“As we step into April, it’s time to shine a light on a vital yet often overlooked aspect of our health: our feet! April is designated as Foot Health Awareness Month, a perfect opportunity to educate ourselves about the importance of foot care and to make conscious efforts to maintain our foot health.

Our feet are the foundation of our mobility, carrying us through life’s journeys, big and small. On average, we take around 8,000 to 10,000 steps each day, which adds up to approximately 115,000 miles over a lifetime! With such a heavy workload, it’s crucial to give our feet the attention they deserve. Neglecting foot care can lead to a myriad of issues, including bunions, plantar fasciitis, and even chronic pain.

One of the best ways to celebrate Foot Health Awareness Month is to prioritize proper footwear. Ill-fitting shoes can lead to a host of problems, from blisters and calluses to more serious conditions like arthritis. When shopping for shoes, ensure they provide adequate support, have a comfortable fit, and allow for natural movement. Remember, style shouldn’t come at the cost of comfort!”

Regular foot inspections are also essential.

 10000 steps=5 miles

April is National Foot Health Awareness Month and research shows that approximately 20 percent of Americans experience at least one foot problem each year. These issues can be the result of an underlying health problem such as obesity, diabetes, or peripheral neuropathy.

Today Dr. Amanda Bartell and Dr. Andrew Bartell of North Florida Foot & Ankle Center in Jacksonville, FL, Southside, and Duval County are sharing their tips for happy, healthy feet!

• Examine your feet each day, using a mirror – if needed – to inspect the bottom of your feet for cracks, peeling, injuries or dry skin. This is particularly important if you have diabetes to avoid a non-healing wound.
• Wear shoes in public areas where your feet can be scratched or cut, leading to infection, athlete’s foot or plantar warts.
• Replace the shoes you wear to exercise every six months or 500 miles to avoid heal and foot pain when the inside of the shoe begins to lose support.
• Stretch your ankles, lower legs and feet daily and before any activity to avoid injury.
• Thoroughly dry your feet and between your toes after bathing to reduce the risk of fungal infections. Follow up by applying a good moisturizer.
• Don’t leave polish on nails all the time as it can lead to fungal toenails.
• Apply sunscreen on ankles and between toes to avoid sunburn and guard against skin cancer.
• There is a good chance you will not wear the same size in shoes your entire life, so have them measured on a regular basis.
• Maintain a healthy weight because extra weight puts pressure on the feet, often causing heel or foot pain, circulatory problems, arthritis, and stress fractures.
• Try to wear shoes with good support and a low heel and use custom orthotics to provide proper arch support.

“Pulmonary fibrosis is scarring in your lungs. It can make it hard to expand your lungs and get enough oxygen to your body. It can be idiopathic (without a known cause) or result from autoimmune diseases, environmental factors or medications. Pulmonary fibrosis usually gets worse over time, but how quickly it gets worse is different for everyone.

 You might also be at a higher risk for pulmonary fibrosis if you:

• Are 65 or older
• Are male
• Have a family member with pulmonary fibrosis
• Have certain conditions caused by changes in your DNA, like dyskeratosis congenita (a rare type of bone marrow failure)”

Cleveland Clinic (Pulmonary Fibrosis: Causes, Symptoms & Treatment)

Symptoms

Signs and symptoms of pulmonary fibrosis may include:

• Shortness of breath (dyspnea)
• A dry cough
• Fatigue
• Unexplained weight loss
• Aching muscles and joints
• Widening and rounding of the tips of the fingers or toes (clubbing)

The course of pulmonary fibrosis — and the severity of symptoms — can vary considerably from person to person. Some people become ill very quickly with severe disease. Others have moderate symptoms that worsen more slowly, over months or years.

Some people may experience a rapid worsening of their symptoms (acute exacerbation), such as severe shortness of breath, that may last for several days to weeks. People who have acute exacerbations may be placed on a mechanical ventilator. Doctors may also prescribe antibiotics, corticosteroid medications or other medications to treat an acute exacerbation.

