Sunday, October 22, 2017

Cold Feet

The most obvious reason that you have cold feet is because your feet are cold. If it’s cold enough to wear a jacket and your feet are bare – maybe you just need to put on some socks. However, there could be medical reasons that your feet are cold.

It’s possible that not enough (warm) blood is getting to your feet. This could be due to poor circulation when the heart can’t pump well enough or from not moving around enough. With exercise, the leg muscles help the veins return blood to the heart allowing fresh blood to enter the feet. It’s counter-intuitive, but blood flow is better with leg elevation so too much sitting can be a problem. Smoking causes blood vessels to constrict, also reducing reducing blood flow. Raynaud’s phenomenon, which causes blood vessel spasm from cold, can be so severe as to temporarily cut off blood supply entirely.

An underactive thyroid can reduce the body’s temperature and heart rate. Both of these can cause cold feet. A partially clogged artery due to high cholesterol will reduce the blood flow to the lower extremities. Not only will there be cold feet, but also pain with exercise since the muscles will not have enough oxygen-rich blood.

Nerve damage can give the sensation that the feet are cold as well as reduce blood flow. An unfortunately common cause of this kind of damage is diabetes.

What to do? First, put on a pair of socks and get some exercise. The next step is to check with your physician to make sure that you don’t have any underlying disease that causes cold feet.

Sunday, October 8, 2017

Dense Breasts

Breasts are not just two lumps on the chest wall: they are composed of metabolically active tissue that adapt in response to time, outside stresses and health changes. Since breasts are not static, it is important to have mammograms at regular intervals to look for worrisome changes.

In a great simplification, breasts are composed of fibrous and fatty tissue. Dense breast have a higher proportion of fibrous tissue. Breast density is influenced by age (decreases after menopause), number of completed pregnancies, breastfeeding and certain medications. Fatty tissue appears black on mammograms and fibrous tissue shows as white. The big question: what is hidden in the tangle of white?

Forty percent of women older than age 40 have dense breasts. These women may benefit from additional breast imaging. Digital mammography (tomosynthesis) is more effective in detecting suspicious masses but may still miss cancer in very dense breasts. Ultrasound is often used as an adjunct and select patients may need MRI.

Physicians may recommend a program of breast studies for high risk patients. High risk for breast cancer include a first degree relative (mother, father, brother, sister or child) with breast cancer or certain gene mutations such as BRCA1 and BRCA2, hormone use and alcohol intake.

One out of eight American women will develop breast cancer in her lifetime. Early detection may improve outcomes.

To learn about breast cancer risk.

A discussion about breast density.