Over the last 10 years Michael has been to see me at least a 30 times.
Always with a complaint of heel pain.
He has suffered so long he knows the regimen as well as I.
Michael is a patient I am always happy to see, almost like sitting with an old friend to catch up.
He may come see me twice a month and then disappear for six, until he shows up again lumbering the way he does.
Pain in the heel has many differentials (Doctor talk for causes) but by far the most common is Plantar Fasciitis (Heel Spur Syndrome).
I could go on and on here about what plantar fascitis is and how it is treated and why you should seek medical attention before it becomes a chronic progressive debilitating entity, but I think that Wikipedia and the other thousands of articles out there on the topic have covered it quite well and frankly I do not have any magical insight to add to this well covered subject.
Instead I wanted to point out to you the reader or patient or caregiver a major contributor to this painful syndrome that is often glossed over in a treatment room with your doctor, most likely because it is uncomfortable to talk about, but it shouldn't be, it should come off the tongue of a doctor as easily as "take two pills and call me in the morning" does.
We as a country are in a crisis, and it needs to be addressed.
The patients I see daily come from all walks of life, some wealthy, some old, some young, some educated, some blue collar, and some professionals yet they all often have one thing in common, being 20 pounds overweight.
Many are 50 - 100 pounds overweight and frankly, at those numbers, I can not help them.
I can ease there pain, I can give them medications, I can give them injections and yes maybe I am doing them a service by temporarily alleviating some symptoms, but I always feel that its only a matter of time before these patients that I become attached to, in more than a casual way are in trouble.
They need help that really starts way above their heels.
When I counsel patients, whether it be for heel pain, ankle pain, diabetes, or a chronic wound, I would be remiss in my duties as a physician if I didn't point out the obvious 800lb.
gorilla in the room (kinda fits here, dontcha think?) which is often times the patients own waist line.
I saw Michael this week, and before I even touched his foot, I walked him over to my scale, which he tipped at 305lbs, he is easily 130lbs over what he would be comfortable carrying on his 5'7" frame.
Unfortunately it is not only his heel that is suffering from the excessive weight.
His primary medical doctor recently started him on blood pressure medication, as well as medication for his rising cholesterol problem.
I asked Michael what his doctor discussed with him about his weight being over 300lbs.
and was unfortunately not shocked to hear that "it didn't come up".
I can write a prescription, give an injection, employ physical therapy modalities, dispensed orthotics all very acceptable treatment paths to take with a patient suffering from plantar fasciitis, but Michael can make the biggest difference by listening to the small amount of advice that I have imparted.
with regard to his diet and exercise routine.
So I treated Michael, he left my office without pain, a small kick in the rear, and some life changing information.
When he left I told him I would see him in 2 months and so would my scale.