Walk a mile in their shoes

What are patients going through? What sorts of questions do they ask in social media? What do they think about what health professionals tell them about their conditions? Do you know?

Suggestion: on Facebook there are many groups for people with different health conditions. Join these groups for a while to see what they are talking about. Do not tout for business, use them an an opportunity to walk in their shoes to see what their issues are.

For example, there is this Facebook group on Freiberg’s disease and this one on Morton’s Neuroma.

Adult acquired flatfoot or posterior tibial tendon dysfunction or progressive collapsing foot deformity?

Which one is the correct name? There is a lot of discussion going on as to which is the more appropriate name. There are merits for each name.

A lot of it comes down to what is the primary pathology and if it is a primary problem of the posterior tibial tendon or is the driving factor and the primary structures that are involved are more than just that tendon, such as the spring ligament.

This topic has been ligated here.

Is ‘Overpronation’ a problem or not

This gets debated a lot. The views are mixed.

The issues are:

  • yes, pronation is a normal healthy motion
  • yes, there is no definition or consensus as to what is normal and what is overpronation
  • yes, plenty of people overpronate and get no problems
  • yes, other overpronate a small amount and gets lots of problem
  • yes, there are multiple causes of overpronation, so there is going to have to be multiple different treatments. One size is not going to fit all.
  • yes, there are too many who consider themselves experts in this when they have no idea what they are talking about.
  • yes, stick to what the consensus of the preponderance of the research says on the topic and not commentary in social media

Samaritan’s Feet Receives $5 Million Commitment From Sanford Health

Press release:

CHARLOTTE, N.C., Aug. 24, 2020 /PRNewswire/ — Sanford Health has committed to donating $5 million to Samaritan’s Feet as the non-profit organization launches a capital campaign to expand its global efforts. This gift from Sanford Health will allow Samaritan’s Feet to begin planning the core strategies of their growth initiatives: increase operational capacity in the United States, maximize efficiency in global delivery, expand experiential education, and ensure sustainability. Sanford Health’s donation will help address the global pandemic of the 1.5 billion people being infected with diseases that are transmitted through contaminated soil (World Health Organization, 2020).

“Samaritan’s Feet serves and inspires children by providing shoes across the world. Theirs is an inspiring mission that fits with the kind of impact Sanford Health strives to have in the world. Manny and his team have an ambitious plan for the future, and it’s a project we’re proud to support,” said Kelby Krabbenhoft, President and CEO, Sanford Health.

In addition to seed funding to expand Samaritan’s Feet’s capacity domestically and internationally, this partnership will foster further collaboration and engagement with Sanford Health and its associates and have the following impact on Samaritan’s Feet programs globally:

  • World Shoe Development: Lead necessary research of the World Shoe 2.0, a second-generation anti-microbial and biodegradable shoe for distribution in resource-constrained countries and vulnerable populations in the U.S.
  • Medical Advisory Champion: Serve on the Samaritan’s Feet Medical Advisory Committee, providing expertise in infectious diseases, podiatry, global health, and psychology.
  • International Programs: Provide shoes of hope in Ghana and Costa Rica, two strategic locations of the Sanford World Clinic, with their insight to determine in-country partners and distribution locations.
  • Domestic Programs: Develop Sanford Health Shoes for Seniors program to serve vulnerable senior citizens with fall-resistant shoes and foot-care information.
  • Shoezeum: Named recognition as the sponsor of Samaritan’s Feet’s Shoezeum, a mobile and permanent experiential learning center with opportunities for visitors to become immersed in cultures and conditions of those Samaritan’s Feet serves globally.

“Sanford Health’s generous gift and partnership play a crucial role in the expansion of Samaritan’s Feet’s programs. Together, we can provide more opportunities to give hope and healing to individuals around the world. We’re grateful for their support and share their commitment to improving the health and well-being of those we serve,” said Manny Ohonme, President and CEO, Samaritan’s Feet. “This donation allows us to kick-off our capital campaign to build our global headquarters in the Carolinas, housing our worldwide volunteer center and creating the Global Servant Leadership Institute.”

Sanford Health has supported Samaritan’s Feet through various fundraising events and shoe distributions in the U.S. and internationally. Through past financial gifts in excess of $1 million, Sanford Health has co-sponsored MLK Day of Service events and inspired barefoot coaches through their annual Barefoot Classic tournament. Additionally, Manny serves as Vice Chair of Sanford Health’s International Board. On Monday, August 24, executives from Samaritan’s Feet will be in Sioux Falls, S.D. meeting with leaders and doctors from Sanford Health.

“The work accomplished to date by Samaritan’s Feet is truly inspiring,” said Micah Aberson, Executive Vice President, Sanford Health. “Knowing what its efforts mean to kids and families across the world, makes this a natural fit for Sanford Health to support. To be part of an organization that can help Samaritan’s Feet take this next step is something all 50,000 Sanford Health employees can be proud to be part of.”

About Sanford Health

Sanford Health, one of the largest health systems in the United States, is dedicated to the integrated delivery of health care, genomic medicine, senior care and services, global clinics, research and affordable insurance. Headquartered in Sioux Falls, S.D., the organization includes 44 hospitals, 1,400 physicians and more than 200 Good Samaritan Society senior care locations in 26 states and nine countries. Nearly $1 billion in gifts from philanthropist Denny Sanford have transformed how Sanford Health improves the human condition. For information, visit sanfordhealth.org or Sanford Health News.

Study challenges widely held belief that gout is primarily caused by diet

Press release:

The widely held belief that gout is primarily caused by diet is not backed up by new evidence published in The BMJ today, which suggests that diet is substantially less important than genes in the development of high serum (blood) urate levels, that often precede gout.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older and is caused by excess uric acid in the blood (known as hyperuricaemia) which forms crystals that collect around the joints.

