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Running and Triathlon are big hobbies here in Central Texas and with training starting for the marathon season, here are some tips to maintain hydration and reduce heat related stress while cycling and running in the Texas sunshine.

During outdoor exercise, the goal is to minimize fluid loss, prevent cramping, and heat related exercise.  Marinating proper fluid balance is essential and to do this, it requires a balance of sodium, potassium and water.

The goal is to add a small amount of salt to your daily food intake; we’re talking 10 – 25mg.  If you sweat heavily, you’ll want to aim towards the 25mg mark.  Studies show the daily ingestion of sodium helps maintain blood osmolality and prevent dehydration better than supersaturating with salt tabs during exercise.

The simple practice of incorporating last week’s suggestions of increasing fruit and vegetable consumption will take care of the extra potassium required.

That being said, it is still important to replace electrolytes during exercise be sure to take a sports drink or water and sports gel if you will be exercising for more than 45 minutes in the heat. Don’t worry about any extra calories or sugars these drinks provide, the calories will be “spent” regulating your body temperature. A sports drink will provide electrolytes to replenish those lost from sweating and it increases blood osmolality allowing for a longer duration between rehydration and refueling breaks!

When you return from exercise, drink a glass of room temperature or tap water. This will prevent vaso-restriction, allowing the muscles to get the water they need. After that you may drink a cold drink of water.

When refueling after exercise greater than 40 – 80 minutes in duration, a piece of fruit with a glass of milk is great – it provides sodium, complete proteins and fuel to replace lost glycogen stores. Other options include cottage cheese and watermelon, or a Texas staple, corn chips and salsa.  Of course good old chocolate milk is great too!

For exercise greater than 80 minutes, I suggest a fruit smoothie: 1 cup plain low-fat yogurt, 1 cup fruit juice or milk, 1 cup frozen fruit and any one or both of the following: 1 Tbs. Old Fashioned Peanut Butter and /or 1 scoop Whey Protein Supplement. If exercise was greater than 2 hours, you may want to add a small bag of pretzels to accompany the smoothie, ensuring enough sodium intake.

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 Contact: Drs. H. Ashley Ledger and Roderick Hunter

ledgerfootandankle.com
(254) 519-3668

Local Foot Surgeon Urges Patients Not to Ignore Foot Pain

Harker Heights, TX — Unexplained foot and ankle may lead to osteomyelitis, a bone infection which can affect healthy children and adults, patients with diabetes mellitus, the elderly, or anyone with a compromised immune system.

According to Harker Height foot and ankle surgeon H. Ashley Ledger DPM, FACFAS, osteomyelitis can occur in bones within days of an infection on the skin, known as cellulitis; from a wound, traumatic or surgical; and spontaneously.  Dr. Ledger explains that the porous nature of bones in people allows infection a fast path of travel, which makes the bone susceptible to amputation. “Because the bones in the feet are close to the skin surface, it’s a short distance to travel from the skin to inside the bone.  Infections can eat a hole in bone quickly,” says Dr. Ledger.  “In fact, many patients visit their foot and ankle surgeon for an infection too late and the damage to skin and bone is too advanced to save the affected area of the foot and/or the leg.  Patients may have to go on long-term antibiotics or worse, amputation.”

While osteomyelitis is most commonly seen in diabetic wounds, healthy adults and children are also affected.  Early symptoms can include increased pain, redness, increased temperature of skin, swelling, and difficulty with normal weight on the foot.   “Oftentimes patients don’t seek treatment for their symptoms for days or weeks thinking the pain will pass or there is delay with their referral to see someone for an infection,” says Dr. Ledger “The best advice is don’t ignore foot pain of any type. Early intervention can make all the difference in your treatment and recovery.”

Infections

Foot and ankle surgeons are able to diagnose osteomyelitis through X-rays, MRI, and/or bone biopsy. Bone biopsies are the most accurate. “This is why prevention and early intervention are key; you never want to be too late in treatment of an infection,” Dr. Ledger explains.

If you are diagnosed with osteomyelitis, it is important to identify the bacteria and start the appropriate antibiotic. MRSA, Methicillin Resistant Staph. Aureus is the hardest to treat.  Its resistance to multiple drugs make it costly to treat and hard to get rid of. “In a recent study, hospital curtains were tested twice a week for three weeks. The 180 samples produced 119 germs. Twenty-six (26%) tested positive for MRSA and 44% tested positive for enterococcus.  Thirteen (13) new curtains were replaced during the study and 12 were contaminated within a week.”

Based on the study, Ledger Foot and Ankle Clinic will be having SparGuard sprayed on all surface to prevent clinic acquired infection from occurring and reduce its spread. Texas Bioguard, the exclusive distributor for SparGuard, is already using this green technology in Texas schools and day cares. Very soon hospitals will be using this to reduce hospital acquired infections, HAI’s.

