Healthy Chocolate?

I just had to share since I love chocolate!!! -Dr Crane

Chocolate is Not Just for Lovers

By Susan Kitchen (Borrowed from USA Triathlon newsletter 2/11/14)

Who doesn’t crave chocolate once in a while? And it’s almost Valentine’s day, so chocolate seems to be everywhere!!! Chocolate can actually be good for you, but don’t just grab a chocolate heart and think you are eating healthy! Not all chocolate is created equal. Dark chocolate packs the biggest health punch compared to milk and white chocolate.

The secret behind dark chocolate’s powerful punch is the cacao bean, rich in a plant-based organic compound called flavonoids. Flavanols, the primary type of flavonoid in cocoa and chocolate, have powerful antioxidant properties responsible for providing numerous health benefits. The downside is cacao by itself is unappetizing with its chalky and bitter flavor. Once milk, butter and sugar are added chocolate gets its yummy, creamy taste we have come to crave. However, the processing of chocolate takes out the flavanols negating the health benefit of cacao.

Here’s the secret, so listen up! Dark chocolate containing at least 70 percent cacao (or cocoa, which is the cacao bean ground and roasted) has higher amounts of flavanols, providing powerful antioxidant benefits.

7 Health Benefits of Dark Chocolate

Boosts Heart Health
Cocoa’s flavanols improve blood flow with anti-clotting and blood thinning properties that work similar to aspirin. The increased blood flow provides an increased flexibility in the veins and arteries, helping to decrease blood pressure. Chocolate eaters benefit from lower LDL (bad) cholesterol and an overall lower risk of heart disease and stroke.

Improves Brain Function
The boost of blood flow to the brain assisted by cocoa’s flavanol improves cognitive function increasing one’s ability to focus better on tasks. In studies with mentally impaired people over 70 years old, cocoa has been shown to improve cognitive function. 

Fights Cancer and Aging
Dark chocolate is rich in antioxidants, which help to clear the body of free radicals causing oxidative damage to cells. Free radicals are known to speed up the aging process, and they’re linked to cancer. Antioxidant-rich foods help protect the body against cancer and keep it looking younger.

Decreases Insulin Resistance
Dark chocolate keeps blood vessels healthy, improving circulation and protecting against Type 2 diabetes. Flavanols help your cells function normally and improve insulin sensitivity, thus reducing the risk for diabetes.

Helps Relieve Stress
As it turns out, emotional eating (in small quantities) might not be so bad for you after all! Studies show that anxious people who ate 1 ounce of dark chocolate a day for two weeks had significantly improved cortisol levels. This can be tied into the increased blood flow to the brain, which helps improve mood. Maybe chocolate does cure a broken heart!

Aids in Sun Protection
Flavanols offer some protection from UV sun damage by increasing blood flow, skin density and hydration. One study showed that subjects who ate chocolate consistently for three months took longer to burn than non-dark chocolate eaters. 

Reduces Cravings
With the cacao bean providing fiber, dark chocolate increases satiety versus lighter colored chocolates. Research shows that dark chocolate lessens cravings for sweet, salty and fatty foods.

How to Choose the Best Dark Chocolate:

1. Make sure cocoa or bittersweet chocolate is the first ingredient on the food label, not sugar

2. Stick with chocolate that has at least 70 percent cacao

3. Avoid if it is processed with alkali (neutralizing natural acidity)

4. Look out for “dutching,” which means processed with alkali (a process that takes out the flavanols)

5. Avoid if soy lecithin is genetically modified

Recommended Dark Chocolate Brands:

1. Ghirardelli Intense Dark: 72% and 86% Cacao

2. Godiva: 72% Cacao

3. Lindt: 70%, 85%, 90% and 99% Cacao

4. Green & Blacks: 70% and 85% Cacao

5. Moser Roth: 70% and 85% Cacao

Chocolate Bars That Don’t Make the Cut (Sorry!):

1. Hershey’s Special Dark: Processed with alkali, high in sugar

2. Dark Chocolate M&M’s: Vague ingredient list, high in sugar, more like candy than dark chocolate

3. Milky Way Midnight: Processed with alkali, more sugar than cacao

4. Dove Dark Chocolate: Processed with alkali, more sugar than cacao

5. Nestle Dark Hot Chocolate: Processed with alkali, loaded with sugar and trans fat

So girls, enjoy the guilty pleasures of dark chocolate in small portions (about 1 ounce per day) while reaping the health benefits too!

Happy Valentine’s Day!

Rash or Athlete's Foot Fungus?

Around 70% of the population will suffer from athlete’s foot at some time in their lifetime! Athlete's foot is the layman’s term used for tinea pedis, which is a very common skin condition that usually affects the sole of the foot and the skin between the toes. It is usually a scaly, red, itchy eruption and occasionally may be weepy and oozing. It affects the feet of all people, not just athletes. Although it is frequently caused by a fungal infection, it can also have an overlying bacterial infection that can become dangerous.

