Many patients and customers ask what exactly is the difference between an “over the counter orthotic” otherwise referred to as a “foot insert”, “foot correction device” or “foot cushion” versus custom foot orthotics besides the vast difference in price.
Over the counter (OTC) orthotics are items that are prefabricated and do not require a prescription. If you are having initial foot pain and shoes that are correct for your foot type have not assisted with your foot issue, OTC orthotics may be of help.
From therapeutic shoe stores, running shoe stores to super centers, chances are you will see a vast selection of over the counter options. Are OTC’s effective? Yes, they can be as long as you have the right type of orthotic to work in concert with the right shoes for your feet.
While you can attempt to purchase over the counter orthotics on your own, it is highly recommended you work directly with a professional such as a Podiatrist or Certified Pedorthist to determine the level and type of orthotic for your feet. Once the OTC orthotic is in the shoe and on the feet, a gait evaluation completed by a professional is important to ensure the orthotics addressing your foot issue. In some cases, accommodations can be added to an OTC by a professional to further tweak the amount of correction.
If after a period of time you are still experiencing foot issues, custom orthotics maybe a consideration. A custom orthotic sometimes called a total contact insert is a custom made over a model of the foot. The orthosis achieves total contact with the plantar (bottom) surface of the patient’s foot.
A properly custom designed orthosis can:
Relieve areas of excessive plantar pressure by evenly distributing pressure over the entire plantar surface.
Reduce shock through the use of shock-absorbing materials.
Reduce shear since the total contact minimizes horizontal foot movement.
Accommodate deformities with the use of soft, moldable materials in the shell.
Stabilize and support deformities and limit joint motion.
First, meet with your local Podiatrist for a complete foot exam. If a decision is reached between your Podiatrist and yourself for you to receive custom orthotics, an actual cast or a high level foot scan is completed for custom orthotics. A foot scan is beyond what you will see in a retail environment as the Podiatrist or Pedorthist utilizes specialized software programs to adjust the amount of correction or offloading pressure areas of the foot. In most cases, the scan or custom casts are sent out to a laboratory for processing. The normal turn around time is anywhere from 2-6 weeks depending on the lab volume, amount of correction or special materials requested for your custom orthotics.
At Healthy Steps, we utilize both traditional casting and electronic scanning methods. Stop in and visit with our staff to learn more about our in store solutions for your feet!
Tuesday, November 10, 2009
Sunday, October 18, 2009
Dark callus in a diabetic patient leads to amputation
I was consulted on a diabetic patient in the hospital last week who was admitted because of a foot infection. They did not know how or why the foot infection came about, only that there was a dark callus on the bottom of their foot for at least a month. They didn’t think anything of it until the foot became red and swollen, then within 24 hours there was significant drainage from the callus, redness that streaked up the leg, fever and flu-like symptoms. They also noticed their sugars running very high. This is what brought them to the emergency room. And it was this draining callus that caused me to amputate part of this patient’s foot the very next day. What was this dark callus and why did it have to end up with losing part of the foot?
With diabetes comes the loss of sensation called neuropathy. And with this comes the inability to feel increased pressure on the bottom of the foot. With this increased pressure to prominent areas, like the ones found under the big toe joint, comes callus formation. If the callus turns dark, that means there is enough pressure to the area to cause bleeding under the skin. This bleeding is what causes the callus to be dark. Any callus that goes unchecked in a diabetic patient with neuropathy can become soft underneath allowing the skin to breakdown and form an open hole called an ulcer. This can become infected, thus leading to possible amputation.
Let’s go back to the patient in the hospital. When I asked how long the callus had been there, the reply was uncertain, “maybe a month”. Daily foot inspection is the number one thing you can do as a diabetic, neuropathy or not, to save your feet. If this callus had been evaluated as soon as it was discovered, he would not have lost part of his foot.
When asked about their last podiatric foot check, the patient responded that they had never seen a podiatrist before, their regular doctor checks their feet every 3-6 months. The next step to saving your feet is to see a podiatrist on a regular basis. Although it is very important to see your primary care physician or endocrinologist (diabetic specialist) to keep your diabetes in control, it is equally important to see a podiatrist. The best thing you can do for your feet is be educated on how to save them. When I explained why I had to amputate part of the foot and how it all came about, the patient said, “If I had only known about that stuff, I would have seen you sooner”.
