Tag: Diabetic wound care in san jose

FOOT PAIN AT NIGHT?

Posted on by Michael Kokinos

As vascular surgeons, many of the consultations and questions we receive revolve around one issue: foot pain!  As people age there can be many sources of foot and leg pain and I want to shine some light onto a few of the most common causes that I see.  They include peripheral vascular disease, chronic venous insufficiency, diabetic foot disease, and sciatica.

Peripheral Vascular Disease:

In all people there are two main kinds of blood vessels, arteries, and veins.  Arteries bring blood from the heart to the feet.  Veins bring blood back from the feet to the heart.  In individuals who have a history of

  • High blood pressure,
  • High cholesterol,
  • Diabetes,
  • Obesity,
  • Smoking

The arteries that lead to the feet can develop blockages, otherwise known as Peripheral Vascular Disease.  When too many blockages develop, the feet do not receive the amount of blood they need to stay alive, and they become very painful.  When this happens, patients tend to hang their feet in dependent positions off the side of the bed at night to allow gravity to help the blood travel through the blockages to the feet.  The pain tends to concentrate on the forefoot and toes where the blood vessels are the smallest.

Chronic Venous Insufficiency

With vein disease, patients tend to have swelling in the legs below the knee including the ankle and feet.  Normally, there are structures in the veins called valves that allow blood to go to the heart but not to go back down towards the feet.  In patients with vein disease, these valves leak and cause blood to pool in in the legs below the knees.  After patients are standing or sitting upright for extended periods of time, the pressure in the veins of the legs builds resulting in an aching pain as well as also causing varicose veins, dark discoloration of the skin, and, in the worst cases, ulcers on the leg.

Diabetic foot disease

Diabetic foot disease is one of the most common problems I see as a vascular surgeon.  These patients describe numbness much more often than pain.  This numbness is a result of the inflammatory damage that high sugar levels in the blood can inflict on the nerves of the foot.  Sometimes, even when these patients develop ulcers, they do not feel any pain because the nerve damage is so severe.  As such, patients with diabetic foot ulcers, though they can experience pain, often experience numbness as well.

Sciatica

Lastly, sciatica can also be a cause of leg and foot pain.  The nerves that detect sensation from the legs and foot originate from the spinal cord in the back of the pelvis and abdomen.  As such, when these nerves are pinched they tend to cause the patient to feel a pain radiating from the lower back or buttock down the leg and sometimes even to the foot.  This radiating pain can be easily distinguished from the pain of peripheral vascular disease and venous insufficiency which is concentrated in the legs and feet.

 

If you or anyone you know suffers from leg pain at night and if any of these stories seem to fit the pain or discomfort that you may be having in your legs, please call one of our South Bay Vascular Offices in either Campbell or Gilroy CA at 408 376 3626 today to schedule an appointment! We Can Help!

WOUND CARE EXPERTS IN SAN JOSE; NON-HEALING LEG OR ANKLE WOUNDS

Posted on by Angelica Rodezno

Leg and foot wounds have become a huge problem in the United States. Fortunately, there are thousands of Wound Care Centers to help with the day to day care of these painful and potentially dangerous wounds. Wound care centers are usually affiliated with hospitals and function as one of many resources that a patients with wounds has at their disposal in an effort to keep their wounds from progressing to where amputation may be the only choice left to salvage the limb. Unfortunately, in many of these wound care centers an underlying cause for why many of these non-healing wounds don’t heal in a timely manner is often overlooked: circulation to the leg or foot. This can be either on the arterial side (Delivering oxygen and nutrients necessary to heal the affected area) or on the venous sid​e, (Removing toxins and fluid from the affected area).

Research has shown that about 70% of people who seek care at Wound Care Centers have an underlying circulation issue. Unfortunately, the current practice in most wound care centers is that this circulatory problem is not diagnosed or considered until after months of futile debridement and dressing changes have failed to achieve long term healing. In an effort to best treat non-healing leg wounds it is critical, therefore, for patients to have their circulation evaluated by a Vascular Surgeon.

This is even more important in patients over the age of 50, if there has EVER been a history of smoking, diabetes, or hypertension.

Finally, this evaluation must be done at the very start of a wound care patients treatment and not be put off until after debridement and other topical approaches have failed. If you or a loved one is currently being seen at a wound care center for non-healing leg wound it is vital that you insist upon getting a vascular ultrasound study if it has not already been done.

