November 2011 - Advanced Physical Medicine
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November is Diabetes Awareness Month

Diabetic Foot Care Tips

It is very important for your FEET that you control your blood sugar when you have diabetes.  High blood sugars can cause the following problems for the feet:

 -Loss of feeling or sensation in the feet

-Delayed wound healing

-Blood flow problems  

1.You should have your feet checked by a foot doctor every few months!  Your blood flow, nerves, skin/nails, and any abnormal foot structures (bunions, hammer toes) will be checked.  You may qualify for diabetic shoes or diabetic insoles because of your diabetes (depends on insurance).

 2.It is very important that you check your feet everyday when you have diabetes.  If you see an open sore or something that looks infected (red, hot, swollen, pus present), it is important to call your medical doctor or podiatrist immediately.

 3.You may put cream on the top and bottom of your feet but no cream or lotions should be used between the toes.  

 4.Check the inside of your shoes each day to make sure no stones or other objects have gotten inside.  These can injure your feet, and you may not be able to feel them.

 5.Control your blood sugar!

Mary Ann Bender, DPM
Foot and Ankle Specialist
Advanced Physical Medicine

Corns and Callouses

Presented by Dr. Bender, Advanced Physical Medicine

When thick skin builds up on the foot due to pressure, it is called a corn (top of the foot) or callous (bottom of the foot). The pressure that causes these can be due to bone problems, such as bunions, hammer toes, or extra bone formation; improperly fitting shoegear; and excessive walking or running. This thickened skin can be painful.

How are Corns and Callouses treated?

It is important to see your podiatrist to have an assessment about why these corns and callouses are developing and to have them trimmed or reduced. It is important to note that the thickened skin will return if the cause of the pressure is not treated. A variety of treatment options are available for reducing pressure on the feet: padding, different shoegear, orthotic devices, creams, and surgery. If you have peripheral vascular disease, diabetes, rheumatoid arthritis, cancer, HIV, or other serious diseases, it is important that you consult a podiatrist for proper treatment, rather than trying to treat the condition yourself. If you cut your skin with these conditions, it can be very dangerous. Additionally, it is important that you do not try over the counter corn removal pads, as these contain acid that can burn/harm the skin.

If you are suffering from painful corns and callouses, please contact us for an appointment with Dr. Bender. Dr. Bender has been in private practice for 10 years and can help you!

The Anatomy of a Vegan

Anatomy of a Vegan

We have all heard stereotypes here and there pertaining to a vegan lifestyle. Critics often believe vegans must be pasty white hippies, feeble from malnutrition due to lack of essential amino acids. These are all misconceptions which are often used to enable non-vegans to avoid thinking about why they do eat meat. At APM we were legitimately curious as to the motivation of why individuals may make a vegan lifestyle choice.  Furthermore, it is important to understand the types of people who choose veganism.  We wanted to address concerns of whether or not vegan living can lead to health deficiencies or conversely, lead to a healthier state of wellness.

1. Healthy eating is important.

The goal of any diet for an individual should be primarily the health and wellness that diet offers. Of course it should taste great as well, but it does not take a dietary archaeologist to know that people have been eating tasty food for a while. Similarly it is known that vegan diets have ancient roots, from civilizations in Italy and Greece to most notably India. We can’t really gauge how healthy they were, since we were not around. While you could argue since the lifespan of people has gone up, they must not have been as healthy back then, but this is an incorrect assumption since there are so many other factors that affect longevity such as war, medical advances, and increased hygiene.

And though cultures throughout history have wanted to eat well, we are not the first generation of peoples to put our principles before our stomachs. Citing the Indian culture, vegetarianism was adopted by the Indians following Jainism and Hinduism’s predecessor, Vedism. Their reasoning was a belief in non violence toward animals, following a tenant called Ahimsa, meaning the avoidance of violence.

Recent times have seen an increase in not only vegetarian and vegan lifestyles, but a variety of offshoots, such as pescarian (excludes all meat but fish).  So an important place to start out analysis is a definition of what a vegan is. There is a difference of opinions about this but a common definition is a vegetarian who omits all animal products from the diet.

2. Veganism is considered good for you.

Contrary to popular belief, vegan lifestyle is a healthy way to live as noted by the Mayo Clinic, “…a well-planned vegetarian diet can meet the needs of people of all ages, including children, teenagers, and pregnant or breast-feeding women.” It goes on to include vegan as a type of vegetarian so it does apply to vegan living.  Main benefits of veganism that make it so healthy are that the diet is much more reliant on vegetables which many Americans do not get enough servings of. However, people often believe that only meat has the 9 essential amino acids (Isoleucine, Leucine, Lysine, Methionine, Phenylalanine, Threonine, Tryptophan, Valine, and Histidine), but this is a mistake.  While it is true most grains and vegetables are not what are called ‘complete proteins’ they usually have some but are missing a few. So as long as diet includes vegetables that complement one another to make up for an individual vegetable’s deficiency, they essentially have the same effect as a ‘complete protein’. Even if that were too hard to do there are vegetables that are complete proteins, namely quinoa and soy. Some nutrients such as iodine, B-12, and vitamin d are a concern in vegan diets, but many vegans food are now fortified with these to prevent these problems. Often these deficiencies are not only found in vegan diets but diets in general, so the important point is that balance amount food groups are essential.

3. Survey

So to get our questions answered, we  did research to find out more about vegans and who they are. Here are the results based on 144 responses from vegans.


Reasons for Becoming Vegan


Our first series of questions was to try and understand why vegans chose this lifestyle. Most typically it was for more than one reason so we listed the most common reasons and asked in the survey how important that reason was to them in making their decision.

The first question was if animal rights were a reason. Results were separated into male and female. The short answer is most often, yes. Over 85% thought Animal rights had some importance in their decision.

The next factor for deciding a vegan lifestyle we asked was if helping the environment was a reason. Also a ‘yes’, but not as strong a reason as protecting animals were.

The 3rd question was if health was a reason to make the change. Another very important factor.

The fourth question was if weight loss goals were a factor in being vegan.

The final question was if they were recommended by family or friends to take up a vegan lifestyle. This was the least important factor in making a change to veganism.

Overall it appears that saving animals’ lives were the primary factor, but it appears that veganism to the vegan is a mutually beneficial decision. They can save the environment and animals while keeping themselves healthy. Most people have enough trouble with the latter, so credit must be at least given for achieving both. Other reasons were cited by respondents in the survey, the most cited reason being ’Social Justice’

Where vegans shop for groceries

One important issue with pursuing a vegan lifestyle is the food choices available to them which can be logistically difficult depending on geography. While many stores are becoming increasingly accommodative in their vegan offerings, it still may present a challenge. This issue may be a sticking point for many considering becoming vegan. Research performed by Advanced Physical Medicine tried to see if vegans in our study could do equally well in finding the foods they need for a balanced diet. Our questioning asked respondents about their frequency of going to certain stores (big chain supermarkets, local grocers, vegan only grocers, and online ordering) to help determine how convenient it is for vegans to shop for groceries.  We used a subjective scale (Never, Rarely, Sometimes, Often, & Always) to gauge frequency of shopping patterns.


The first question asked participants how often they shopped at ‘Big Supermarkets’.  It appears many do shop there with some frequency.