Oh it’s just a bit inflamed. Uh huh. Right. Just another platitude doctors feed their patients, right up there with “this won’t hurt a bit” and “of course your insurance covers this.” And it always seems like the inflammation lingers on, appearing perilously close to an infection. So what is inflammation anyway, and why does it always take so mighty long to resolve? That, my young NYC podiatry patients, fans and haters is the subject of this week’s engaging, entertaining, and thrill packed blog. And in honor of a certain uber-nerd science fiction trilogy x 2 +1 that is set to be released this weekend, this blog Stars many Wars related terminology.
Inflammation, as it turns out, is a very important process and body force, the hallmark of which was described centuries ago by Celsus as involving pain, swelling, redness and heat, and loss of function was added by Galen. Any insult to the body’s natural process, in the form of infection, injury, blunt or penetrating trauma- such as a blaster or light saber injury- has the potential to evoke an inflammatory response. This response involves many body systems, starting with the basic immune cells that are summoned at light speed to rush to the area of insult by signal markers that course through the bloodstream. A cascade of events then occurs, including blood vessel dilation, clotting, combatting invasion of foreign cells such as bacteria, and tissue repair. As with the normal healing process, the initial priority is damage control- stop the bleeding and prevent invasion of the planet by the evil bacterial empire. The next step is to rebuild and then remodel the tissue, with an alliance of friendly cells. And here’s where the most annoying part of the process begins.
As we have discussed many times, swelling is frustratingly slow to resolve in the foot, whether after injury, infection or even surgery. And it’s precisely because of the chronic phase of healing, during which inflammation is the primary activity. The area is swollen because it’s a proverbial work zone, full of new tissue formation, cells, and fluid. As the injured or inflamed area is repaired, the swelling resolves, however the chronic phase is slow, and can take many months, even in the case of what seems to be a minor injury. And in a disease state that produces chronic inflammation such as certain types of arthritis, the area may always be slightly swollen. The low level of redness, swelling and warmth is markedly different from the pronounced redness, swelling, warmth and possible discharge of an acute infection, although the differences can be subtle.
So the take home lesson here kids, is that inflammation is a natural reparative process by our bodies, and can be a slow one to complete. Inflammation is not the same as infection, just like The Hunger Games is not the same as The Maze Runner (dude, I’m totally hip to the YA lit scene), although they all represent a certain dystopian state that is in need of repair. It’s important to maintain regular follow-ups with your neighborhood NYC foot doc to ensure proper healing, just like I ask my 17 year old daughter when I need to understand what it is that Katniss sees in Peta anyway.
See you in the office, and may the Force of merchandising be with you.
Ernest Isaacson
