Your Feet & Legs Are Warning You! - Signs Of Poor Health & A Decreased Lifespan | Dr. William Li

today I'm going to tell you how your legs and feet can warn you about your health I'm a medical doctor and I trained an internal medicine which means I take care of men and women young and old and healthy and sick and I'm also a scientist who studies blood vessels and blood vessels and what they do actually lead to those signs in your legs and feet that tell you if you got a heart problem so I'm an expert on circulation and what I'm going to tell you today will help you pay attention to what's going

on in your legs when it comes to your circulation now your blood vessels bring oxygen and nutrients and all the oxygen that you breathe the nutrients that you eat right to uh the cells muscles tendon and Bone uh in your legs uh uh and in your feet when those blood vessels are working well you're actually going to be able to walk around and run and do all the things that you normally do in life without a problem when those blood vessels have a problem one of the common problems is that they get blocked up with

aosc lotic plaque they narrow down now think about it it's like a drinking straw that you cut in half what's going to happen you're not going to get as much fluid in it just like if you had a half the size of drinking straw same amount of sucking uh up the liquid it's going to be a lot harder and you're going to get a lot less now that's frustrating when you're actually drinking out of a small thin straw but it's actually terrible when it actually happens in the legs when your legs don't get enough blood

flow because your blood vessels are narrowed then you actually have a crisis in your legs right because your muscles when they're Contracting need oxygen and they also need energy they need glucose they also need all the other things that are actually happening uh that your blood is carrying so what happens when there's a compromise well a sign that something's going on with your legs and feet is when you got cramping now we've all had cramping before but I'm talking about the cramping where you just walk like a 100 yards and all of a sudden you

can't walk anymore like you've got this terrible cramp and it can get worse and worse where you then walk even 100 feet or if you were in a shopping center from you know one part of the store to the next you can't actually continue because you get terrible muscle cramping that's actually not normal that's a warning sign that you're having uh blood flow problems right in your legs without enough blood flow your muscles cramp up all right and you got to stop so cramping is one of those warning signs Telltale warning signs that there is

something actually going on because your muscles are carrying around your frame they H do a lot of work and then when you're actually walking around uh they consume a lot of energy and if they're not getting that energy they're not getting that oxygen they're going to seize up and you're going to actually have a cramp now this is the condition that's called Peripheral arterial disease peripheral because it's not Central in your body all right it's uh certainly in your periphery your legs are considered to periphery your legs and feet for sure um Peripheral arterial so

this means that the arteries are getting narrowed right um and disease obviously p a is what we call it pereral arterial disease um if you were in England they call it PA aod pereral arterial occlusive disease occlusive means it's actually getting very very narrow and this is actually a problem because that I know about because what you really want to do is to stimulate new blood flow in order to grow around the blockage to restore blood flow right now what happens if you have this type of cramping a surgeon a vascular surgeon will do all

the studies to to Define exactly where the blockages are and they can take a catheter through your groin and stick a balloon all the way down into where the blockages and blow the balloon up press the plaque out or just actually rotor rotter out um the blockage and put maybe put a stent in okay this is like a wire basket that pops open and Pops that blood vessel open where it was narrowed and now you've got blood flow again so you can actually solve this problem of Peripheral arterial disease with a stent or angioplastic which

is actually where you blow up the balloon um to be able to open up uh the blood vessels now listen this is not a local problem people with peripher arterial disease have a systemic problem so it's narrowing of the blood vessels everywhere these are the people that have narrow l blood vessels in their organs uh in their brain so they can also have basically uh narrowing of the brain blood vessels and that can lead to cognitive issues uh memory problems and in fact ultimately vascular dementia vascular dementia is much more common in Alzheimer's disease it's

actually something that we see as blood vessels get harded okay um so now you learn about one warning sign uh that is actually cramping uh in your leg now a warning sign number two that you should be aware of is when you actually have a wound on your feet that doesn't heal now look most people if you cut your feet on something like step on a piece of glass step on a nail hopefully you had your tetno shop but let's say you cut yourself what's going to happen first you're going to react in pain ouch

pull your feet back and then you're going to lift your foot up okay uh you're going to see if it's bleeding and if it's bleeding you're going to rinse it off you're going to wash off all the bacteria that might be on there could put a bandage on it right and basically um as long as you keep that clean uh and it's not too deep and you've removed all the foreign material uh that's there which is why you want to really wash it off well that wound will heal up I mean it starts to heal

as soon as it forms but by a week to 10 days your wound will actually do pretty well the foot the bottom of the foot especially is a very dirty part of our body because it's in contact with the ground or the inside of your shoe you know we wear shoes so we don't actually get our feet dirty but you know how dirty the inside of a shoe is nasty inside of an old tennis shoe or you know an old pair of work shoes that you're actually wearing every single day not good so if you're

going to actually cut your foot normally uh you know wash it off put a Band-Aid on you might want to put a sock on before you slip it into a shoe and a lot of people say well just walk around flipflops well be careful because then your the bottom of your foot's exposed to everything so put a bandage on check it change that Band-Aid uh after a day or so take it when you take a shower take a little bit of soap and clean off uh the the cut area as well believe me if you're