Complications

Complications of pulmonary fibrosis may include:

• High blood pressure in your lungs (pulmonary hypertension). Unlike systemic high blood pressure, this condition affects only the arteries in your lungs. It begins when the smallest arteries and capillaries are compressed by scar tissue, causing increased resistance to blood flow in your lungs.This in turn raises pressure within the pulmonary arteries and the lower right heart chamber (right ventricle). Some forms of pulmonary hypertension are serious illnesses that become progressively worse and are sometimes fatal.
• Right-sided heart failure (cor pulmonale). This serious condition occurs when your heart’s lower right chamber (ventricle) has to pump harder than usual to move blood through partially blocked pulmonary arteries.
• Respiratory failure. This is often the last stage of chronic lung disease. It occurs when blood oxygen levels fall dangerously low.
• Lung cancer. Long-standing pulmonary fibrosis also increases your risk of developing lung cancer.
• Lung complications. As pulmonary fibrosis progresses, it may lead to complications such as blood clots in the lungs, a collapsed lung or lung infections.

Diagnosis

To diagnose your condition, your doctor may review your medical and family history, discuss your signs and symptoms, review any exposure you’ve had to dusts, gases and chemicals, and conduct a physical exam. During the physical exam, your doctor will use a stethoscope to listen carefully to your lungs while you breathe. He or she may also suggest one or more of the following tests.

Imaging tests

• Chest X-ray. A chest X-ray shows images of your chest. This may show the scar tissue typical of pulmonary fibrosis, and it may be useful for monitoring the course of the illness and treatment. However, sometimes the chest X-ray may be normal, and further tests may be required to explain your shortness of breath.
• Computerized tomography (CT) scan. CT scanners use a computer to combine X-ray images taken from many different angles to produce cross-sectional images of internal structures in the body. A high-resolution CT scan can be particularly helpful in determining the extent of lung damage caused by pulmonary fibrosis. Also, some kinds of fibrosis have characteristic patterns.
• Echocardiogram. An echocardiogram uses sound waves to visualize the heart. It can produce still images of your heart’s structures, as well as videos that show how your heart is functioning. This test can evaluate the amount of pressure occurring in the right side of your heart.

Lung function tests

• Pulmonary function testing. Several types of pulmonary function tests may be conducted. In a test called spirometry, you exhale quickly and forcefully through a tube connected to a machine. The machine measures how much air your lungs can hold and how quickly you can move air in and out of your lungs. Other tests may be conducted to measure your lung volumes and diffusing capacity.
• Pulse oximetry. This simple test uses a small device placed on one of your fingers to measure the oxygen saturation in your blood. Oximetry can serve as a way to monitor the course of the disease.
• Exercise stress test. An exercise test on a treadmill or stationary bike may be used to monitor your lung function when you’re active.
• Arterial blood gas test. In this test, your doctor tests a sample of your blood, usually taken from an artery in your wrist. The oxygen and carbon dioxide levels in the sample are then measured.

Tissue sample (biopsy)

If other tests haven’t diagnosed the condition, doctors may need to remove a small amount of lung tissue (biopsy). The biopsy is then examined in a laboratory to diagnose pulmonary fibrosis or rule out other conditions. The tissue sample may be obtained in one of these ways:

• Bronchoscopy. In this procedure, your doctor removes very small tissue samples — generally no larger than the head of a pin — using a small, flexible tube (bronchoscope) that’s passed through your mouth or nose into your lungs. The tissue samples are sometimes too small for an accurate diagnosis. The biopsy may also be used to rule out other conditions.The risks of bronchoscopy are generally minor and might include a temporary sore throat or discomfort in your nose from the passage of the bronchoscope. However, serious complications can include bleeding or a deflated lung.During bronchoscopy, your doctor may conduct an additional procedure called bronchoalveolar lavage. In this procedure, your doctor injects salt water through a bronchoscope into a section of your lung, and then immediately suctions it out. The solution that’s withdrawn contains cells from your air sacs.Although bronchoalveolar lavage samples a larger area of the lung than other procedures do, it may not provide enough information to diagnose pulmonary fibrosis. It might also be used to rule out other conditions.
• Surgical biopsy. Although a surgical biopsy is more invasive and has potential complications, it may be the only way to obtain a large enough tissue sample to make an accurate diagnosis. This procedure may be done as a minimally invasive surgery, called video-assisted thoracoscopic surgery (VATS), or as an open surgery (thoracotomy).During VATS, your surgeon inserts surgical instruments and a small camera through two or three small incisions between your ribs. The camera allows your surgeon to view your lungs on a video monitor while removing tissue samples from your lungs. This procedure is performed after you’ve been given a general anesthetic, so you’ll be asleep during the procedure.During open surgery (thoracotomy), a surgeon removes a lung sample through an incision in the chest between your ribs. The procedure takes place after you’ve been given a general anesthetic.

