HEALTHY MATTERS

with Dr. David Hilden

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Get a Foothold on Feet with Specialist Dr. Nicole Bauerly

In Episode 14 of the Healthy Matters Podcast, I talk to podiatrist Dr. Nicole Bauerly – a foot and ankle surgeon. Yeah. Everyone loves the foot doctor.

“They do!” Dr. Bauerly humbly agreed, because most of the time podiatrists are successful at treating some very uncomfortable foot pain. And at Hennepin Healthcare, this includes open wounds from diabetes complications, trauma, fractures and much more.

One pain many of us can relate to is plantar fasciitis. I got it when I was running and it was a bugger. But evidently it can also be related to not wearing the right kind of shoes – or not wearing shoes at all.

“I would say, since the pandemic, plantar fasciitis is very common because people have transitioned to working at home and they are barefoot and not getting the support from shoes anymore,” explains Dr. Bauerly. “We’re seeing an uptick in biomechanical-related pain – or just wear-and-tear aches and pains.”

So what exactly is plantar fasciitis? Dr. Bauerly said that it’s a structure that starts at the heel bone, runs through the arch of the foot and out to the toes.

“It can be as simple as inflammation in there, or if it’s left untreated some really small tearing can occur. It’s very painful – it feels like your heel is broken, but it’s not. It’s just the attachment of the fascia on the heel bone.”

Dr. Bauerly was kind enough to offer some tips on how to avoid foot pain and one included a trip to the shoe store for an annual upgrade. If your shoes are more than a year old, the lining can start to break down and won’t offer the cushion and support you need. And yuck – apparently bacteria and fungus can break down the lining.

She also answered questions about gel and over-the-counter shoe inserts work, as well as the availability of custom-fit inserts made by an orthotist – when needed – right at Hennepin Healthcare’s podiatry clinic.

The significance of diabetes and wound care cannot be overlooked when talking about podiatric care. I asked Dr. Bauerly why people who live with diabetes get sores on their feet.

“It’s related to the neuropathy – the kind of the inappropriate sensation where the nerves don’t work correctly because of the years of high blood sugar that damages the nerves,” she explained. “If we lose sensation in the feet, a diabetic patient might end up with a blister or a sore spot from a shoe but not know it. And then they’ll end up rubbing into a deeper wound. But you or I would take our shoe off and look at it right away, change shoes, and figure out why it’s hurting. People with neuropathy don’t have that pain sensation and will end up with a wound. They also have an increased chance for infections. So even though we would heal from a simple wound — a diabetic patient would have a harder time healing that wound and it might lead to an infection.”

Dr. Bauerly also described Hennepin Healthcare’s unique limb preservation program that combines four different departments – podiatry, hyperbaric medicine, vascular surgery, and interventional radiology.

When we’re talking about feet there are many directions we can go – but don’t take my word for it. Check out Episode 14 of the Healthy Matters Podcast to hear the feats we’re taking to keep your feet healthy.

 

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Talking all things pharmacy with a PharmD

Did you know that the average American adult takes four prescription medications? In Episode Thirteen of the Healthy Matters Podcast, you’ll meet a Doctor of Medication – Laurie Willhite, PharmD, a pharmacist who wears many hats around Hennepin Healthcare (and rocks the pillbox). Laurie is part of a trusted, comprehensive team of PharmD’s providing critical oversight of all the medications at Hennepin Healthcare. No small feat for a Level I Trauma Center and teaching hospital!

“We’re the backbone of medication use in the hospital, from the pharmacists and technicians in our central pharmacy to our PharmDs up on the patient care units,” explains Laurie. “The PharmDs on the units are consulting, answering questions, making suggestions for appropriate antibiotic therapy or talking about a drug interaction. We have some new PharmDs up on the units that are trying to plan very carefully for patients who are going home from the hospital, what we call transitions of care. They are making sure that when the medication leaves the hospital, that the patient can afford it, knows how to take it, and that the patient is set up with the pharmacy and has the follow-up appointments in place.”

Laurie is also an expert in opioid abuse prevention. For several years she’s been involved with the work at the Hennepin Healthcare Pain Clinic to promote the safe and effective use of opioid pain medication. She’s on the board of the Steve Rummler Hope Network (www.steverummlerhopenetwork.org) and often works closely with addiction medicine expert Dr. Charlie Reznikoff, who was my guest in Episode Four of the Healthy Matters Podcast.

