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News Article
Arthritis: Oh my aching feet

Complaints of joint pain seem common place and are even expected as people age. Arthritis is the leading cause of disability in the United States affecting more than 40 million people. It is more common as you get older, especially in the elderly, however it can occur at any age, and the word literally means pain within a joint. Arthritis, describes the inflammation and swelling of the cartilage and lining of the joints, along with increased fluid in the joints.

Arthritis and the feet
The feet seem more susceptible to arthritis than other parts of the body because the feet have 52 bones and 33 joints that can be affected, and they bear the brunt of walking and standing. Arthritis in the feet can cause loss of motion in the joints and loss of independence, but that may be avoided with early diagnosis and proper medical care.

Causes
There are three types of arthritis that may affect your foot and ankle.
Osteoarthritis is wear and tear arthritis. It is common in people after they reach middle age. Over the years, the smooth cartilage at the ends of the bone wears down causing inflammation, swelling, and pain in the joint as the bone edges rub together. It progresses slowly and the pain and stiffness worsen over time.
Rheumatoid arthritis is an inflammatory disease seen in joints all over the body caused by a person's own immune system attacking and destroying the cartilage.
Arthritis can develop after an injury to the foot or ankle, especially if the injuries were ignored and not treated. This type of arthritis is similar to osteoarthritis and may develop years after a fracture or severe sprain.
Gout is a form of arthritis caused by a buildup of the salts of uric acid -- a normal by-product of protein in the diet. The big toe joint is the most commonly affected area. Avoiding proteins such as shellfish, red meat, cold cuts and cheese can prevent or delay the attack of arthritis.
There are other causes of arthritis including bacterial and viral infections to the joint, bowel disorders, and even some drugs.

Symptoms
Different forms of arthritis affect the body in different ways. Once cartilage is damaged it cannot be reversed. Signs and symptoms of arthritis of the foot vary, depending on which joint is affected. Common symptoms include joint pain or tenderness, early morning stiffness or reduced motion, swelling and difficulty walking.

Diagnosis
Early diagnosis is important for effective treatment of all types of arthritis. Your podiatrist will diagnose arthritis by using medical history, a physical examination and other tests. Additional tests may include an exam of the way you walk (gait analysis). This shows how the bones in the leg and foot affect walking. X-rays can show changes in the joint space between the bones or in the shape of the bones themselves. A bone scan, computed tomographic (CT) scan, or magnetic resonance image (MRI) may also be ordered for more evaluation.

Treatment
The objectives of treatment of arthritis are controlling inflammation, preserving or restoring joint function and curing the disease if possible. Depending on the type, location, and severity of the arthritis, there are many types of treatment available. Arthritis may be treated in many ways.
Education is very important. Physical therapy and exercise are important to make sure the joint continues to move. Other non-surgical treatment options include pain relievers and anti-inflammatory medications to reduce swelling, shoe inserts (orthotics), custom-made shoes, such as a stiff-soled shoe with a rocker bottom, a brace or a cane, weight loss and control or nutritional supplements such as Chondritine and Glucosamine and medications, such as a steroid medications or fluid injected into the joint.
If arthritis doesn't respond to non-surgical treatment, surgical treatment might be considered. The choice of surgery will depend on the type of arthritis, the severity of the disease, the impact of the disease on the joints, and the location of the arthritis. Sometimes more than one type of surgery will be needed.
Surgery performed for arthritis of the foot and ankle may include arthroscopic debridement to clean out the joint, arthrodesis or fusing the joints together permanently, and arthroplasty, a joint replacement.
Remember, arthritis is a chronic, long term condition that will require long term treatment. If you have symptoms of arthritis you don't have to suffer in silence, there is relief available if you see your podiatrist.

oFor more information, email me at foothealth242@gmail.com or visit www.foothealth.org, apma.org or orthoinfo.aaos.org. To see a podiatrist, visit Bahamas Foot Centre on Rosetta Street or call 325-2996 or Bahamas Surgical Associates on Albury Lane or call 394-5820.

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News Article
Dealing with Tailor's bunion

Most people have heard of or seen a bunion at some time on the foot. When there is a bump on the outer side of the foot near the little toe, it is a Tailor's bunion. It is also called a bunionette. This foot deformity received its name centuries ago, when tailors sat cross-legged all day with their feet rubbing on the ground, which led them developing a painful bump at the side of the little toe.
A Tailor's bunion is an enlargement of the head of the long bone behind the little toe. This produces a pressure area and callus at the bottom of the fifth toe.

Causes
Tailor's bunion is caused by inherited faulty mechanical structure of the foot. Constant pressure causes changes in the bony shape of the foot, resulting in the development of the enlargement. The fifth metatarsal bone starts to protrude outward, while the little toe moves inward. This shift creates a bump on the outside of the foot that becomes irritated whenever a shoe presses against it. Sometimes a Tailor's bunion is an outgrowth of bone on the side of the fifth metatarsal head. Regardless of the cause, the symptoms of a Tailor's bunion are usually aggravated by wearing shoes that are too tight in the toe, producing constant rubbing and pressure.