if it's normal a cut on your foot will actually heal up but that's not the warning sign the warning sign is actually when the wound that's on the bottom of your foot doesn't heal in other words the wound you get a cut uh the cut may not even be painful but it's there and it stays there uh more than a few days more than a week it's there two weeks later what it's not healing yet it's 3 days later still not healing a lot of people don't even know that they actually have a foot wound

uh particularly they've got diabetes because the nerves in in some conditions like diabetes um are dying back if you don't have enough nerves in your foot you're not going to feel when you actually cut your your foot right now those nerves are dying back because the blood vessels uh that support the nerves are also are damaged this is one of the issues with diabetes you've got a diabetic neuropathy which is actually a problem with the nerves dying back so diabetics have difficulty feeling the bottom the soles of their feet very easy to step on a

piece of glass all right and be cut and you don't even feel it all right now one of the reasons that the nerves are dying back is that the blood vessels feeding the nerves are insufficient or they're blocked up all right so every nerve has its own blood supply feeding it makes a lot of sense right you got a telephone line that's going from pole to pole along the highway you're going to have to have a support line going along with it and those blood vessels are the support lines bringing oxygen and nutrients to the

nerve along its entire Journey on the bottom of your foot now I I told you that in diabetes there's blood vessel problem s and those blood vessels feeding the nerves are not normal they they're dying back and now without oxygen and nutrients the nerves die back and now you have an understanding of what diabetic neuropathy actually is problems of the nerves start with problems of blood vessels and that's an area that I study so that's why I'm going to give you this level of detail now when you cut yourself you need blood vessels to grow

back that's a process called angiogenesis angiogenesis angio blood blood vessels Genesis is how they grow and uh this is actually uh very very important from your entire over your entire life that your body is able to use this process of androgenesis one of the health defense systems to make sure that all the tissues in your body have the right amount of blood at all times all right and you get you got right amount of blood flow so in diabetes you wind up having damaged blood vessels it's the lining of the blood vessels the endothelium is

what we call it is damaged all right and when that's damaged the blood vessels actually more easily uh clog up okay and also clot and when you have those uh ever narrowing blood vessels that happens in diabetes uh when it's when those are the blood vessels that follow the nerves and support the nerves when those blood vessels go guess what the nerves go so diabetic neuropathy diseases of the nerves are partly caused by diabetic vasculopathy meaning that diabetes causes a problem in the health of the blood vessels bad blood vessels to nerves bad nerves right

so this is what actually happens in the feet um uh of people with diabetes so they don't even feel it when they step on a nail when they step on a tin can when they step on a piece of glass and that cut that occurs actually uh you can be dragging it around for a long time if you're not checking the bottom of your feet if you don't feel a pain remember I told you normally you step on something you cut yourself boom you pull your leg back and you go check your foot that's the

Natural Instinct but if you don't feel it now you're just going to you know after the cut you're going to just slide your foot back into the your Barefoot back into the shoe and and Tool around and you might not even know that you actually had a cut and in fact some people with diabetes winding up having these uh uh foot wounds don't even know that there's an injury until days later maybe weeks later um they start smelling something really foul coming from their body and it turns out to be coming from their foot because

now they've got rotten tissue that wound is not healed and that's the warning sign a chronic wound that doesn't heal this is actually something that's pretty common unfortunately in diabetes and also it can also happen with pereral arterial disease um but uh it's kind of a silent epidemic people don't like to talk about holes on the B and the feet that don't healing that aren't healing and doctors actually don't know most doctors don't know how to actually handle a diabetic foot ulcer now I happen to be one of the people who've led to charge both

research treatment uh policy uh wise uh to figure out how to actually heal these chronic wounds because you know what happens if you don't have heal that chronic wound unfortunately that wound will get deeper and deeper because it's not healing the bacteria will kind of get in there and you'll start it'll start losing pus all right and then the tissue will start to die in that area uh and eventually you could actually get an abscess the bacteria can get into your bloodstream you could get septic and by the time uh many people many patients actually

you want them going to their doctor and their doctor goes hey I don't know what to do with that finally they get the patient gets referred to a wound clinic all right there are you know several hundred wound clinics around the country not enough of them by any means compared to the number of people diabetes and those special wound clinics have uh trained staff and experts clinical experts that know how to actually apply Advanced Technologies to be able to start healing that wound if you don't go to the doctor all right you're going to be

walking around with basically a rotting piece of your foot that's going to get worse and worse and when that rot continues to go bad you can get gang GRE so the treatment for diabetic foot ulcers when it's detected early on you know will clean out the wound we maybe even cut out the non-healing wound to kind of get a fresh margin um and then there's all kinds of different tricks of the trade that can be applied that actually work really well everything from putting a a living skin equivalent it's kind of like a living bandage

on it to help heal there's a growth factor it's like a it's called ranic by Capman it comes like in a small tube like a travel tube of toothpaste you squeeze some on there it's a protein that stimulat Ates angiogenesis so it stimulates healing that's already way too slow um in the diabetic foot somebody with diabetes so just go ahead and stimulate it and in fact this growth factor gel the thing that comes in a toothpaste called bapin was FDA approved because clinical trials showed that it actually sped up the rate of wound healing what

