Dr. Roach: Is a foot box the answer to relieving nighttime foot cramps?
Dear Dr. Roach: I am a very healthy 74-year-old male. I am not on any medications and enjoy normal blood pressure and great stats from my regular bloodwork. I weigh 140 pounds and have been exercising every day faithfully for decades.
A couple of years ago, I started getting cramps in both legs throughout the night. My toes would curl down and my entire leg would get stiff; the pain was horrible. I had a terrible time “walking it off,” and very often when I finally got it to pass, as soon as I got back in bed the whole thing would start all over again. Sometimes I would go a few nights without having a problem, but there was always the fear that I would have another episode.
I read online advice to get the weight of the sheet and covers off the feet. I took a strong cardboard box and sleep with my feet in the open end of the box. The first time I got in bed with this rigged up, it felt very strange not having anything on my bare feet, but eventually I got used to it. The remarkable news is that I have not had a single episode since fabricating the box over six months ago.
Dear G.K.: I appreciate your writing in. I have had many patients use a box during sleep for acute gout, where even a sheet on top of the affected toe can be exquisitely painful, but I had not heard this used for nocturnal leg cramps. Some patients have noticed that the symptoms do seem to be started or exacerbated by the weight of blankets.
Before resorting to that, I recommend regular exercise, even a few minutes of riding a stationary bicycle before bed can help. Couple that with regular stretching of the calf and hamstring muscles and adequate hydration. Although many people ask about it, I do not recommend quinine for most people, and it’s quite rare for the cause to be disturbances of sodium, potassium, calcium or other electrolytes. B complex vitamins and magnesium are helpful in some people, but I restrict iron to people with proven iron deficiency.
If all else fails, prescription medications such as verapamil may be helpful.
Dear Dr. Roach: Ever since my husband and I had the flu in February, my taste buds are not working. My husband’s have gotten better with time, but mine seem to be worsening. I asked my doctor, and he said it was just old age. I think not. Any suggestions?
Dear M.J.W.: Severe upper respiratory infections such as influenza (”the flu”) can be complicated by damage to the nerve receptors in the nose. I do realize you said your taste buds. Much of our ability to perceive taste derives from our far more sensitive sense of smell.
Up to 31% of people can be affected, and a smaller percentage may have long-lasting effects. While it is true older adults may gradually lose their ability to taste and smell as acutely as before, the sudden onset around the time of a viral infection makes me suspect this is the most likely cause. Fortunately, 80% of people who developed loss of sense of smell with a viral infection will recover by 12 months.
You didn’t mention any medications, but they are another common cause of taste and smell problems.
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