Symptoms
The symptoms of tailor's bunions include redness, swelling, and pain at the outer side of the foot. These symptoms occur when wearing shoes that rub against the bump, irritating the soft tissues underneath the skin and producing inflammation. Constant rubbing and pressure on the skin forms a callus and the tissues under the skin also grow thicker. Both the thick callus and the thick soft tissues under it are irritated and painful.

Diagnosis
Tailor's bunion is easily diagnosed on physical examination.

However, x-rays may be ordered to help the podiatrist determine the cause and extent of the deformity and will help if surgery is necessary later.

Non-surgical treatment
Initial treatment for a Tailor's bunion begins with non-surgical therapies. Your podiatrist may select one or more of the following:
o Shoe modifications. Choose to wear shoes that have a wide toe box, and avoid those with pointed toes or high heels.
o Remove the callus. For pain relief, the podiatrist can also remove some of the built-up callus and hard skin in the area. This is an important step to prevent pain and even ulcers from developing at the site of the Tailor's bunion.
o Padding. Bunionette pads can be placed over the area to help reduce pain.
o Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), may help relieve the pain and inflammation.
o Icing. An ice pack may also be applied to reduce pain and inflammation.
o Injection therapy. Injections of corticosteroid may be used to treat the inflamed tissue around the joint.
o Orthotic devices. In some cases, custom orthotics devices may be provided by the foot and ankle surgeon.

Surgery
Surgery is often considered when the pain continues regardless of treatment efforts. Based on the extent of the deformity, a corrective surgical procedure will be selected. The podiatrist will take into consideration the extent of the deformity based on the x-ray findings, the age, the activity level, and other factors. Surgery usually involves removing the prominence of bone underneath the bunion to relieve pressure. Before deciding on the procedure extra bone is removed and the fifth toe and joint is straightened. The recovery time after surgery, will vary, depending on the procedure or procedures performed.

oFor more information, email me at foothealth242@gmail.com or visit www.foothealth.org or apma.org. To see a podiatrist, visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates on Albury Lane, telephone 394-5820.

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News Article
Defence Force officers called in as sick-out hits prison

Defence force officers have been placed in sections of Her Majesty's Prisons (HMP) since Friday after a significant number of prison officers called in sick, according to Superintendent Dr. Elliston Rahming.
Rahming said 35 percent of the prison's staff called in sick and had not returned to work up to yesterday, although he maintained that operations are normal at the prison.
He revealed that prison recruits, who have entered the apprenticeship program at HMP, have also pitched in to maintain order.
"There is no undue security risk," Rahming told The Nassau Guardian.
"We have a number of prison officers who are turning up to work. They are being assisted, and they are doing an excellent job."
For security reasons, he declined to disclose the number of Defence Force officers stationed at the prison.
At a press conference yesterday, executives of the National Congress of Trade Unions of The Bahamas (NCTUB) and its affiliate, the Bahamas Prison Officers Association (BPOA), said prison administrators, as well as the present and past governments have failed to address the majority of prison officers' concerns.
"The brave men and women charged with overseeing the care and protection of inmates have been subjected to deplorable and dangerous conditions that have caused short and long-term illnesses to the point where they are unable to work," said NCTUB President Jennifer Isaacs-Dotson at the press conference at the Bahamas Musicians and Entertainers Union's headquarters on Horse Shoe Drive.
However, National Security Minister Tommy Turnquest said the government has done "a great deal" to address these concerns.
"I think if you compare what we have done, compared with any other administration you would have to conclude that we have done a great deal," Turnquest said.
This is the third time prison officers have conducted a sick-out "just weeks before a general election", according to Dr. Rahming.
Isaacs-Dotson said the actions taken by the officers are not politically motivated.
She also said the umbrella union will increase its public campaign "and do what it must", including taking legal action to ensure HMP staff work in a "safe and healthy environment".
Last month, NCTUB threatened industrial action over labor issues it claimed were outstanding, such as insufficient drinking water for staff; poorly functioning running water facilities in the prison; the perimeter wall not being completed after more than five years and the roof of the maximum security wing needing repairs.
Rahming claimed many of the issues are longstanding, "beyond the scope of the prison itself and many of them are just outright not true", although he did not elaborate.
Turnquest said the Defence Force officers stationed at the prison have the necessary training and qualifications to properly carry out prison duties.
Defence Force officers were recently called on to work at Lynden Pindling International Airport when the union that represents customs and immigration officers took industrial action over outstanding issues in its industrial agreement.
When asked if the Defence Force was being stretched by the recent actions of unions, Turnquest said: "It means that they can't do their regular duties, but they are called upon to fill in when there are some national security concerns."
He said he was of the understanding that the association's concerns were resolved, or being resolved, and has maintained an open door policy for its executives.