For centuries, diet has been seen as a risk factor for the development of gout. Recent studies suggest that certain foods (eg. meat, shellfish, alcohol and sugary soft drinks) are associated with a higher risk of gout, while others (eg. fruit, vegetables, low-fat dairy products and coffee) have a protective effect. Studies also show that genetic factors play an important role.

To better understand how both diet and genes might influence the development of gout, a team of researchers based in New Zealand analysed dietary survey data for 8,414 men and 8,346 women of European ancestry from five US cohort studies.

Participants were aged over 18 without kidney disease or gout, and were not taking urate-lowering or diuretic drugs.

Blood urate measurements and genetic profiles were recorded. Factors that could have affected the results, such as sex, age, body mass index, daily calorie intake, education, exercise levels, and smoking status, were also taken into account.

Dietary analysis revealed seven foods associated with raised urate levels (beer, liquor, wine, potato, poultry, soft drinks, and meat) and eight foods associated with reduced urate levels (eggs, peanuts, cold cereal, skimmed milk, cheese, brown bread, margarine, and non-citrus fruits).

However, each of these foods explained less than 1% of variation in urate levels.

Similarly, three diet scores, based on healthy diet guidelines, were also associated with lowered urate levels, while a fourth, based on a diet high in unhealthy foods, was associated with increased urate levels. Again, however, each of these diet scores explained very little (less than 0.3%) variance in urate levels.

In contrast, genetic analysis revealed that common genetic factors explained almost a quarter (23.9%) of variation in urate levels.

The researchers point to some limitations, such as the use of different food questionnaires between studies, and the fact that the study was limited to individuals of European ancestry without gout, so the findings may not be generalisable to other populations or to people with gout.

Nevertheless, they say their data “are important in showing the relative contributions of overall diet and inherited genetic factors to the population variance of serum urate levels.”

They conclude: “Our data challenge widely held community perceptions that hyperuricaemia is primarily caused by diet, showing for the first time that genetic variants have a much greater contribution to hyperuricaemia than dietary exposure.”

In a linked editorial, researchers at Keel University point out that people with gout often experience stigma from the misconception that it is a self-inflicted condition caused by unhealthy lifestyle habits and, as a result, are often reluctant to seek medical help.

This study, they say, “provides important evidence that much of patients’ preponderance to hyperuricaemia and gout is non-modifiable, countering these harmful but well-established views and practices and providing an opportunity to address these serious barriers to reducing the burden of this common and easily treatable condition.”

Treating Foot and Ankle Conditions During the COVID-19 Crisis

Press release:

During this unprecedented time, it’s still important to take care of your overall wellness, and your feet are no exception. Healthy feet and ankles are crucial for balance, mobility and a healthy body. 

However, it’s important to identify which issues can be taken care of via telemedicine and which should be done in person. It’s also important to take steps on your own to keep feet healthy. 

“Foot and ankle surgeons are here to help keep you healthy via telemedicine visits for non-urgent care and in the office for urgent or serious issues,” says Dr. Brett Sachs, DPM, FACFAS, a foot and ankle surgeon and Fellow Member of the American College of Foot and Ankle Surgeons. 

Not sure whether your condition requires an in-person appointment? According to Dr. Sachs and the experts at the American College of Foot and Ankle Surgeons, the following conditions can be seen by foot and ankle surgeons via telemedicine:

  • Heel and arch pain, generalized foot pain
  • Achilles tendinitis
  • Metatarsalgia
  • Skin rashes and athlete’s foot
  • Planter warts
  • Big toe pain
  • Arthritis
  • Gout

However, Dr. Sachs notes that you should visit your doctor for the following conditions and situations:

  • Post-operative care
  • Injuries (sprains or trauma, anything that requires an x-ray for suspected bone fractures)
  • Infections
  • Ingrown toenails
  • Wounds
  • Foot ulcers
  • Calf pain with warmth, redness, or swelling, which could possibly be a blood clot

It’s important to know that if you do have to make an in-person appointment, foot and ankle surgeons are taking many steps to protect patients. These measures include taking patients temperatures and performing a comprehensive screening process, having patients and staff wear masks or face coverings, limiting patients and family in the waiting room, limiting patient appointments to prevent overlap, practicing social distancing where possible, and performing extensive deep cleaning of all patient rooms and common areas throughout the day.

A bit of preventive care can also support healthy feet. Here are a few tips from the American College of Foot and Ankle Surgeons you can follow while at home:

  • Stay active. Do sit-ups, pushups, planks, squats and leg lifts or check out virtual fitness classes online. You can still get outside for fresh air without putting yourself at risk. Go for a walk, run or hike while practicing social distancing. If you feel better staying inside, take scheduled breaks to get up and walk around your home.
  • If you suffer from foot pain, such as a neuroma, avoid wearing narrow shoes and also avoid walking on hard surfaces barefoot, even in the house.
  • Do eccentric strengthening exercises like calf raises on a step to prevent or treat Achilles tendinitis.
  • Examine your feet regularly for bumps, lumps or other changes.
  • Wear comfortable, sensible shoes, especially for exercise.
  • Continue using padding, insoles or whatever special footwear you’ve been prescribed.

To find a foot and ankle surgeon near you or to find more foot and ankle health tips, visit FootHealthFacts.org, the patient education website of the American College of Foot and Ankle Surgeons.

“While the COVID-19 crisis is understandably top-of-mind for many right now, taking steps to protect your overall health is vital,” says Dr. Sachs. “Because so many health problems stem from the feet, paying attention to them is essential for your comfort, safety and overall wellness.”