the professional sports world, it's not a matter of whether he can come back as much as it is whether there will be any ripple effect of the injury on his retirement plans. Or, for that matter, the Lakers plans as they pertain to him.

Bryant has one season left on his contract (worth $30.4 million), and would likely return just as the Lakers are facing a free agency period in the summer of 2014 that could have the likes of King James himself on the market. What's more, one has to wonder how center and free-agent-to-be Dwight Howard will assess his situation with this drastically-changed Lakers landscape. Before Bryant's injury, all signs had been pointing to Howard wanting to re-sign with the Lakers.

According to Dr. Asheesh Bedi on the website, SportsMD.com, the typical return from an Achilles tear and surgery is between six and nine months. Bryant mentioned during his postgame discussion with reporters that he'll be doing homework on athletes who have suffered an Achilles tear and, one can assume, proceed to push his way back faster than every man and woman on that list. His goal going forward should be to channel his inner Dominique Wilkins.

As documented in a comprehensive study of Achilles injuries in the NBA by analyst Kevin Pelton (who's now with ESPN), the Atlanta Hawks star tore his Achilles at the age of 32, then returned to play his way onto two more All-Star teams before retiring at the age of 39. The what-not-to-do blueprint comes courtesy of Detroit Pistons great Isiah Thomas, who was forced into early retirement at the age of 32 after tearing his Achilles. More recently, Los Angeles Clippers guard Chauncey Billups, who was 35 at the time, returned 10 months after tearing his Achilles on Feb. 8, 2012.

Tuesday, August 14, 2012

Pedicures and Painful Nails



While having a pedicure at the local nail salon may seem like a luxury that you deserve, it’s a good idea to keep your eyes and ears open and to make sure that you keep your feet safe by following a few easy tips.

If you schedule your pedicure first thing in the morning, you may find that the foot bath is the cleanest it will be all day. If you can’t be the first customer, however, make sure that the technician cleans both the tub and the filter prior to your pedicure.

If at all possible, bring your own pedicure tools to the salon. Bacteria and fungus can easily be transferred from person to person on these tools, especially if the salon does not use proper sterilization techniques. Never allow technicians to use blades or knives to cut your calluses or to eliminate thick, dead skin. Only use pumice stones, foot files or exfoliating scrub. Once you soak your feet for a few minutes, this thickened skin can be easily sloughed off with these types of tools.

The pedicurist should trim your nails straight across. Do not let them dig into the sides of the nails or try to trim out ingrown nails. If you think you may have an ingrown toenail, see a podiatrist immediately.

Only healthy nails should be painted with colored polish. Make sure to change the polish frequently and to check your nails when the polish is off. Signs of fungus and other nail problems can often be hidden under nail polish, so be vigilant in checking your nails.

If your skin bleeds or gets nicked at the salon, make sure to carefully clean and disinfect that area and then watch for signs of infection. Call Dr. Weaver immediately if you have any signs of redness or skin irritation after your salon visit.

Sunday, December 18, 2011

Foot Anatomy: Your Amazing Feet

Despite delicate foot anatomy, your feet are able to take a pounding every day. Help them go the distance by identifying and correcting common foot problems, from corns and calluses to Athlete's foot and hammertoes.

The human foot has 42 muscles, 26 bones, 33 joints, and at least 50 ligaments and tendons made of strong fibrous tissues to keep all the moving parts together … plus 250,000 sweat glands. The foot is an evolutionary marvel, capable of handling hundreds of tons of force — your weight in motion — every day. The foot’s myriad parts, including the toes, heel, and ball, work in harmony to get you from one place to another. But the stress of carrying you around puts your feet at high risk of injury, more so than other parts of your body.

Many foot problems, including hammertoes, blisters, bunions, corns and calluses, heel spurs, claw and mallet toes, ingrown toenails, toenail fungus, and athlete’s foot, can develop due to neglect, ill-fitting shoes, and simple wear and tear. Your feet also can indicate if your body is under threat from a serious disease. Gout, for instance, will attack the foot joints first.