Once he heals the surgery site, he will be able to walk like a normal person with a special insert inside his shoe. And now he is better educated and understands how important it is to check his feet every day and see me on a regular basis. If he sees anything that looks like a callus, he knows to call me right away. Very simple, but very important.
Getting back to normal after ankle sprains
You’ve sprained your ankle and it hurts. You’ve put ice on it and it still hurts. You are using crutches and it still hurts. You even wrapped it with an ace bandage. Now what? Ankle sprains are painful. And the worse the injury, the more the pain. But understanding how to rehab ankle sprains can greatly reduce the painful time and get you back in action sooner.
First things first…stop your activity, rest and apply ice as soon as possible. Elevating the leg and wrapping the ankle with an Ace bandage will help control the swelling. If you cannot walk without significant pain, use crutches. Taking anti-inflammatories like aleve, advil or ibuprofen with help with swelling and pain. If your pain does not drastically improve over 2-3 days, a visit to your local podiatrist is next. If the sprain is severe, seek immediate treatment at a local emergency room.
So what are we looking for when you come in our office? First thing we want to know, “did you break a bone?”. If not, then our next step is getting that ankle moving as quickly as your pain tolerates to reduce instability of the ankle.
Rehabilitating an ankle sprain is the most important part of getting back to normal. This starts with home range of motion exercises, rest and wearing proper shoe gear. Notice I said nothing about returning to high heels or flip flops! Next, expect ankle pain to be present 3-6 weeks depending on severity, but this can be lessened by attending physical therapy.
Professional physical therapy services provide multiple modalities that can reduce your pain, increase your range of motion and increase your ankle stability, thus reducing your likelihood of another ankle sprain. Physical therapists can perform things like ultrasound, cold laser therapy, positional joint release and deep massage to help get you back to your old self again. Often ankles that have previously been sprained and require surgery several months later, did not properly rehab after the initial ankle sprain.
If you just injured your ankle, don’t wait months for it to get better. Start the rehab today. The physicians at Foot and Ankle Associates of North Texas are happy to help you in the process.
Tuesday, October 6, 2009
Plantar Fasciitis
“I work out and my heel hurts.” “I run and I am fine, it’s afterwards, my heel hurts.” “I stand all day at work and my heel hurts.”
Some of you may be familiar with the above statements. Some of you are looking for the quick fix, the magic stretch or device to make the “hurt” go away. I hear this a lot from customers and patients of the practice who visit me at the store. It is hard to see the look of despair particularly of runners who want to eliminate this “hurt” they cannot seem to control themselves. When a patient is diagnosed with Plantar Fasciitis from their Podiatrist, they are in a frantic search to make the pain go away fast. Rightfully so as they want to get back to life prior to the diagnosis.
So lets review exactly what this is and options on what to do once you have been told you in fact have good ole Plantar Fasciitis or also known as PF….
How do you say Plantar Fasciitis?
PLAN-tar fashee-EYE-tiss. It’s intriguing to hear from people their version however, this is the correct way to pronounce the words.
What does the Plantar Fascia do?
The plantar fascia is the thick ligamentous band in the bottom of the foot which is attached to the heel. The band runs forward and inserts into the ball of the foot. The plantar fascia encapsulates muscles in the bottom of the foot, however the main function is to support the arch of the foot by acting as a bowstring that connects the ball of the foot to the heel. This "support" enables us to propel ourselves forward more effectively.
Where exactly is the pain located?
Plantar fasciitis pain is found in the center or toward the inner side of the bottom of your heel. A lot of people notice the pain when they stand up after any period of rest especially after sleeping all night. After walking around for a bit, the pain can lessen or virtually disappear.
The interesting thing about this is PF is not caused by the heel striking the ground. PF is often referred to as heel spur syndrome however the spur is not the actual cause of pain. The spur is a sign the PF has been stressed for a period of time. Heel spurs are deposits of calcium in the plantar fascia where it attaches to the heel. You see, a spur is your body trying to respond to the injury and inflammation. So you really cannot blame the spur for causing the pain. It’s actually pretty common for people to have spurs and not have pain.
What caused my Plantar Fasciitis?
Common situations are:
An increase in activity. I.E. cutting grass in the spring on uneven ground and wearing improper footgear.