“We want to do everything possible to keep our patients that do not have infections from getting ones that we treat in the office,’ says Dr. Ledger.

If you are suffering from foot pain or suspect you may have a foot or ankle infection, call Ledger Foot and Ankle Clinic at 254-519-FOOT (3668) for an evaluation.

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I found myself thinking about life recently. About living. Of the average life, so to speak. And how it’s evolved over time in the recent past. Consider this, the average life expectancy for a person born in 1850 was about 38 years old. By the turn of the century it had risen to around 48 years. Thirty years later it was up to 58 years. By 1970, another 40 years later, and it had risen up to 68 years. Now, present day, another 40 years or so later and we find ourselves enjoying, under best circumstances, a life expectancy of about 76 for men and 81 for women in this country. That’s pretty remarkable when you think about it; the average life doubling in time over the span of a 150 years.

What that means for a society, a country, a community, is that more and more of us are going to be reaching an age that at one time wasn’t so commonplace. And more and more families are going to be touched by this effect in a very tangible way and in fact most are, or have been.

The word dementia is derived from Latin and means to be “out of one’s mind.” Not a place anyone wants to be, as our mind is central to who we are, to our essence. But the risk for dementia goes up each decade of our lives to where, by the age of 65, nearly 1 in 10 will suffer from it.  Just as the aging of one’s heart and the vessels that supply it can lead to health consequences, and can be seen elsewhere in the body with the aging of our brain.

I was sitting with friends recently discussing their personal experience with dementia in their families. The struggles it brought. The challenges. It requires the best of us as individuals. As families. As communities.

From a simplified perspective, dementia refers to a loss of function in the brain. In an acute setting such concerns require a prompt medical evaluation for potential reversible and/or treatable causes. Thyroid dysfunction and Vitamin B12 deficiency are examples of such treatable problems for which recommended screening tests exist. Other potential causes related to infectious causes such as lyme disease, syphilis, or HIV can be considered and screened for.

However in the majority of cases, dementia proves chronic. Over 50% will meet criteria for Alzheimer’s, and another 20% relate to vascular issues. Quite frankly dementia often becomes tied to the decline and aging of one’s brain. And with more of us living longer lives, and with parents or other family members doing the same, we all will ultimately prove to be touched by it.

It is difficult knowing this not to harbor a degree of fear over it, and it is not uncommon for a family physician to discuss this concern with a patient, that their memory isn’t what it used to be. True dementia requires more than this, however. It requires broader effects upon our brain’s function such as impacting speech or the ability to perform simple tasks, so it is often a matter of reassurance from a clinical standpoint.

When it is real. When it does exist. Effective treatment often proves elusive. The differences in treatment for the consequences of aging of our brain versus our heart, relates to our ability to acutely detect and then effectively intervene in the causes. As treatment from a surgical approach is infrequently indicated, the treatment from a pharmaceutical standpoint often proves to be of debatable value and must be determined on a personalized basis.

What isn’t debatable is the importance of being vigilant in early assessment. The earlier the identification, regardless of treatment options, the value found for families being able to effectively plan and address it is clear. We must also remain vigilant in our support of our friends, families, and neighbors who might confront it. Vigilant in our support of continued research for future treatments and hope for a cure. And most importantly, mindful of the value for such vigilance.

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09/05/13- “Dr Galt and Dr Gonzalez are both treasures. They are fabulous. If you have to stand on your head to keep them at Seton-Do it.”

09/05/13-“ I really like Seton. I’m glad you are here and I hope you stay here.”

08/16/13-“ Excellent care. Best hospital I’ve ever been in.”

08/16/13-“‘A+ care. I will choose Seton if I ever need care again.”

08/16/13- “I have traveled around the world and I have been in many hospitals. I have never been in a hospital like yours. The rooms were beautiful, the nurses were great, the techs were great. I didn’t want to go home. I’m switching from Scott&White to Seton.”

08/13/13- “Amazing care. Everyone was nice, even the pharmacy. They even used warm packs on my arms before drawing my blood and starting my IV. I will choose Seton over any other hospital in town.”

07/13/13- “I arrived at the front desk in the ED to fill out paperwork. I was having chest pain. I was told, that I was more important than paperwork and we would take care of that later. Everyone was wonderful-Excellent care.”

07/31/13-“The doctors were wonderful-Le, Gonzalez ,Ledger, McCollough, Johnson. Mr. Mike was terrific.”

07/30/13- “Excellent care. I knew the nurses would come to me right away when I called.”

07/29/13- “I’m switching all of my hospital care to Seton.”

07/31/13- “10 out of a 1-10 scale.”

07/31/13- “ One a scale from 1-10, Seton was an 11. All of the nurses were very polite and nice to me.”

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