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What is Gout?

Gout is a form of arthritis that is unusually painful. A slight touch can send shooting pain. The most common area for gout to occur is in the metatarsal phalangeal joint of the big toe. Other areas of the body frequently affected by gout are the knees, elbows, fingers, ankles and wrists. 

Gout occurs when there are elevated levels of uric acid in the blood. This condition is called hyperuricemia. Hyperuricemia is a genetically pre-disposed condition about 90% of the time and occurs because the kidneys do not produce the correct amount of uric acid. Children of parents who have had gout will have a 20% chance of developing it themselves. The excess uric acid in the blood forms crystals that deposit in between joints causing friction with movement.

Symptoms of gout caused by this friction include pain, redness, swelling, and inflammation. Fever and fatigue may occur as well, although these symptoms are rare. The pain can be worse during the night when the body’s temperature lowers.

Gout can be diagnosed clinically by a doctor’s observation of the redness, swelling, and pain. More definitive tests can be performed by the doctor as well. Blood tests check for elevated uric acid levels in the blood. The synovial fluid in the joint can also be withdrawn through a needle to be checked for uric acid crystals. Chronic gout can be diagnosed by X-ray.

Treatment given for acute gout diminishes the symptoms. Non-steroid anti-inflammatory drugs such as Colchicine and other corticosteroid drugs will stop the swelling, redness, and inflammation in cases of acute gout. If gout becomes chronic, there are multiple ways to combat it. Lifestyle changes and changes in diet may be necessary, as well as preventative drugs. 

Gout can be aggravated by a sedentary lifestyle. Exercise will reduce probability of future cases of gout. Certain foods cause or increase the risk of gout and their consumption should be avoided or kept at a minimum. These foods include red meat, alcohol, sea foods, and drinks sweetened with fructose. 

Lifestyle changes and diet that help prevent gout include exercise and certain foods that help decrease the chance of gout recurring. Gout preventative foods include Vitamin C, coffee and some dairy products. New drugs have been discovered that inhibit the body’s production of certain enzymes. These are the enzymes that produce uric acid. Lowering your levels of uric acid will greatly reduce the chances of developing further cases of gout.

 

What is a Podiatrist

The branch of medicine that is focused on the treatment, diagnosis, and study of disorders of the lower leg, ankle and foot is referred to as podiatry. Because people often spend a great deal of their time on their feet, many problems in this area can occur. A person seeks help from the field of podiatry when they need treatment for heel spurs, bunions, arch problems, deformities, ingrown toenails, corns, foot and ankle problems, infections, and problems with the foot that are related to diabetes and additional diseases.

To treat problems of the foot, ankle or lower leg, a podiatrist may prescribe physical therapy, drugs, perform surgery on lower extremity fractures. Individuals may also be recommended to wear corrective shoe inserts, custom-made shoes, plaster casts and strappings in order to correct deformities.

When trying to gather information on a patient problem, a scanner or force plate may be used in order to design orthotics. During this procedure, patients are told to walk across a plate that is connected to a computer; the computer then takes a scan of the foot and indicates weight distribution and pressure points. The computer readouts will give the podiatrist information to help them determine the correct treatment plans.

Diagnosis is also provided through laboratory tests and x-rays. Through the foot, the first signs of serious problems such as heart disease, diabetes and arthritis can show up. For example, individuals that have diabetes may frequently have problems such as infections and foot ulcers because they experience poor circulation in the foot area. A podiatrist can then have consultations with patients when symptoms arise and referrals will be made to specialists that handle the greater health problems.

Some podiatrists have their own solo small private practices or clinics where they have a small staff and administrative personnel but many work within group practices. They usually spend time performing surgery in ambulatory surgical centers or hospitals or visiting patients in nursing homes. They typically spend between 30 to 60 hours of week working. Some podiatrists specialize in public health, orthopedics, surgery, or primary care. Some other fields include specialties in geriatrics, dermatology, pediatrics, diabetic foot care and sports medicine.

Some podiatrist specialists complete extra training in the area of foot and ankle reconstruction that result from the effects of physical trauma or diabetes. There are also surgeons that perform surgery of a cosmetic nature to correct bunions and hammertoes.

 

Corns: What Are They, and How Do You Get Rid of Them

Corns are areas of the skin where it has thickened to the point of being irritating and sometimes painful. Corns are circular or cone-shaped and are commonly found on the feet where there are areas of pressure or friction, such as on the little toe where it may rub against shoes or on the ball of the foot. The medical term for corns is helomas.