Foot Problems: Athlete's Foot
Caused by a fungus that likes warm, dark, and moist environments like the areas between the toes or on the bottoms of the feet, athlete’s foot can inflame the skin and cause a white, scaly rash with a red base. The athlete’s foot fungus also causes itching, burning, peeling, and sometimes a slight odor; the infection can also migrate to other body parts. You can avoid athlete’s foot (also called tinea pedis) by keeping your feet and toes clean and dry and by changing your shoes and socks regularly. Over-the-counter antifungal creams or sprays can be used to treat athlete’s foot. If these remedies do not work, however, you may need to see a podiatrist and ask about prescription-strength medication.

Foot Problems: Hammertoes
If your second, third, or fourth toe is crossed, bent in the middle of the toe joint, or just pointing at an odd angle, you may have what’s called a hammertoe. Hammertoes are often caused by ill-fitting shoes. Early on, wearing inserts or foot pads can help reposition your toe, but later it becomes fixed in the bent position. Pain then sets in and you may need surgery. Because hammertoes are bent, corns and calluses often form on them.

Foot Problems: Blisters
It’s this simple: If your shoes fit well, you won't have blisters. Soft pockets of raised skin filled with clear fluid, blisters are often painful and can make walking difficult. It’s important not to pick at them. Clean the area thoroughly, then sterilize a sewing needle and use it to open the part of the blister located nearest to the foot’s underside. Drain the blister, slather with antibiotic ointment, and cover with a bandage. Follow these same care steps if a blister breaks on its own.

Foot Problems: Bunions
A bunion is a crooked big-toe joint that sticks out at the base of the toe, forcing the big toe to turn in. Bunions have various causes, including congenital deformities, arthritis, trauma, and heredity. A bunion can be painful when confined in a shoe, and for many people, shoes that are too narrow in the toe may be to blame for the formation of bunions. Surgery is often recommended to treat bunions, after conservative treatment methods like over-the-counter pain relievers and footwear changes fail.

Foot Problems: Corns and Calluses
Corns and calluses form after repeated rubbing against a bony area of the foot or against a shoe. Corns appear on the tops and sides of your toes as well as between your toes. Calluses form on the bottom of the foot, especially under the heels or balls, and on the sides of toes. These compressed patches of dead skin cells can be hard and painful. To relieve the pain, you may want to try placing moleskin or padding around corns and calluses. Don’t try to cut or remove corns and calluses yourself — see a podiatrist for care.

Foot Problems: Plantar Fasciitis and Heel Spurs
It’s common for doctors to confuse heel spurs and plantar fasciitis when a patient comes to them with heel pain. Heel spurs are found in 70 percent of patients with plantar fasciitis, but these are two different conditions. Plantar fasciitis is a painful disorder in which the tissue that connects the ball of the foot to the heel – the fascia – becomes inflamed. Heel spurs are pieces of bone that grow at the heel bone base and often develop after you’ve had plantar fasciitis. The heel spurs themselves are not painful; it’s the inflammation and irritation caused by plantar fasciitis that can hurt. Heel spurs are often seen on X-rays of patients who do not have heel pain or plantar fasciitis.

Foot Problems: Claw Toes and Mallet Toes
Claw toe causes all toes except the big toe to curl downward at the middle of the joints and curl up at the joints where the toes and the foot meet. Calluses and corns may often form when someone has claw toes. While tight shoes can be blamed for claw toes, so can nerve damage to the feet (from diabetes or other conditions), which weakens foot muscles.

With mallet toes, the last joint of the toe bulges, and a painful corn will grow near the toenail. Generally the second toe is affected because it’s the longest. Injuries and arthritis are among the causes of mallet toe.

Foot Problems: Gout
Gout is a type of arthritis caused by a build-up of uric acid in joint tissues and joint fluid, which happens when the body is unable to keep uric acid levels in check. One of the first places for this build-up to occur is in the big toe joint — temperature-wise, the toes are the body’s coolest parts, and uric acid crystallizes with temperature changes. You’ll know a gout attack when it happens: The toe will get warm, red, and swollen and will be painful to even the slightest touch. The best way to prevent a gout attack is to learn to identify triggers, including high-purine foods, red meat, seafood, and alcohol. Applying ice, keeping hydrated, and staying bed may help, too.

