Blisters

Blisters

 

You just couldn't resist a bargain. Those shoes

looked great with your new outfit, even if they

didn't feel so great on your feet. "They'll stretch out,

" you told yourself, and then patted yourself on the

back for getting such a good deal. Unfortunately,

you got more than you bargained for--namely,

painful blisters to go with your new shoes.

Blisters are tender spots that fill up with fluid

released by tiny blood vessels in an area where

delicate skin tissues have been burned, pinched, or

just plain irritated. Virtually everyone has

experienced friction blisters, the kind caused by hot,

sweaty, or ill-fitting shoes. If you have one now,

read on to find out how to take care of it. Then

continue reading to learn how you can help protect

your tender tootsies in the future.

Make a tent.

Instead of simply placing an adhesive bandage right

on top of the blister, "tent" the bandage by bringing

in its sides so the padding in the middle of the

bandage raises up a bit. "This will not only protect

the blister but allow air to circulate, which will aid

in healing," says Nelson Lee Novick, M.D.,

associate clinical professor of dermatology at the

Mount Sinai School of Medicine in New York.

Use a double-duty bandage.

Another type of bandage, available in pharmacies,

contains a gel and antiseptic to cushion and "clean"

the blister, says Wilma Bergfeld, M.D., head of

clinical research in the Department of Dermatology

at the Cleveland Clinic Foundation in Ohio. Ask

your pharmacist about it.

Let it breathe.

Some physicians believe that a blister should not be

covered at all for maximum aeration. Jerome Z. Litt,

M.D., assistant clinical professor of dermatology at

Case Western Reserve University School of

Medicine in Cleveland, is one such doctor. He even

suggests slipping your shoe off while you sit at

your desk at work in order to give your blister some

air.

Smear on an ointment.

Whether you decide to cover your blister or not,

you should apply an antibacterial/antibiotic

ointment to it. Doctors generally recommend

Bacitracin or Polysporin, which may be less likely

to cause an allergic reaction or sensitivity than

other over-the-counter ointments.

Pad it.

When a blister is in a particularly annoying spot,

like the bottom of the foot, padding might provide

more of a cushion than just a bandage would,

advises Bergfeld. She suggests using the circular

pads made of foam adhesive found in the foot-care

aisle of drug- and beauty-aid stores. "Pharmacies

also carry sheets of padding that you can cut to size

for a more exact fit," says Bergfeld. Cut the

padding in the shape of a donut, and place it on the

skin surrounding the blister so that the blister fits in

the hole in the opening of the donut. Then gently

cover the blister with an antibacterial ointment and

bandage.

Put it up.

Elevating the blistered area can help relieve the

pressure, advises Bergfeld.

Be patient.

Expect it to take about a week to ten days for the

blister's fluid to be reabsorbed by the body.

Drain it.

While some doctors believe that a blister should

never be popped because of the risk of infection,

most agree that a blister causing extreme pressure--

such as one on a finger or toe or under a nail--is a

candidate for draining. If you should decide to pop

it, first wipe the blister and a sewing needle with

alcohol. "Never sterilize a needle over a flame,"

says Novick. "It can create soot on the tip of the

needle, which can 'tattoo,' or dirty, the blister."

Prick the blister once or twice near its edging; then

slowly and gently press out the fluid.

Keep the roof on it.

Once you have popped the blister and drained the

fluid, do not remove the deflated top skin. This skin,

called the blister's roof, protects the blister from

infection and forms a "bridge" for new cells to

migrate across on their journey to heal the site.

Soak first.

To drain a blister on a tough-skinned area, such as

the sole of the foot, Litt suggests first soaking the

blister in Burow's solution, available from

pharmacies in packets or tablets (follow the

directions on the package). He recommends

soaking the blister for 15 minutes, three to four

times a day. A day or two of this will soften the

blister and make draining easier.

Watch for signs of infection.

Redness, red streaks, or pus in an intact or a

"popped" blister should be treated by a doctor.

Buy shoes in the afternoon.

"Over the course of the day, your feet may swell by

as much as half a shoe size," says Gastwirth. When

trying on shoes, wear the same type of socks that

you plan to use with the shoes.

Look for leather.

Unlike nonporous vinyl and plastic materials,

leather has microscopic pores that allow air to

circulate, keeping the foot drier. In the same way,

so do the clusters of perforated holes primarily

found on many styles of sports footwear. A dry foot

is less likely to develop blisters.

Don't exercise at midday.

The heat of midday, especially in the summer, can

make the feet perspire more, making them more

blister-prone.

Never wear wet shoes.

