Tag Archives: Blood clots

THE DOCTORS 101 CHRONIC SYMPTOMS & CONDITIONS #35: HIP FRACTURES

Hip fracture is an iconic bugaboo of old age. It is a chronic condition in the sense that its complications, such as Depression, blood clots and pneumonia often extend long beyond the healing process.

Predisposing factors include old age and associated risk factors like osteoporosis, sarcopenia (loss of muscle mass and strength), poor vision, poor balance and hazards in the home.

FALLING is the usual agency that produces the fracture. At the risk of being ostracized, I will point out that thousands of injuries sustained by walking or tripping over dogs (and cats) occur every year.

In my small “hilltop” group of friends, there was 1 fatality, 1 shoulder fracture-dislocation, 1 hip fracture, and 0 acknowledgements of animal causation. Members of the family are immune to blame.

Treatment of hip fracture involves surgery with pins, or the more cost-effective Hip replacement. PREVENTION is critical. Osteoporosis must be prevented by exercise, Calcium, vitamin D, and avoidance of certain medication like Corticosteroids.

Balance should be developed by exercises. Vision problems, such as cataracts,should be corrected. Muscle mass should be preserved by diet and exercise, and the home cleared of throw-rugs and obstacles removed.

Just yesterday, a friend wearing socks (reducing friction?) fell down some stairs after stepping over a dog-gate. She is scheduled to have her elbow pinned. Have I mentioned SLEEP, DIET and EXERCISE RECENTLY?

–Dr. C.

HEALTH: “COMPRESSION THERAPY” REDUCES CHRONIC CELLULITIS & LEG EDEMA

New England Journal of Medicine (Aug 13, 2020) – In this small, single-center, nonblinded trial involving patients with chronic edema of the leg and cellulitis, compression therapy resulted in a lower incidence of recurrence of cellulitis than conservative treatment.

The researchers have conducted a single-center, randomized, nonblinded trial that aimed to find out an association between the compression therapy and controlled incidents of chronic edema of the leg and people with cellulitis that can be defined as an infection of the skin that involves subcutaneous tissues or the innermost layer of the skin. Cellulitis can be caused by trauma or scratching of other lesions due to animal or human bites that result in fever, extreme pain, and redness of the skin.

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Read NEJM Study

COMMENTARY

I have been using compression stockings for decades, since the discovery of the difference in color of my feet. An evaluation by a vascular surgeon revealed incompetence in the valve of my left popliteal vein. It wasn’t long before I developed small varicose veins.

Comfortable with PREVENTATIVE MEDICINE after a career in ALLERGY, I started wearing Jobst compression stockings, with 30-40 mm of constrictive force. After a decade or so of daily wearing, my big toes started to overlap my second toes, and I began using toe-spreaders; scissor-toe and hammer-toe were my worry, and I wanted to prevent this discomfort.

After a while, I began to notice that the Jobst stockings tended to bunch my toes together. Also, with the developing arthritis in my fingers, it was increasingly hard to get the 30-40mm stockings on without straining my arthritic hands. I now wear OPEN-TOE 15-20mm compression Medi stockings, which are easier to get on, and don’t bunch up my toes.

I still use the visco-elastic toe spreaders. Now, back to the compression stockings for treatment of cellulitis complicating ankle swelling. Of course it works. Beta Hemolytic Streptococci and Staph aureus like nothing better to feed on than a warm pool of interstitial fluid, which is the juice that comprises the ankle swelling.

And BLOOD CLOTS tend to form in the stagnant pools of blood which aggregates in varicose veins, particularly when you are sitting for a long time, such as during a long airline trip. By all means, use compression stockings if you have ankle edema, or even a condition predisposing to ankle edema like varicose veins. Don’t wait for the complication to develop. Be PROACTIVE, and STAY HEALTHY.

–DR. C