Biomechanical issues of the foot
A sudden injury
Wearing the wrong shoes
Weakened/Inflexible calf muscles
BEING OVERWEIGHT
Spending too much time on your feet
Or, quite frankly, it could be just one of those mysteries of life.
Notice the culprit listed in bold capitol letters above? Yep, your weight has a heck of a lot to do with PF. If you think about it, the foot must take on significant weight on a constant basis. Each step taken, the body weight is absorbed through both feet. The heel takes the brunt of the pressure. When the load is greater than what can be physically tolerated, damage starts and PF begins.
Does this mean fit people including star athletes cannot have PF? Absolutely not. Even football greats such as Eli Manning, quarterback of the New York Giants is in fact dealing with PF as I write this blog.We do however notice individuals who could be more fit for themselves often dealing with PF as opposed to those who control their weight.
So how do I fix it?
Here are a couple of thoughts on fixing PF....
You need to have your feet checked out by a Podiatrist to rule out if in fact you have PF or if there is another cause to your pain.
Wear the appropriate shoes. Don’t know what to wear – consult your local Certified Pedorthist.
If determined the appropriate shoe does not resolve the issue, orthotics are often utilized. Over the counter or custom orthotics may be helpful.
Physical Therapy – if recommended by your Podiatrist, PT can provide amazing results. The key with PT is you have to stick with the program!
Patience - Many people are frustrated when they are not seeing immediate results. As mentioned earlier, recovery takes time.
Finally, it all boils down to this...you need to follow your Podiatrist’s recommendations. No cheating here. PF can be controlled. You need to realize this simply does not go away overnight and it takes time. In some cases, surgical interventions are necessary after exhausting all other treatment avenues. If you truly want to get back to your routine whether it be walking or running or simply to stand up without heel pain, you need to follow the course of treatment which may include one or all of the above.
A note to the ladies….During treatment, your shoe fashion may result in quality athletic shoes. Future shoe options may require more focus than the cutest trends or the sale on the buy one get one teasers. It is a hard transition for some, but quite frankly, don’t you owe it to yourself and your feet?
Healthy Steps….for your feet….for your life!
Some of you may be familiar with the above statements. Some of you are looking for the quick fix, the magic stretch or device to make the “hurt” go away. I hear this a lot from customers and patients of the practice who visit me at the store. It is hard to see the look of despair particularly of runners who want to eliminate this “hurt” they cannot seem to control themselves. When a patient is diagnosed with Plantar Fasciitis from their Podiatrist, they are in a frantic search to make the pain go away fast. Rightfully so as they want to get back to life prior to the diagnosis.
So lets review exactly what this is and options on what to do once you have been told you in fact have good ole Plantar Fasciitis or also known as PF….
How do you say Plantar Fasciitis?
PLAN-tar fashee-EYE-tiss. It’s intriguing to hear from people their version however, this is the correct way to pronounce the words.
What does the Plantar Fascia do?
The plantar fascia is the thick ligamentous band in the bottom of the foot which is attached to the heel. The band runs forward and inserts into the ball of the foot. The plantar fascia encapsulates muscles in the bottom of the foot, however the main function is to support the arch of the foot by acting as a bowstring that connects the ball of the foot to the heel. This "support" enables us to propel ourselves forward more effectively.
Where exactly is the pain located?
Plantar fasciitis pain is found in the center or toward the inner side of the bottom of your heel. A lot of people notice the pain when they stand up after any period of rest especially after sleeping all night. After walking around for a bit, the pain can lessen or virtually disappear.
The interesting thing about this is PF is not caused by the heel striking the ground. PF is often referred to as heel spur syndrome however the spur is not the actual cause of pain. The spur is a sign the PF has been stressed for a period of time. Heel spurs are deposits of calcium in the plantar fascia where it attaches to the heel. You see, a spur is your body trying to respond to the injury and inflammation. So you really cannot blame the spur for causing the pain. It’s actually pretty common for people to have spurs and not have pain.
What caused my Plantar Fasciitis?
Common situations are:
An increase in activity. I.E. cutting grass in the spring on uneven ground and wearing improper footgear.
Biomechanical issues of the foot
A sudden injury
Wearing the wrong shoes
Weakened/Inflexible calf muscles
BEING OVERWEIGHT
Spending too much time on your feet
Or, quite frankly, it could be just one of those mysteries of life.