The wetness can cause more "dragging" between

the foot and shoe and can result in blisters. If you

jog twice a day, for instance, you may want to buy

a second pair of running shoes for your second run

each day.

Protect "hot spots."

If you have a chronic "hot spot," or place where

blisters tend to develop, apply petroleum jelly to it,

then slip on your sock. Foam or felt pads, used

alone, can also absorb the friction and protect a hot

spot. For best results, make sure the padding covers

more area than you think a blister would take up,

since the neighboring areas can become irritated,

too.

Wear the right socks.

Specially made sport socks with extra padding in

hot spots can help prevent blisters. Natural fibers

such as cotton and wool tend to keep the feet dry by

absorbing moisture. However, according to

Gastwirth, recent research suggests that acrylic

fibers may, through a wicking action, actually

move moisture away from the foot, keeping it drier

and making it less prone to blistering. Your best

bet? Try them both and see which type of fiber

keeps your feet drier and more comfortable. In

addition, make sure the sock fits your foot, so there

is less chance of it bunching up inside the shoe and

causing a blister.

Try a sprinkle.

Foot powders may aid in keeping the foot dry and

preventing painful blisters from forming.

Bladder Infection

Bladder Infection

 

You have to go, and you have to go now. Come to

think of it, it seems like you've had to go every 15

minutes since you woke up this morning. And each

time, it's been the same story. Not much comes out,

but it burns like crazy. What in the world is going

on?

If you have pain or burning on urination, the

frequent urge to urinate, and/or blood in your urine,

chances are you have a bladder infection (also

called cystitis, urinary tract infection, or UTI).

These symptoms may also be accompanied by

lower abdominal pain, fever and chills, and an allover

ill feeling.

Bladder infections are caused by a bacterial

invasion of the bladder and urinary tract. "The urine

in the bladder is normally sterile," explains Amanda

Clark, M.D., assistant professor of obstetrics and

gynecology at Oregon Health Sciences University

in Portland. "However, if it becomes contaminated

with bacteria, a bladder infection can develop."

If you're a woman who suffers from bladder

infections, you're not alone. "Women tend to suffer

more bladder infections than men because the

female urethra, the tube leading from the bladder to

the outside of the body, is only about one-and-ahalf

inches long--a short distance for bacteria to

travel," says Sadja Greenwood, M.D., a women's

health specialist and assistant clinical professor in

the Department of Obstetrics, Gynecology, and

Reproductive Sciences at the University of

California at San Francisco. (A man's urethra is

about eight inches long.) Frequently, the urinary

tract becomes contaminated with Escherichia coli,

bacteria that are normally present in the bowel and

anal area. In 10 to 15 percent of cases, bladder

infections are caused by another organism, such as

Chlamydia trachomatis.

Women also suffer more bladder infections

because sexual intercourse can irritate the urethra

and contribute to the transport of bacteria from the

anal area and vagina into the bladder. "We don't

really know exactly why intercourse increases the

risk of bladder infections," says Clark. "We think it

might make the bladder tissues a little more

receptive to having an infection or it may cause

more bacteria to move up the urethra."

Women who use the diaphragm for birth control

have a greater risk of bladder infections, too, says

Clark. The diaphragm presses against the neck of

the bladder, which inhibits normal urination, she

says. As urine flow decreases, pressure within the

bladder increases, and the bladder is unable to

completely empty itself. The pooled urine then acts

as a growth medium for bacteria.

Pregnant women are also more likely to suffer

from bladder infections. The changing hormones of

pregnancy and the pressure exerted by the enlarged

uterus on the bladder and ureters (the two tubes that

carry urine from the kidneys to the bladder) put

pregnant women at greater risk.

Men can also suffer from this malady. In men,

bladder infections are almost always secondary to

an infection of the prostate gland (prostatitis),

according to Theodore Lehman, M.D., a urologist

in private practice and director of The Oregon

Impotence Center in Portland. "Primary infection of

the bladder in men just doesn't happen, because the

bladder is well protected," explains Lehman. "But

the prostate sits right in front of the bladder, and

bacteria can get into it--through sexual intercourse,

trauma like bouncing on a bicycle seat, or some

kind of blockage--and it stirs up an infection in the

prostate. Then the prostate infection can 'move

upstream,' if you will, and infect the bladder."

In men, prostate infection usually feels like

"you're sitting on a brick," says Lehman. When the

infection extends to the bladder, the symptoms of

irritation, urinary frequency, and pain and burning

on urination join the achy-bottom feeling.

