Symptoms Not To Ignore
Living day to day with arthritis, youve probably figured out when to wait out pain and when to call the doctor about it. But what if you experience something completely different youre short of breath, the slightest bump leaves a bruise or youre shedding pounds without trying?
Believe it or not, these and many more symptoms that dont affect your joints can be related to your arthritis. And some require immediate medical attention.
Here are 10 symptoms you should never ignore, why and when to call your doctor about them.
Increase in fatigue.
More fatigue than usual could mean increased inflammatory disease activity, fibromyalgia, depression or anemia. These sometimes can be caused by rheumatoid arthritis and sometimes by medications used to treat various forms of arthritis. Nonsteroidal anti-inflammatory drugs , such as ibuprofen and naproxen , as well as corticosteroids come with a risk of gastric bleeding that can lead to anemia. Methotrexate, a disease-modifying antirheumatic drug , can interfere with the formation of blood cells, which also can lead to anemia.
Although a day of increased fatigue may simply be your bodys way of telling you to slow down and rest more, you should let your rheumatologist know if it is frequent, severe or goes on for more than a week, says Scottsdale, Ariz., rheumatologist Paul Howard, MD.
Easy bruising or bleeding.
Shortness of breath.
Change in the appearance of a mole.
Unexplained weight change.
Side Effect Of Vitamin K Overdose
Blueberries are a good source of Vitamin K and eating one cup of blueberries provide around 29 micrograms of Vitamin K. Vitamin K is a vital nutrients that plays an important role in keeping us healthy and performs a number of functions in our body, like regulates blood clotting, improving bone density and making our bones stronger, reducing risk of cancer, providing cardiovascular benefits etc .
Although Vitamin K provides a lot of benefits there are some side effects associated with the intake of high dosage of Vitamin K and for this reason, it is advisable to eat blueberries in moderation.
High dosage of Vitamin K may give rise to symptoms like difficulty in swallowing, irregular breathing, fainting, shortness of breath, skin rashes, increased risk of internal bleeding and bruising, etc . Blueberries are also not suitable for the individuals who on anticoagulant medicines as the Vitamin K present in blueberries may interfere with the function of anticoagulant medicine and increase the risk of bleeding.
Bruises Or Blood Flow
You may have had bruises that temporarily turned part of your skin a shade of black, blue, or purple. Those injuries usually heal on their own without treatment. But if your foot starts to take on a purple color without any bumps or bruises, you should see your doctor. Purple feet are a sign of a circulation problem that can be potentially serious.
When circulation in your feet is healthy, cuts heal quickly and your skin retains its natural color. Blood reaches your feet through a network of arteries, which are the blood vessels that carry blood from your heart. Your blood travels through veins back to your heart and lungs for more oxygen and the start of another round trip.
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Which Joints Are Involved In Gouty Arthritis And Why Is It Most Common In The Foot
As with all other known types of arthritis, Gout has particular joints it tends to attack, and the foot is its most common location. Gout especially favors the bunion joint, known as the first metatarsophalangeal joint , but the ankle, midfoot and knee are also common locations, as is the bursa that overlies the elbow.
The bunion joint is the first joint involved in 75% of patients and is ultimately involved in over 90% of those with this condition. . It is thought that this joint is especially involved in gout because it is the joint that receives the highest pounds per square inch of pressure when walking or running.
Late in gout, if untreated, multiple joints can be involved, including the fingers and wrists. The shoulder joint is very rarely involved by gout and the same is true of the hip.
Figure 5: Location of Gout Attacks
Treating A Gout Attack
Treating an attack of gout doesnt lower your urate levels or stop future attacks. The treatment helps you to manage your symptoms when an attack happens.
The most commonly used drug treatments for attacks of gout are:
Some people will be better suited to NSAIDS, while others will be suited to colchicine. But your preference is also taken into consideration many people with gout quickly learn what works best for them.
In cases where one drug doesnt seem to be working on its own, your doctor might suggest a combination of NSAIDs with either colchicine or steroids.
Non-steroidal anti-inflammatory drugs
Attacks of gout are often treated with NSAID tablets, which can help with pain and reduce some of your inflammation. Ibuprofen, Naproxen and diclofenac are three NSAIDs you could be given.
If youve been prescribed NSAIDs to treat an attack, you should start taking them as soon as you notice signs of one coming on. Your doctor may let you keep a supply so you can start taking them at the first signs of an attack.
The earlier you start treatment, the better.