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News Article
Osteoporosis and foot pain

Osteoporosis may seem like an odd condition for a podiatrist to encounter, however the reason why I chose to discuss this topic is that it affects the feet -- maybe not so much from a fracture standpoint but definitely for the foot pain it causes. Foot pain in the elderly is one of the most common complaints seen by the podiatrist every day.
Osteoporosis, which means porous or holey bone, is a condition in which bones become weak and thin due to lack of calcium. People with osteoporosis have an increased risk of bone fractures (breaks). Osteoporosis is often called a silent disease because many people do not realize they have it until they break a bone with or without trauma.
While the bones of the spine, hip, and wrist are the most common bones to become broken as a result of osteoporosis, metatarsals and other bones in the feet can also be affected. In fact, some people first find out they have osteoporosis because of a fracture in the foot.
It is estimated that over 10 million Americans (eight million women and two million men) have osteoporosis and another 34 million have low bone mass, known as osteopenia which, if left untreated, will deteriorate to osteoporosis in the future. At the present time, the majority of hip fractures occur in Europe and North America. In 50 years, it is estimated that 75 percent of all hip fractures will occur in developing countries like The Bahamas, with the numbers of hip fractures rising three-fold to 6.3 million a year. Osteoporosis is most commonly seen in women over age 50, but younger people and men can also have it too.
Risk factors for osteoporosis include:
o Gender. Women get osteoporosis more often than men.
o Age. The older you are, the greater your risk of osteoporosis.
o Body size. Small, thin women are at greater risk.
o Ethnicity. White and Asian women are at a higher risk than Black and Hispanic women.
o Family history. Osteoporosis tends to run in families.
Other factors that can be changed may include low estrogen levels in women after menopause, a diet low in calcium and Vitamin D, lack of exercise, cigarette smoking and drinking alcohol.
In most people, the highest bone mass is reached around age 30, but the bone continues to grow over time. Bone cells make and break down bone all the time. If the amount of bone made is equal to the amount of bone break down, then the bones stay strong. When this process is off balance, with more bone breakdown than bone building, the bone structure weakens and breaks easily.
Many older people present to the podiatrist's office complaining of generalized, nondescript pain in both feet. The patient often cannot pinpoint any particular area of the foot. Sometimes, these people may also suffer from arthritic joints, but can clearly point out these areas. When older persons complain of vague foot pain, many times it can be from osteoporosis. As the bones of the feet demineralize over time, they become weaker but are still expected to support the whole body as people continue their usual activities. This weakness in the bones reduces the strength of the individual bones and it is manifested as generalized foot pain. Sometimes, people may present with increased pain with walking, redness and swelling on the top of the foot, which may be signs of foot injury or even a fracture. These people should be seen by a podiatrist immediately.
Osteoporosis is diagnosed by a bone mineral density tests called a DXA (Dual-energy x-ray absorptiometry) scan or test. Not only is this test used to make the diagnosis, but can also be used to see if the treatment that the patient is receiving is actually strengthening their bones. X-rays can also be used as a diagnostic tool. On x-rays the bone looks faded, thin and washed out.
The following treatment is recommended to prevent osteoporosis.
o Supplements. Calcium and magnesium supplements help to build and strengthen the bone. A vitamin D supplement is needed for calcium absorption and bone building.
o Eat foods rich in Vitamin K and highly absorbable calcium such as broccoli, cabbage and spinach, romaine lettuce, sesame seeds and bok choy which will be more than adequate to build strong bones.
o Try not to eat too much meat, excess proteins, refined grains and sugar which causes the blood to become acidic. This causes the bones in the body to lose calcium instead of gaining calcium.
o Exercise. Even low to moderate weight-bearing exercise provides tension on the bone and strengthens it.
o Stop smoking and avoid
alcohol because they lead to calcium loss from the bone.
o Speak with your primary care physician to discuss if HRT (hormone replacement therapy) , it is good for you.
For the individual that already has osteoporosis, the condition may not be completely reversible. There are medications available that work by either stopping the cells that break down bone or that help by building up bone. However, it is vitally important to stop the conditions that lead to bone loss such as eating a high protein (meat) diet, smoking, drinking alcohol and a sedentary lifestyle.
As far as foot pain from osteoporosis, wearing laced shoes with a good arch can support the feet and go a long way to reducing the stress placed on the bones of the feet. The podiatrist may order pain medications for a short while for relief. Building strong bones is the most effective strategy for complete pain relief and prevention of fractures.

oIf you suspect you have osteoporosis see your primary care physician. If you continue to have foot pain you need to see a podiatrist. For more information on osteoporosis, email me at foothealth242@gmail.com or visit www.foothealth.org or www.footpainexplained. com. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street or call 325-2996 or Bahamas Surgical Associates on Albury Lane or call 394-5820.

