Daily Express

Are socks that dent my skin making puffy feet worse?

- Dr Rosemary Leonard GETTING TO THE HEART OF MEDICAL MATTERS • If you have a health question for Dr Leonard, email her in confidence at yourhealth@express.co.uk. Dr Leonard regrets she cannot enter into personal correspond­ence or reply to everyone.

Q I am prone to puffy feet. I wear trousers far more than skirts or dresses and used to wear knee-high pop socks, but recently they seem to dig in under my knees. Ankle-highs are more comfortabl­e but they make a dent in the skin too. I’m wondering whether they could be making my foot issues worse, as my shoes are quite uncomforta­ble by the end of the day.

A It sounds as if the elastic of the socks is too tight for both your upper and lower calves, and that dent that it is causing is likely to cause compressio­n on the veins underneath the skin.

This in turn will reduce the flow of blood returning from your feet, and the increased pressure within the veins will encourage fluid to leak into the tissues under the skin, making any tendency to swelling worse.

If possible, you should avoid wearing any socks that make a dent in your skin and instead switch to a trainer liner style, which just covers the base of your foot and your heel.

These do leave your lower legs and ankles uncovered and can be a bit draughty in winter months, but now the weather is warming up they are a good alternativ­e to standard socks.

Having puffy feet can be a sign of a problem with your circulatio­n, including weakening of the heart muscle, so it is very important you see your doctor about them if you have not already done so, as medication may be very helpful in reducing the swelling. Meanwhile, whenever you are sitting, try to keep your legs raised, ideally with your feet at or, even better, above the level of your hips, as this will aid blood returning up the veins to your heart.

Q I’m in my late sixties and after many years on my own I am now in a relationsh­ip. However, I’m finding it difficult to get an erection, which is so embarrassi­ng. My partner says she really isn’t bothered, but I am. I bought some Viagra from the chemist but it gave me a headache. Is there anything else I could try? Speaking to my doctor would be far too embarrassi­ng at my age.

A Erectile dysfunctio­n can occur at any age, but is especially common in older men, affecting up to 49 per cent by age 70. Although “performanc­e anxiety” can play a role, in 90 per cent of older men there is an underlying physical cause – and at your age, cardiovasc­ular disease with narrowing of arteries, including the main one that supplies the penis, is top of the list.

Other possible causes include diabetes and also low testostero­ne levels. So your problems in the bedroom could well be an indicator of other serious health issues and for this reason you really should see your doctor. Not only do you need to have blood tests, but also a check of your blood pressure.

Unfortunat­ely headache is a common side effect of both Viagra and the similar drug Cialis, but some men find one more suitable than the other, so you may want to give Cialis a try. It is now available from chemists, but I would much prefer that you got it on prescripti­on under medical supervisio­n from your GP (which would also be free of charge). A rather different alternativ­e is Eroxon, a gel that is applied directly to the penis and which may help to give an erection in 10 minutes.

It is newly available and there have only been trials on small numbers of men, but it may be worth a try.

It is available online and from high street chemists and costs £24.99 for four single-use tubes.

Another reader wrote to ask if Eroxon could benefit someone who has lost their bladder and prostate to cancer. An erection normally occurs when something you see or think makes nerves from the brain send messages via the spinal cord to the blood vessels in the penis.

Similarly, stimulatin­g the penis directly can send messages via the nervous system to change the blood flow. The arteries relax and the veins narrow, which results in the blood becoming trapped inside the penis, which then expands, making it hard.

Surgery to treat both prostate and bladder cancer can damage the nerves supplying the penis, leading to problems getting an erection. Eroxon is thought to work by having a direct effect on the tissues of the penis, but no trials have been done on men who have had cancer surgery, and so it is impossible to say whether it will help or not. But it is unlikely to do any harm, so is worth a try.

Q I’ve been diagnosed with pre-diabetes, which my doctor said was mainly because I am overweight, causing me to become insulin resistant. Is there a test for this? My doctor said if I could get my weight down then my insulin resistance would fall too, but it would be good to monitor my progress.

A Insulin produced by the pancreas helps glucose – a type of sugar in your blood – to enter cells where it is used for energy. When blood glucose levels rise after eating, the pancreas makes more insulin, which in turn keeps blood glucose levels in the normal range.

Insulin resistance occurs when the body’s cells don’t respond properly to insulin, so the pancreas has to produce more than before to keep blood glucose. There is a limit to how much insulin can be produced and this can lead to blood sugar levels rising above normal, a condition known as pre-diabetes. If the insulin resistance gets worse, then sugar levels may rise into the diabetic range.

Insulin resistance is strongly linked to being overweight and having too much body fat, so the best way of tackling pre-diabetes in most people is to lose weight by eating a healthy low fat, low carbohydra­te diet, and taking regular exercise.

It is possible to test for insulin resistance by measuring blood glucose levels at frequent intervals after an injection of glucose, but this is usually only ever done as part of research projects as it is time consuming and expensive.

In practice, doing an HbA1c test is just as useful.

This measures the amount of blood glucose attached to the haemoglobi­n in red blood cells and can give an accurate picture of your average blood sugar over the previous two to three months.

As you lose weight, your insulin resistance should reduce and your HbA1c level should gradually go from being pre-diabetic back into the normal range.

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