Thanksgiving is definitely on my list of top holidays during the year. Seeing family and catching up, eating food and not having to buy presents or coordinate an Easter egg hunt makes it relatively low key. In our family we do typically discuss Christmas plans, so by the end of the evening, I do feel some pressure to get moving on shopping but there isn’t any hauling of gifts or supplies. It has usually just been bring a couple dishes to help out the host. If you have been in to see me before, you may already be aware of my love of carbs. So of course, a holiday where I can eat stuffing, sweet potatoes, mashed potatoes and corn bread all on the same day is awesome to me!
All that being said, I realize how lucky I am that I can enjoy food without fear of any big repercussions. Sure, over the years I have found that my body will tell me in more ways than it did before if I’ve overdone it. However, I have not had to worry about blood sugars being an issue later or whether I could end up with elevated blood pressure or a gout attack. Some day, who knows, maybe I will.
So, in this article today, I wanted to cover the possible things that can happen in your feet after a holiday of eating.
First, I wanted to discuss gout. This is a systemic condition with foot symptoms occurring in many cases. Gout is caused by either over-production or under-secretion of uric acid in the body. Uric acid is normal to produce in the process of protein metabolism, but in some cases our bodies don’t mediate the levels appropriately and this results in flare-ups or gout ‘attacks’ as some people call them.
Why does this happen in some people? One reason may be a genetic predisposition. Some people unfortunately inherit this ineffective protein breakdown. Read carefully though, this is ONE possible cause of gout. Some people with a family history may NOT actually suffer from gout themselves. Some people WITHOUT a family history may still suffer from out. Let’s read on for more possible causes.
The second reason people may suffer from gout is due to some medications. There are many medications out there with a myriad of possible side effects. Especially in cases where a patient takes a ‘water pill’ such as Lasix, they may have more of a tendency to develop gout. If you are taking any new medications when you notice pain in the joint that seems to come on out of nowhere, ask you PCP if it is possibly due to a change in medications.
A third possible cause of developing a gout attack is your diet. While red wine and red meats get a bad rap, nearly any heavy or very rich foods including fats and proteins can trigger an attack.
When we see patients who are suffering from gout attacks, they are usually seen in the big toe joint or the ankle joint. If the ankle joint is affected, it is usually very easy to aspirate (or remove) some fluid from the joint. The big toe joint is such a small joint space that trying to remove fluid is exceedingly difficulty. In either area, steroid injections can be of great benefit to quickly reduce inflammation and pain. In instances where we are unable to perform a steroid injection, a short course of oral anti-inflammatories helps to reduce pain as the condition runs its course. Typically within 1 week the pain will be completely resolved.
After we see our patients for a gout attack, we want to try and get a definitive diagnosis of gout. What does that mean? It means that by talking with our patients and performing a full and thorough evaluation, we can usually infer that the cause of pain is a gout attack. Your exam and discussion with the doctor does not identify gout crystals, so it is not what we call “diagnostic.” There could be other causes of this pain. So a blood test or confirming the presence of uric acid crystals with evaluation of the aspirated fluid is how this is done.
If we have a positive test diagnosing gout or we have a high suspicion, we typically recommend evaluation and discussion with your primary care or general practitioner, or a rheumatologist. This is in order to treat the condition fully. Some cases necessitate medication on a regular basis which can minimize flare ups.
So now that we have covered gout, let’s talk about another possible issue after Thanksgiving. If you are like my family, you may head out to the yard to play a little game of tag football. If you are like many others, you may not play flag football more than just this one time of year. If that’s the case, your agility, strength and skills may not be homed in for this activity. Also, not everyone wears gym shoes to Thanksgiving, so you might not be wearing shoes that will help support your feet.
If you go out and play football, you could of course suffer an ankle sprain or even fracture a bone in your foot. Any swelling, difficulty walking or bruising should have you calling for an appointment. Start with icing and resting the area and try to keep weight off of it, if putting weight on it increases pain or is difficult. If you feel unstable, take a step back and let your body start to recover.
If you don’t actually have an injury and fall, you may have some soreness or pain the next day. While this may just be regular generalized pain from the change or increase in activity, it may be something more. Take it easy, ice any painful areas. Wear your best supportive shoes and if the pain doesn’t turn around in a few days – or worse yet is feeling more painful over time – call for an appointment. The sooner tendinitis or fasciitis or capsulitis are addressed, the more quickly they respond and the faster you can walk without pain.
Finally, another ‘condition’ you may experience after Thanksgiving (with respect to your feet) is swelling. Even if you are an otherwise healthy person, the increase in salt intake may cause water retention. You may notice in your fingers that your rings are more tight than usual or they are hard to get off to shower in the morning. In your feet and legs, you may notice an overall puffiness to both sides. If the swelling is in both feet and you do NOT have a history of heart disease, increase your water intake and pump your calves to help reduce the swelling. Sometime pineapple juice can help, or even some tea with lemon may reduce this swelling. As long as you do NOT have a history of heart disease or pain associated with the swelling you notice, it will subside as you get back to your regular diet…so take it easy on the leftovers!
Enjoy the Thanksgiving holiday, but do it responsibly. If you run into foot troubles, don’t wait until Christmas or New Years to address this. We are happy to help get you back on your feet. It can also make the difference in how soon you get started on tackling those New Years’ resolutions! 😉