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News Article
Back pain and your feet

If your lower back has been hurting, and you don't remember doing anything to injure it, have you considered that the source of your pain could be your feet? Foot pain is something that many people try to ignore, but if you have been experiencing foot pain for quite awhile, it could be causing problems in your ankles, knees, hips and even your back.
Back pain is a very common complaint for many people and one of the most common reasons why people see their physician. In fact, most people will experience some type of back pain at least once during their lives. Eighty percent of United States citizens complain of back pain. There are many causes of back pain including arthritis, sports injuries, nerve and muscular problems, poor posture, weak abdominal muscles, pregnancy, degenerative disc disease, etc. One quarter of the bones in your body are located in your feet, and your feet are the foundation and support for the rest of your body.
Our bodies are like a chain, with one link, or bone, connecting at the joint to the next link. Think about what would happen if the first link in the chain was out of position. The point at which it meets the next link would eventually affect that link and adversely affect the entire chain.
That's what happens when we have foot pain. If we experience pain when walking normally, we would tend to instinctively change our walking pattern to ease the pain. For example, if you have arthritis, and your big toe joint hurts, you will change your gait (the way you walk) to avoid bending the joint and causing pain. Changing your gait changes the mechanics of your ankle joint, eventually causing ankle pain. This change in your walking pattern can also affect the whole chain of your lower body -- from the ankle, to the knee, to the hip, and then to the lower back. When foot pain or a foot deformity causes you to change the way you walk, it changes the way the bones of all those other joints work with each other. Cartilage in the joints can wear down, ligaments and tendons can be stressed beyond their normal range, and early arthritis can set in.
When you pronate, or roll your feet in toward the heels, you tend to lean forward which predisposes you to more low-back pain and aggravates any previous back injury. When walking or standing, rotating your feet to the outside often eases intermittent low back pain because it rotates your hips backwards and shifts your center of gravity. Walking this way may help the back, but it is not good for the feet and may cause foot pain and sprained ankles. Standing in a more upright posture will give your back muscles a break. But, the best way to properly reduce the pressure on the spine and back muscles is to correct and balance your feet.
Since the feet are the foundation of the body, shoes play a big role in making sure that this foundation is stable ensuring that all joints work well together and are pain free. Wearing poorly constructed shoes, or shoes that are not for your foot type can cause a significant amount of foot and maybe even back pain. Shoes that can cause back pain are extremely high heels -- especially the pencil thin ones that don't offer much support. On the other hand, wearing properly fitted, supportive shoes, can put your feet in balance and improve the alignment of the rest of your body, helping you reduce back pain. For persons who may have flat feet or high arches they may need more structural support in their shoes. Accommodative inserts, braces, cushions/pads and/or orthotics can also be used to address a particular foot type and help relieve foot and back pain problems.
If your feet or ankles are causing you pain, don't ignore them. It can lead to, or aggravate back pain. Contact your podiatrist for an evaluation and they can fix the problem from the foundation -- your feet. If this does not fix the problem you may need to see an orthopedist, a physiotherapist or even a chiropractor. Your back (knees and hips) will thank you!

oFor more information or to see a podiatrist, visit Bahamas Foot Centre, Rosetta Street (325-2996), Bahamas Surgical Associates, Albury Lane (394-5820) or email foothealth242@hotmail.com, or visit www.foothealth.org or www.apma.org.

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News Article
Woman tries to grab House mace

Police had to restrain and forcibly remove a woman who was clutching a Bible from the gallery of the House of Assembly yesterday after she tried to grab the mace out of the hands of a clerk as Speaker of the House Dr. Kendal Major was making his way inside the chamber.
The woman, identified as Janice Curtis, 46, of Mystic Gardens, said that God told her to come to the House and remove the mace, Major told reporters.
The incident occurred at about 10:45 a.m., just before the House's morning sitting began.
Assistant House Clerk David Forbes was holding the mace and leading Major's procession into the chamber when the woman grabbed at the mace as the group walked past her.
Major then grabbed hold of the woman and a minor struggle ensued as he restrained her on a chair.
The House's Sergeant-at-Arms Kendal Pennerman and officer Keith Ferguson forcibly removed Curtis from the gallery moments later as startled parliamentarians and other spectators looked on.
She was immediately placed in the speaker's custody and held in the Central Police Station following the incident.
Major credited his quick action and quick response from police officers for diffusing what could have been a dangerous situation.
He described how he was forced to briefly restrain the woman.
"The mace bearer [was] right in front of me and when she snatched at the mace he pulled back and she didn't grab it and I sensed it and I essentially helped him," Major said.
"Next thing I know I found myself holding her until the officer grabbed her from me."
Major said Curtis acted "suspiciously" before the incident and was being monitored by the sergeant-at-arms.
He said she was seen fidgeting in the gallery and at one point took her shoes off and rubbed her feet on the carpet.
In spite of the incident, Major said he feels safe in the House.
But he said the matter underscores the need for stringent security measures in Parliament.
"We are always mindful to see how best we can increase our [security] to protect this from happening again," he said.
When the House resumed its sitting after the lunch break, Major informed members that he placed a one-year ban on Curtis from visiting the House of Assembly.
Major also ordered an immediate psychiatric evaluation of Curtis before any further action is taken.
According to Major, Curtis could face a $600 fine and/or six months imprisonment.
He said her actions violated rules governing Parliament.
Security at the House of Assembly was increased earlier this year.
In January, Major said the sergeant-at-arms, who was previously only supplied with a billy club, was given a gun.
A metal detector that was purchased by the previous administration, but never used, was put in place and made operational at the entrance of the House.
But many people still walk through the metal detector without it being manned.
The House's security was heightened after an invasion and robbery at the home of Deputy Prime Minister Philip Brave Davis last December. Davis was acting prime minister at the time.

