Achilles Tendinitis
Achilles tendinitis means you feel pain in the large
tendon that extends from in the back of your heel to your calf
muscle. It hurts most when you get up in the morning and when
you start to walk or run. It will heal only if you stop running and
find another sport that doesn't hurt when you do it, such as
cycling, swimming, or pulling on a rowing machine.
The Achilles tendon is made up of thousands of
individual fibers, like a rope with thousand of strands. The fibers
can be broken if you apply a force greater than their inherent
strength. No medicines hasten healing. As soon as the tendon
stops hurting, doctors usually prescribe strengthening exercises,
but you have to exercise against greater resistance to become
strong and strong resistance prevents healing. If you want to
return to running or jogging, start out by jogging very slowly daily
until your tendon starts to hurt and then quit for the day. When
you no longer have any pain, you can strengthen the tendon by
learning how to run fast. You must stop immediately if you feel a
pulling behind your heel and each intense workout will require
several easy days to allow you to recover. Try to run very fast
once or twice a week, never on consecutive days.
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Reports from DrMirkin.com
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Dear Dr. Mirkin: Should I get vitamin B12 injections to treat
pernicious anemia?
Most people with pernicious anemia can a cured by
taking a 1000 microgram pill of vitamin B12 once a day; they
usually do not need to take injections. Pernicious anemia is due
to lack of vitamin B12 which results in progressive nerve damage
that causes forgetfulness, loss of ability to concentrate and
abnormal nerve sensations such as burning, itching or loss of
feeling. However, many people with pernicious anemia do not
have abnormally low blood levels of vitamin B12. One study
showed that older people have lower blood levels of a chemical
called homotranscobalamin II that carries vitamin B12 into the
cells, so they need higher blood levels of B12 to have normal
tissue levels.
The diagnosis of pernicious anemia is often made late in
the course of the disease after a person has suffered permanent
nerve damage. One report showed that two percent of
Americans over 60 have low blood levels of vitamin B12, but the
incidence of vitamin B12 deficiency causing nerve damage in
older people is much higher than that, perhaps as high a 50
percent. Many older people who are diagnosed with senility
actually suffer from lack of vitamin B12. Lack of vitamin B12 also
can cause heart attacks, so all people over 60 should be
screened for B12 deficiency. Those with normal levels of B12
who have symptoms of nerve damage or arteriosclerosis should
also get a blood test called homocysteine. Low levels of B12 can
be associated with stomach diseases, absorption problems and
infections such as Helicobacter pylori. See reports #G123 on Helicobacter and
#G206 on Celiac Sprue.
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Dear Dr. Mirkin: My mother and two sisters have diabetes. Am I
doomed to become a diabetic too?
You inherit a susceptibility to Type II diabetes; you do not
inherit diabetes. A study in the Journal of the American Medical
Association (October 8, 2003) shows that one of three Americans
will become diabetic, with women more likely to develop diabetes
than men. The authors showed that the average person who is
diagnosed with diabetes at age 40 will die 11.6 year earlier than
a non-diabetic and he or she will be severely incapacitated with
one or more side effects of diabetes 18.6 years before a non-
diabetic.
Risk factors for developing diabetes:include: a family
history of diabetes; storing fat primarily in the belly; high
triglycerides; low HDL (good) cholesterol; blood sugar higher
than 200 thirty minutes after a meal; fasting blood sugar above
110; excess hair on the face or body (in women); or diabetes
during pregnancy. A person with any of these warning signs
should immediately make lifestyle changes to prevent diabetes:
avoid refined carbohydrates (foods made with flour, white rice,
milled corn; all added sugars and drinks that contain sugar),
exercise regularly, lose weight if you are overweight, and keep
your weight controlled for the rest of your life. If you do this you
will be at low risk for developing diabetes, even if you have the
genes that make you susceptible.
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Recipe of the Week
An easy whole-meal salad with endless variations:
Seafood Tossed Salad
List of Diana's Healthful Recipes
May 9, 2004