Q. Do feet get larger as you age?

Feet get bigger over decades of pounding. Some people over the age of 40 can gain half a shoe size every 10 years.

Feet flatten out because their supporting tendons and ligaments lose their elasticity. As the tendon along the length of the sole elongates, the arch lowers. Another reason feet enlarge is that the force of your weight thins the fat pads cushioning the bottom of the feet.

Not all older people notice the reality that their feet have been getting bigger. A recent study of senior patients at a U.S. Department of Veterans Affairs hospital found that three quarters of them were wearing shoes that were too small.

Q. Is Clostridium difficile common? My husband got it in the hospital.

Clostridium difficile, which is often called C. diff or C. difficile, has become one of the most common infections in hospitals.

C. diff can produce two virulent toxins that attack the lining of the intestine. In the United States, C. diff causes at least 5,000 deaths annually.

C. diff is what is called a "healthcare-associated infection," which means that it is one you pick up in a hospital or similar facility such as a nursing home.

About one in five hospital patients get C. diff, but only about one in three of these suffer symptoms. C. diff isn't just an institutional threat; you can get it elsewhere.

The bacteria are eliminated in feces and then spread by infected people who don't wash their hands thoroughly with soap and warm water.

C. diff can cause diarrhea with 10 or more watery bowel movements daily. C. diff can also produce severe colon inflammations including fatal colitis.

Q. What are varicose veins?

Varicose veins are twisted and enlarged veins that bulge in legs, but they can appear in other places. Varicose veins are more common in legs because veins from the groin to the ankles endure the most pressure of any veins in the body.

Varicose veins affect half of people over the age 50. Women get varicose veins more often than men.

Spider veins, which are named for the spider webs they resemble, are like varicose veins, but they're smaller. Hemorrhoids are anal varicose veins.

Aging is a major cause of varicose veins. As we get older, our veins stretch and the valves in them weaken. These valves keep the blood flowing toward the heart. If the valves malfunction, blood backs up in the veins and engorges them.

These bulging veins can be painful, but, for many, they are just ugly nuisances. There are many options available to treat them, including lasers, injections, heat and surgery.

Order "How to be a Healthy Geezer," a 218-page compilation of published "Healthy Geezer" columns, at: www.healthygeezer.com.

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