Wednesday, January 30, 2013

Frostbite - Should Health Women Worry??

When we think of frostbite in Chicago and other large cities, most people think of the homeless and others out without proper foot protection from the elements.  But working women, especially those who commute downtown, should also be cautious!

So many of my patients commute to the city.  They take the train from Naperville or surrounding western suburbs and walk to their offices from the train.  I can tell you that most of these women are not wearing Uggs as part of their winter foot wear if there is no snow.

Most women tend to wear the same dress shoes and hosiery for their multiple block walks to and from the train - unless they wear sneakers for a previously discussed foot problem.  These shoes, or fashion boots, lack the warmth that winter boots provide and most dress shoes leave a good part of the foot exposed.  This exposure - especially when the temps dip into the teens - can lead to frostbite in some people.

Risk factors include anyone with circulation problems or diabetes but even health women should be cautious if they are smokers, take certain medications or have something called Raynaud's. 

Raynaud's is often associated with some rheumatic diseases (Raynaud's phenomenon), but it can also be present by itself   Raynaud's is fairly common - even my 15 year old daughter has it!  Toes and occasionally fingers get very cold and even turn white when exposed to cold temperatures or other stressful triggers.  It is more common in women and those who live in colder climates.  Even while at home, my daughter's second toe often turns white.

I have my daughter rewarm her toe in warm water or with a warm compress until the normal color returns to her toe; but prevention is the key with women who experience this problem.  Wearing socks (even in the house during the cold months), wearing boots when outside and limiting exposure to the very cold air.  On the really cold days, I recommend to my patients that they take a cab to and from their offices and the train.

Raynauds is a vasospastic problem of the arteries which blocks the blood flow to the toes or fingers.  Risk factors for health women include the use of cold medications that include pseudoephedrine (Chlor-Trimeton, Sudafed) and birth control pills.  Women should not smoke if they have Raynauds - its the perfect and very real reason to give my daughter not to start smoking!

Tuesday, January 22, 2013

Shoe Shape vs. Foot Shape

I recently saw a Rachel Ray segment that talked about "foot shape" and how wearing a shoe that is a different shape than your foot can cause deformities such as bunions and hammertoes.  If only it were that simple!

"Foot shape" as referred to in the piece is more a result of the length of your toes.  Some people  have longer second toes and others have a longer great toe.  Either way, you need to fit shoes to the longest toe.  BTW- it is said that those with longer second toes are natural born leaders!

Toe box shape - square, round or pointed -  is only one factor in shoe construction and the way they affect the feet.  Heel height, the cut of the toe box and the point at which the pointed toe shoes curve  are even more important factors!  A pointed shoe that has an extended (faux) toe can be quite comfortable for many women no matter which toe is longer.  Similarly, rounded toe shoes can often cut across the bunion area and be quite a problem.

Finally, I want to make sure everyone understands, shoes do not cause bunions!  Bunions are caused by a combination of foot type, genetics and are influenced by daily shoe wear.  Certainly, if you wore a narrow, constrictive shoe 24 hours a day for years, your foot would take on that shape; but that is rarely the case!