does it do it stimulates androgenesis more blood vessels growing guess what not only is it healing the wound repairing the wound but the other thing that it's actually doing is that it's also um helping to restore the nerve function as well and nerves will grow back nerves will grow back if you allow them to grow um by right eating the right Foods by um not killing the nerves some more nerves grow back about one millimeter a day that's about a millimeter right there okay a tiny bit then the next day then the next day and

then next day you can actually grow nerves back pretty quickly All Things Considered all right so the warning sign we're talking about here are chronic non-healing wounds that might be on your foot you should always check your feet if you've got diabetes before you go to bed you should you know cross your legs look at the bottom of your foot on the right take a look at the bottom of your foot on the left check around your ankles make sure there's no wounds um and if you're actually taking a shower that's another example another opportunity

to be able to take a look look at your uh skin on your foot uh and also keep it nice and clean all right soap up your foot uh that's actually a really important little tack I would actually say in order to be able to avoid the problem but if you actually have a non-healing wound time to see a doctor all right you're probably going to be need to be seeing a wound specialist somebody who works in the wound clinic but don't be afraid to advocate for yourself and ask your doctor to refer you to

a wound care center all right they're around and they have all the technology all the tools Hyperbaric uh living skin equivalents growth factors um uh all kinds of different things and most most importantly the experience of actually getting a wound to actually heal back up if you don't I'm just telling you these wounds will get worse and worse they'll get infected um your immune system and diabetes is also lower so now you've got poor blood vessels poor nerves uh and now you got an infection and your immune system is also down this is why uh

diabetic foot ulcers are a common reason uh that doctors wind up amputating the the feet and the legs of of patients who have these chronic wounds so you don't want to be there I trust me on this one all right so uh that's a second tell warning sign which would be actually a wound on your foot that doesn't heal all right now Telltale sign number three major swelling in your feet and ankles and into your calves right and you've probably seen this recognize this I mean you know you've seen somebody maybe they're on a bus

or in a Subway they might even be on a plane uh maybe on a beach but somebody who's got you know really really swollen uh calves and ankles and foot and the foot is sort of um kind of like pillow-shaped really really swollen and it's actually filled with fluid now swelling in the feet can actually happen for a lot of different reasons all right some of the reasons that are harmless are for example uh if you're on a long plane flight so you're flying across the country flying across the ocean to Asia or uh Europe

you're sitting there for a long time and even though an airplane has a pressurized cabin they artificially um put air pressure in the cabin it's a lot less than when you're actually noted an airplane standing on the ground all right so with lower cabin pressure compared to what is on planet Earth when you've got your feet on the ground less uh pressure means that the water inside your body can seep out Under the Skin not through the skin under the skin from your blood vessels out into the tissue out towards the skin and the leg

the calf ankle swells up the foot swells up all right that's called pedal edema p d l pedal edema and the fluids pooling into them connective tissue uh in in your under your skin now we test for that to see what if it's really fluid that is just oozed out by pushing a finger into the uh swollen foot or ankle or calf when you push in it's kind of like the Pillsbury Doe Boy or pushing into a ball of pizza dough you're going to get a print a fingerprint in there or a thumb print if

you use your thumb uh right in there okay and you'll see the indentation will stay there for a little a while before the fluid comes right back out and actually uh uh removes and fills back out uh your fingerprint or thumb print that's pedal edema and it can actually happen a little bit when you're flying on a on a very long long haul flight not enough air pressure and so for some people not everybody for some people uh the fluid actually comes out and that's a relatively harmless uh situation you know once you if you're

taking a flight once you land you know you might have a little more problem than than you'd expect by putting on your shoes but then once you're walking around okay you know you get your luggage from the overhead you walk off the plane now you're walking through the terminal to the baggage claim or wherever you're going all right that physical activity back on Tera Firma on regular Earth okay with higher uh pressure is going to push that fluid back into your blood vessels and then your veins will actually take it all all back into your

heart um and now it's out of your ankles and calves and and feet back into your body all right so that's the harmless kind of swelling but if you have it you want to pay attention to it because you know it's something that is in it's just one of those telltale signs that something is going on um in under normal conditions it's just less air pressure around you okay um but it's hard and that's particularly harmless however there are situations where edema can signify something something really really severe all right lower extremity edema is what

we call it all right now this is now one of the things I told you about is these really fat swollen feet and ankles and now when you actually put your finger on it pitting edema you can it's it's like like I said like like poking a piece of pizza dough you'll see the hole where your finger was and it will take a long time before it actually fills back out again all right and this can actually go all the way up your shins all the way up to the calves as well all right you

get that dimpling if you actually put your finger on it all right now that's the kind of fluid that has actually come out and uh it's and the fluid is not going back in the blood vessels to the heart so this pitting edema is actually not a normal situation and it can actually happen when you have congestive heart failure so pitting edema all right big fat calves ankles and feet all right uh might be a sign that you have have congestive heart failure and that's why when you have edema uh that doesn't go away time

to talk to your doctor and get some attention to it you know even though we're talking about the foot that might actually be the tip off that there's something going on with the heart and a doctor can actually use an ultrasound and do a stress test and do all kinds of different types of testing in order for you to be able to actually um check the uh the Vitality of uh your uh heart all right now how does heart failure cause leg swelling well you know our circulation is a closed system so the heart right