The dermatophyte family of fungus causes athlete's foot; and these can be contracted in many locations, including gyms, locker rooms, swimming pools, nail salons, and from contaminated socks and clothing. The fungi can also be spread directly from person to person by contact. Most people acquire fungus on the feet from walking barefoot in areas where someone else with athlete's foot has walked. Some people are simply more prone to this condition while others seem relatively resistant to it.

Without the proper environment (warmth and moisture), the fungus may not easily infect the skin. Fungus loves the winter when we spend most of our time in socks and sweaty shoes!

To avoid getting athlete’s foot fungus, there are some simple things that you can do:
1.   keep your feet clean and dry,
2.   avoid prolonged moist environments,
3.   use socks in airport security lines,
4.   remove shoes periodically and allow the feet skin to "breathe,"
5.   avoid walking barefoot, especially in public areas like swimming pools and gyms,
6.   avoid contact with known infected people,
7.   avoid soaking and contaminated tool usage at nail salons
8.   Disinfect old shoes and periodic weekly or monthly sprinkling of antifungal foot powder into shoes can also be helpful.
9.   It is imperative to take your own nail instruments, including nail files, to any public nail salon, unless you know the salon practices strict instrument sterilization and/or uses all disposable supplies.

Make athlete’s foot fungus take a hike! Disinfect your shoes regularly and make sure to wear moisture wicking socks this winter!

Kobe Bryant is Out for the Rest of the Season After Suffering a Torn Achilles Tendon

The Laker fans are crying this morning after their star, Kobe Bryant, suffers a torn Achilles tendon last night. Kobe felt a "pop" and stated he thought someone kicked him during a routine cut to the basket last night. He took a time out, then returned to make his free throws on one foot. He watched the rest of the game from the locker room. He is having an MRI this morning to plan for surgical repair of his torn tendon.

Several times in the last few weeks, it has been discussed whether or not this was the last season for the 35-year-old Laker. The Lakers are holding onto the last playoff spot by the tips of their fingers and it seemed like Bryant was playing them into the playoff with sheer will and determination. What will happen to the Lakers now? They are one game up on the Jazz for the last playoff spot with two games to go.

Will Kobe come back next season? Good question. He has the will and determination, but this is a devastating injury that often takes up to a year to recover from. That would put him out most of the next season as well. At 35, this could be the end. This is the same injury that ended Dan Marino's career to name just one of many stars who's bodies betrayed them before their mind had given up the game.

For more on Achilles injuries, Achilles tendon surgery. If you have chronic Achilles pain or suffer an injury like Kobe, contact us for help! The doctors at Foot and Ankle Associates of north Texas in Grapevine and Keller, Texas are here to help!

Foot and Leg Cramps Driving You Crazy?

Foot and leg cramps can be caused by all sorts of things. Nighttime cramps are usually a sudden spasm, or tightening, of the muscles in the calf, arch and toes. They often occur just as you are relaxing and falling asleep or when waking up. The cause can be mysterious in many cases.

Muscle cramps can be caused by many condition and activities. Here are 10 of the most common:

1.       Exercising, injury or overuse of muscles

2.       Standing on hard surfaces or sitting in an awkward position for a long time.

3.       Peripheral arterial disease (PVD)

4.       Abnormal foot biomechanics like flat feet or really high arches

5.       Kidney or thyroid  disease

6.       Multiple sclerosis

7.       Peripheral neuropathy

8.       Lack of potassium, calcium, magnesium and other mineral in your blood

9.       Dehydration

10.   Many medications including diuretics, birth control pills, statin, steroids and antipsychotics

How can you eliminate the cramping?

1.       Massage and stretch the muscles involved

2.       Soak your feet in warm water or take a warm bath

3.       Stretch the areas

4.       Take a walk

5.       Over-the-counter anti-inflammatories like Advil or Aleve

6.       Drink plenty of fluids, especially an electrolyte solution like Gatorade can be helpful

7.       Wear supportive shoe gear and talk to your doctor about arch supports or custom orthotics if you feel it is foot fatigue related

How can you prevent muscle cramps?

1.       Drink plenty of water and other fluids

2.       Limit alcohol and caffeine, especially on hot days

3.       Eat healthy foods rich in calcium, potassium and magnesium

4.       Take a multivitamin every day

5.       Exercise every day, especially walking, running or riding a bike to move your muscles

6.       Stretch on a regular basis, as well as before and after exercise

7.       Don’t suddenly increase your exercise regimen. Don’t increase by more than 10% each week.

8.       Tal k to your doctor about any new medications that you are taking that may be causing the cramping.

If the cramping keeps occurring even though you are doing all of these things, a thorough exam is needed to assess for peripheral arterial disease, peripheral neuropathy, thyroid and liver disease as well as any underlying biomechanical problems that may be causing cramping. Foot and leg cramps are never normal, so don’t ignore them!

For more info contactus@faant.com or click here

Acute Vs. Chronic Heel Pain: New Treatments Available

Dr Marybeth Crane discusses acute versus chronic heel pain in this informative video. It is important to understand the difference between acute plantar fasciitis and chronic plantar fascists and their treatments.