Foot Problems: Ingrown Toenails
The right way to clip toenails — straight across — is key to foot health. If you don’t cut them properly, the corners or sides of the nail can dig into skin and become ingrown. Other causes of ingrown toenails include shoe pressure, a fungus infection, and even poor foot structure. When you cut your toenails, use larger toenail clippers and avoid cutting nails to short, as this can also cause ingrown toenails or infection.

Foot Problems: Toenail Fungus
Toenail fungus can give nails an unattractive, deformed appearance. It can alter the nail’s color and spread to other nails, even fingernails. Avoiding toenail fungus is difficult, especially if you walk through wet areas where people tend to go barefoot, such as locker rooms and swimming pools. People with chronic conditions, such as diabetes or immune deficiency diseases like HIV, are especially vulnerable and may want to keep their shoes on.

Monday, February 28, 2011

Only 7% of the 60 Million with Prediabetes Are Aware

Measuring glycated hemoglobin levels may be an appropriate means of catching patients with prediabetes....

Ronald Ackerman, MD, MPH, of Indiana University, and colleagues reported in Preventive Medicine that, HbA1c testing yielded similar probabilities for developing diabetes and heart disease as those estimated by using the 2003 American Diabetes Association definition for prediabetes. "The A1c test may provide a badly needed, clinically practical indicator of the composite risk for incident diabetes and cardiovascular disease," they wrote.

Fasting plasma glucose and two-hour plasma glucose, two commonly used tests for assessing diabetes and prediabetes, are limited because they require a patient to return on a separate day after an overnight fast and remain in the office for 2-3 hours which is a potential barrier to test completion, the researchers said.

Measuring HbA1c is easier -- it requires only one blood draw. In June 2009, the International Expert Committee, which represents several major diabetes groups, recommended using HbA1c to diagnose diabetes.

The recommendations of the committee have stirred up some controversy, still, the researchers said, only about 7% of patients with prediabetes -- who are thus at risk for later diabetes and heart disease -- are aware of their status.

To estimate the risks of developing diabetes and cardiovascular disease for adults with different HbA1c levels, Ackerman and colleagues assessed data from the National Health and Nutrition Examination Survey (NHANES) 2003-2006.

Among adults who met the 2003 ADA definition for prediabetes, the probabilities for developing Type 2 disease over 7.5 years and cardiovascular disease over 10 years were 33.5% and 10.7%, respectively.

The researchers found that using HbA1c alone -- with a range of 5.5% to 6.5% defining prediabetes -- would identify a population with comparable risks for diabetes and heart disease (32.4% and 11.4%, respectively).

But using a slightly higher cutoff -- beginning at 5.7% -- would identify increased risks of 41.3% for diabetes and 13.3% for heart disease.

These risks are comparable to those seen in patients enrolled in the Diabetes Prevention Program, which had an enrollment criteria of both elevated fasting plasma glucose and impaired glucose tolerance, the researchers said.

Thus, they concluded, using a bottom cutoff of 5.7% for diagnosing prediabetes may be more appropriate.

Either way, they said, HbA1c measurement "should be considered a means of identifying greater numbers of patients at risk for diabetes and heart disease" -- especially because "of its practical nature and wide availability."

The study was limited by its use of cross-sectional data, and it may be lacking in generalizability. For instance, a greater number of African Americans would be identified as having prediabetes than if using fasting plasma glucose or two-hour plasma glucose testing, the researchers noted.

Tuesday, January 25, 2011

To Bandage or Not to Bandage

Q: What is the best way to treat diabetic ulcers on the legs? I have new ones every day and it's hard to decide if they should be bandaged or not. They are always seeping. Please send some advice.

A: Leg ulcers can indeed be difficult and frustrating to treat, and they usually take a long time to heal. Treatment recommendations have changed over the years; it's confusing to decide what to do. Unfortunately, the treatment of leg ulcers is not simple. Specific therapy depends on the cause, size and depth, location and duration of the ulcer. That's why there is not just one answer to the question. What Dr. Benjamin Weaver suggests is to work with your doctor to develop the best treatment plan for your specific situation.