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News Article
Along life's road

Who then is the greatest in the kingdom of heaven? Jesus put a child in the midst and said, "Whoever then humbles himself as this child, he is the greatest in the kingdom of heaven." -- Matthew 18:1,4.
Mostly when I am out of town, it is customary for me to call and find out how everything is going. I was on the phone with my sister, Bertha, when she got a call from my sister-in-law, Sharon, saying that Reuben was in the Intensive Care Unit (ICU). On asking which Reuben it was, I found out that it was my little seven-year-old nephew, the son of my brother, Pastor Reuben. I was standing, but my faith stabilized me.
That day on Thursday, February 16, I was already in a very reflective mood since it was my late mother's birthday, and precious memories were flowing. Reuben's death happened so suddenly and without notice. It seemed to be the flu, but it took him immediately to the ICU with a grave prognosis. In three short days, little Reuben went to be with the Lord. My sister, Carmella, told me that on his first day in ICU, he removed the mask from his face and said "Psalm 17" and please do read it.
As I look over my nephew's life, I cannot but conclude that angels are not for the long haul, but for the expressed purpose of a mission to be accomplished. He was highly intelligent, technologically savvy, musically endowed with the most crystal clear voice I have ever heard. I attended Marjorie Knowles' music recital at St. Matthew's during the Christmas and he performed "The First Noel" flawlessly. I was extra excited because my first music recital given by Meta Cumberbatch at age eight was held in St. Matthew's schoolroom.
Reuben was meek, gentle and well-spoken. He was as Christian as his faith was strong. His seven-year-old life could have been measured symbolically in the life of one who had fulfilled all the requirements needed for entrance to the pearly city. Now I know that the days of our life are three score years and 10, but it does not necessarily mean that it is out of God's will if one dies before 70, but any part or parcel of the 70 must be lived in the will of God.
It is amazing that the late Whitney Houston was not even buried, yet that the tongues of some of the religious order were criticizing Reverend Marvin Winans about his sermon. "He ain't do this and he shudda do that and he the next." These are the Christian preachers. Yet, on the other hand, high level media personalities were giving the entire service along with the sermon, high marks.
Such was the case in Jesus' day as recorded in our text. Rather than rescuing the perishing, caring for the dying and witnessing to lost men about the salvific gospel of Jesus Christ, they were trying to find out among them, who was numero uno in the kingdom of God. Who among us could preach the best, has the biggest church with the most members? Who is popular in every nook and cranny? Who is wearing the latest and longest suit and the most expensive shoes? Whose robe is the grandest of them all?
Jesus had just come down from the mountain where His Transfiguration took place in the presence of Peter, James and John, and the multitude were waiting for him. A certain man among them begged Jesus to heal his lunatic son, as the many attacks were beginning to take a toll on the health of both he and his wife. Jesus rebuked the demon and the child was restored to good health.
Thereafter the disciples came to Jesus to find out who was the greatest in the kingdom of heaven. And Jesus called a little child unto Him, and set him in the midst of them, and said, "Verily I say unto you, Except ye be converted, and become as little children, ye shall not enter into the kingdom of heaven. Whosoever therefore shall humble himself as this little child, the same is greatest in the kingdom of heaven. And who so shall receive one such little child in my name receiveth me. But who so shall offend one of these little ones which believe in me, it were better for him that a millstone were hanged about his neck, and that he were drowned in the depth of the sea."
For me, through the death of little Reuben, the word of God has become more clear as to how we should live our lives and our daily behavior each to the other. Children are innocent, pure and chaste and never harbor jealousy or sow seeds of ill wind. They are just pure children who though spanked, will still share a smile. They do not support grudges and will speak the truth even though it may be to the detriment of others. While some may wait for the later years to train children, the wise ones know that from the moment a child comes into this world, serious training must begin. By the time a child reaches the age of seven, the life pattern of that child is already defined.
Once a man and twice a child to me has nothing to do with the physical condition of an individual, but all the graces and virtues of what it is to be a child. Our lives must begin as virtue-packed as that of an innocent child, and in our adult years must possess and show all the love, peace and kindness as if we are still children at play in an open playground. Thank you Father for your word, and thank you God for little Reuben of seven - fit for heaven.
 
oE-mail rubyanndarling@yahoo.com; write to P.O. Box SS 19725, Nassau, Bahamas with your prayer requests, concerns and comments. God's Blessings!