Notice the culprit listed in bold capitol letters above? Yep, your weight has a heck of a lot to do with PF. If you think about it, the foot must take on significant weight on a constant basis. Each step taken, the body weight is absorbed through both feet. The heel takes the brunt of the pressure. When the load is greater than what can be physically tolerated, damage starts and PF begins.
Does this mean fit people including star athletes cannot have PF? Absolutely not. Even football greats such as Eli Manning, quarterback of the New York Giants is in fact dealing with PF as I write this blog.We do however notice individuals who could be more fit for themselves often dealing with PF as opposed to those who control their weight.
So how do I fix it?
Here are a couple of thoughts on fixing PF....
You need to have your feet checked out by a Podiatrist to rule out if in fact you have PF or if there is another cause to your pain.
Wear the appropriate shoes. Don’t know what to wear – consult your local Certified Pedorthist.
If determined the appropriate shoe does not resolve the issue, orthotics are often utilized. Over the counter or custom orthotics may be helpful.
Physical Therapy – if recommended by your Podiatrist, PT can provide amazing results. The key with PT is you have to stick with the program!
Patience - Many people are frustrated when they are not seeing immediate results. As mentioned earlier, recovery takes time.
Finally, it all boils down to this...you need to follow your Podiatrist’s recommendations. No cheating here. PF can be controlled. You need to realize this simply does not go away overnight and it takes time. In some cases, surgical interventions are necessary after exhausting all other treatment avenues. If you truly want to get back to your routine whether it be walking or running or simply to stand up without heel pain, you need to follow the course of treatment which may include one or all of the above.
A note to the ladies….During treatment, your shoe fashion may result in quality athletic shoes. Future shoe options may require more focus than the cutest trends or the sale on the buy one get one teasers. It is a hard transition for some, but quite frankly, don’t you owe it to yourself and your feet?
Healthy Steps….for your feet….for your life!
Wednesday, September 30, 2009
What the Heck is a Sausage Toe?
A patient came in the other day with a swollen tip of her second toe. She also had a funny looking, thick toenail and really thought that was the cause of her pain and swelling. She related that she had been experiencing throbbing pain, redness and swelling for several months in just the tip of the toe. It had never spread or gotten much worse. She had never experienced drainage or infection symptoms around the toenail. She was unable to wear a closed in shoe and was to the point that she wanted her toe amputated. She had been treated with topical anti-fungals and antibiotics without much result. She was sent to me for another opinion after taking two months of oral anti-fungals and having no change in the nail or toe appearance. What a strange presentation....or is it?
Sausage toe is a whimsical term used to describe a red, hot swollen toe often seen in psoriatic arthritis. It can also be seen in Reiter's syndrome and other seronegative arthropathies. In English, a non-rheumatoid type arthritis. Sausage toe is inflammation of the distal interphalangeal joints (tip of your toe and adjacent knuckle) that looks like a sausage or lollipop. In psoriatic arthritis, it is often accompanied by nail changes that mimic onychomycosis or a fungus in the nails. The nails can be pitted, yellow, thickened, fragmented, and lifting from the tip of the toe. Psoriatic arthritic can occur without the typical skin changes seen in psoriasis, but most patients have some skin lesions.
Sausage toes should be treated aggressively to decrease the inflammation and joint destruction. Long term inflammation can lead to erosive changes and permanent joint pain and stiffness. Joint ankylosis (complete fusion of the joint) can occur in severe cases. Basic treatment starts with nonsteroidal anti-inflammatory drugs, exercise, physical therapy and education. Patient should be taught the "move it or lose it" principal of arthritis management. Exercise and mobilization of the joints, but not overuse and abuse, should be reinforced. Some patients need more aggressive treatment, and this should be part of a comprehensive treatment plan by a rheumatologist.
Sausage toes should not be ignored. They can be caused by many factors such as trauma, infection, osteomyelitis (infection of the bone), and many different rheumatologic disorders as discussed. If you experience a painful, red, swollen toe that just seems to persist; seek the opinion of your podiatrist. Treated early, sausage toe can just be part of a whimsical story instead of a long term disability.
