Silent but Deadly!

This week I am reminded again of how often high blood pressure goes unnoticed. Many patients come in for other reasons (sore throat, sprained ankle, funny rash) and are surprised to see that their blood pressure is running quite high. Headaches, chest pains and blurred vision can all be signs of high blood pressure, but often do not occur until the pressure is extremely elevated. Often people notice high blood pressure at the dentist's office, but ignore it, thinking that it was only elevated because they were nervous about their visit. While "white coat high blood pressure" certainly exists, do NOT ignore a high reading! Let that alert you to check your pressure several more times under low stress situations, such as when you are doing your routine grocery shopping. Pop your arm in the cuff that is usually set up in the pharmacy section, and check your pressure. If it is running high (top number above 140 or bottom number above 90), I'd suggest you get your own cuff and check pressures daily for a couple weeks. Record these pressures, and take them with you to see YOUR family doctor!
BOTTOM LINE: Don't wait for symptoms to check your blood pressure!

Hot Dog Hazards!

I believe it's common knowledge that we do NOT want to know what goes IN to a hotdog, but does everyone know that the real hazard of a hotdog is where the hotdog might end up? I'm talking about when the hotdog gets stuck in the airway. Over 10,000 kids (under the age of 14) end up in the emergency room each year from choking on food, and a hotdog is to blame for roughly one out of six of these visits. The American Academy of Pediatrics has officially asked for hotdogs to receive a similar "choking hazard" label as toys with small parts. Better yet, they hope the manufacturers of hotdogs can be convinced to reshape their product. Right now, we advise parents of young kids to cut up their hotdogs like "french fries", rather than slicing a quick row of dime-shaped segments.
BOTTOM LINE: Remember that choking hazards apply to FOODs as well as toys with small parts, and make sure you cut them up appropriately!

Too Tired to see the Doctor?

Should you bother going to the doctor when your only complaint is "I'm tired"? Well, truthfully, it depends. If there is an obvious explanation- having a newborn and getting no sleep, starting back to school while working two jobs (and getting no sleep), having a teenager learning to drive (and getting no sleep)- see the trend? However, if you have not changed your diet or sleep patterns significantly and you find yourself sleepy or fatigued all the time, then YES, DEFINITELY go see your doctor!
What could it be? Anemia (low red blood cell count), thyroid disease, diabetes, infections (especially chronic viral ones such as mono or hepatitis), fibromyalgia (and other rheumatic diseases) and vitamin deficiencies are the most common causes that I see. Certainly there are other more serious causes such as cancers, kidney or heart failure, or neurologic disease, to name a few, but my point here is that there are many causes of fatigue that can be improved or cured IF you are looking for them!
BOTTOM LINE: Don't be "TOO TIRED" to go to the doctor and find out what might be causing your fatigue!

...9998, 9999, 10,000!

Before we leave the topic of exercise and feet, let me share my favorite inexpensive toy- the PEDOMETER. I love these! They are terrific if you are currently in or out of shape. Buy one, clip it on, and you're off! Simply note your baseline steps, and then try to add 200 steps per day until you reach your goal. I recommended 10,000 steps per day as that goal. Many people think they are "always walking" at work, but are surprised to find how little it really is when they wear a pedometer. Additionally, it's fun! How wonderful to see immediate feedback, and the constant positive reinforcement of MEETING your daily fitness goal will propel you forward.
BOTTOM LINE: Buy a pedometer and get moving!!

Keeping Me On My Toes!

I think it's a bit ironic that after two back-to-back posts about shoes this week, I had occasion to see some serious shoe experts at work when I took our older daughter to be fitted for her first pointe shoes- talk about a science! Who knew there were so many different types of ballet shoes out there? A vast selection of pointe shoes must each be tried on in multiple different ballet positions, culminating in the classic "en pointe" (the highlight of the session, of course!)
Caution- these shoes are not for young girls wanting to "play" ballerina. Before a young ballet student can go "en pointe", she must have developed specific muscle strengthening and flexibility, taught through many months of intense "pre-pointe" classes typically around age twelve, and after years of classical ballet classes. Most of my daughter's pre-teen and teenage classmates have been taking lessons literally for ten years!
The primary purpose of this post, however, is not to brag that my daughter is advancing in her sport, but to point out (pun intended) that as parents, we need to make sure we and their coaches are not pushing them to levels of performance beyond their age and body maturity. With the early specialization in sports that seems to be required of even elementary students these days, it's easy for kids to be pushed beyond appropriate limits- especially if they show real promise.
BOTTOM LINE: Pushing kids beyond the appropriate level of athletic endeavors for their body's maturity will lead to injuries. If you think your child's coach has unrealistic expectations, talk with your family doctor or a sports medicine doctor!

