• Q: What are foot and toe ulcers, and when should I see a doctor about them?
Barron Elleby, DPM, Podiatrist and Wound Care Provider, Maui Memorial Medical Center Wound Care and Hyperbaric Therapy: Foot and toe ulcers are wounds on your feet that don’t heal, or keep returning. Around 15 percent of people with diabetes will get them. If they aren’t treated, these wounds can become infected, and sometimes this means the foot will need to be amputated.
Some foot ulcers occur because of numbness in the feet. They can form on pressure points, or on a cut or blister that you don’t feel. Other ulcers form because poor blood circulation causes tissues in your feet to weaken and die. Poor circulation also is one reason why these wounds have trouble healing.
If you have diabetes, you should check your feet and toes regularly, and see your health care provider right away if you find a sore. With treatment, these wounds can take weeks or months to heal.
Ulcers can be treated with regular wound care, antibiotics and other medications, and elevating the foot. Your doctor might have you wear compression wraps or orthotics, or use crutches or a brace to relieve pressure on the wound. In some cases, surgery might be recommended.
You can take care of foot and toe ulcers at home by keeping the area clean and dry, changing bandages regularly, and taking medications as they’re prescribed. Drinking plenty of fluids and eating a healthy diet can also help support wound healing.
If you have diabetes, you can reduce your risk of foot ulcers by wearing appropriate shoes and socks, and never going barefoot. Check your legs, feet and toes daily for blisters, cuts, sores, calluses and hot spots. Care for your toenails by keeping them trimmed and filed. And, have regular checkups with your podiatrist to keep feet healthy.
For nonhealing wounds, Maui Memorial Medical Center’s Wound Care and Hyperbaric Therapy Clinic provides traditional and advanced therapies and techniques that are proven to reduce healing time and improve healing rates. Patients do not need a doctor referral. For more information call (808) 986-4500 or visit mauihealth.org/woundcare.
• Q: What is fibroid embolization, and is it available on Maui?
Dr. Nathanael Sabbah, Interventional Radiology, Maui Memorial Medical Center: If you suffer from fibroids, you’re not alone. As many as half of all women of childbearing age have these noncancerous growths, which can cause uncomfortable symptoms like pain and bleeding.
Uterine fibroid embolization is one treatment option, and many people don’t know that it is available at Maui Memorial Medical Center. This minimally invasive procedure involves inserting a small catheter into the wrist or groin and injecting small particles into the arteries that supply blood to the fibroids. These particles cause the fibroids to shrink.
There are several advantages to this procedure. First, it’s far less invasive than surgical options for treating fibroids, including hysterectomy (the total removal of the uterus). It can also offer a more permanent solution than hormonal treatments, in which fibroids can grow back when treatment stops.
Most importantly, it’s highly effective. Studies show as many as 90 percent of people who undergo this procedure see their fibroid-related symptoms improve or go away.
Fibroid embolization is a minimally invasive procedure that can be done under local anesthetic. A radiologist performs the procedure and uses an X-ray camera to guide the catheter into position. Most patients can go home the same day.
However, this procedure may not be suitable for everyone. There can also be some side effects including cramping and discomfort for several days after the procedure. That is why it is important that you discuss your options with your doctor or schedule a consultation with a specialist.
And while in most cases, fibroids do not grow back after embolization, if they do, you may eventually need additional treatment, including a hysterectomy.
The bottom line is that while uterine fibroids can cause uncomfortable and even painful symptoms, there are options for treatment. For many people, embolization is a safe and minimally invasive option that can provide relief. If you have any questions about fibroid embolization, or would like to schedule a consultation, please call the Maui Memorial Medical Center Imaging Department at (808) 243-3012.
* Physicians, providers and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.
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