here is pumping pumping pumping jetting blood out through the artery the big arteries called the aorta right over the top kind of like a a fountain like The Fountains of balagio squeeze pump blood goes out the heart all right and the arteries take it to all the rest of the body um but what happens is that uh it has to return the the blood has to be returned on the other side through the Venus or vein system all right now if the heart is not doing vigorous pumps but it's getting blood out there and the

blood is coming back to the heart but the heart can't accept it fast enough so you're pumping out and now it's like wiggly jiggly it's not ready to accept more you yet more flute is coming back yep well okay we'll get we'll get it again let's do another pump and it becomes kind of like a feeble half-hearted pump what happens to the water the blood that was supposed to come back the blood backs up okay it's like a toilet that's not flushing completely the fluid backs up uh and then when it backs up from your

heart it backs up all the way in the other side of your veins right you're not moving fluid through your heart that's supposed to fluid comes into the heart fluid is pumped out of the heart that's how it's supposed to work but if the fluid isn't going out of the heart as quickly it backs up and when it backs up you know what it backs up and goes down the column of fluid that's called gravity uh in your uh Venus system in your body and then it builds up in your legs and feet because those

are the lowest parts of the body all right unusual severe swelling that when you poke it you leave a dimple in it could be a Telltale sign that there's actually a heart problem so this is basically how legs and feet can tell you something very important about something that is not below the waist all right and if you actually suspect you've got congested heart failure it is time to go see a cardiologist and your primary care doctor should be right on it okay this is not difficult stuff this is common sense stuff when the pump's

not working well the blood's going to back up uh because you're trying to Jet it out it's not working efficiently enough so the blood backs up that fluid goes down the column of your body leaks out through um the blood vessels accumulates within the muscle and tissue of your uh lower extremity your calves your ankle your foot and then your and they swell up and you can dimple them all right now that's a warning sign okay let's talk about the next warning sign and these are uh called Venus leg ulcers it's also a kind of

wound but it's not like a diabetic wound which is kind of round and deep Venus leg ulcers are kind of they're they can take any shape they kind of look like the map of uh the United States for example uh or an island from Outer Space if you look took a picture from a satellite it's an interesting Geographic shape and not very deep this is not a deep wound but it can actually be a very large wound in terms of the surface area it's just a shallow uh uh sea like kind of like the Salt

Lake in Utah not very deep but really wide and it's got really irregular borders that could be a Venus leg ulcer and if you haven't heard about Venus leg ulcers don't worry most doctors your your general your GP probably doesn't really know what one is either the PR common but uh the regular doctors your GP your primary care doctor probably doesn't know how to manage it now so let's talk a little bit about these shallow wounds that can form around your uh calves uh near your ankles on top of your foot but it's generally sort

of between your knee and your ankle all right they're not deep they're very shallow and what's happening is again this is let's go back to the blood vessels you have something a problem called Venus in sufficiency all right Venus meaning veins right arteries are the blood going out of the heart veins are the blood coming back into the heart and the blood vessels that bring the blood back are called veins and the V veins are insufficient all right that's Venus insufficiency what is it about those veins what part is insufficient uh well let me explain

to you so when the blood is actually finishing the arteries and it's going to go back to the heart it gets you know it goes down to your legs it's got to get pumped all the way back to your heart and remember I told you is that the blood when you're standing up the blood can pull very easily so the way that mother nature designed the return system it's that blood that's that was pumped out that's collected back uh into the veins and gets and that vein starts to bring the blood back to your heart

now in order for that blood column not to sink and cause your legs to swell the fluid to leak out and swell there are valves in your veins all right and these valves allow the blood to get pumped up and then the valves open up like this okay and now the blood can't go back and the whole water column is trapped and then the next pump pumps that column of water a little bit higher oh another another another valve system traps it so it can't fall back down okay another pump Boom the blood column goes

up and then it falls back to another valve and these valves actually keep the blood going up up up up back to your heart all right very very important concept so Venus insufficiency all right what do you think happens when those valves don't work or one of the valves don't work let's say if there's a failure of a valve well that column of blood on its way back to your heart isn't going to actually stay in one place because there's nothing that's propping it up so it's going to fall back down and just like kind

of like a like a dominoes the next one falls down the next one falls down and now you've got blood that's actually pooling again and you're like kind of like congestive heart failure but in this case the ticker is okay but the valves in the veins are failing okay they're insufficient so this is called Venus insufficiency and what happens is that in your leg so let's call it below the knee that back up of fluid that then leaks into Under the Skin okay and creates that big fat leg and dimpling effect that I told you

about well look in uh uh Venus insufficiency it's really the superficial area the thin part of the skin that wears down all right uh and a little little hole will actually get bigger and bigger and bigger usually it doesn't bleed actually it's just kind of like area of the skin that's breaking down so much fluid is out stretching the skin the Skin's not getting enough oxygen all right and all it takes is for a tiny little thing a bump uh you know on the side of a table or tripping on a branch or something like

