If you have diabetes, here’s what you need to know about amputation — and how to avoid it.

By Mayo Clinic staff

Foot care is especially important if you have diabetes. Diabetes can impair blood flow to your feet and cause nerve damage. Without proper attention and care, a small injury can develop into an open sore (ulcer) that can be difficult to treat. Sometimes amputation is necessary if an infection severely damages the tissue and bone.

The good news is that with proper diabetes management and careful foot care, amputation may be preventable. Here’s what you need to know about the link between amputation and diabetes — and how to keep your feet healthy.

Why does diabetes pose a risk of amputation?

Diabetes can cause two potentially dangerous threats to your feet.

• Nerve damage (diabetic neuropathy). When the network of nerves in your feet is damaged the sensation of pain in your feet is reduced. Because of this, you can develop a blister or cut your foot without realizing it.
• Reduced blood flow. Diabetes can also narrow your arteries, reducing blood flow to your feet. With less blood to nourish tissues in your feet, it’s harder for sores to heal. An unnoticed cut or sore hidden beneath your socks and shoes can quickly develop into a larger problem.

Left untreated, a minor foot injury could become a serious infection — even leading to tissue death (gangrene). Severe damage might require toe, foot or even leg amputation.

How can amputation be prevented?

To prevent diabetes complications, make a commitment to managing your diabetes. Eat healthy foods, include physical activity in your daily routine and keep your blood sugar under control. Then put your best foot forward with these simple foot-care tips:

• Wash your feet daily. Wash your feet in lukewarm water once a day. Dry them gently, especially between the toes. Sprinkle talcum powder or cornstarch between your toes to keep the skin dry. Use a moisturizing cream or lotion on the tops and bottoms of your feet to keep the skin soft.
• Inspect your feet daily. Check your feet for blisters, cuts, sores, redness or swelling once a day. If you have trouble bending over, use a hand mirror to see the bottoms of your feet or ask someone to help you.
• Trim your toenails carefully. Trim your nails straight across. If you have any nail problems or poor feeling in your feet, ask your doctor about professional nail trimming.
• Don’t go barefoot. Protect your feet with comfortable socks and shoes, even indoors. Make sure new shoes fit well, too. Even a single blister can lead to an infection that won’t heal.
• Wear clean, dry socks. Wear socks made of fibers that pull (wick) sweat away from your skin, such as cotton and special acrylic fibers — not nylon. Avoid those with tight elastic bands that reduce circulation or that are thick or bulky. Bulky socks often fit poorly, and a poor fit can irritate your skin.
• Use foot products cautiously. Don’t use a file or scissors on calluses, corns or bunions. You can injure your feet that way. Also, don’t put chemicals on your feet, such as wart removers. See your doctor or podiatrist for problem calluses, corns, bunions or warts.
• Don’t smoke or use other types of tobacco. Smoking reduces blood flow to your feet. Talk to your doctor about ways to quit smoking or to stop using other types of tobacco.
• Schedule regular foot checkups. Your doctor can inspect your feet for early signs of nerve damage, poor circulation or other foot problems. Your doctor may refer you to a foot specialist (podiatrist).
• Take foot injuries seriously. Contact your doctor if you have a sore or other foot problem that doesn’t begin to heal within a few days. Your doctor may prescribe antibiotics to treat an infection. In other cases, infected tissue may be drained or removed. Sometimes surgery is needed to remove infected bone or increase blood flow to the affected area.

What if amputation is the only option?

If an infection has progressed too far or becomes life-threatening, an amputation may be the only option. The surgeon will remove the damaged tissue, being careful to preserve as much healthy tissue as possible. After surgery, you’ll be monitored in the hospital for a number of days. It may take four to eight weeks for your wound to heal completely.

While you’re recovering from surgery, your rehabilitation team — which usually includes a physical therapist, occupational therapist, social worker and other health professionals — will help you adjust to life after amputation. You may be fitted for an artificial limb and learn exercises to strengthen the affected area. You may learn how to use assistive devices and adapt your home, if needed, to help you resume your usual activities. If you experience pain in the amputated limb (phantom pain), you’ll learn techniques to deal with the discomfort.