NSAIDs arent suitable for everyone, so talk to your doctor about them first if you have any other conditions. They can also interact with other drugs, so make sure you talk to a doctor before starting on any new medication.
Colchicine isnt a painkiller, but can be very effective at reducing the inflammation caused by urate crystals.
Colchicine tablets can cause diarrhoea or stomach aches.
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How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.
How Is Gangrene Diagnosed
If you have symptoms of gangrene, your healthcare team will give you a physical exam to check for signs of tissue death. They may also ask you about any chronic health conditions you have that could be linked to the gangrene.
Your healthcare provider may also want to do lab tests to check for gangrene. A higher than normal amount of white blood cells, for example, can mean you have an infection. Your healthcare provider may take samples of tissue or fluid from the affected area and look at in the lab. If your healthcare provider thinks you may have internal gangrene, he or she may order imaging tests or surgery to find out for sure.
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Black Toenail From Trauma
Trauma is the most common cause of a black toenail. The trauma can be abrupt or accrued over time.
Sometimes a sudden blow, like dropping a heavy object on your toe, or having your foot stomped on during a soccer game, will burst blood vessels in the nail bed and bruise the adjacent flesh.
The attrition of repetitive trauma, like constantly jamming your big toe against the end of your too-short running shoe during a half marathon, can likewise break blood vessels under a toenail.
Myth: If You Stay Away From Liver And Alcohol You’ll Avoid Gout Attacks
Truth: Alcoholic drinks especially beer and organ meats such as liver and some fish, including anchovies and sardines, are very high in a class of natural substances known as purines. When the body breaks down purines it creates uric acid, so eating a lot of purine-rich foods does increase the risk of an attack. But while avoiding these foods may reduce attacks, it won’t halt them, says Reveille.
Gout can be life threatening if left untreated.
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Myth: There Aren’t Effective Medicines For Gout
Truth: Many medications put the brakes on gout. Some control pain and inflammation immediately and others get at the root cause by eliminating the deposited uric acid crystals.
Colchicine is prescribed for acute gout flare-ups. A plant extract, it’s been used to treat gout for 2,000 years, says Reveille. Colchicine works within several minutes to several hours to block gout inflammation. The sooner you start it, the more likely the attack will resolve quickly. An injected steroid also tackles inflammation, usually controlling pain and swelling within 24 hours.
Prescription drugs such as allopurinol , febuxostat and probenecid all alleviate gout by controlling blood levels of uric acid. Also, two years ago the FDA approved an intravenous drug for people with advanced gout pegloticase that lowers uric acid levels and reduces deposits of uric acid crystals in the joints and soft tissue.
Most people who have gout will need to be on a uric-acid-lowering drug for life, usually just one or two pills a day, says George Washington University’s Baraf.
Changing your diet can help reduce the frequency of gout attacks.
Symptoms Of A Foot Stress Fracture
The symptoms of a foot stress fracture will generally develop over time and become more severe as the injury progresses. Symptoms may include:
- Tenderness. The injured bone may feel painful or sore when touched this is called pinpoint pain.
- Deep, dull pain. The pain may be felt deep within the foot or toes.
- Weakness. The area where the fracture is located may feel weak and normal performance may be diminished.
- Intermittent pain. Pain caused by a stress fracture will typically intensify during weight-bearing activity and diminish during rest.
- Swelling. The injured foot may appear swollen this can occur anywhere on the foot but it is most likely to be seen on the top portion because of injury to a metatarsal.
- Changes in biomechanics. Some may notice they are running or walking differently to avoid putting pressure on the painful area.
- Sharp, localized pain. Putting weight on the foot may cause sharp pain at the site of the fracture, especially in injuries that have progressed.
- Bruising. The area around the fracture may appear reddish, bluish, or purplish in color because of blood rushing towards the injury.
Not everyone will experience all of these symptoms. In some cases, symptoms may go away for a period of time and return worse than they were before.
Read more about Stress Fracture Symptoms
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How Is Gout Diagnosed
In a clear-cut case, a primary care physician can make the diagnosis of gout with a high level of confidence. However, often there are two or more possible causes for an inflamed toe or other joint, which mimics some of the symptoms of gout, so tests to identify the presence of uric acid is performed.
Since the treatment for gout is lifelong, its very important to make a definitive diagnosis. Ideally, the diagnosis is made by identifying uric acid crystals in joint fluid or in a mass of uric acid . These can be seen by putting a drop of fluid on a slide and examining it using a polarizing microscope, which takes advantage of the way uric acid crystals bend light. A non-rheumatologist, when possible, can remove fluid from the joint by aspirating it with a small needle and send it to a lab for analysis. A rheumatologist is likely to have a polarizing attachment on their microscope at their office. Gout crystals have a needle-like shape, and are either yellow or blue, depending on how they are arranged on the slide .