Blood tests

Doctors may also order blood tests to evaluate your liver and kidney function, and to test for and rule out other conditions.

Treatments

The lung scarring that occurs in pulmonary fibrosis can’t be reversed, and no current treatment has proved effective in stopping progression of the disease. Some treatments may improve symptoms temporarily or slow the disease’s progression. Others may help improve quality of life. Doctors will evaluate the severity of your condition to determine the most appropriate treatment for your condition.

Medications

Your doctor may recommend newer medications, including pirfenidone (Esbriet) and nintedanib (Ofev). These medications may help slow the progression of idiopathic pulmonary fibrosis. Both medications have been approved by the Food and Drug Administration (FDA). Additional medications and new formulations of these medications are being developed but have not yet been FDA approved.

Nintedanib can cause side effects such as diarrhea and nausea. Side effects of pirfenidone include rash, nausea and diarrhea.

Researchers continue to study medications to treat pulmonary fibrosis.

Doctors may recommend anti-acid medications to treat gastroesophageal reflux disease (GERD), a digestive condition that commonly occurs in people with idiopathic pulmonary fibrosis.

Oxygen therapy

Using oxygen can’t stop lung damage, but it can:

• Make breathing and exercise easier
• Prevent or lessen complications from low blood oxygen levels
• Reduce blood pressure in the right side of your heart
• Improve your sleep and sense of well-being

You may receive oxygen when you sleep or exercise, although some people may use it all the time. Some people carry a canister of oxygen, making them more mobile.

Pulmonary rehabilitation

Pulmonary rehabilitation can help you manage your symptoms and improve your daily functioning. Pulmonary rehabilitation programs focus on:

• Physical exercise to improve your endurance
• Breathing techniques that may improve lung efficiency
• Nutritional counseling
• Counseling and support
• Education about your condition

Lung transplant

Lung transplantation may be an option for people with pulmonary fibrosis. Having a lung transplant can improve your quality of life and allow you to live a longer life. However, a lung transplant can involve complications such as rejection and infection. Your doctor may discuss with you if a lung transplant may be appropriate for your condition.

“The word “pulmonary” means lung and the word “fibrosis” means scar tissue— similar to scars that form on the skin from an old injury or surgery. Pulmonary fibrosis is a process that causes lung scarring, in which fibrotic tissue blocks the movement of oxygen from inside the tiny air sacs in the lungs into the bloodstream.

Pulmonary fibrosis isn’t just one disease. It is a family of more than 200 different lung diseases that all look very much alike. The PF family of lung diseases is part of an even larger group of diseases called interstitial lung diseases (also known as ILD), which includes all of the diseases that have inflammation and/or lung scarring. When the cause of PF is unknown, it’s called idiopathic pulmonary fibrosis (IPF). IPF is the most common type of pulmonary fibrosis.”

Pulmonary Fibrosis Foundation (Pulmonary Fibrosis Foundation | Pulmonary Fibrosis Foundation)

Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, you become progressively more short of breath.

The scarring associated with pulmonary fibrosis can be caused by a multitude of factors. But in most cases, doctors can’t pinpoint what’s causing the problem. When a cause can’t be found, the condition is termed idiopathic pulmonary fibrosis.

The lung damage caused by pulmonary fibrosis can’t be repaired, but medications and therapies can sometimes help ease symptoms and improve quality of life. For some people, a lung transplant might be appropriate.