Even after amputation, remember that it’s important to follow your diabetes treatment plan. Eating healthy foods, exercising regularly, controlling your blood sugar level and avoiding tobacco can help you prevent additional diabetes complications. If you’re having trouble accepting the amputation or how it’s changed your life, share your feelings with friends, loved ones or other close contacts. If necessary, contact a mental health professional for additional support.

(Source:  http://www.mayoclinic.com/health/amputation-and-diabetes/DA00140/NSECTIONGROUP=2)

Healthy Choices for a Long and Healthy Life

Because nearly 40% of all deaths in America can be attributed to smoking, poor exercise habits, inadequate diet, and alcohol misuse, it’s pretty easy to see how you can add years to your life. Don’t smoke, get moving, eat healthy food and moderate any alcohol consumption. Clearly, healthy behavior choices are one prescription for successful aging.

A Quick Review of Chronic Disease

The Center for Disease Control (CDC) estimates that 88% of people over age 65 have at least one chronic health condition. The major chronic disease killers include heart disease, cancer, stroke and diabetes. Healthy behavior choices reduce the occurrence of chronic disease. Here are a few more facts and links.

• Arthritis and conditions related to arthritis are the leading cause of disability in the U.S. Go to Strong Health’s Orthopaedics  program for more information.
• Heart disease is the nation’s leading cause of death. Three factors–tobacco, poor nutrition, and lack of exercise–are major contributors to heart disease.
• Cancer is the second most common cause of death in the U.S. To control cancer we need prevention, early detection, and high-quality treatment. Go to the James P. Wilmot Cancer Center for more information.
• Aging brings increased risk of colorectal cancer, but improved screening tools and treatments have increased the chance of curing it.
• Breast cancer is also somewhat related to aging. Seventy-six percent of all diagnosed cases of breast cancer occur in women age 50 years and older. Find out what you need to know about breast care.
• Diabetes is an increasingly common chronic disease. About 20% of people 65 and older have diabetes.
• Epilepsy and seizures are more prevalent among the very young and the elderly. About 3% of all Americans will be diagnosed with epilepsy by the time they turn 80.
• Obesity among adults of all ages has doubled in the past 25 years. All of the other chronic diseases mentioned in this list are a greater risk to seniors who are seriously overweight or obese. In severe cases bariatric surgery may be recommended.

What is Elder Abuse?

Everybody’s heard of child abuse, but what about abuse of the elderly? Abuse can be physical, sexual, emotional, and financial. Both neglect and self-neglect are forms of abuse. The Office of the Aging says that hundreds of thousands of seniors are abused, neglected, and exploited—often by family members—every year.

Learn more about elder abuse, including telephone hot lines to report suspected elder abuse to Adult Protective Services at the Department of Social Services. You do not have to identify yourself when making a report.

(Source:  http://www.stronghealth.com/services/seniors/healthmatters/commonissues.cfm)

Live a Healthy Lifestyle

• Eat a healthy diet. Choosing healthful meal and snack options can help you avoid stroke and its complications. Be sure to eat plenty of fresh fruits and vegetables.Eating foods low in saturated fat and cholesterol and high in fiber can help prevent high blood cholesterol. Limiting salt or sodium in your diet can also lower your blood pressure.

  For more information on healthy diet and nutrition, see CDC’s Nutrition Web site.

• Maintain a healthy weight. Being overweight or obese can increase your risk for stroke. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). Doctors sometimes also use waist and hip measurements to measure a person’s excess body fat.If you know your weight and height, you can calculate your BMI at CDC’s Assessing Your Weight Web site.
• Be active. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. The Surgeon General recommends that adults should engage in moderate-intensity exercise for at least 30 minutes on most days of the week.For more information, see CDC’s Physical Activity Web site.
• Don’t smoke. Cigarette smoking greatly increases your risk for stroke. So, if you don’t smoke, don’t start. If you do smoke, quitting will lower your risk. Your doctor can suggest ways to help you quit.For more information about tobacco use and quitting, see CDC’s Smoking and Tobacco Use Web site.
• Limit alcohol use. Avoid drinking too much alcohol, which causes high blood pressure. For more information, visit CDC’s Alcohol and Public Health Web site.