Figure 11: Uric Acid Crystals Under Polarizing Light Microscopy
There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting .2
Table 1: Diagnosing gout when no crystal identification is possible
Ideally, 6 of 10 features will be present of the following:
The Four Stages Of Gout
Gout is best understood by seeing it as having four phases or stages :
Stage 1: High uric acid
Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.
Stage 2: Acute flares
This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.
Stage 3: Intercritical periods
These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.
Stage 4: Advanced gout
This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .
Figure 1: Stages of Gout
Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the “bunion joint,” represent a gouty tophus.)
Figure 3: Progression of Gout
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Prevention Of Traumatic Black Toenail
However, there are ways that you can prevent black toenails caused by repetitive impact. Trim your toenails frequently. Keep them short and square. Make sure there is at least a half-inch distance between the tip of your longest toe and the end of your shoe. And always wear shoes with a roomy toebox, to give your toes plenty of lateral space.
Symptoms Of Fungal Infection In A Toenail
When fungus gets a foothold under a toenail, the resulting symptoms may include:
- Toenail discoloration. Fungal infections can cause the affected toenail to turn yellow, blue, green, brown, or purple, as well as black.
- Thick toenails. The nail becomes thick and brittle. Portions of the nail may break off, and the surface of the nail may become flaky.
- Foul odor. An odd, unpleasant smell may emanate from the nail.
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Warts Under A Toenail
Warts are generally harmless. But in rare cases of one starting to grow under a toenail, it can lift the nail and separate it from its bed. Most warts are brown or flesh-colored, but accumulated debris under the nail can give it a black appearance.
While the location can make treatment a bit tricky, standard medical practice for warts, including injections and/or oral medication, will generally work under the nails as well.
Nodules Under Your Skin
Untreated gout can cause deposits of urate crystals under your skin . These feel like hard nodules and can become painful and inflamed during gout attacks. As tophi build up in joints, they can cause deformities and chronic pain, limit mobility, and can eventually destroy your joints entirely. The tophi may also partially erode through your skin and ooze a white chalky substance.
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Restless Feet At Night: Iron Deficiency
“Restless feet and legs at night is often a signal that you have an iron deficiency,” says Arielle Levitan, MD, a physician of internal medicine and co-founder of Vous Vitamin LLC. To help combat this symptom and the underlying issue, Levitan recommends taking a daily vitaminand if even that doesn’t help, make sure to schedule an appointment with your physician.
Balding Toes: Peripheral Arterial Disease
Losing some or all of the hair on your toes can be a sign of poor blood circulation caused by peripheral arterial disease. Also known as P.A.D., this disease occurs when narrowed blood vessels reduce blood flow to the limbs. Other P.A.D. foot symptoms include a weak or absent pulse in the foot and sores that don’t heal. Talk to your doctor if your toes suddenly become bald. The good news is that P.A.D. is treatable, typically through heart-healthy lifestyle changes, medication, and sometimes surgery.
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Thick Yellow Toenails: A Fungal Infection
A thick, yellow toenail is usually a sign of a fungal nail infection, according to the Centers for Disease Control and Prevention . Though the infection usually isn’t painful unless it becomes severe, it’s notoriously difficult to treat. When you visit the doctor for treatment, they will likely prescribe oral antifungal pillsthough if they’re ineffective and the case is severe, your toenail may need to be removed completely.
Myth: Once You’ve Got Gout Lifestyle Changes Don’t Really Help
Truth: Lifestyle changes can reduce both the severity and frequency of attacks. For starters, when people lose weight, they often have fewer attacks, says Reveille.
Animal proteins have a higher level of purines, so it’s better to eat vegetable proteins like beans and peas.
In fact, a 2010 review in the rheumatology journal Current Opinion in Rheumatology notes that protein-rich foods such as dairy products, nuts, beans, peas and whole grains are healthy choices for people with gout, reducing the risk of heart disease and possibly lowering the risk of insulin resistance.
Baraf says that he asks patients to abstain from alcohol during the first six months of treatment, until medications have stabilized uric acid levels. After that, he says, it’s fine to drink in moderation.
Dorothy Foltz-Gray is a freelance writer who lives in North Carolina.Remember to go to the AARP home page every day for tips on keeping healthy and sharp, and great deals.
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