Poor Circulation in the Foot and Ankle

How Do I Know If I Have Poor Circulation?
How does a diabetic know if they have poor circulation in their feet?
There is an increased incidence of peripheral arterial disease in diabetics. Peripheral arterial disease (PAD) is narrowing or blockage of arteries that results in poor blood flow to your legs. When you walk or exercise, your leg muscles do not get enough blood and you can get painful cramps. Peripheral arterial disease is also called peripheral vascular disease or simply poor circulation.Just like clogged arteries in the heart, clogged arteries in the legs mean you are at risk for having a heart attack or stroke. Plaque buildup in the legs does not always cause symptoms, so many people can have PAD and not know it. People who do experience symptoms, such as pain or cramping in the legs, often do not report them, believing they are a natural part of aging or due to another cause.
One in every 20 Americans over the age of 50 had PAD and it is estimated that over 8 million are undiagnosed. Early detection of PAD has been shown to save limbs and lives, so if you have any of the risk factors you should undergo PAD screening by your podiatrist yearly or more often if symptoms occur.
The exact cause of plaque buildup in the limbs is unknown in most cases. However, there are some conditions and habits that raise your chance of developing poor circulation.
Your risk increases if you:
1. Are over the age of 50.
2. Smoke or used to smoke. Those who smoke or have a history of smoking have up to four times greater risk of P.A.D.
3. Have diabetes. One in every three people over the age of 50 with diabetes is likely to have PAD.
4. Have high blood pressure. Also called hypertension, high blood pressure raises the risk of developing plaque in the arteries.
5. Have high blood cholesterol. Excess cholesterol and fat in your blood contribute to the formation of plaque in the arteries, reducing or blocking blood flow to your heart, brain, or limbs.
6. Have a personal history of vascular disease, heart attack, or stroke. If you have heart disease, you have a one in three chance of also having PAD.
7. Are African American. African Americans are more than twice as likely to havePAD as their white counterparts.
What are the symptoms of PAD?
Most patients with PAD have little or no symptoms until the disease is advanced; that’s why screening exams are so important. Those who do experience symptoms have reported these typical signs and symptoms:
Claudication: fatigue, heaviness, tiredness, cramping in the leg muscles (buttocks, thigh, or calf) that occurs during activity such as walking or climbing stairs. This pain or discomfort goes away once the activity is stopped and during rest.
Rest Pain: pain in their legs at night that often disturbs their sleep
Wounds or sores that heal very slowly or not at all
Color changes to the skin of their feet and lower legs
Cold, pale feet and legs
Decreased hair and nail growth on their feet
How is PAD Diagnosed?
Your podiatrist will start with checking the pulses in your foot and ankle, examining the skin for changes and wounds that are poorly healing. Often an ABI (ankle-brachial index) is evaluated which compares the blood pressure in your arms to your ankles. A Doppler exam may be ordered. This test uses sound waves to measure the blood flow in the veins and arteries in your arms and legs. If any of these exams are abnormal, your podiatrist may refer you to a vascular surgeon to discuss options for treatment.
How is PAD Treated?
The overall goals for treating PAD are to reduce any symptoms, improve quality of life and mobility, and prevent heart attack, stroke, and amputation. There are three main approaches to treating PAD: making lifestyle changes; taking medication; and in some cases, having a special procedure or surgery. Your physicians will determine the best treatment options for you, based on your medical history and the severity of your condition.
How Can I Prevent PAD If I am Diabetic?
The cornerstone of prevention is lifestyle changes.
Exercise is very important and you should aim for 30-45 minutes of moderate intensity exercise each and every day.
Stop smoking immediately and ask your doctor for help if you find you cannot.
Keep your cholesterol and blood glucose levels down. Aim for a HgA1C of 6!
Keep your blood pressure in the normal range.
Decrease stress.
If you are overweight or obese, aim for a normal weight and again, ask your doctor for help! A diet low in saturated fats, trans fats and cholesterol is also helpful.
More than anything, talk to your doctors about a comprehensive treatment plan for your diabetes that also decreases your PAD risks.
One in every 20 Americans over the age of 50 had PAD and the incidence is higher in diabetics. Most patients have little or no symptoms until it is too late! Early detection of PAD has been shown to save limbs and lives, so if you have any of the risk factors you should undergo PAD screening by your podiatrist yearly or more often if symptoms occur.
Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

