Dr. Paul Donohue

DEAR DR. DONOHUE: I have a painful bunion, but I don’t want surgery. I have heard horror stories about it. I have a friend who hasn’t been able to walk normally after her surgery. Why do bunions form? Do advertised devices that you wear over the big toe correct a bunion? What else can be done? — L.M.

A: There are two components to a bunion. One is the painful swelling at the side of the base of the big toe. The other is a deviation of the big toe inwardly toward the second toe. The swelling is partly due to inflammation of the tissues in that region.

More women than men suffer from bunions. One explanation for why they form is that women force their feet into narrow shoes with high heels, and that causes the anatomic changes of a bunion. That can’t be the only reason, since men get them and so do a few people who live in shoeless societies. A family trait exerts its influence on bunion formation. Being born with a peculiar alignment of the big toes accounts for a percentage of cases.

You can ease bunion pain by wearing low-heeled shoes that have lots of room in the front section and have cushioning soles.

The splint you describe might work to keep the toe from deviating farther. Such devices are usually worn at night. They might not correct the deviation you already have, but they could offer you some respite from pain.

Orthotics — shoe inserts — redistribute forces on the feet and toes, and can stop a bunion from worsening. They also can bring pain relief. Orthotics specially fashioned for your foot are the best kind. If you want to try a commercial orthotic, you can find them in most drugstores.

Your fear of bunion surgery is overblown. Everyone can cite a bad outcome of every kind of surgery. Surgery corrects the root of a bunion problem. I know only satisfied surgical bunion patients.

DEAR DR. DONOHUE: I was diagnosed with diabetes in 2005. I am 50 and have been taking glipizide ever since then. Is this the correct medicine? I ask because now I get dizzy about half an hour after eating. I don’t have a primary doctor as yet. What do you think of this medicine? — E.

A: Glipizide (one brand name is Glucotrol) is an oral diabetes medicine that’s been around since 1984. Many diabetics have achieved good blood sugar control with it.

Whose name is on your prescription for the medicine? Call up that doctor and tell him or her what’s happening to you. I would like to make a case that your blood sugar is dropping too low because of the medicine, but that’s not likely to occur after a meal.

No one with diabetes and no one taking diabetes medicines should be left on his or her own. Diabetes requires great attention in order to avoid its complications and avoid the complications that can come from taking diabetes medicines unsupervised.

DEAR DR. DONOHUE: What is your opinion on the chewable caramels that contain calcium — Viactiv? Are they as effective as the regular calcium tablets? Are they safe for your teeth? — P.C.

A: Viactiv Soft Calcium Chews come in chocolate, raspberry or caramel flavors. They’re a pleasant way to get your calcium requirement.

Yes, they’re effective.

How do you mean “are they safe for your teeth?” Are you worried about tooth decay? Anything with sugar can be a cause of tooth decay, but the amount of sugar in one piece of Viactiv isn’t all that great. Or are you worried about the caramel variety pulling out your dental fillings? I suppose it’s possible. Anything chewy can do that. It’s a question you have to answer for yourself.