Sausage toe is a whimsical term used to describe a red, hot swollen toe often seen in psoriatic arthritis. It can also be seen in Reiter's syndrome and other seronegative arthropathies. In English, a non-rheumatoid type arthritis. Sausage toe is inflammation of the distal interphalangeal joints (tip of your toe and adjacent knuckle) that looks like a sausage or lollipop. In psoriatic arthritis, it is often accompanied by nail changes that mimic onychomycosis or a fungus in the nails. The nails can be pitted, yellow, thickened, fragmented, and lifting from the tip of the toe. Psoriatic arthritic can occur without the typical skin changes seen in psoriasis, but most patients have some skin lesions.
Sausage toes should be treated aggressively to decrease the inflammation and joint destruction. Long term inflammation can lead to erosive changes and permanent joint pain and stiffness. Joint ankylosis (complete fusion of the joint) can occur in severe cases. Basic treatment starts with nonsteroidal anti-inflammatory drugs, exercise, physical therapy and education. Patient should be taught the "move it or lose it" principal of arthritis management. Exercise and mobilization of the joints, but not overuse and abuse, should be reinforced. Some patients need more aggressive treatment, and this should be part of a comprehensive treatment plan by a rheumatologist.
Sausage toes should not be ignored. They can be caused by many factors such as trauma, infection, osteomyelitis (infection of the bone), and many different rheumatologic disorders as discussed. If you experience a painful, red, swollen toe that just seems to persist; seek the opinion of your podiatrist. Treated early, sausage toe can just be part of a whimsical story instead of a long term disability.
Sunday, September 20, 2009
Ankle pain with no sprain?
I see several patients on a weekly basis that complain of ankle pain that have no history of recent ankle sprain or any trauma. They describe their pain as sharp and burning on the inside of the ankle with swelling and pain that is worse with walking, but continues as aching pain at rest. Some patients can have so much pain that they are unable to walk without crutches.
On exam, I will find that the posterior tibial tendon is swollen and painful usually from behind the ankle bone down to where the tendon inserts in the foot. The job of this tendon is to help the foot swing inward in gait and support the arch. But with flat feet, the tendon is overworked and often then forms small tears in the area just described which then causes pain and swelling. When asking a patient to walk in my office, the affected foot will show minimal to no arch height and the ankle will appear to be falling inward, sometimes almost touching the ground. There is usually pain with isolating this tendon on a muscle exam as well.
If you think you may have this condition, the physicians at Foot and Ankle Associates of North Texas are here to help!
Friday, August 28, 2009
Ugly Toenails Linked With Depression! New Treatments Are Available!
Many people suffer from a common problem: ugly, thick toenails. Often this is caused by onychomycosis, a fungal infection in the nails. Most people actually feel this is simply a minor cosmetic problem and really do not classify this as a disease. Reality is that onychomycosis can actually be a devastating problem for many people. In fact, a recent study has linked onychomycosis with depression in otherwise healthy patients.
Onychomycosis, over a period of time, makes your nails yellow, thick and often extremely disfigured. This is embarrassing and many people hide their toes in closed in shoes due to the disfigurement. Many people will even wear sneakers to the beach to avoid showing their toenails. Surveys have shown a lack of intimacy, decreased feelings of self-worth and depression associated with onychomycosis. With almost 30% of the adult population suffering from toenail fungus, and this number increasing to almost 90% in the elderly, why do most people feel it is just cosmetic? Because it hasn’t happened to them yet!
There is hope for people who suffer from toenail fungus. Traditional topical and oral therapies have been less successful than patient expectations. Lots of unhappy people with sever frustration!
Topical therapies patients have tried encompass a wide variety of products and folklore including the use of Vick’s Vaporub, organic cornmeal soaks, and a variety of over-the-counter products. Even the only FDA approved prescription topical, ciclopirox, is shown to be only 8% effective in their own package insert! Imagine painting your toenail with a topical therapy for over a year, every day, and still having ugly toenails!
After failure of topical therapy, most people discuss oral anti-fungals with their doctors. Common oral therapies include terbinafine, fluconazole, and itraconazole. These are more effective than any topical, but come with possible side effects including many drug interactions and liver problems. They are touted as somewhere between 50 and 70% effective depending on dosage and duration of therapy. Many people after taking these medications still have ugly toenails! More frustration!
Hope has recently increased for patients who have struggled with chronic onychomycosis. New laser therapy for onychomycosis is the most exciting treatment now available. A pulsed UVA laser has been shown in preliminary studies to eradicate much of the fungus and often clearing is seen in 9 to 12 months. This therapy is not widely available, but has been shown to be around 80% effective in these early studies. The FDA is still reviewing the Patholase laser application for approval, but the treatment is available in limited areas as an “off-label” usage. The laser light is painless and only affects the infected tissue. Hope abounds!
