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Walking difficult for 93-year-old

Sat., April 2, 2011

DEAR DR. GOTT: I will be 93 this month and have been blessed with good health all my life. My recent medical checkup was good, and everything was normal. However, during the past year, I have noticed my walking has become somewhat laborious and stressful. Even a small incline on the street makes walking more difficult. I have a little dog, and she needs to be walked.

My physician ordered an ultrasound of both legs, and the result was normal. He also prescribed pentoxifylline to increase the circulation in my legs. I go to an exercise class three times a week and even dance a couple of times a week. My right leg is slightly swollen and feels very firm in comparison to the left leg.

Holding you in high esteem as a doctor of medicine, I wonder if you could recommend anything to improve my walking to normalcy.

DEAR READER: We could all take a lesson from your lifestyle! It’s extremely important to remain as active as possible, and you are certainly a testimony to that.

Circulation can become impaired as we age, which is why your physician prescribed pentoxifylline, the generic form of a drug that improves blood flow and helps reduce symptoms of vascular disease such as you may be experiencing. Of extreme importance is that your personal physician be informed of any and all prescription medication as well as over-the-counters you may also take that might have been prescribed by another physician or specialist, because there are 33 (138 brand and generic) medications (such as aspirin and atenolol) known to interact with some brand-name drugs in this class.

I might question whether you eat foods that contain a lot of sodium (salt) or add it to your food, which might cause leg edema (swelling). We often fail to read labels to determine how much sodium is included, or we arbitrarily add salt to foods prior to tasting them to determine whether it is even a necessary additive. If appropriate, stay away from chips, salted nuts and other snack items that might have a high salt content. When you sit (between dancing and exercise), do you elevate your legs? These two simple measures alone might decrease the swelling and allow for easier walking. Beyond that, you might ask your physician his views on a mild diuretic that will remove excess fluids from your system and be sure that he checks your blood pressure on your next visit.

I am not making light of your situation by any means but I feel you are ahead of the game to be in the condition you are at the tender age of 93. Try my suggestions, speak with your physician and, above all else, keep up your lifestyle as long as you can. You’re incredible.

Readers who would like related information on medication (not longevity) can order my Health Report “Consumer Tips on Medicine” by sending a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website’s direct link at order_form.pdf.

DEAR DR. GOTT: My left big toe is black 90 percent of the time. I assume this is a circulation problem. My GP said it was no big deal. (He didn’t look at it.) I wonder what your opinion is. I’m a 54-year-old male and very active. Thanks.

DEAR READER: Two hints from the minimal information you gave me – specifically that 10 percent of the time your toe is not black and that you are very active – lead me toward possible stress placed on your feet, primarily the big toe. In essence, you could have impact trauma from pushing your toe to the front of your shoe(s) when walking, running, or engaging in sports activities such as baseball, soccer and football. I must rule out a melanoma under the toenail or a fungal infection, because both conditions would be present 100 percent of the time.

Another consideration might be peripheral vascular disease or another circulatory disorder, but you are young. Do you have a history of smoking? Is there pain involved? Are you a diabetic or have a family history of another disorder? Are you on any medication or herbal supplements? Is it related to cold temperatures?

Not knowing the specific cause of your black toe and because your doctor said it was no big deal without even looking at it, I urge you to be seen by a vascular surgeon for a proper diagnosis. The history you provide, coupled with examination of the toe, should allow him or her to direct you toward the most appropriate next step. I urge you to stop smoking, if you even do so, wear good support footwear depending on your level of activity, and get advice for what could be a health issue.


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