Bladder infections can often be treated at home

with the self-care tips that follow. However, if your

symptoms persist for more than 24 hours, if they

don't respond to home remedies, or if you suspect

that your symptoms may be due to a sexually

transmitted disease or other infection, see your

physician.

Load up on fluids.

At the first sign of bladder infection, start drinking

water and don't stop. During the first 24 hours,

Greenwood recommends drinking at least one eightounce

glass of water every hour. People who suffer

from recurrent bladder infections usually don't

drink enough liquids. So even when you don't have

an active infection, you should make a habit of

drinking eight tall glasses of water every day.

According to Lehman, drinking lots of fluid not

only dilutes the urine, giving bacteria less to feed

on, it also has a "washout" effect on bacteria. "The

more bacteria you can wash out," says Lehman,

"the less there will be to reproduce."

Clark warns, however, that people who suffer

from urinary leakage (incontinence) probably

shouldn't increase their fluids. She says it can make

the bladder infection and the incontinence worse.

Have a cranberry cocktail.

If you've never developed a taste for the sweet

tanginess of cranberry juice, now's the time.

Cranberry juice (without added sugar) may make

urine more acidic and less hospitable for bacterial

growth, says Clark. Drinking cranberry juice is also

a way to increase your fluid intake.

Go, go, go.

Lehman advises both men and women to avoid

what he calls "L.A.-freeway-driver bladder."

"Many people don't urinate when they first get the

urge because it's inconvenient or there isn't the time

or place," he says. "Take a guy who gets off work,

has a couple of cups of coffee or a couple of beers,

and gets on the freeway in rush-hour traffic. He

feels the urge to urinate, but he can't get off the

freeway. When he finally gets home and urinates,

it's difficult and it burns. By the next day, he's

calling his doctor with a prostate infection."

Holding urine allows it to concentrate in the

bladder, creating a perfect medium for bacterial

growth. In older men, holding urine can cause

congestion, inflammation, and obstruction of the

prostate and can eventually lead to a prostate

infection or sometimes a bladder infection. Not

urinating at the first urge also causes the bladder to

distend and stretch. "Essentially, the bladder is a

hollow muscle," says Lehman. "If you repeatedly

stretch it, then it won't void completely and creates

a place for bacteria to grow."

Heat it up.

For lower abdominal pain, use a heating pad or hotwater

bottle or take a hot bath, advises Greenwood.

Lehman says that heat not only relieves the

symptoms, it also brings more blood with white

blood cells and other infection-fighting blood

products to the affected area. (Pregnant women,

however, should not sit in a hot bath or hot tub for

too long, since raising the body temperature above

100 degrees Fahrenheit for long periods may cause

birth defects or miscarriage.)

Take a bath.

If you have a lot of burning, a warm "sitz" bath

(sitting in three to four inches of water) can ease the

pain.

Take a break.

Rest in bed, especially if you have a fever. You'll

conserve energy and speed healing.

Wear cotton underwear.

Cotton underwear, cotton-lined panty hose, and

loose clothing will allow the genital area to breathe

and stay dry. For men, boxer-type shorts rather than

jockey-style shorts are better if prostate and bladder

infections are a problem.

Avoid alcohol.

Alcohol is a urinary tract irritant for both men and

women and should be avoided during a bladder

infection.

What about spicy foods, tea, and coffee? Clark

says, "They really shouldn't hurt a bladder infection.

" However, the caffeine in coffee, tea, and colas

does stimulate the kidneys to produce more urine

and makes the bladder fill up faster during a time

when urination is painful. If caffeine seems to make

your symptoms worse, avoid it until the infection

goes away.

Take a pain reliever.

Bladder infections can be painful. Acetaminophen,

ibuprofen, or aspirin, especially if taken at bedtime,

can ease the pain.

Wash up, lovers.

Both partners should wash up before intercourse.

Urinate after lovemaking.

If you suffer from recurrent bladder infections,

urinate immediately before and after intercourse,

advises Clark. This can help flush out bacteria that

may have entered the urinary tract.

Switch birth-control methods.

Women who use a diaphragm and suffer from

recurrent infections should try switching to

condoms or a cervical cap. "If you have recurrent

bladder infections, see your doctor to have your

diaphragm's fit rechecked," says Clark. "You may

do better with a smaller diaphragm or a cervical cap"

Keep a bladder-infection diary.

If you suffer from recurrent bladder infections,

keep a diary to discover what patterns precede an

attack. Some people find that their infections are

related to stress, menstruation, lovemaking, or other

factors. Once you discover what precipitates your

infections, you can make changes to alter those

patterns.