Funky looking toenails can also occur from psoriasis, eczema and other nail pathologies. If you have thick, nasty looking toenails, a visit to your local podiatrist for a PAS (Periodic acid-Schiff) stain of a piece of your toenail will determine if you have a fungal infection. If you have a positive PAS stain, look into the new laser therapy before your toenails cause a lifestyle change! There is hope even if you have suffered from embarrassing toenails for years!
Onychomycosis, over a period of time, makes your nails yellow, thick and often extremely disfigured. This is embarrassing and many people hide their toes in closed in shoes due to the disfigurement. Many people will even wear sneakers to the beach to avoid showing their toenails. Surveys have shown a lack of intimacy, decreased feelings of self-worth and depression associated with onychomycosis. With almost 30% of the adult population suffering from toenail fungus, and this number increasing to almost 90% in the elderly, why do most people feel it is just cosmetic? Because it hasn’t happened to them yet!
There is hope for people who suffer from toenail fungus. Traditional topical and oral therapies have been less successful than patient expectations. Lots of unhappy people with sever frustration!
Topical therapies patients have tried encompass a wide variety of products and folklore including the use of Vick’s Vaporub, organic cornmeal soaks, and a variety of over-the-counter products. Even the only FDA approved prescription topical, ciclopirox, is shown to be only 8% effective in their own package insert! Imagine painting your toenail with a topical therapy for over a year, every day, and still having ugly toenails!
After failure of topical therapy, most people discuss oral anti-fungals with their doctors. Common oral therapies include terbinafine, fluconazole, and itraconazole. These are more effective than any topical, but come with possible side effects including many drug interactions and liver problems. They are touted as somewhere between 50 and 70% effective depending on dosage and duration of therapy. Many people after taking these medications still have ugly toenails! More frustration!
Hope has recently increased for patients who have struggled with chronic onychomycosis. New laser therapy for onychomycosis is the most exciting treatment now available. A pulsed UVA laser has been shown in preliminary studies to eradicate much of the fungus and often clearing is seen in 9 to 12 months. This therapy is not widely available, but has been shown to be around 80% effective in these early studies. The FDA is still reviewing the Patholase laser application for approval, but the treatment is available in limited areas as an “off-label” usage. The laser light is painless and only affects the infected tissue. Hope abounds!
Funky looking toenails can also occur from psoriasis, eczema and other nail pathologies. If you have thick, nasty looking toenails, a visit to your local podiatrist for a PAS (Periodic acid-Schiff) stain of a piece of your toenail will determine if you have a fungal infection. If you have a positive PAS stain, look into the new laser therapy before your toenails cause a lifestyle change! There is hope even if you have suffered from embarrassing toenails for years!
Wednesday, May 13, 2009
Pregnancy and Your Achy Feet
I'm Pregnant.. My belly is getting bigger, I expected that. What I didnt expect was the swollen feet, the burning arch pain and the change in shoe size.
Did you know that during pregnancy your foot size increases at least a half size per pregnancy and is usually permanent after the 2nd one. Some women would be happy with that, an excuse to buy new shoes.. The problem is that most women dont realize that there shoes are to small. Measure your feet once a month and every time you buy shoes! You would be surprised by the changes in your feet.
Buying new shoes.. an easy fix.. But what about all the pain in my feet, and why are they so achy and tired. I have never had a foot problem before...
As your waist line expands, the weight gain can actually cause a change in your posture. The change in posture can cause you to walk differently.... which leads to abnormal stress on your back, knees, and feet. Your body is not used to this stress and will respond with pain, tenderness and overall discomfort.
The most common complaints that I see in my pregnant patients are: swollen feet, over pronation( foot flattening out like a pancake), arch pain, arch fatigue, heel pain, ingrown toenails and cramping of the feet and legs.
There are some easy fixes to make you a little more comfortable during this wonderful time of pregnancy. Make sure your shoes are the right size.. this will help prevent ingrown toenails, always wear supportive shoes, and never go barefoot. Maternity compression stockings are a good way to prevent swollen feet. Make sure you are stretching your legs and feet, always stretch before any type of exercise and make sure you are taking your prenatal vitamins.