She shared her thoughts on what led to the increase in opioid addiction.

“I think a lot of us were really naïve about the risk of opioids in the nineties,” she said. “And we were, very susceptible to some misinformation from some of the pharmaceutical companies about the addictive potential of opioids and when they should be used. But a big part of that blame should be on healthcare professionals. We need to be more critical thinkers. Drug companies sell drugs. That’s what they do. We’re the ones that should be looking out for patients. So definitely opioids were overprescribed. They were prescribed for chronic pain conditions where opioids aren’t effective and a lot of people became dependent on them, and some of those people developed an addiction, unfortunately.”

Medication safety and compliance was also an important part of our conversation. Laurie emphasizes the importance of keeping medications out of reach of children.

“It’s super important to store your medications properly so that when your grandkids come over, they don’t start rooting around in your purse for some gum and instead find your blood pressure medicine, which can be very scary – even if a child takes a single pill.”

It can be difficult to keep track of the medications you’re supposed to take and when you’re supposed to take them. Laurie endorses the use of a pill box to sort them by day (and time of day if needed) because it helps you remember when to take your medications and is a great adherence tool. Again, make sure these pill boxes are stored safely.

Can you guess what the number one prescribed drug in that pill box might be? We talk about the top ten prescribed medications in Episode Thirteen of the Healthy Matters Podcast, where you’ll also learn how many pounds of medications were discarded at Hennepin Healthcare drug disposal kiosks last year (clue: it’s the weight of the Minnesota Vikings starting lineup).

Thanks for listening to Healthy Matters – please shoot me an email to suggest topics or ask a question you’d like answered on Hilden’s House Calls to healthymatters@hcmed.org.

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Ah-AH-Allergies!

For those of you who suffer from allergies or those who care about people with them (or if you have a morbid curiosity about microscopic creatures that defecate under your bed) – Episode Twelve of The Healthy Matters Podcast is for you.

Why do allergies exist? They not only keep my guest and colleague Dr. John Sweet busy in our allergy clinic, but they are also indicative of an overactive, “very healthy, well-nourished immune system,” and one that’s “bored” and “looking for something to do.”

This is how Dr. Sweet explains this to his patients:

“Your friends without allergies are exposed to the exact same things you are. Their body sees it and ignores it. They see tree pollen; they see grass pollen. They see pet dander. And nothing happens to them. But you, my patient, unfortunately your immune system sees it as a threat and your immune system is trying to get rid of it. So think of that sneeze, that postnasal drip, that drainage as a way of your body trying to get it out instead of ignoring it. And that leads to a lot of symptoms that can be pretty uncomfortable.”

You’ve often heard that in order to conquer your enemy, you have to know your enemy – and immune systems have (albeit mistakenly) declared war on allergens, so in this episode we answer itching questions like what is the biggest allergy culprit? (Does it have four legs and a tail?) What’s the deal with pollen? And of course, “how many eggs do dust mites lay each month?”

I also asked Dr. Sweet if he has any recommendations for people when they know they’ll experience their inevitable, annual allergy symptoms.

“If you have allergies and you know that spring is your season, the best thing is to get ahead of it. All the allergy medications you can get over the counter best work preventively, but they don’t work as well if you already have the symptoms. If you know your pollen season is coming, start your antihistamine and your steroid nasal spray a week or two before the onset of your symptoms. You’ll end up having fewer symptoms or less severe symptoms if you do.”

Seasonal allergies, snow mold, pet dander, dead skin, HEPA filters and giant pollen collectors are also discussed in this episode.

“If you’re allergic to pollen, you need to take a shower before you go to bed at night,” continues Dr. Sweet. “Because your hair acts like a giant pollen collector. Pollen is sticky. Get it off you before you go to sleep at night. If you know you have outdoor allergens, don’t bring it in the house.” He also suggests wearing a hat to keep that pollen off your head.

 The dust hit the fan when we talked about my bedroom, but you’ll have to listen to Episode Twelve to hear more about that – as well as Dr. Sweet dispelling myths about breed-specific pet allergies, the benefits of Bamba snacks, and the proper use of neti pots.

 

 

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