Risk factors

Factors that make you more susceptible to pulmonary fibrosis include:

• Age. Although pulmonary fibrosis has been diagnosed in children and infants, the disorder is much more likely to affect middle-aged and older adults.
• Sex. Idiopathic pulmonary fibrosis is more likely to affect men than women.
• Smoking. Far more smokers and former smokers develop pulmonary fibrosis than do people who have never smoked. Pulmonary fibrosis can occur in patients with emphysema.
• Certain occupations. You have an increased risk of developing pulmonary fibrosis if you work in mining, farming or construction or if you’re exposed to pollutants known to damage your lungs.
• Cancer treatments. Having radiation treatments to your chest or using certain chemotherapy drugs can increase your risk of pulmonary fibrosis.
• Genetic factors. Some types of pulmonary fibrosis run in families, and genetic factors may be a component.

Causes

Pulmonary fibrosis scars and thickens the tissue around and between the air sacs (alveoli) in your lungs. This makes it more difficult for oxygen to pass into your bloodstream. The damage can be caused by many different factors — including long-term exposure to certain toxins, certain medical conditions, radiation therapy and some medications.

Occupational and environmental factors

Long-term exposure to a number of toxins and pollutants can damage your lungs. These include:

• Silica dust
• Asbestos fibers
• Hard metal dusts
• Coal dust
• Grain dust
• Bird and animal droppings

Radiation treatments

Some people who receive radiation therapy for lung or breast cancer show signs of lung damage months or sometimes years after the initial treatment. The severity of the damage may depend on:

• How much of the lung was exposed to radiation
• The total amount of radiation administered
• Whether chemotherapy also was used
• The presence of underlying lung disease

Medications

Many drugs can damage your lungs, especially medications such as:

• Chemotherapy drugs. Drugs designed to kill cancer cells, such as methotrexate (Trexall, Otrexup, others) and cyclophosphamide, can also damage lung tissue.
• Heart medications. Some drugs used to treat irregular heartbeats, such as amiodarone (Cordarone, Nexterone, Pacerone), may harm lung tissue.
• Some antibiotics. Antibiotics such as nitrofurantoin (Macrobid, Macrodantin, others) or ethambutol can cause lung damage.
• Anti-inflammatory drugs. Certain anti-inflammatory drugs such as rituximab (Rituxan) or sulfasalazine (Azulfidine) can cause lung damage.

Medical conditions

Lung damage can also result from a number of conditions, including:

• Dermatomyositis
• Polymyositis
• Mixed connective tissue disease
• Systemic lupus erythematosus
• Rheumatoid arthritis
• Sarcoidosis
• Scleroderma
• Pneumonia

Many substances and conditions can lead to pulmonary fibrosis. Even so, in most cases, the cause is never found. Pulmonary fibrosis with no known cause is called idiopathic pulmonary fibrosis.

Researchers have several theories about what might trigger idiopathic pulmonary fibrosis, including viruses and exposure to tobacco smoke. Also, some forms of idiopathic pulmonary fibrosis run in families, and heredity may play a role in idiopathic pulmonary fibrosis.

Many people with idiopathic pulmonary fibrosis may also have gastroesophageal reflux disease (GERD) — a condition that occurs when acid from your stomach flows back into your esophagus. Ongoing research is evaluating if GERD may be a risk factor for idiopathic pulmonary fibrosis, or if GERD may lead to a more rapid progression of the condition. However, more research is needed to determine the association between idiopathic pulmonary fibrosis and GERD.

“Data are for the U.S.

Center for Disease Control and Prevention – CDC

(www.CDC.gov – FastStats – Infertility)

If you and your partner are struggling to have a baby, you’re not alone. In the United States, 10% to 15% of couples are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.

Infertility may result from an issue with either you or your partner, or a combination of factors that prevent pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, women with infertility may have irregular or absent menstrual periods. In some cases, men with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.

Most couples will eventually conceive, with or without treatment.

Risk Factors to being prone to this diagnose:

Age. Women’s fertility gradually declines with age, especially in the mid-30s, and it drops rapidly after age 37.

Tobacco use. Smoking tobacco or marijuana by either partner may reduce the likelihood of pregnancy.

Alcohol use. For women, there’s no safe level of alcohol use during conception or pregnancy. Alcohol use may contribute to infertility. With men it can decrease sperm count.