Testing for circulation is a non-invasive process and can be done, in most cases, in under an hour. Testing is pain free and does not involve the use of any drugs and or anesthesia. Using simple sound waves a Registered Vascular Ultrasonographer can easily scan for circulatory deficiencies and provide your physician with the critical information they need to develop a plan for how to best approach healing your wounds.

Non-healing leg wounds and ulcers fall into several different categories:

Diabetic Wounds: If you have diabetes, you may be prone to foot ulcers since you may not have protective sensation on your feet. Causes of foot ulcers include excessive pressure or rubbing against the skin that may result from wearing ill-fitting shoes or walking barefoot.

Arterial Wounds: Complete or partial arterial blockage can lead to ulcers. If you have arterial disease, you may have tests to measure blood flow or to locate a blockage in your arteries.

Venous Wounds: These ulcers are usually a symptom of venous disease, where the veins in your legs are compromised, causing blood to build up. Typical venous ulcers appear near the ankle and are often painful.

South Bay Vascular Center and Vein Institute, with offices in both Campbell and Gilroy, CA. specializes in the treatment of Non-healing leg and foot wounds. Led by Dr. Polyxene Kokinos, MD. RPVI. South Bay Vascular Center Physicians are world class experts in revascularization techniques that can help re-establish blood flow to areas suffering from circulatory illness. Recognized as an expert in her field, Dr. Kokinos teaches advanced revascularization techniques to local vascular surgeons looking to offer similar care to their patients. If you or anyone you know suffers from non-healing leg or foot wounds, call today at 408-376-3626 to schedule your appointment.

WE OFFER HOPE WHEN OTHERS SAY THERE IS NONE!

DIABETIC WOUND CARE IN SAN JOSE-TREATMENT FOR DIABETIC WOUNDS

Posted on by Angelica Rodezno

Silicon Valley’s South Bay Vascular Center and Vein Institute physicians are recognized as the leading wound care doctors in the greater San Francisco Bay Area. Dr. Kokinos is the current medical director at both the Verity/O’Connor Wound Care Center in San Jose and at St Louise Hospital Wound Care Center in Morgan Hill, CA. She is recognized as one of the regional experts in Northern California and provides cutting edge treatment for the care and treatment of Non Healing Diabetic wounds. Together with her partner Dr. Brad Hill who served as chief of Kaiser Hospital’s entire Northern California Vascular Surgery Department for over 17 years, South Bay Vascular Surgeons provide unmatched cutting edge and compassionate care to patients suffering from non-healing diabetic foot wounds.

Millions of Americans suffer from wounds that don’t heal. It’s a problem most don’t even think about until they or a loved one develops this type of wound. After all, every one of us has fallen or hurt ourselves with a resulting wound. It generally hurts for a little, we put a little Neosporin or a band-aid on it, and forget about it. Pretty soon, it is gone, and there is a little or big scar in its place. However, as we get older, and develop medical issues, this healing may not happen. A wound that has been “open” for more than four weeks, is called a chronic wound, and often needs the special attention of a wound care center. In these centers, team of specially trained nurses and doctors use a variety of diagnostic and therapeutic tools to help promote healing.

Diabetics must pay special attention to their feet and ankles and it is vitally important to NOT ignore a small wound when it develops. Diabetic wounds, when left untreated, are the cause of 85% of the amputations that occur in these patients. Once these ulcers develop, they often DO NOT HEAL just by putting a Band-Aid over them, or even with wound care and ointments prescribed by your primary care doctor.

Several different problems can contribute to wound healing. The most common of these is a circulation issue. Either the arteries are blocked that supply oxygen and nutrients to help heal the wound, or the veins that promote drainage of toxins and fluids are not functioning properly. This can occur either because they have leaky valves, or because they too are blocked. In general, it has been discovered that about 70% of wounds seen in wound care centers have an underlying vascular issue. This problem is most often an issue with leg or foot wounds. For this reason all of these should be consulted on by a vascular surgeon, a specialist in treating circulation problems. Simple tests, most of which are not invasive, can reveal problems in the arteries and veins. It is very important to do this, because treating these issues alone can greatly improve the wound healing rate.

If you suffer from non-healing leg or ankle wounds, especially if you are a diabetic, call the diabetic wound care experts at South Bay Vascular Center to schedule an appointment to have these wounds evaluated. We offer hope when others say there is none. 408-858-3586.