These small, red blisters on the feet are usually due to fungus or yeast in the skin. They can also be due to an allergic reaction. The Ph of the skin should be 5.6. Neutral is 7.0, with greater than 7 being alkaline and less than 7 acid. Most adults in 2002 take showers rather than baths. They wash off the soap from their hair and face and then get out of the shower without rinsing off the rest of the soap from their bodies. This soap buildup produces an alkaline condition and is evidenced by dry, flaky, skin. This can be an ideal situation for fungus and yeasts. An excellent treatment is to soak your feet in a "cider vinegar" solution of 30 to 50 percent. This produces a more physiological skin Ph, and kills fungus, yeasts, and bacteria. If this is not successful or you don't have the time to sit and soak, a prescription medication, "Loprox" can be prescribed by your Podistrist. This medication seems to work well for these pesky summer yeast and fungus infections.

Eric R. Hubbard, DPM
Diplomate, American Board of Podiatric Surgery
Member, South Bay Independent Physicians Medical Group, Inc.

Every time I have my eye pressure checked at the doctor's office, it's always within normal range. Does it mean that I won't have glaucoma?

The answer is "NO"; Glaucoma is a disease of the optic nerves which responds to the visual image transmission to the brain. It is the leading cause of blindness in the United States, but it can be prevented with early detection and treatment. Although most of the time it's related to high-pressure inside the eye, it can happen in patients who have never had high eye pressure; this is called "normal tension glaucoma". Several mechanisms have been proposed, but most people agree that it is due to the fragile optic nerve that leads to glaucomatous damage even under normal range eye pressure. Frequently, this is a kind of glaucoma most easily misdiagnosed. The other factor is the fluctuation of the eye pressure. The eye pressure can have big diurnal fluctuation, especially for the glaucoma patients. That means a patient can have normal pressure in the morning and high pressure in the afternoon. If this patient is checked in the morning with normal pressure, he/she can be misdiagnosed if it is only relied upon eye pressure. Some patients who have very narrow drainage angle structure, may always have normal pressure and one night he/she may have an attack which can increase the pressure 3 or 4 fold of normal range. All of those possibilities rely upon the ophthalmologist's careful evaluation of the optic nerve, the drainage angle and the visual field at the ophthalmologist's discretion, in addition to a eye pressure check to rule out the possibility of glaucoma.

Shirley S. Jeng, M.D.
Diplomate,
American Board of Ophthalmology Member,
South Bay Independent Physicians Medical Group, Inc.

Yes, it is possible to still come down with the flu after having been vaccinated before the flu season. Typical symptoms include headache, muscle aches, runny nose, nasal congestion, fever and cough. The flu vaccine is usually developed from three flu virus strains predicted to potentially cause the flu for a particular flu season. Even if the virus strain is a little different than the flu strain used to make the vaccine, the shot may still be effective.

In young people and in people with good immune systems the immunization is especially effective. However, in the elderly and in the chronically ill the flu vaccination may be life saving even though it may not prevent all the symptoms. Try to get the vaccine in the autumn so that your body can build up the necessary resistance before you are exposed to the flu.

MARK C HOWARD, MD Diplomate,
American Board of Family Practice;
Member, South Bay Independent Physicians Medical Group, Inc.

NSAID stands for nonsteroidal (cortisone) anti-inflammatory drug. These drugs are widely used for rheumatic aches and pains, and arthritis, and several are now available over-the-counter. Three years ago a new class of NSAID called Cox II became available and are widely advertised. Many patients mistakenly believe they are stronger, but their actual advantage is that they are safer and much less apt to cause stomach irritation.

Patients who have had an ulcer, take cortisone, or are over age 65 are at increased risk of this from the older Cox I drugs such as Ibuprofen. All NSAIDs need to be used cautiously in persons with liver or kidney problems, and in combination with a number of medications. They may cause some increase in blood pressure or fluid retention. Patients on low-dose aspirin for its anti-platelet effect should continue taking it. These new medications are only available on a prescription and your doctor can best advise you whether they would be beneficial for you.

H. M. Kline Jr., M.D.
Diplomate, American Board of Internal Medicine and Rheumatology F.A.C.P. F.A.C.R.
Clinical Associate Professor of Medicine, UCLA
Member, South Bay Independent Physicians Medical Group, Inc.

What is an ankle sprain?

The incidence of ankle injuries has been on the rise with the increase in exercise and sports related activities. Ankle sprains are one of the most commonly encountered injuries of the lower extremity. Ankle sprains frequently occur during activity and occur when someone "rolls" the ankle. The injury causes some degree of tearing of the ligaments that support the outside of the ankle. Approximately 15% of ankle sprains involve tearing of the ligaments on the inside of the ankle too. Swelling and pain are the most common symptoms experienced with this type if injury. Occasionally, small fractures occur in the foot. Treatments for an ankle sprain vary based on the severity of the ligament rupture and if any associated fractures occurred. Rest, ice, elevation, and anti-inflammatory medication are the mainstay of treatment and immobilization in frequently necessary. Instability of the ankle is sometimes experienced long term and physical therapy may be utilized to help regain the stability.

Jonathan M. Labovitz, D.P.M.,
A.A.C.F.A.S. Diplomate,
American Board of Podiatric Medicine and Surgery Member,
South Bay Independent Physicians Medical Group, Inc.