Wednesday, April 29, 2009

Diabetics can't afford to wear flip-flops

Some people wear flip-flops year round. Others await the warm days of spring and summer.

Regardless, medical experts focus on the ugly side of the rubbery soles.

Podiatrists contend flip-flops can lead to heel pain and injury, and should only be worn for short periods like a trip to the beach or walking around a pool.

When it comes to diabetics, however, the risk goes one step further.

The reasons are many.

Skin Exposed

Flip-flops expose the skin and do nothing to reduce the chance of injuries to the feet.

Diabetics are prone to having nerve disease or artery disease or both. Either disease by itself causes poor blood circulation in the feet, which can lead to nerve damage.

This leaves diabetics without the normal sensation to feel pain. As a result, untreated sores can result in infections, which could lead to amputation of the foot or leg.

Diabetics must take extra precautions to care for their feet at all times.


Dr. Melissa Meredith, an endocrinologist at the University of Wisconsin School of Medicine and Public Health, suggests the following:

Ask a doctor about special shoes to protect your feet. They may be covered by insurance.
Wash feet in warm water every day and dry them thoroughly.
Use lotion on feet to prevent cracked skin, athletes' foot and other conditions that can cause infections.
Keep toenails properly manicured by using a nail clipper and emery board.
See a doctor if you notice sores, cuts, calluses and other irritations that could lead to infections.

The ADA also suggests not putting oils or creams between toes because the extra moisture can lead to infection.

While not wearing flip-flops certainly plays a role in having healthy feet, the No. 1 enemy is smoking, the ADA reports.

Smoking exacerbates artery disease, causing even worse circulation.

Most diabetics who need amputations are smokers.

The good news is proper care can prevent woes.

Tuesday, April 28, 2009

What Is Peripheral Arterial Disease?

What Is Peripheral Arterial Disease?

Peripheral arterial disease (P.A.D.) occurs when plaque (plak) builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.

When plaque builds up in arteries, the condition is called atherosclerosis (ATH-er-o-skler-O-sis). Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.

P.A.D. usually affects the legs, but also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs.

Normal Artery and Artery With Plaque Buildup

The illustration shows how P.A.D. can affect arteries in the legs. Figure A shows a normal artery with normal blood flow. The inset image shows a cross-section of the normal artery. Figure B shows an artery with plaque buildup that’s partially blocking blood flow. The inset image shows a cross-section of the narrowed artery.


Blocked blood flow to your legs can cause pain and numbness. It also can raise your risk of getting an infection in the affected limbs. It may be hard for your body to fight the infection.

If severe enough, blocked blood flow can cause tissue death (gangrene). In very serious cases, this can lead to leg amputation.

If you have leg pain when you walk or climb stairs, talk to your doctor. Sometimes older people think that leg pain is just a symptom of aging. However, the cause for the pain could be P.A.D. Tell your doctor if you're feeling pain in your legs and discuss whether you should be tested for P.A.D.

Smoking is the main risk factor for P.A.D. If you smoke or have a history of smoking, your risk for P.A.D. increases four times. Other factors, such as age and having certain diseases or conditions, also increase your risk.


If you have P.A.D., your risk for coronary artery disease, heart attack, stroke, and transient ischemic attack (“mini-stroke”) is six to seven times greater than the risk for people who don’t have P.A.D. If you have heart disease, you have a 1 in 3 chance of having blocked leg arteries.

Although P.A.D. is serious, it’s treatable. If you have the disease, it’s important to see your doctor regularly and treat the underlying atherosclerosis.

P.A.D. treatment may slow or stop disease progress and reduce the risk of complications. Treatments include lifestyle changes, medicines, and surgery or procedures. Researchers continue to explore new therapies for P.A.D.

September 2008

Monday, April 27, 2009

With Peripheral Artery Disease, Med Adherence Is Low

With Peripheral Artery Disease, Med Adherence Is Low
04.23.09, 08:00 PM EDT
Survival, though, is greater when guidelines are followed, study finds

FRIDAY, April 24 (HealthDay News) -- Less than half of those who have peripheral artery disease are taking the recommended combination of medications to control it, new research says.

Researchers collected data on 711 people with peripheral artery disease who had vascular surgery at 11 hospitals in the Netherlands in 2004. Three years later, 465 of the surviving 552 patients answered a questionnaire about their medication use.

About half were taking the guideline-recommended medical therapy, a combination of aspirin and statins in all patients and beta blockers in those who also had ischemic heart disease, said study author Dr. Don Poldermans, of the Erasmus Medical Center in Rotterdam.

Those who were taking the recommended medications had a better chance of being alive three years after their surgery, the study found.

Researchers also found that after three years, aspirin was being taken by 74 percent, statins by 69 percent and beta blockers by 54 percent.

"Guideline-recommended medical therapy use for the combination of aspirin, statins and beta blockers ... was lower than expected," the authors said in a news release from the American Heart Association. "These data clearly indicate the need for initiating optimal medical treatment at the preoperative outpatient clinic, as well as improvement of long-term medication use."

Their research was to be presented Friday at the American Heart Association's 10th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke in Washington, D.C. and will be published in Circulation: Cardiovascular Outcomes and Quality.

Peripheral artery disease is a circulatory problem in which narrowed arteries reduce blood flow to the limbs. Symptoms typically include leg pain when walking.

The disease is also often a sign of atherosclerosis, a chronic inflammation and build-up of plaques in the arteries, which can reduce blood flow to the heart, brain and legs.

Friday, April 24, 2009

Answer…Monthly Poll April 2009

Despite advanced interventional techniques to restore straight-line flow, amputation continues to be a common “therapy” for lower limb ischemia. Estimated how many amputations are performed in Europe and the USA annually?

ANSWER...An estimated 200,000 amputations are performed in Europe and the USA annually.

Visual Clues to PAD and Arterial Insufficiency

• Cool, dry, atrophic skin on legs may have signs of cellulitis
• Thickened or deformed nails-dystrophic
• Hair loss or uneven distribution on legs
• Muscle weakness or atrophy
• Bruits on auscultation
• Ulcers or wounds on lower extremities
• Gangrene

The Benefits of Screening for PAD
Early detection = increased PAD therapy options
Patients return for continuing care
Increased credibility within the community for saving patient limbs
Increase patient well-being and prolong life

The Encompass patient screening and accountability network allows our network of highly specialized medical professionals to deliver accurate and effective diagnosis and treatment of both the symptoms and the cause of Peripheral Artery Disease and lower limb ischemia in dialysis patients.

Partner with Encompass Network Partners! For more information, contact Kelly Burleson at

Tuesday, April 14, 2009

PAD and Encompass Network Partners - Teamwork!

Peripheral Artery Disease restricts the flow of blood through the vessels beyond the heart. Circulation disorders in these vessels, which carry oxygen and other nutrients to vital organs and tissues, are most often caused by atherosclerosis (also called hardening of the arteries), a progressive disease process caused when plaque (composed of fat, cholesterol, and other substances) is deposited on the inner wall of the artery.

The Encompass patient screening and accountability network allows our network of highly specialized medical professionals to deliver accurate and effective diagnosis and treatment of both the symptoms and the cause of Peripheral Artery Disease and lower limb ischemia in dialysis patients.

Thorough Screening, Consistent Screening , Proper Treatment and Specialized Care... These all ADD UP to: Patient quality of life - Better long term care - Delivering results!

Partner with Encompass...For your patients sake!

For more information how you can partner with Encompass Network Partners, contact us at