Corns can easily be confused with a callus, but there is a difference between the two. Corns can be a raised bump that feels hard to the touch and painful. They consist of a thick, rough area of skin that may be dry and waxy. Corns tend to be surrounded by inflamed skin and are usually smaller than calluses.

The key to treating a corn is to remove the dead skin that has built up. Salicylic acid is the most common medication used to accomplish this. Salicylic acid works by dissolving keratin, the protein that makes up the majority of corns. You can purchase salicylic acid over-the-counter in the form of wart removers. It comes in medicated pads, drops or creams. People with diabetes should not use salicylic acid, but should immediately consult their doctor.

To treat corns, apply the medication directly onto the corns according to the product directions. The top layer of the corn will turn a white color. When that happens, the layers of skin can then be peeled away, making the corn smaller. It is never a good idea to try and shave off corns with razors or other pedicure equipment. This can lead to infection. If your corns get infected or do not respond to over the counter treatment, a visit to the doctor is necessary.

Orthotic inserts fitted by a podiatrist also help to treat corns and help prevent their return. Inserts fit into shoes and help to adjust the way your foot fits in your shoe, thus fixing the way you walk. This will reduce friction, lowering your chances of getting a corn and eliminating the pain for current corns.

Surgery is seldom an option for corns, but does occur on rare occasions. Surgery for corns actually deals with the underlying issue causing the corns. During surgery, the bone is shaved and any abnormalities are corrected to reduce the amount of friction that occurs during walking.

The first step to preventing corns is to reduce any possible friction. Wear well fitting shoes that don’t rub on your feet. If you notice rubbing developing, pads can be purchased to help reduce the friction. These can be purchased over the counter and are simply placed on the area that is being irritated. Friction can also be reduced by using cushioned insoles in your shoes, and making sure to wear well-fitting shoes. This will make sure your foot is not being squeezed awkwardly, and stop corns from forming in the first place.

 

Causes, Symptoms, and Treatment of Poor Blood Circulation in the Feet

Poor blood circulation in the feet and legs is often caused by peripheral artery disease (PAD), which is usually the result of a build up of plaque in the arteries. Plaque build up, or atherosclerosis, can be the result of excess calcium and cholesterol in the bloodstream, which restricts how much blood can flow through arteries. Reduced blood flow to a certain area of the body severely limits the amount of oxygen and nutrients that part of the body receives, causing degeneration in the muscles and other tissues. Sometimes, poor blood circulation in the feet and legs can be caused by other conditions, such as damage to or inflammation of blood vessels, known as vasculitis.

The lack of oxygen and nutrients caused by poor blood circulation can restrict muscle growth and development, as well as cause muscle pain and cramps, weakness, and stiffness. Other common symptoms include numbness in the legs and feet, skin discoloration in the affected limbs, slower nail and hair growth, and erectile dysfunction in men. In more severe cases of PAD, pain can be present even when a person isn't exercising, and may range from mildly uncomfortable to completely debilitating.

Poor blood circulation in the feet and legs is more common in those who are overweight or obese, have diabetes, high blood pressure, high cholesterol, who smoke, or who have a family history of PAD or related conditions (heart attack, stroke, etc.). Diabetes and smoking place a person at greatest risk for developing poor blood circulation, although advanced age (over 50) can also increase risk.

If you are experiencing poor blood circulation in the feet and legs caused by PAD, it is important to make changes to your lifestyle in order to reduce your risk of experiencing a heart attack or stroke caused by this condition. If you smoke, quit completely -- this will increase the amount of oxygen in your bloodstream. Exercising and reducing the saturated fats in your diet (which come from fatty meats, fried foods, whole milk, etc.) can make a difference in improving blood circulation in feet. It is also important to avoid developing influenza and to carefully control your blood sugar if you have diabetes.

Your doctor may recommend combining lifestyle changes with a prescription medication regimen to improve blood circulation. The most commonly-used medications for PAD are called statins and work by blocking the amount of enzymes in your body that produce cholesterol. They are known by the brand names Zocor, Lipitor, Crestor, and others.

 

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Dr. Mayer Salama and Dr. Daniel Salama
3408 West Rd (In Grange Plaza)
Trenton, MI 48183 -(734) 676-4664

2200 Monroe
Dearborn, MI 48124 - (313) 274-0990

6770 Dixie Hwy. Suite 101
Clarkston, MI 48346 - (248) 625-1110

23800 Orchard Rd Suite 201
Farmington Hills, MI  48336 - (248) 474-0040