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News Article
Fine dining and fashion: The perfect way to spend a Saturday afternoon

It's going to be an afternoon of elegance and sophistication with fine dining and entertainment not to be missed at The Balmoral on Saturday at the Luncheon on the Lawn.
From the opening cocktail party to a delicious lunch and attention grabbing fashion show, the luncheon to support the Cancer Caring Centre will be spectacular, said Judy Higgs, a member of the organizing committee.
"It will be a very elegant affair that you will remember. It's the kind of event to which you wear a beautiful dress and hat. The afternoon will start off with cocktails upstairs in the club at noon. At 1 p.m., the luncheon will begin," Higgs explained.
"There will be three wonderful courses, then there will be some music and lots of entertainment. It will be a really nice outing for a good cause. Not only will you have a good time but you will be supporting the Cancer Caring Centre, which is a facility that houses Family Island cancer patients who come to New Providence for treatment."
Flat shoes are recommended for the event, which is on the lawn. Table favors for the ladies will be from Jo Malone, donated by John Bull.
Adding to the elegance of the event, a fashion show coordinated by fashion guru Tyrina A. Neely will be held later in the afternoon. Neely said it will be absolutely fabulous and will feature the hottest looks from the Spring 2012 fashion and resort wear collection.
"We have partnered with numerous local boutiques like Cole's of Nassau, Bahama Handprints, Rubins, Tommy Hilfiger and Splash Dance to show the latest in casual and resort wear. There are lots of great things that are new and vibrant this season that will catch your eye from the bright colors to the graceful styles," she said of the event which will also include The Plait Lady as a partner.
"Currently, colors like tangerine, turquoise, coral and shades of green like lemongrass are the hot colors. Pink is also still big this season, and pastels are also popular. A lot of the fashions that will be shown are new arrivals and are available in the boutiques that are sponsoring the event."
Expect to see Grecian-inspired pieces, casual fun cuts and asymmetrical designs. There will also be handmade accessories by Cute Confections, and some of the latest prints and bags for the season will also be displayed.
"People can really look forward to a beautiful showcase of spring pieces and the hottest trends. This will be spectacular. This event is something for people who just love to give back and are dedicated to helping others. They can attend knowing they will get an event they can thoroughly enjoy," said Neely.
A traditional auction hosted by Ed Fields will add to the excitement. Prizes to be won include a quilt made by Stepping Stone Quilters; jewelry from Coin of the Realm; a trip to Pineapple Fields, Eleuthera for two; a weekend at Highbourne Cay, Exuma; two nights at Dunmore Beach in Harbour Island and a portrait by artist, A.J. Watson.
"Breast cancer is very high in The Bahamas and it affects so many people, so we hope many people will come out. We're anticipating some 300 people to attend - more would be good, but that's a good start. We really have to do what we can to support those in need and an organization that cares," said Higgs.
Bank of The Bahamas International has also signed on to the initiative as the sole sponsor of the Luncheon on the Lawn.
"The setting alone is fantastic, but more importantly, the cause is so important," said Michael Basden, marketing manager at BOB, who serves on the bank's active sponsorship review committee.
"Cancer is a disease that touches all of us and at BOB, we want to do everything we can to assist in education about its causes, prevention and the care of those afflicted.
"The Cancer Caring Centre is especially critical for cancer patients from the Family Islands, many of whom would not be able to sustain treatment in Nassau were it not for the center providing a home away from home, a place of comfort where they can stay while undergoing chemotherapy.
"We have been told that all 10 beds at the center are always full and there is a waiting list. That waiting list could include people for whom immediate treatment could mean the difference between life and death; it could make a difference in the quality of life."
Tickets for the nearly sold-out lunch are $150 and may be purchased by calling Betty Sands at 393-1797 or Carleton Robertson at 328-2625.

Luncheon on the Lawn
When: Saturday, February 25
Where: Balmoral Club, Sanford Drive
Time: Noon
Cost: $150

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News Article
Ankle sprains are the most common sports injury

Ankle sprains are the most frequent musculoskeletal injury seen by primary care physicians. It is estimated that thousands of people around the world on a daily basis require medical care for ankle sprains of the ankle joint, which is made up of three bones held together by ligaments that provide stability by limiting side-to-side movement.
Ankle sprains are common sports injuries but can also happen during everyday activities. An ankle sprain is an injury to one or more ligaments in the ankle, usually on the outer side of the ankle. The severity of an ankle sprain depends on whether the ligament is just stretched, partially torn, or completely torn, and on the number of ligaments involved in the injury. Ankle sprains are not the same as strains, which affect muscles rather than ligaments and an ankle fracture means broken bones.