that and now you're actually going to scrape off some of the skin and Venus like ulcers start to form just because there's so much fluid all right when they start forming as I mentioned you they're not deep wounds they're very shallow woundes but they can actually cover a huge area and that is called Venus insufficiency so you tell your doctor your doctor may or may not know what to do with it all right um and if they don't if not sure you should ask your doctor to refer you to a wound clinic they're all over

the country all right but they're really really specialized these are a Navy SEAL Navy seals for wounds they know exactly what they're doing and uh in ways that your regular doctor are not going to know and if they don't know if your doctor your own primary doctor doesn't know a wound care specialist that's fine just uh go online and go ahe and look up wound associations there's a few of them out there I'm on the board of one of them and uh uh some of them actually have lists of providers or Healthcare Providers or wound

clinics you can actually go to there are some really really good ones and by the way uh a conference that uh you know I have gone to for many many years uh with nurses and doctors and surgeons all going to this conference it's called the Symposium for advanced wound care s AWC all right and that's where a lot takes place twice a year uh different cities and that's actually where you can meet some of the wound care provider so I know that in the past when I've been at that meeting sometimes patients will show up

all right right they hear about their meeting they show up and guess what they are suddenly right in the middle of all the experts in the country uh for wound care and they can you know introduce themselves and often get help that way so if you got a Venus leg ulcer uh you want to let your doctor know if your if your doctor doesn't know how to deal with it uh and they should refer you if they don't know how to refer you well you might be actually stuck looking for it yourself uh uh but

uh you're looking for you're searching for wound clinic in your ZIP code or in your city so Venus leg ulcers are another warning sign shallow wounds uh in your legs your lower legs all right this is very common in older people they generally are hard pretty hard to heal but if you see them I'm just going to tell you because I'm one of the experts in this area um what to do for wounds uh wrap it there's compression uh and what you want to do is kind of keep enough compression there because guess what valves

aren't good enough to keep the fluid going forward well maybe we need to squeeze in a little bit uh you know that old ace bandage you can wrap it around the leg not loose pretty tight because you want to actually you know kind of force the blood to go back into the system uh and and uh and that'll actually be helpful in terms of the healing uh as well all right so compression is the primary way of closing or healing these wounds but if it's still not healing again a wound care provider might put some

growth factors on there might put a living skin equivalent on there Amic membrane uh they might give you hyperbaric oxygen this is where you go into a little chamber originally developed for deep sea divers who come up too fast and get that bend so this Hyperbaric HBO is intended to help people divers avoid the bend but guess what um it actually could be useful for healing the wound so I'm going to tell you exactly what happens if you um pop into one of these HBO's hyperbaric oxygen uh centers so at a wound center they might

actually put you into a hyperbaric chamber uh and uh what this hyperbaric chamber does is it uh puts lots of oxygen under a high oxygen pressure to flood your uh body but especially the wounds with high oxygen right so I just told you these chronic wounds occur because they're not getting enough oxygen so let's go and flood the area of the oxygen uh in order to be able to get more oxygen which is necessary for healing and you think that well you keep on doing Dives and every time you're getting the oxygen the wound is

healing a little bit actually that that does happen a little bit but what's really happening and this is where I'm coming at this from a researcher kind of an expert in this field is that you're training under every time you go into a dive chamber a hyperbaric chamber you are um pumping the wound full of oxygen during that 1H hour dive let's say 20- minute dive the tissue your own tissue where the wound is is uh getting used to the party of actually having a lot of oxygen all right uh so then when you step

out of the dive chamber all right you're going to get back in your car and you're going to drive home the visit's done well actually it's what happens is that when you're actually out of the chamber before the next time you go into the chamber your wound not after the first time not after the second time maybe starting up the third time you do a dive when you come out of the chamber it's so used to having a party with a lot of oxygen around that when you step out and you get into the car

into the parking lot your wound Felix is choking oh man I'm not get enough oxygen all right and then this is the setup for what actually happens because when a wound when tissue feels oxygen starved all right this is called hypoxia or relative hypoxia I mean it's look it's just in regular air so it shouldn't be start of oxygen but it's been trained to be addicted to high oxygen that's how HBO works this addiction now the wound goes well we don't have enough oxygen let's go ahead and create proteins and release proteins ourselves in the

wound like vascular endothelial growth factor VF this is an angiogenic growth factor A protein that causes blood vessels to sprout it's like pouring putting Ser fertilizer um on the ground all right and then putting some grass seeds on what's going to happen you're going to actually grow lots of grass and this is what happens after between Dives is that your wound senses it's not getting as much oxygen as would make it happy all right because you've trained it and now it sends out these proteins to grow new blood vessels and once you have androgenesis and

you turn on the genes for healing now the that Venus leg Al will begin to actually close meaning that the skin grows over less wound is exposed less the less wound that's exposed the less chance there is for infection all right so a lot of ways to actually deal with vus leg ulcers um but that's another warning sign so what do we talk about we talked about um cramping we talked about uh swelling right uh we talked about uh wounds that open up we talked about diabetic wounds we talked about Venus wounds all right so

these are all uh things that we should be paying attention to these are these are the warning signs on your legs and your feet that you have actually a problem uh uh and then here's another one all right uh and this is the last one I'm going to talk about the fifth warning sign if your toes become black black toes all right and I'm talking about black like burnt hot dogs all right and this again is a sign of Peripheral arterial disease this is the condition where blood vessels get narrowed or blocked and now the