Prevent or Treat Your Medical Conditions

If you have high cholesterol, high blood pressure, diabetes, or heart disease, there are steps you can take to lower your risk for stroke.

• Have your cholesterol checked. Your health care provider should test your cholesterol levels at least once every five years. Talk with your doctor about this simple blood test.
• Monitor your blood pressure. High blood pressure has no symptoms, so be sure to have it checked on a regular basis.
• Manage your diabetes. If you have diabetes, closely monitor your blood sugar levels. Talk with your health care provider about treatment options.
• Take your medicine. If you’re taking medication to treat high cholesterol, high blood pressure, or diabetes, follow your doctor’s instructions carefully. Always ask questions if you don’t understand something.
• Talk with your health care provider. You and your doctor can work together to prevent or treat the medical conditions that lead to heart disease. Discuss your treatment plan regularly and bring a list of questions to your appointments.

(Source: http://www.benzinga.com/press-releases/10/11/p630207/orthopedic-institute-combines-team-spirit-with-the-spirit-of-giving)

People with Multiple Sclerosis are often told to rest and not overdo. At the same time, the fear of fatigue can become unbearable. However, there’s no real basis for this fear, because people with MS are not fragile.

Also, clinical trials have shown that proper exercise can increase fitness and also reduce fatigue. The process is slow and begins with a carefully developed exercise prescription. As with any medication, the exercise routine should be prescribed either by a physical therapist or by a physician who knows how to develop exercises for a specific individual.

For people with MS any exercise prescription should have four elements:

1. Type (aerobic, strengthening, balance, coordination, stretching, etc)
2. Duration (how long one should exercise)
3. Frequency (how often one should exercise)
4. Intensity (how hard one should exercise)

As already said, exercise Multiple Sclerosis exercise is a controversial subject. This is mainly because the term exercise is misunderstood – for many people it means no pain no gain. However, for persons with Multiple Sclerosis exercising to the point of pain means fatigue and increased weakness. For people with Multiple Sclerosis exercise has to mean fitness. Fitness implies general overall health and its goal is improving the functioning of lungs, muscle, heart and all the other organs. This is attained with proper diet, not smoking, and appropriate exercises.

As already said, for a person with MS best way to learn which exercises are good, is to ask help from a professional and get a prescription, as there are different exercises used to reduce spacticity, and different exercises in combating weakness and reducing stiffness, etc. Relaxation must be considered an equally important thing, because a person who is under stress will experience increase in weakness. This is why knowing how to relax should be part of any program destined to reduce weakness and fatigue.

The proper exercise prescription needs to take into account that no exercise should cause pain – “no pain no gain” doesn’t apply to MS. The proper exercise routine needs to be a balanced one that includes different types of exercises that lead to improving the overall condition. With this kind of improvement, a gain in strength is to be expected.

(Source:http://www.allaboutms.com/multiple-sclerosis-exercise.html)

National Stroke Association’s Virtual Health Fair Learn Virtually Anything About Stroke National Stroke Association’s inaugural Virtual Health Fair is a live online event scheduled January 19, 2011. This free event is for anyone interested in stroke – the third leading cause of death in the U.S. – to learn more about prevention and recovery. It’s easy to attend. You must register and have access to a computer and the Internet. Online space is limited. Don’t miss the opportunity to: * Learn about stroke 101, advocacy, how to talk to your doctor, and mobility and intimacy issues after stroke. * Hear from experts and survivors with practical prevention and recovery tips. * Browse online booths for downloadable information, coupons and prizes. * Chat with fellow attendees and booth hosts. * Learn how to raise awareness and inspire others to become stroke champions.

Learn Virtually Anything About Stroke

Stroke is a brain attack that is also the third leading cause of death and a leading cause of adult disability in the U.S. It is largely preventable, yet it impacts more than 6 million survivors and millions more family members and caregivers.

Warning for users of warfarin

SALT LAKE CITY — There is a warning Monday to users of the prescription drug known as warfarin. If you’re using the medication, which is designed to prevent blood clots, beware of mixing it with herbal and dietary supplements. Twenty seven of the top 40 selling supplements have a dangerous interaction. Out of the top 10, nine interact with the blood thinning medication.