Causes
Ankle sprains are usually caused by an unnatural twisting motion occurring in the ankle joint, most commonly when the foot is pointing downward and is forced inward awkwardly. Persons would describe this as "rolling their ankle". This stretches the ligaments on the outer side of the ankle. Sprained ankles often occur during sporting activities and can result from a fall, a sudden twist, stepping on uneven surfaces or in a hole and even wearing the wrong shoes.

Symptoms
When the ankle is sprained the soft tissues around the ankle are injured and inflamed. The symptoms may include pain or soreness, swelling, bruising or redness, difficulty walking or stiffness in the joint. The symptoms vary depending on the severity of the sprain.
There are four key reasons why an ankle sprain should be promptly evaluated and treated by a podiatrist.
o An untreated ankle sprain may lead to chronic ankle weakness/instability and more injury.
o Sometimes it may be difficult for you to tell the difference between a sprain and an ankle fracture.
o An ankle sprain may be accompanied by other foot injury that must be treated as well.
o Rehabilitation of a sprained ankle needs to begin right away. If rehabilitation is delayed, the injury may be less likely to heal properly.

Diagnosis
When evaluating your injury, the podiatrist will get a history of the injury and the symptoms you are experiencing. X-rays or other imaging studies such as a CT scan may be ordered to help determine the severity of the injury. A complete physical exam will be done, touching and moving the parts of the foot and ankle to determine which parts have been injured.
The initial care for a sprained ankle at home involves reducing pain and speed up healing. Persons will often report that immediately after a suspected ankle sprain they would soak their foot in hot water. This is not recommended! In fact, it increases swelling and can make the ankle worse. Always remember RICE -- rest, ice, compression and elevation. All of these are done to reduce and prevent inflammation and can be started at home even before you see the podiatrist.
Rest: For the first 24 to 48 hours after the injury your activities need to be seriously decreased or stopped all together.
Ice: For the first 48 hours after the injury, place an ice pack or frozen vegetables wrapped in a towel on the sprained ankle for 20 minutes at a time every three to four hours.
Compression: Wrap the ankle in an ace bandage from the toes to above the ankle. The wrap should be snug but not too tight so that it's uncomfortable.
Elevate: Keep your ankle elevated as high as possible by sitting in a recliner, or putting books or pillows under the ankle.
After twisting your ankle, if you have pain, swelling and difficulty walking or standing, it is time to see the podiatrist. Treatment by the podiatrist will continue the RICE treatment. The podiatrist may also apply an ankle brace or cast boot to reduce motion in the ankle joint. Crutches are also used to prevent people from walking or bearing weight on the ankle. The most common medications used to treat ankle sprains are anti-inflammatory, that reduce both pain and help control the inflammation.
When you have an ankle sprain, rehabilitation is crucial -- and it starts the moment your treatment begins. Early therapy helps to promote healing and increase your range of motion. This may include doing prescribed exercises or even seeing a physical therapist, who will help with flexibility and strengthening exercises. A follow-up visit is usually scheduled one to two weeks after the initial treatment to monitor healing progress.
Most ankle sprains heal without complications or difficulty, leaving the person able to walk and play their sport without pain or swelling. The healing time depends upon the severity of the ankle sprain and if there was any other accompanying injury. If people do not get treatment and rehabilitation after an ankle sprain, chronic ankle instability results which makes the ankle weak, "gives way" at times and increases the risk of more injuries in the future. Very seldom surgery may be needed to repair torn ligaments around the ankle.
Ankle sprains can be prevented by wearing proper shoes for the activity you are engaged in. Always wear stable shoes that give your ankle support -- like high-top basketball shoes. High heels or platform shoes are not the best choice if you want to prevent an ankle sprain. For athletes, balanced training may keep the ankles strong and flexible. They may also consider having a weak ankle taped or wear an ankle brace for extra support during the game.

oFor more information on ankle sprains visit www.apma.org or www.footphysicians.com. To see a podiatrist visit Bahamas Foot Centre, Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates, Albury Lane, telephone 394-5820.

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News Article
Pain in the back of your heel could mean you have Achilles tendinitis

Have you ever had pain in the back of the heel, close to the bone, that is worse with walking and stretching? Then you may have had Achilles tendonitis.

What is the Achilles tendon?
A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the "heel cord", the Achilles tendon is the largest tendon in the body and facilitates walking, running and jumping by helping to raise the heel off the ground.
Achilles tendonitis is the inflammation of the Achilles tendon. Inflammation is the body's natural response to injury or disease, and is often short-lived. Over time, if not resolved, the condition may progress and degenerate the tendon, leading to Achilles tendonitis. The tendon loses its highly organized structure and develops very tiny tears. In rare cases, chronic degeneration may result in the rupture of the tendon.
There are two types of Achilles tendinitis, based on which part of the tendon is inflamed. Inflammation may occur in the middle portion of the tendon, where it has begun to break down with tiny tears, swelling, and thickening. This commonly affects younger, active people. Tendonitis involving the lower portion of the heel, where the tendon attaches to the heel bone, causes damage to the tendon fibers and may also calcify (harden), causing a bone spur (extra bone growth) to form. This affects the insertion of the tendon and can occur at any time, even in patients who are not active.