Wipe from front to back.

Most women wipe from back to front, which moves

bacteria from the rectum dangerously close to the

urethra.

Black Eye

Black Eye

This morning's racquetball game was going so

well--until your opponent hit that unbelievable shot

that bounced off the wall and hit you right in the

eye. After he finished apologizing profusely and the

pain subsided somewhat, you picked up your ego

and went home. But now you're beginning to

resemble a prizefighter who lost the prize! Your

eyelid is nearly swollen shut, the area around your

eye is turning black and blue, and the throbbing

pain is back in full force. You're starting to wonder

if there's more to this injury than meets the eye.

As horrifying as a black eye can look--and as

embarrassing as it can be to explain--it is usually

nothing that will cause lasting or serious damage.

"A black eye is simply a hemorrhage around the

eye. The blood underneath the skin comes through

as a purplish color. While there are many diseases

and conditions that can cause black eyes [see

"Other Causes of Black Eyes"], a true shiner is

most often the result of trauma to the eye caused by

a fistfight or a sports injury," says Jon H. Bosland,

M.D., a general ophthalmologist in private practice

in Bellevue, Washington. "If the swelling comes

down rapidly and your vision is good, it is not

likely that there is any serious damage to the eye,"

he says.

Still, Bosland urges anyone with a black eye to see

a doctor in order to rule out damage to the eye itself.

(It is especially important to see a doctor without

delay if there is any change in vision.) Once you

are sure everything is all right, there are some steps

you can take at home to care for your shiner. There

are also some preventive measures that you can

take to help keep your eyes out of the black in the

future.

Ice the area.

"This will reduce the swelling and numb some of

the initial pain," says Carol Ziel, M.D., an

ophthalmologist with the Eye Clinic of Wausau in

Wisconsin. Hold an ice pack or some ice cubes

wrapped in a washcloth on the eye. "Putting

crushed ice in a plastic bag and placing the bag on

top of a cold washcloth over the eye also works

well," says Charles Boylan, M.D., a pediatric

ophthalmologist at A Children's Eye Clinic of

Seattle.

Pack it in popcorn or peas.

A bag of frozen, unpopped popcorn kernels or

frozen peas placed over a washcloth on the affected

eye can also help cool the area and bring some

relief.

Clean it up.

Clean any small lacerations with mild soap and

water. "Then continue to keep them clean and dry,"

says Ziel. This will help to keep the area from

becoming infected with bacteria. "Some-times, the

tissue around the eye can actually split because the

soft tissue is being pushed against a hard surface of

underlying bone. You can get a considerable

hemorrhage from this, which can leave a bit of a

lump afterward," adds Bosland.

Avoid pressing on the eye itself.

The area has already been traumatized enough, and

pressing on it will only cause further trauma, says

Bosland. So be gentle when you apply an ice pack

or clean the area.

Keep your chin up.

OK, so you look and feel a little like Rocky Balboa.

Be thankful you can see yourself in the mirror, and

try to resign yourself to the added color for a while.

"The discoloration tends to last one to two weeks,"

says Bosland. It will lessen during that time, but it

won't fade completely for a couple of weeks or so.

Wear goggles.

As is true with so many injuries, the best treatment

is prevention. While you may not necessarily like

the way you look in goggles, wearing them can

help you ensure that you'll be able to see the way

you look. Any sport that involves close contact

with other individuals and/or the use of a small ball

of some sort is likely to put you at risk for a black

eye. "The majority of black eyes we see are caused

by the eye being hit by an elbow, hand, or knee or

by an object small enough to fit inside the bony

structure around the eye," says Boylan. Tennis

doesn't really qualify because the ball is too big.

But squash, racquetball, and skiing (the end of the

pole can hit the eye) are particularly dangerous to

the eye. And basketball, where arms and legs are

flying in close quarters, can also leave you

vulnerable to a nasty black eye. To protect your

eyes, Boylan suggests that you wear protective eye

wear, such as goggles or even glasses with

shatterproof glass or plastic lenses. "Anyone with

only one good eye should always wear protective

eye wear if there is a chance of being hit with

anything," stresses Boylan. As far as how to

choose the right goggles or glasses, it's not too

difficult. "Make sure the lenses are shatterproof and

the glasses or goggles fit comfortably," says Boylan.

"The goggles worn by squash and racquetball

players often don't contain any lenses, and that's

OK. The frame itself will keep the ball away from

the eye," he continues. Most sporting goods stores,

as well as eye-wear stores, carry protective eye

wear for sporting events. If you can't locate any,

consult your eye doctor.