Jennifer Strohecker, a Pharm D researcher at Intermountain Medical Centers Heart Institute said, “Glucosamine/chondroitin, fish oil, melatonin, coenzyme Q10 and multivitamins containing vitamin K have the potential to interact with warfarin.”

Warfarin and herbal and dietary supplements “compete” in the liver. This competition changes the way the blood thinner works, thereby increasing the risk of bleeding, or by reducing its effectiveness, increasing the risk of stroke, said Dr. T. Jared Bunch, a heart rhythm specialist at the heart institute.

“This data is important because it demonstrates how important it is for physicians to understand our patients’ knowledge about and use of these products,” Bunch said. “We need to do a better job of teaching our patients about the dangers of mixing warfarin with these products.”

Heart patient Marc Buckley ate tons of spinach and broccoli, and took daily vitamin supplements. He still does, but now working with his physician, he’s learned how to lower and balance what he’s taking so as not to interfere with warfarin.

“Whereas before I might have spinach three meals in a row,” Buckley says, “now it’s more regular and consistent so that my levels stay in range.” He’s doing the same with vitamins.

Strohecker says, “Almost 90 percent of the patients we surveyed said that they would be comfortable speaking with their doctor or pharmacist about supplements, if they were asked.” But doctors need to ask as well. The study says communication on both sides is absolutely essential for patient safety.

For 50 years, warfarin or coumadin has been the standard of care. It works very well as an anticoagulant, but it’s super-sensitive to interactions. That’s why the FDA has approved and added a new drug to the arsenal that may not have the same problems. Unlike warfarin, the new drug called dabigatran does not require continual blood tests, nor does it appear to have all the drug-drug, drug-supplement or drug-food interactions.

In the U.S. alone, pharmacists fill 2.2 million prescriptions for warfarin every year.

E-mail: eyeates@ksl.com

(Source: www.ksl.com)

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) causes tissues lining the joints to become swollen, stiff, and painful (inflamed).

Over time, this inflammation may destroy the joint tissues. This can limit your daily activities and make it hard for you to walk and use your hands.

Rheumatoid arthritis is 2 to 3 times more common in women than in men. It often begins between the ages of 40 and 60.

What causes rheumatoid arthritis?

The exact cause of rheumatoid arthritis is not known. But rheumatoid arthritis is an autoimmune disease. This means that the body’s natural defense system attacks the joints. The disease also runs in some families.

What are the symptoms?

The main symptoms of rheumatoid arthritis are pain, stiffness, and swelling in the joints of the hands, wrists, elbows, feet, ankles, knees, or neck. The disease usually affects both sides of the body at the same time. In rare but severe cases, it may affect the eyes, lungs, heart, nerves, or blood vessels.

See a picture of the most commonly affected joints.

Sometimes rheumatoid arthritis can cause bumps called nodules to form over the elbows, knuckles, spine, and lower leg bones.

How is rheumatoid arthritis diagnosed?

There is no single test for rheumatoid arthritis. Your doctor will look at your joints for signs of swelling or tenderness. He or she will also ask about your symptoms and past health.

You may have blood tests, X-rays, and other tests to find out if another problem is causing your joint pain.

How is it treated?

There is no cure for rheumatoid arthritis, but treatment may help relieve symptoms and control the disease. Treatment continues throughout your life.

Treatment includes medicine, exercise, and lifestyle changes.

Experts recommend early treatment with medicines that may control rheumatoid arthritis or keep it from getting worse. Early treatment also may lower the chances that inflammation will destroy your joints and limit your daily activities.

Many of the medicines used to treat rheumatoid arthritis have side effects. So it is important to have regular checkups and talk with your doctor about any problems. This will help your doctor find a treatment that works for you.

At home, you can relieve your symptoms and help control your disease if you:

• Rest when you are tired.
• Protect your joints from injury by using special kitchen tools or doorknobs.
• Use splints, canes, or walkers to ease pain and take stress off your joints, if your symptoms are severe.
• Eat a balanced diet.
• Exercise regularly.
• Stay at a healthy weight.

If medicine, exercise, and lifestyle changes do not help enough, surgery may be an option. Total joint replacement can be done for many joints in the body.

