What Causes Gout?

"Gout is caused by an increase, or build up, of uric acid in the body.  It is usually a result of a decreased excreation of uric acid in our urine.  Initially the uric acid is found in the blood, but over time it will defuse throughout the body.  This includes the joints.  As uric acid increases in concentration in the joints it is more likely to crystallize.  These crystals can cause a lot of pain during an acute gout attack. 
 

The question can be asked: Why is gout usually seen in the feet?  Uric acid is not water soluble.  This means that it will crystallize if given the right conditions.  First, in high enough concentrations it can crystallize.  Second, as temperature decreases it is more likely to crystallize.  Gout can be found in any joint, but I believe it happens more in the feet because of the decreased temperature found in the feet.  The feet are the structures in the body that are furthest from the heart, making them the coolest. 

Symptoms of an acute gout attack include pain, edema (swelling), and erythema (redness) around the joint involved.  It is common to see a patient that was drinking alcohol or eating a steak dinner one evening to wake up the next morning with an acute gout attack.  The pain is usually 10 out of 10 and can be so painful it hurts to even let the bed sheets rest on the affected area.  An acute gout attack can mimic different arthritic conditions, including septic arthritis.  A diagnosis is made definitively through joint aspiration, which is then sent to a pathology lab."

- Dr. Marshal Gwynn

Foot Exams Help Prevent Ulcerations

diabetic foot syndrome

We urge all of our patients to make sure their primary-care physicians check their feet during every office visit for signs of ulcerations that, left untreated, can lead to infection and ultimately result in lower limb amputations.

It’s a simple exam that takes two minutes to determine if you are at risk for developing a foot ulcer. Perhaps the easiest way to remember to get your feet checked is to remove your shoes and socks in the examining room. Most diabetic patients are vulnerable to foot ulcerations caused by poor blood circulation in the lower extremities and neuropathy that inhibits nerve sensation.

Ulcers are the leading cause of foot amputations among people with diabetes, but they are preventable in most cases if doctors routinely check their patient’s feet.

In a routine foot exam we check for nerve sensation, skin irregularities (corns, calluses, punctures and areas of redness), swelling, drainage, and foot deformities that cause unnatural pressure points that are prone to ulceration.

Patients with diabetes who have their feet checked regularly can prevent foot ulcers or have them treated at early stages by their podiatrist.

Why a foot doctor?

Dr. Kate and I were talking the other day about the different types of doctors and other fields she might of considered entering other than Podiatry. After talking, I started wondering why Dr. Kate chose becoming a Doctor of Feet afterall and here's what she had to say!

What made you decide to become a foot doctor? When was this? My grandpa was Type 1 Diabetic with complications and he was the only grandparent I never met, this made me become interested in Diabetes. I also wanted to specialize in surgeries as opposed to an orthopedic doctor or doing hip surgeries, etc. Another reason is because I was an athlete in school and was exposed to injuries. So Podiatry covers all of the above- Diabetes, Surgeries and Sports Medicine! I believe I made the decision my senior year in college.

You're a young doctor, do you think its an advantage or disadvantage drawing patients to you? I 100% believe it's an advantage because Podiatry training is becoming better, you're well trained and are given good exposure to multiple aspects of Podiatry.

What do you love about your job? Helping people overcome their disease or complication and educating them on how it affects their foot health. Also, I met my current boyfriend through a patient (who is a good friend now!) and am thankful this career has led me to the person I hope to marry!

What do you do in your free time? When I can I spend time with my friends and family and try to live a healthy and active lifestyle with sporting activities.

How would you encourage others to enter this same profession? I would encourage them to shadow which is following a doctor around to educate them on what they would be taught and able to do.

Thanks Dr. Kate for taking the time out of your hectic day to inform others on what it's like to be a Podiatrist!

Sports Injuries & Children

English: Child Soccer player. (Photo credit: Wikipedia)

If your children are playing sports this fall, pay attention to six tips that could protect them from serious ankle injuries.

Every fall season, foot and ankle surgeons see an increase in ankle injuries among young athletes. Football, soccer and basketball are the sports most likely to lead to sprains, broken bones and other problems, says Roanoke and New River Valley area podiatrist Jennifer Feeny, DPM.

"What seems like a sprain is not always a sprain; in addition to cartilage injuries, your son or daughter might have injured other bones in the foot without knowing it. Have a qualified doctor examine the injury," says Dr. Feeny. "The sooner rehabilitation starts, the sooner we can prevent long-term problems like instability or arthritis, and the sooner your child can get back into competition." Dr. Feeny, who is a Fellow of the American College of Foot and Ankle Surgeons (ACFAS), offers these additional tips for parents:

--Have old sprains checked by a doctor before the season starts. A medical check-up can reveal whether your child's previously injured ankle might be vulnerable to sprains, and could possibly benefit from wearing a supportive ankle brace during competition.

--Buy the right shoe for the sport. Different sports require different shoe gear. Players shouldn't mix baseball cleats with football shoes.

--Children should start the season with new shoes. Old shoes can wear down like a car tire and become uneven on the bottom, causing the ankle to tilt because the foot can't lie flat.

--Check playing fields for dips, divots and holes. Most sports-related ankle sprains are caused by jumping and running on uneven surfaces. That's why some surgeons recommend parents walk the field, especially when children compete in non-professional settings like public parks, for spots that could catch a player's foot and throw them to the ground. Alert coaching officials to any irregularities.

--Encourage stretching and warm-up exercises. Calf stretches and light jogging before competition helps warm up ligaments and blood vessels, reducing the risk for ankle injuries.

For more information on treating ankle sprains, visit ShenandoahPodiatry.com