the the the tissue in this case the toes are not getting enough oxygen and when it gets severe enough basically the meat of your toes the Flesh of your toes the muscle in your toes the bone in your toes just basically dies all right it's just not getting enough oxygen all right and when that actually happens when that tissue dies it turns black and it'll actually dry out and you'll wind up getting gang GRE that's what it is when your toes turn black all right now remember I told you this is the process this narrowing

of the blood vessels is the process not just in the Toes or the feet it's happening everywhere the narrowing is happening in your heart it's happening in your lungs it's happening in your liver it's happening in your brain so this is a Telltale sign if you wind to P me black toes you're probably having narrowing of the arteries elsewhere in your body as well you got a problem not just of the toes that's serious enough in your toes but there's a tip this is a tip off that you better go have the rest of your

body checkout so who actually does a checkout well vascular surgeons are uh that's this is their domain this is their belly Wick they're supposed to know that's what they do how to assess your circulation all throughout your body but the black black toes that's a great uh sign uh to be able to pay attention to all right if you don't have enough blood F blood flow to your foot the toes can turn black you don't have enough blood flow to your heart you can get a heart attack not a blood flow to the brain you

can actually start to lose cognitive U power you're actually you become dull as opposed to Sharp s mentally that's not what you want and that's the problem that's actually happening everywhere black toes a clue you're not getting enough circulation uh to any part of your body and in the toes when the skin dies it actually turns black now that black is called Gang Green and Gang Green is a very dangerous condition because essentially not only does it tell you that your circulation is compromised all over including your brain and your heart but the fact of

the matter is that uh eventually that ganger can spread to the rest of your foot all right you might have to amputate your foot it can spread up even further and you might need to amputate up Upstream uh your to the rest to the upper part of your leg uh as well all right so this is Peripheral arterial disease leading to less blood flow all right all the way down to the tippy toes literally and the when the toes the meat of the toes the muscle the flesh the bone connective tissue don't get enough oxygen

they basically die and when they die they turn black so black and Toes a sign of danger that's helping happening elsewhere in your uh body time to see a doctor who should be referring you to a surgeon not just any surgeon but a vascular surgeon because one of the things that they'll do is they'll do a scan all right uh an an angiogram and this is basically like a kind of an x-ray but they inject a Dye into you that circulates all throughout your body and and and basically they can are able to map out

where the narrowing is occurring in your legs all right and if they once they actually pick out where that narrowing is guess what they can send in The A Team to try to see if they can open up the blockage now I told you this is happening all throughout the body so it's very unlikely it's just one area uh and so vascular surgeons have to assess this by squirting the dine is it one area they can get to or is it defuse meaning it's a little bit of narrowing everywhere which is often what's actually happening

with Peripheral arterial disease now I took part in efforts years ago to be able to develop uh lots of treatments to actually TR uh be able to get around this pereral arterial disease uh to avoid black and toes and to heal uh the wounds these arterial ulcers is what we called them I can tell you one of some of the most impressive work that still isn't ready for prime time but I'm just sharing an experience with you is uh doing gene therapy to deliver the gene the DNA that codes for one of the growth factors

that help stimulate speed androgenesis and healing um and what we did is you know there was a big clinical trial uh the the gene was injected into the muscle of the leg all right all over and uh lo and behold what we found is that blood vessels would grow in oxygen starve legs so we could actually stimulate androgenesis by delivering genes through gene therapy I mean this is pretty futuristic stuff right yeah well look I took part in it I can tell you although that it's still early days of development but in the clinical trials

I will tell you that there were some patients for whom it was a home run all right we haven't been able to repeat that enough to enough people to really call it a wind so that's why it's still research area but I can tell you you know the the world of discovery Innovation and breaking new ground you know if you want to be a path breaker uh particularly medicine all progress begins with one patient and so I can tell you I've seen that one patient respond beautifully when you do androgenic gene therapy and now it's

still in development because it's a steep Road uh to solve it how do you design the trials etc etc in any event uh that's actually for the future all right you go see a vascular surgeon and they'll actually uh take some dye inject it in see where the blockage is and they might be able to go snake in a catheter right up to the blockage put a balloon in it poke it right through the blockage blow up the balloon when they blow up the balloon the pla plaque it'ss pressed back they can even suck out

the plaque if they're drilling through it suck it out all right put into a bucket on the other side uh this is all going through your groin um they can put a stent a basket and it goes deploys open and now the the the art The Vessel the artery won't close down can't shut down all right and that's actually a way of actually opening up uh the blood vessels to restore blood flow now if you can't sometimes the blockages are so serious or the anatomy is so difficult that the vascular surgeon can't quite get to

uh that area I can't kind of get through that area um so now what do they do now you can actually undergo bypass spheral arterial disease can be treated with bypass surgery so basically what you do is you just the surgeons once you take a a vein and just plug it on one side that has good blood flow and then pop P patch it in right beyond the area that's blocked said you know what we don't even need that blocked area we're just going to go right around to supply uh the tissue and so uh