It can be hard to live with a long-term illness that can limit your ability to do things. It is common for people with rheumatoid arthritis to have some depression. Be sure to seek the help and support you need from friends and family members. Professional counseling also can help you cope with long-term pain and depression.

Osteoporosis Conference

Welcome to the Osteoporosis Conference 2010 section of the National Osteoporosis Society website. I am very pleased to announce that the Osteoporosis Conference 2010 will be held in the vibrant city of Liverpool from 28 November – 1 December 2010.

The conference is open to all health professionals and scientists with an interest in osteoporosis. It will present an unrivalled opportunity for attendees to increase their knowledge, learn from internationally renowned experts about recent advances, interact and network with a large multidisciplinary audience, exchange ideas and experiences and discover how to tackle complex clinical challenges.

If you would like further information about the event, please choose a menu option from the left hand side of this page. You will also find a list of useful dates at the bottom of this page.

I very much hope to welcome you to Liverpool.

Professor Roger Francis
Chair of the Osteoporosis Conference Programme and Organising Committees and Chair of the National Osteoporosis Society Medical Board

Useful Dates

16 July 2010: Acceptance Correspondence Sent to Abstract Authors
10 September 2010: Early bird registration deadline
19 November 2010: Pre registration Closes

Follow the Conference on Twitter by clicking the button below:

(See Source website for details not found on left side of page)

(Source: http://www.nos.org.uk/NetCommunity/Page.aspx?pid=300)

1st Asia-Pacific Osteoporosis Meeting In Singapore To Focus On Clinical Management Of Osteoporosis

Main Category: Bones / Orthopedics
Also Included In: Conferences
Article Date: 30 Aug 2010 – 3:00 PDT

Plenary lectures enhanced by meet-the-expert sessions, orthopaedic and diagnostic roundtables

Clinicians, researchers and allied health professionals with an interest in osteoporosis and its prevention, diagnosis and management, are invited to convene in Singapore for the IOF Regionals – 1st Asia-Pacific Osteoporosis Meeting from December 10 -13, 2010.

The meeting promises a stimulating scientific programme featuring plenary lectures by key international experts and thought leaders from the Asia Pacific region.

• Plenary lectures to discuss epidemiology, bone quality, gaps in management, FRAX®, corticosteroid-induced osteoporosis, exercise, nutrients, treatment issues, osteoporosis and fracture prevention in Asia.
• Meet-the-expert sessions to provide practical perspectives on the latest advances in clinical management. Topics include oestrogens and bone, vitamin D, bone markers, vertebro and kyphoplasty, and osteoporosis management in the elderly.
• Orthopaedic and Diagnostic Roundtables as well as numerous satellite symposia will focus on specific clinical topics of interest to a broad range of clinicians
• Abstracts to be published in the field’s leading journal, Osteoporosis International. Deadline for submissions is August 31, 2010 (CET). Submit here.
• Top five ranking abstracts by researchers 40 years of age or under will be selected for IOF Young Investigator Awards, valued at USD 1,000. Winners will have the opportunity to highlight their research at a special presentation session.
• Singapore, one of Asia’s most exciting cities:
  Enjoy Singapore and participate in varied social events including gala dinner (included in fee for registered participants), reception, patient forum and healthy bones event at Esplanade Park featuring renowned martial arts expert Picasso Tan.
  See you in Singapore!

Complete meeting information, online registration and abstract submission is available here.

Key dates:
Abstract Deadline: August 31, 2010
Earlybird Registrations Close: October 13, 2010

Source:
L. Misteli
International Osteoporosis Foundation

(Source:  http://www.medicalnewstoday.com/articles/199319.php)

Balance & Gait Training

Many balance and gait disturbances arise from muscle weakness, vestibular disorders (inner ear problems), visual deficits or loss of somatosensory (touch) input. At Comprehensive Therapy we take into account any or all of these issues that may be contributing to the patient’s condition.

Poor balance can lead to an increased risk of falling. Among the elderly, falls are one of the more serious health concerns. Our Balance Training Program first focuses on identifying the factors affecting your balance. Comprehensive Therapy’s Balance Training Program will improve your balance, reduce your risk of falls, and make a major difference in your quality of life.

(Source: http://www.comptherapyonline.com/balance_gait_training.aspx)