Causes
Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress or over-use of the tendon. This often happens when we push our bodies to do too much, too soon. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Because the stress on the tendon is continuing, the body cannot repair the injured tissue. The tendon structure is then altered, resulting in continued pain. Several other factors can make it more likely to develop tendinitis, including a sudden increase in the amount or intensity of exercise activity, tight calf muscles, and a bone spur where the Achilles tendon attaches to the heel bone. Athletes are at high risk for developing Achilles tendonitis. It is also common in persons whose work puts stress on their ankles and feet, such as gardeners, "weekend warriors" (people who participate in athletics only on weekends or infrequently) and people with flat feet.

Symptoms
Common symptoms of Achilles tendinitis include:
o Pain and stiffness along the Achilles tendon especially in the morning, and the pain along the tendon or back of the heel that worsens with activity. The pain can be severe the day after exercising.
o Thickening or nodules may be felt in the tendon. A bone spur may be felt where the tendon attaches to the heel bone.
o Swelling that is present all the time and gets worse throughout the day with activity. If you have experienced a sudden "pop" in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.

Diagnosis
As the podiatrist examines you, he or she will evaluate the range of motion of the ankle and the condition of the tendon by looking for signs of swelling along the Achilles tendon or at the back of your heel, thickening or enlargement of the Achilles tendon, bony spurs at the lower part of the tendon, and the location of pain. The podiatrist may also order imaging tests such as X-rays and Magnetic Resonance Imaging (MRI)

Treatment
Treatment approaches for Achilles tendonitis is based on how long the injury has been present and the degree of damage to the tendon. In most cases, nonsurgical treatment options will provide pain relief, although it may take sometimes up to three to six months for symptoms to completely subside. Seeking medical treatment promptly is important to ensure the best chance of healing the condition. Treatment options may include:
o Rest: The first step in reducing pain is to decrease or even stop the activities that make the pain worse. If you regularly do high-impact exercises (such as running), switching to low-impact activities will put less stress on the Achilles tendon.
Cross-training activities such as biking, elliptical exercise, and swimming are low-impact options to help you stay active.
o Immobilization: With severe pain, immobilizing the tendon may be needed and may involve the use of a cast or removable walking boot to reduce forces through the Achilles tendon, promote rest and healing.
o Ice: To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice directly against the skin.
o Oral medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
o Orthotics and supportive shoes: For those with over-pronation or gait abnormalities, custom orthotic devices may be prescribed. Pain from insertional Achilles tendinitis is often helped by certain shoes and orthotic devices. For example, shoes that are open or softer at the back of the heel can reduce irritation of the tendon and heel lifts can move the heel away from the back of the shoe, where rubbing can occur, taking some strain off the tendon.
o Night splints: Help to maintain a stretch in the Achilles tendon during sleep.
o Exercise: Calf stretching is important to help strengthen the calf muscles and reduce stress on the Achilles tendon.
o Physical therapy: May include more stretching and strengthening exercises, soft-tissue massage/mobilization, gait and running reeducation, stretching, and ultrasound therapy.
o Extracorporeal shockwave therapy (ESWT): a non-invasive therapy that does not require a surgical incision and has minimal risks. It is sometimes tried before surgery is considered. During this procedure, high-energy shockwave impulses are applied to the area which stimulates the healing process in the damaged tendon tissue.
o Cortisone injections: Cortisone, a type of steroid, is a powerful anti-inflammatory medication. Cortisone injections into the Achilles tendon are not recommended because they can cause the tendon to rupture (tear).
When is surgery needed?
If non-surgical approaches fail to restore the tendon to its normal condition and pain persists for more than six months, surgery may be necessary. The foot and ankle surgeon will select the best procedure to repair the tendon, based upon the extent of the injury, the location of the damage to the tendon, the patient's age and activity level, and other factors.

Most patients have good results following surgery. The greater the amount of tendon that is injured, the longer the recovery period will be, and the less likely the patient will be able to fully return to their level of sporting activity. Pain, wound infection or healing delays are the most common complications after surgery. Physical therapy is a vital part of recovery and may be required for a long time.
Prevention
To prevent Achilles tendonitis from recurring after surgical or non-surgical treatment, the podiatrist may recommend daily strengthening and stretching exercises to the calf muscles. Wearing proper shoes for the foot type and sporting activity is also important in preventing recurrence of the condition.

For more information on Achilles tendinitis, visit www.apma.org or www.foothealth.com or send questions to foothealth242@gmail.com. If you have foot pain or any concern, visit a podiatrist at Bahamas Foot Centre, Rosetta Street, telephone 325-2996; Bahamas Surgical Associates, Albury Lane, telephone 394-5824 or the Foot & ankle Institute Dean's Lane, telephone 326-5402.

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