uh bypass surgery is uh a very uh important and still common way of actually dealing with this we don't have gene therapy yet but um sometimes the basket uh can open up uh an anoplasty to suck out the bits that can actually work as well now what's really interesting is that there's some foods that look like they can be helpful uh to improve better blood flow so let's talk a little bit about those how do blood vessels that are narrow um dilate well you know you actually have something called nitric oxide actually a gas a

normal gas in the body when you got nitric oxide you take that blood vessel and the nitric oxide the gas actually causes the blood vessel to um dilate expand now you got better blood flow right through it right narrow blood vessel add nitric oxide and now it opens up now blood can actually flow right through it so nitric oxide is not something that most doctors are using routinely but guess what there are medications that can actually stimulate nitric oxide one of them is Viagra now you know that Viagra is used for uh retile dysfunction what's

a rectile dysfunction not enough blood in the penis right not enough blood flow tra captured in the penis for during an erection so um the same thing that can actually happen in the brain in fact there was a clinical study that showed that men who were taking uh Viagra for erectile dysfunction actually had a lower rate of developing dementia partly because the blood vessels uh feeding the brain were opened up and bringing better blood flow okay so that's a drug not everybody wants to be on viagra for example you know like you get you'll get

that like side eye from the pharmacist when you're uh filling that prescription for something that's not a rectile dysfunction um but what foods can actually do that well turns out spinach and beets spinach and beets are two foods that actually can create that nitric oxide help your body create that nitric oxide widen your blood vessels um and actually help to deliver better blood flow which could actually help all right it's not a Magic Bullet but it could actually help to Stave off amputation to uh give you better give you some more better blood flow prevent

more Gang Green from actually happening it's not the complete solution all right you really need a surgeon to be able to take a look at it but I'm telling you this is a tool in the toolbox that your doctors is not going to be prescribing you and if you are to facing such a serious condition where you've got black toes and maybe your whole leg needs to be amputated want to stay away from that you want to do what you can at home to be able to save that tissue all right I.E your leg check

this out I got a free guide on the five drinks to help remove fat from your liver and it's free I walk you through why your liver is so important why you should take care to make sure it's functioning properly in your body and a five drinks I recommend to enjoying to support it all you have to do is click on the link below and enjoy so spinach uh and beets these are produce that grow uh close to the ground and and the soil has a lot of nitrogen so these plants absorb nitrogen into their

into the root in the case of uh beetroot uh and into the leaves in the case of spinach and when you actually eat spinach or beets all right and and you chew it so I'm I'm I'm telling you savor it make sure it's cooked in a way that you actually enjoy all right I'll tell you how I enjoy it I love here's my one of my favorite spinach dishes um it's actually I I was inspired by Spain you get um uh spinach you sauté it in a little bit of extra virgin olive oil some garlic

all right to get this fragrant uh uh smell then you uh add some golden raisins into the mix little splash of white wine the alcohol will burn right off and then you toast some pine nuts and then throw them in there turn off the heat mix it together and now you've got this wonderful um spinach dish that tastes amazing now why am I telling you about making the food taste amazing is because when you have the spinach you want to chew it Chew Chew Chew Chew Chew Chew choo choo choo and the reason that you

want to do that for vascular Health blood vessel health is that the microbi on your tongue okay healthy bacter on your tongue when it's in contact with spinach that food that absorbs nitrogen from the soil and now you're chewing it all right um and and you're and you're loving it because it tastes great now you're chewing it and the longer you chew the more contact the spinach has with your tongue microbiome all right and when that actually happens the uh bacteria convert the nitrogen from the spinach into a form that when you swallow it gets

absorbed into the bloodstream as nitric oxide the same thing that Viagra creates it's also all throughout your body and we know it actually works because within a few minutes after eating spinach in the manner in which I described the blood vessels dilate everywhere in your body and in fact your blood pressure uh goes down a few points all right now this is actually quite impressive because normally you've got to give cardiac blood pressure meds to able to do the same effect spinach will have that uh type of effect as well but it's Kinder and it's

gentler in order to be able to do that okay now uh beets same way right so I love roasted beets uh little extra olive oil you want to let the beets cool uh what else could you do you can get some orange slices Mandarin slices beets and uh uh orange slices are really good uh you could put some balsamic vinegar on it there's a lot of different recipes you can do with beets makes a great beet salad for example uh and if you don't know how to actually cook something like beats type beats uh uh

into Google uh type recipe and then type video and up will pop all these videos and you can actually play it and have somebody who knows what they're doing meaning they know how to make a delicious beet dish they will teach you how to do it and if you do if you do this in a grocery store by the way in front of the beat section and and you're like M what do I do with this like dark red ugly kind of dirty looking thing just take a few minutes in a video at a store

and and watch they'll show you the exact technique of how to actually create a delicious beet dish and then usually they also talk about all the other ingredients you actually need to buy as well oh and here you're in the store that's really convenient now you know it can make your own beet salad but beets when you chew them the same thing as a spinach Chew Chew Chew Chew chw Chew the healthy bacteria in your tongue will interact with the beets the nitrogen in the beets that came from the soil change it chemically in a

