Posts for: February, 2012
If you watch TV, chances are you’ve seen the commercial with the middle-aged gentleman carrying around a large vial partially filled with a green liquid. The advertisement is for a new medication designed for the treatment and prevention (prophylaxis) of gout. To my knowledge, Uloric is the first medication to be approved by the FDA for gout prophylaxis in approximately 30 years. This commercial has caused an increased awareness as well as a concern to many people who have had pain in their feet that they believe may be attributed to gout.
While this particular advertisement focuses on the big toe joint, which is the most common area, gout can occur nearly anywhere in the body. I have personally seen gout attack non-joint areas such as the web spaces just above the toes. Gout is precipitated by a high amount of uric acid in the blood that will leak out of the bloodstream and typically settle in a joint. Upon settling it becomes crystallized into condensed bunches called tophi.
Acutely this will cause the affected area to be swollen, hot, red, and painful. Many patients relate that anything that touches the area, even the rubbing of a sheet across the area will cause severe pain. Chronically, long after the acute pain is gone, the gouty tophi can erode the joint surface causing arthritic pain to the area.
This type of arthritis is on the rise – particularly among men. More than 8 million people have it, and the rates have doubled in the last 50 years. Gout is no respecter of persons. It can strike anyone including famous people and professional athletes. When he wasn't lopping off his wives' heads, King Henry VIII of England was coping with attacks of gout. David Wells, the left-handed pitcher who played for the New York Yankees and Toronto Blue Jays has struggled with gout throughout his baseball career. Maurice Cheeks, coach of the Philadelphia 76ers and Portland Trail Blazers, who played 15 seasons in the NBA with 4 All-Star appearances, was 46 when he started experiencing severe pain secondary to gout.
How is it treated? At Advanced Foot & Ankle Care Centers of Ohio we typically will treat an acute flare of gout with a cortisone injection to the area. This has been found to give the most relief the fastest. Other medications that help are non-steroidal anti-inflammatories such as Indomethacin. Colchicine is another effective medication but is not prescribed as often as is commonly causes severe diarrhea. I will usually check the blood uric acid level. If it is elevated I will give the patient the option of taking a long-term medication such as Uloric or Allopurinol that will decrease the amount of uric acid in the bloodstream. Either one of these medications must be taken on a daily basis to help prevent future arthritis due to gout as well as the recurrence of a gout attack. If you feel that you may have gout or have had gout in the past and would like to discuss options for treatment, please feel free to make an appointment at any one of our 4 locations in Huber Heights, Troy, Piqua, or Sidney.
We are very excited to receive our new Cutera laser in our Huber Heights office! This is one of the most high-tech lasers on the market. The reason that we at Advanced Foot and Ankle Care purchased this laser is because this particular laser can do things that others cannot. This laser can eliminate unsightly veins in the legs and arms without burning the skin. It passes through the skin cauterizing the small vessels making them disappear before your very eyes. Another reason that we purchased the Cutera Xeo is its ability to kill fungus in toenails without harming the tissues that it passed through. This is performed without the use of anesthesia and little to no pain usually in one treatment. The reception if this laser has been phenomenal. Its ability to do things that other lasers cannot do has been unparalleled in the field of lasers in the last 20 years. This is the most exciting innovation yet! Many of the lesser expensive lasers create additional heat and have only a one to two millimeter spot size. The Xeo has a variable spot size up to 10mm, making its efficiency to clear lesions unbeaten. Additionally, spots and varicose veins disappear before your very eyes. To accomplish these feats, a very specific wavelength of light is utilized in a highly focused manner, requiring a very sophisticated patented computerized feedback mechanisms to assure that tissue is not being over heated or harmed, only targeting the pathologic tissues. Additionally, this laser is capable of reducing the size and appearance of scars almost instantaneously. As far as we know, we are the only office in the state of Ohio to have such a laser that can perform all of the above functions without harming the adjacent tissues targeting only what we want to remove while leaving a very satisfactory result.