Q. I have varicose veins. For a while they were just unsightly, but now my legs have started to ache. What’s wrong?
A. Varicose veins are superficial veins that have dilated due to improper blood flow. Most people think their visible veins are the problem, when in reality the issue is high pressure in one or more of the main superficial veins in the legs, which are deeper and less obvious to the eye. To treat your pain and get to the root issue, I recommend seeing a vein specialist for a complete examination and diagnostic ultrasound. A specialist can locate the source of your problem to recommend the best comprehensive treatment plan for you. In your case, treatment may begin with a minimally invasive therapy called endovenous thermal ablation to eliminate the main pressure points in your diseased veins. Once this is taken care of, large, bulging varicose veins can be removed using micro-incisions as small as 2 to 3 millimeters in diameter. Finally, you can undergo a procedure called sclerotherapy to eliminate the smaller spider and reticular veins.
Q. I was told retinoids were key to keeping my skin young. What exactly are retinoids and why are they so popular?
A. Retinoids are chemical compounds related to vitamin A. When retinoids are converted to retinoid acid, they can significantly improve the cellular function of aged and/or photodamaged skin. Prescription retinoids are already formulated as retinoic acid, so they have the strongest effect on your skin. Applied topically, these include tretinoin (found in Retin-A, Renova, Atralin, Avita, ReFissa, and Retacnyl), tazarotene (found in Tazorac), and adapalene (Differin). Tretinoin was first discovered in the 1980s and continues to be the gold standard for skin rejuvenation. For best results, aestheticians recommend beginning a low-dose prescription retinoid in your thirties. But be forewarned: a retinoid can irritate your skin, causing redness and peeling in the first few weeks of use. Often, it’s best to start with a non-prescription cream containing retinol and “graduate” to a prescription retinoid. Retinol, another derivative of vitamin A, changes to retinoic acid only after it is applied to the skin. It is found in over-the-counter products and can produce noticeable results after about three to six months of daily use. In contrast, prescription retinoids can produce noticeable results in as little as six to eight weeks.
Q. Are electric toothbrushes better than manual brushes?
A. Yes, for two main reasons. First, most people brush far less than the recommended time and skip over certain areas, leaving behind unwanted plaque. To address this, electric toothbrushes have a timer that vibrates when it’s time to move from quadrant to quadrant. Second, people tend to “scrub” back and forth when using a manual brush, which can damage the gum tissue. Electric toothbrushes use an oscillating motion, vibrating motion, or both – all of which are more effective at cleaning and healthier for the teeth and gums.
Q. I’m a competitive runner and have terrible pain in my left heel. What can I do?
A. Runners tend to suffer from one of two types of heel pain. The most common is plantar fasciitis, which is pain on the bottom surface (plantar) of the heel. The second most common is Achilles tendonitis, which is pain on the back part (or posterior) of the heel. The first line of attack for either type is to stop all activity that exacerbates pain, so take a break from running to let your body heal. In the meantime, you can switch to low-impact activities like cycling, core strengthening, upper body lifting, modified rowing, and/or aqua jogging – a form of deep water running that closely mimics the actual running movement. Other first line treatments include:
• Stretches – begin focused stretching on the plantar fascia and Achilles tendon
• Pain meds – take a short-course of NSAID (non-steroidal anti-inflammatory) medicines such as ibuprofen or naproxen
• Massage – perform a deep tissue massage on your calf muscle and bottom of your foot using a lacrosse ball or frozen water bottle
• Added support – visit a running-specific shoe store to improve your footwear and ensure you have proper arch support
Most cases of heel pain will resolve within three to six months after beginning conservative treatment. If your pain persists, seek the advice of an expert.
Q. My elderly mother is always watching the news and it adds to her depression and low mood. What can I do?
A. Depression among the elderly is more common than we think. And unfortunately, sitting in front of the television and watching news stories from around the world for hours can contribute to even more feelings of depression and impending doom. While staying current on events is important, it’s equally as important to limit the amount of news we feed our brains each day. As much as you can, encourage your mom to engage in other activities. Puzzles, walking outside, and crafts are a few great options for engaging the mind in a positive way. Continue to encourage your mother and redirect her to healthier alternatives. Over time, she can form better habits that will improve her mood and make her happier and healthier!