Foot pain from Gout

Gout used to be known as the disease of kings. Too much red meat and red wine caused the kings of old to suffer from gout. This is actually only one cause of gout, but an important safety tip! Gout is a disorder that results from a build up of uric acid crystals in a joint. This can be your big toe joint, ankle, or knee, most commonly; but can occur in any joint or tissue in the body. (I’ve seen it in an earlobe!) Simply said, gout hurts so bad you don’t even want a sock or sheet on your foot, let alone a shoe!
What causes gout?
Gout is a buildup of uric acid crystals in the joint or tissue. Uric acid is normally found in the blood and eliminated by the kidneys. Gout attacks are caused by either too much uric acid in your blood due to the kidneys having trouble eliminating it or simply you just make too much. Gout attacks the big toe joint most commonly, because uric acid turns to crystals as it cools down, and your big toe joint is the furthest from the heart, so the coolest joint in the body. (I always thought big toes were cool!) Seriously though, many people inherit the tendency to have gout and it is much more common in men than women. Other factors that precipitate gout can be high blood pressure, diabetes, obesity, surgery, chemotherapy, stress and certain medications. Food can cause gout attacks. Uric acid is the result of the breakdown of purines, so food with high levels of purines can cause gout. These included red meat, red wine, beer, shellfish, and organ meat. (I knew there was a reason I never liked liver and onions, it causes gout!).
Please see the following website for advice on which foods to avoid and foods to enjoy:
http://arthritis.about.com/cs/goutdiet/a/goutpurines.htm
The diagnosis of gout requires an extensive physical exam including family history, x-rays and laboratory tests for uric acid levels. It is important to distinguish gout from an infection or other inflammatory joint problem.
Treatment for gout starts with anti-inflammatory medication or injection therapy, padding and shoe gear modification. Dietary restrictions are discussed and often a long-term medication is needed to control the build up of uric acid in the blood. In a large, long-term prospective study of men aged 40 years and older, long-term caffeinated coffee consumption was associated with a lower risk for incident gout, so if you fall in this category, this may help as well. Gout can cause degenerative arthritis, so often orthotics or surgery is needed to treat the arthritic joint.
If you have the symptoms of gout, do not delay. The longer the uric acid is accumulating in your joint, the more destructive the crystals can be. Long-term outcomes hinge on immediate care. Call or contact the office today to schedule an appointment with Dr. Williams or Dr. Silvers today.

Eric M. Silvers, DPM, PA
Kory D. Williams, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

New Website

Advanced Foot and Ankle Center, the office of Dr. Eric Silvers and Dr. Kory Williams has a new website. www.advancedfoottexas.com

Dr. Silvers and Dr. Williams are foot and ankle specialists trained to treat all foot and ankle conditions. With offices in McKinney and Prosper, Texas, we assure you that we are close by.

We serve McKinney, Propser, Frisco, Allen, Anna, Melissa, Plano, Princeton and surrounding areas.

Please visit our website and call 972-542-2155 to set up an appointment.

Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155

New Blog Page for McKinney Podiatrists

Dr. Kory Williams, a foot and ankle surgeon with Advanced Foot and Ankle Center has just created a new Blog for our office. Please visit it at http://advancedfoottexas.blogspot.com/

Dr. Williams joins Dr. Eric Silvers in Practice. Both surgeons serve McKinney, Prosper, Allen, Anna, Frisco, Plano and surrounding communities.

Call our office at 972-542-2155 or visit our website for an appointment.


Eric M. Silvers, DPM, PA
Board Certified Foot and Ankle Specialist
Advanced Foot and Ankle Center
McKinney, Texas
Prosper, Texas
http://www.advancedfoottexas.com
972-542-2155