Ask the Doctor: sleep aids, plantar warts and flat feet

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from July 2nd.

Pat: What is a good sleep aid?

I’m not a fan of medications for sleep. They have a high potential for side-effects, they may leave you feeling groggy in the morning, and they can lead to a cycle where you need to take the medication every night in order to sleep. I encourage people having sleep problems to get into a sleep routine where you go to bed about the same time every night and get up about the same time every morning—even on the weekends. Take both caffeine and alcohol out of your life for a while. Make sure you create a good sleep environment—dark and quiet—no TV’s or other screens on in the room. Vigorous exercise during the day is good for you in lots of ways, including better sleep at night. A cup of warm milk at bedtime can be soothing and relaxing, too. If these measures aren’t cutting it, the problem may be due to a medical or a psychological issue, so seeing your doctor for further evaluation may be helpful.

Bridger: What is the best way to remove plantar warts from the bottom of the foot?

Plantar warts are caused by viruses that infect the skin cells on the bottom of the foot. If they get thick enough, they can really be annoying as it can feel like you’re walking on something with every step. I encourage people with this problem to start with the over the counter preparations—things like Compound W which contains an acid that helps to destroy those infected cells. If that’s not effective, doctors have lots of tricks. We have stronger chemicals that can be applied. We can freeze the warts with liquid nitrogen. We can inject the warts with substances which stimulate the immune system to destroy the wart. We can destroy the warts with electrocautery, or, usually as a last resort, remove them surgically. So try the simple things at home first and follow-up with your doctor if you’re not successful.

Jackie: Is there anything that can be done to correct flat feet other than orthotics?
Flat feet have several possible causes. It can just be genetic, it can be due to laxity of the ligaments, or it can be due to collapse of the arch from certain medical conditions or from overuse as we see sometimes in dancers and other athletes. This can sometimes be painful but not always and simple measures can be helpful. Sometimes, just wearing a good pair of shoes—like a well-designed jogging shoe—is helpful and all that’s needed. As our viewer suggests, orthotics can help some people to rebalance the forces on the foot and that can be helpful. Your doctor can teach you some stretching exercises of the Achilles tendons which can help some people. Unfortunately, no medication is really helpful here, so if these measures aren’t working and the problem is severe, surgery is sometimes the last and best option.