High Heels- High Price!

So yesterday, I said it was time to go shoe shopping, and with Valentine's Day around the corner, you may have thought that I was going to talk about shopping for the sexy, red high heels on the cover of my book! But alas, no, I was only talking about running shoes. So what do I tell my patients about heels?
First of all, my general advice is to save the major heels for a fun night out. Wearing high heeled, toe pinching shoes to work each day may look fashionable, but it's not worth the price. When I was a medical student, I spent a few weeks with an orthopedic surgeon who specialized in feet- and I vowed then and there to do everything I could so my decades over 40 would not be spent suffering from daily foot pain! I immediately increased my shoe size by a whole size to allow my toes more wiggle room. At 5'2" tall, I like to wear heels to raise my height, but now I rely more on boots and shoes that have a raised platform but less height differential from the heel to the toes. Of course, I also married a man who is 6'4" tall, so even super high heels make NO difference- which decreases the incentive for the whole thing!
If you are going to wear high heels regularly, buy and use the gel supports, and try to avoid super pointy toes. If they hurt- hello- they are NOT good for your foot health. Women who tell me their five inch spike heels are "comfy" have obviously never worn UGGs. Loving that boots of all heel heights are in style this year- take advantage and wear the most truly comfortable ones you can find!
So what do I wear to work? Happily, I wear scrubs and my white lab coat to see patients, and clogs or nice, clean sneakers are the shoes of choice. To be honest, I wear the scrubs BECAUSE of the shoes, not the other way around.
BOTTOM LINE: High heels are sexy, but save your feet by not wearing them every day.

It's time to go SHOE shopping!

A quick word or two about shoes...I find myself frequently telling patients that "new shoes are cheaper than new knees/hips." I am the first person to complain about the cost of shoes or clothes, but I never skimp on running/walking shoes. Flip over your shoe and look at the sole. If the tread is worn off (typically along one side), it's time for new shoes, even if the tops look great. Find a real athletic shoe store in your area, and go in with an open mind (and yes, open wallet :0) We're lucky in Austin to have RUNTEX (and Karavel, for more advanced medical podiatric issues.) The staff watch you walk and jog in your socks first, then after assessing your gait & pronation, etc., bring out some different shoes that will best fit your foot. Remember, you will likely need a whole size larger than you are used to wearing in non-athletic shoes, so don't get caught up in the number! The correct shoes will prevent injuries all the way from your feet and ankles up to your hips. Also, don't let a salesperson tell you that you need to "break in" your new shoes- that's simply not true. I also suggest shopping later in the day, when your feet might be swollen, if you tend to retain fluid. Finally, despite the cost, I usually buy two pair at a time, so I can alternate days and extend the life of my shoes.
BOTTOM LINE: If you're going to walk/jog/run for exercise, remember new shoes cost less than new joints!

Happy Groundhog's Day!

Today we'll all be watching Punxsutawney Phil as his shadow determines whether or not we are going to continue with winter. In the meantime, with a nod to the "Groundhog's Day" movie, have you ever found yourself making the same health-related mistake over and over again? Well, let's make February 2, 2010, the day to break that cycle. Whether it's snacking on candy bars, relying on sodas or coffee for that afternoon pick-me-up, or grabbing fast food because it's easier than planning ahead on those busy afternoons, let's make today the day that we make a positive change!
BOTTOM LINE: Pick ONE unhealthy habit that has snuck into a regular cycle for you, and replace it with a HEALTHY choice TODAY!

Change Your Air Filters Today!

Happy February 1st! On the first day of each month, I try to remind my patients (and most importantly for me, my wonderful husband) that it's time for that special monthly chore- changing the air filters. Especially here in Austin, where pollens are crazy year-round, it's really important to change the filters to reduce allergens in your home. You'll be amazed twenty-four to forty-eight hours later when you wake up breathing easily and headache-free.
How do you pick an air filter? Easy- kind of like choosing a wine off a menu where you don't recognize the vineyards. You don't want the cheapest, but you don't need the most expensive, either. Choose a filter that is corrugated. If you have the deluxe models that you need to take outside and wash periodically, make the first of each month your wash day.

BOTTOM LINE: Tired of waking up with headaches, sneezing, and/or stuffy nose? Change your filter the first of every month!