form that when you swallow the beets um and the nitrogen it's in a form that is absorbed into your bloodstream as nitric oxide dilute dilates the blood vessels blood pressure comes down and by the way it's even be studied it even been studied that beetroot juice you know this is this kind of like um really intense red juice uh uh by the way you can make a rotto using that in the juice and you get this beautiful beet red risotto rice dish but back to the leg and getting blood flow into the leg beetroot juice

has actually been shown to also be beneficial all right uh so that's actually uh a little food tip for you uh spinach and beets can be helpful in dilating the blood vessels to improve blood flow to your leg uh in Peripheral arterial disease and if you wind up actually uh having black toes this would be something that as you're working with your doctor how can you get out of this Jam well there's something you can do for yourself at home spinach and beets are there now some people will say what about um uh you know

oxalates and and spinach and you know beets and things like that what do I do about that I don't want to have kidney stones I don't want to have gout look you're you're balancing things we're really talking about saving your leg let's focus on that um if the dietary approach isn't for you well maybe you need to ask your doctor or the vascular surgeon for other medications that you're probably going to be given um maybe to dilate the blood vessels a little bit all right um and again I'm not giving medical advice here I'm I'm

giving information that you can take and do some more research on it ask your doctor about might give you give some medicine to dilate your blood vessels all right because you can have nitrates um it's kind of medication uh that actually turns into nitric oxide as well or or even Viagra all right so again uh the other thing that the vascular surgeon will probably do is give you um some blood thinners uh which might sound uh scary but many people are on them it's actually pretty safe as long you don't you know get in the

car wrecks and slam your head on the on the tile floor in the shower or anything like that um you got to be a little careful not to have accidents physical accidents that could cause more bleeding but otherwise these blood thinners actually keep your blood nice and smooth and actually it's a way of salvaging the and preserving your leg in fact there's a whole uh kind of dis subdiscipline in wound healing called limb preservation that means don't cut off the leg all right so if that sounds severe I'm just telling you it's like pretty common

uh as somebody who works has worked in the wound healing area um there's more people that uh wind up having gang greine and black and Toes than you'd actually think all right uh and by the way this last example of the food is also showing you how the gut microbiome with a gut this time in the mouth mouth is part of the gut how it interacts with uh uh the food that we eat to be able to um help uh support your health now there's another way of actually stimulating uh healing uh and actually growing

blood vessels in your legs uh and this is again I know I this you know I I talk about food a lot but I also think that this is an area that many people suffer from but they may not know how an experienced uh physician or an expert would actually approach it so I'm sharing with you some Pro tips that you can get armed and do research on and then bring it to your own doctor or vascular surgeon to advocate for yourself and say hey how about this I'd like to get that now one of

the other devices that can actually um stimulate blood vessel growth to uh preserve and protect your leg all right this whole video is really about problems in your uh uh feet and your legs that signifies something else is going on so let's stick to that doesn't have to be food it could be anything goes right to save your leg so there are now devices that actually deliver energy to your leg you're right you you heard me correctly there are devices that deliver energy to your feet that goes into your leg to be able to stimulate

angiogenesis blood vessel growth and healing amazing right so these are electrical pads right um uh that that don't shock you but they're flat pads you put your feet on them you you kind of if you're sitting in a chair the perfect thing is that they you can put them sort of where your feet are and you can just rest your feet on it and it actually delivers electrical currents right through the bottom of your foot the balls of your feet all right and those electrical currents send signals to your blood vessels and it actually uh

uh somehow these signals travel up the leg the lower extremity leg and they activate the leg to grow new blood vessels quite amazing uh I've I've worked with people who have used it it's actually quite dramatic in terms of it's the benefits that can occur and it's a way if you got black toes maybe to actually avoid going towards the major surgery route all right um buy you some time uh but also something you can do at home so if you have an office you could put one beneath your desk in your office at home

you can put one you know in front of the couch or maybe the dining room floor so when you're eating you can actually be on this current device and it doesn't sh elect give you electrical shock it's like low voltage low current going into your leg and that electrical therapy all right and you know listen this is pretty amazing that like wound therapy can use electricity they're even inventing electric bandages by the way you know like not the brand Band-Aid but but you know that the little square in the middle of the bandage they're actually

making electrical signals that can beam out as well so electrical plate uh that can actually do electrical signaling to stimulate androgenesis is another way of actually um addressing uh a problem that you might actually find uh in your feet that signify a much bigger problem of circulation throughout your body and that's been the theme of this video uh I study androgenesis your blood supply our body's got 60,000 miles worth of blood vessels 400 miles are in your brain the rest of it is distributed there's a lot of blood vessels Muses beneath your uh waist in

your legs in your muscles around your knees going all the way down to your calves and then into your feet when there's problems with those circulation it's a signal that other things are going around but you might see uh the cramping the swelling the wounds that aren't doing doing so well uh the the black and toes all right these are all warning signs that something else in your uh body is going on your feet and your legs are the tip off uh that you need to actually go see medical attention all right now hope you

learned something new I'm pretty sure you did this is I gave you a lot of information from the perspective of a vascular blood vessel researcher and a doctor who works in this space including some of the clinical trial things that we've actually been doing so I hope you learn something from this uh and thanks very much for watching I will see you on the next video hi there have you enjoyed watching this video I know you'll love the next one stay here and check it out and I'll see you you there