Being overweight. Among American women, an inactive lifestyle and being overweight may increase the risk of infertility. Sperm count for men can be affected by low sperm count.

Being underweight. Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia.

Exercise issues. A lack of exercise contributes to obesity, which increases the risk of infertility. Less often, ovulation problems may be associated with frequent strenuous, intense exercise in women who are not overweight.

When to take a trip to the doctor:

You probably don’t need to see your health care provider about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a care provider, the earlier the better, but if you haven’t yet go if you are:

• age 35 or older and have been trying to conceive for six months or longer
• over age 40
• having irregular or absent periods or very painful periods
• with known fertility problems
• diagnosed with endometriosis or pelvic inflammatory disease
• have had multiple miscarriages
• have undergone treatment for cancer
• have a history of endometriosis
• have a history of fallopian tube damage or blockage
• have a history of cancer and its treatment
• history of pelvic adhesions

Men should talk to a health care provider if they have:

• A low sperm count or other problems with sperm
• A history of testicular, prostate or sexual problems
• Undergone treatment for cancer
• Small testicles or swelling in the scrotum
• Others in your family with infertility problems

Know for many infertility can be treated with medicine, surgery, intrauterine insemination, or assisted reproductive technology.  So go to the doctor if you are having problems and they can give you direction.

“Research has shown that walking at a lively pace at least 150 minutes a week can help people:

• Think better, feel better and sleep better.
• Reduce your risk of serious diseases like heart disease, stroke, diabetes and several types of cancer.
• Improve your blood pressure, blood sugar and blood cholesterol levels.
• Increase your energy and stamina.
• Improve your mental and emotional well-being and and reduce risk of depression.
• Improve memory and reduce your risk of dementia.
• Boost bone strength and reduce your risk of osteoporosis.
• Prevent weight gain.”

American Heart Association (April is Move More Month featuring National Walking Day, Stress Awareness Month, National Pet Month, National Garden Month and more … | American Heart Association)

Here are tips to help manage stress:

1. Take care of your body and mind. This can include regular exercise, adequate sleep, a healthy diet, and relaxation practices. You may want to combine some of these habits for optimal self-care. For example, after a workout stretch your muscles while practicing deep breathing techniques. Eat a nutritious meal while practicing mindfulness of the moment. Get to bed at a decent hour and practice progressive muscle relaxation to help you wind down and fall asleep relaxed.

2. Identify your priorities and establish boundaries. Consider what is most important and valuable to you during the holidays and keep those as priority. This will require you to set boundaries around your priorities. Say no to “lesser” priorities, and ask for help when needed. For example, if exercising regularly is a priority, set boundaries around your time to ensure you’re able to get to the gym on a consistent basis. Similarly, if you want to spend quality time with loved ones you don’t see often, then you may have to say no to other responsibilities. This will keep you from feeling like you’re being pulled in all directions. It may also help reduce the risk of feeling resentment or disappointment once the holidays are over.

3. Be realistic. Assess your expectations of yourself and others. Try not to expect the holidays to go perfectly, and realize that you do not have to be perfect. You don’t have to prepare an ultra-fancy meal or give the perfect gift to every friend and family member. Practice some relaxation skills (mentioned above) to help clear your mind and determine what’s most realistic and what’s not. If family conflict has popped up in past holidays, don’t expect there to be perfect peace and harmony this year. Instead, plan ahead for your healthy response to conflict that may arise and be prepared to set boundaries if needed.

4. Cultivate gratitude. There is growing research on the benefits of gratitude, particularly on physical, psychological, and relational well-being. An “attitude of gratitude,” as Dr. Robert Emmons (a leading researcher on the science of gratitude) calls it, has been linked to greater stress tolerance, increased positive emotions, better sleep, improved physical health, and healthier relationships. It can be beneficial to create a daily habit of remembering what you are thankful for. Keeping a gratitude list at the beginning or end of each day is a great way to do this. If certain well-meaning friends or family members start stretching your patience, remind yourself of why you are thankful to have them in your life.  Which at times may not be easy so walk away and get a a breath or two by taking a walk.

5.  Maintain the safety interventions needed to prevent