Is Bunion Surgery Worth It?

Is Bunion Surgery Worth It?

Interesting question that can be answered yes and no.

Yes, if you have pain every day in your foot around the bunion and it is keeping you from doing the things you want to do.

No, if you just think the bunion is ugly and it is keeping you from wearing cute shoes.

In general, surgery for bunions is only recommended when pain from the bunion prevents a patient from wearing normal shoes and performing their normal daily activities. If your bunions only hurt when you are wearing pointy toed, high heeled shoes; surgery is not your best option. You should try padding, wider shoes, orthotics and injections; as well as much more sensible wider toe box, lower heeled shoes.

There is a common misconception that surgical treatments for a bunion are better and quicker than non-surgical treatments. Unfortunately, patients who rush into surgery may have unrealistic expectations, and may be unsatisfied with surgery.

Patients considering bunion surgery should understand the following about surgical treatments of bunions and also dispel some common misperceptions or myths about bunion surgery:

Myth #1: It is a common myth that bunion surgery is often unsuccessful or “botched”. This is simply not true. Almost 95% of patient surveyed 6 months after bunion surgery would not only do it again, but would recommend it to their friends and family. That’s a pretty good success rate. Patients must have realistic expectations. Bunion surgery can be helpful at relieving pain, but patients should not expect to have "perfectly normal" feet after surgery. And surgery cannot make your foot fit into a 4 inch heeled shoe comfortably.

Myth #2: Bunion surgery is extremely painful. Again, simply not true. Bunion surgery is not particularly "more" painful than other surgeries.  There is pain after surgery, but most patients only require narcotic pain medication for a few days after surgery then use anti-inflammatories to control their discomfort and swelling. Foot surgery, in general, can lend itself to increased pain post-operatively because the foot is below the level of the heart and blood can rush to the area, causing a throbbing feeling. This can be well controlled with a post-operative pain management program.

Myth #3: Bunions come back even after surgery. Again, not true. A majority of patients are satisfied with their outcome after bunion surgery. Recurrence is possible, but not particularly likely. And, return of a bunion is not necessarily a complication, but something that can happen over time. Some patients have excessive motion in the foot that may predispose them to recurrence. This is why functional foot orthotics are needed in many patients post0operatively to control foot function. Another possible reason for recurrence occurs when a procedure that was performed did not best suit the severity of the particular bunion -- so it's important to have the surgery tailored for your particular bunion. Discuss this with your surgeon or get another opinion prior to surgery.

Myth #4: Bunion Surgery = cast and crutches for months. While this was true years ago, more modern techniques have allowed surgeons to mobilize patients quicker. Mild bunions typically involve walking in short walking boot cast for one month, then a sneaker for another month. Surgeons consider casting with crutches with larger bunions because setting the bones is more complex. Some surgeons have moved away from bone cuts and instead perform a fusion procedure that allows for realignment of the entire deviated bone. This fusion procedure is called the Lapidus Bunionectomy, and contemporary approaches allow for early protected walking at four to six weeks postoperatively. Recent technological advances in medical implant devices have also helped surgeons modify their techniques to get patients moving quicker.

Myth #5: You have to be off work. This, again, is simply not true, and a function of the demands of your workplace. A patient can return to a sedentary desk job within a week of the surgery, and varies based on surgeon protocol and type of bunion surgery performed. Jobs that require excessive walking, standing and physical activity may require a medical leave of absence -- which can be up to two to three months depending on healing and job requirements. Getting around can be difficult and driving may be off limits if you have your right foot operated on and/or drive a manual. Job demands of a pilot certainly differ than those of a secretary.

Myth #6: Don't fix a bunion unless extremely painful. The concern with surgically correcting a non-painful bunion is that the surgery can result in longstanding post-operative pain that may not have been there prior. The old rule-of-thumb, if it ain’t broke, don’t fix it. However, people do have surgery for non-painful bunions if the bunion interferes with activity, continues to become larger, or if they have difficulty wearing certain shoes. Surgeons strongly prefer that patients have a painful bunion before they consider surgery. Fortunately, pain is the most common reason people seek treatment.

Myth #7: Bunion surgery results in ugly scars: Surgical healing is part of the process with any surgery, and bunion surgery is no different. Incisions can be minimized, or alternate surgical approaches may be used to hide surgical scars. Bunion incisions are usually located on the top of the foot and technique varies based on surgeon. A surgeon may perform a plastic surgery-type closure to keep scaring minimum. Decreasing swelling, avoiding infection in the postoperative period, and scar cream can also minimize scars.

Bunion surgery, just like any surgery, has its share of myths. Basically, because not all bunions are treated the same, information that may apply to someone with a large bunion may not apply to someone with a small bunion. Take the time to discuss your reservations and alternatives with your surgeon. Often you will find that myths like the 7 discussed are just simply not true. 

The majority of patients, having bunion surgery for the right reasons, end up with a good to excellent outcome and would tell you that bunion surgery is definitely worth it!