Did you know that during pregnancy your foot size increases at least a half size per pregnancy and is usually permanent after the 2nd one. Some women would be happy with that, an excuse to buy new shoes.. The problem is that most women dont realize that there shoes are to small. Measure your feet once a month and every time you buy shoes! You would be surprised by the changes in your feet.
Buying new shoes.. an easy fix.. But what about all the pain in my feet, and why are they so achy and tired. I have never had a foot problem before...
As your waist line expands, the weight gain can actually cause a change in your posture. The change in posture can cause you to walk differently.... which leads to abnormal stress on your back, knees, and feet. Your body is not used to this stress and will respond with pain, tenderness and overall discomfort.
The most common complaints that I see in my pregnant patients are: swollen feet, over pronation( foot flattening out like a pancake), arch pain, arch fatigue, heel pain, ingrown toenails and cramping of the feet and legs.
There are some easy fixes to make you a little more comfortable during this wonderful time of pregnancy. Make sure your shoes are the right size.. this will help prevent ingrown toenails, always wear supportive shoes, and never go barefoot. Maternity compression stockings are a good way to prevent swollen feet. Make sure you are stretching your legs and feet, always stretch before any type of exercise and make sure you are taking your prenatal vitamins.
Thursday, April 30, 2009
The $2,000 Rusty Nail!
It all started with a late Saturday afternoon phone call. My hairdresser, Anne, called to ask if I could possibly look at her foot. Now! It seems that she and her daughter were in a creative mood while doing yard work that afternoon. They decided to rip up an old deck and make a new flower bed. Unfortunately, that old deck had a lot of ancient rotted wood held together with rusty nails. Anne was unlucky enough to have stepped on one of those rusty nails and had it stuck in her foot. Her daughter removed the board with the nail, but now, just a few hours later, Anne was quite concerned with the way her foot looked. She had cleansed the area with peroxide and put some ointment on it; but now her foot was red and swollen. Help!
Anne came over to my house so I could look at her foot. She had a typical puncture wound on the bottom of her foot with redness surrounding the wound and lots of drainage. It definitely looked like she may still have part of the nail and even maybe part of her shoe still in her foot. Infection was setting in! Off to the ER she went for x-rays and I scheduled an operating room to clean out the wound.
Her x-rays showed at least 50 small pieces of metal still in her foot. After I performed surgery to clean the wound, spending an hour taking small pieces of rust and metal shavings, as well a piece of sock and shoe out of her foot; Anne’s foot was on it’s way to recovery. Unfortunately, her wallet was $2,000 lighter after paying her deductible. So much for saving money by doing your own yard work!
What have we learned from Anne’s story? Hire yard workers? No, a better lesson is to address puncture wounds immediately! They are often much more contaminated than they look. Puncture wounds are extremely common in the foot. Even though they are extremely common, most people do not treat them adequately. Getting proper treatment within 24 hours is important in decreasing the infections that lead to serious complications.
Foreign bodies embedded in a puncture wound are extremely common. All kinds of things like toothpicks, glass, small pebbles, needles, nails and even wiry pet hair can become stuck in a puncture wound. Even pieces of your own skin, sock and shoe as well as dirt and foliage can be contaminating a puncture wound. Remember that all puncture wounds are considered dirty wounds because they involve penetration of the skin with a non-sterile object. Regardless of the foreign body, anything that remains in a wound can become an abscess and lead to a severe infection.
Treatment of puncture wounds should begin within 24 hours of the wound and start with cleansing of the wound and close monitoring until it is healed. Surgical cleaning with removal of any foreign bodies is often necessary coupled with a week or two of antibiotics, depending on the wound contamination. X-rays may even be needed to evaluate the bone structure for any involvement. A bonus is that metallic foreign bodies can also be detected by x-ray.
Often foreign bodies can be missed in the emergency room, so proper follow up with your podiatrist is important. Infection is a common complication, so your doctor will monitor your wound closely until it heals. Any changes, swelling, redness or discharge should be reported immediately. In diabetics or patients with poor circulation, a puncture wound can lead to an infection so serious that it leads to an amputation. Do not delay treatment! Hindsight is always 20/20, but you don’t want to be the one wishing they had come into the office when they are in the hospital with a severe infection.
Do not play around with puncture wounds, seek medical attention immediately!
Anne came over to my house so I could look at her foot. She had a typical puncture wound on the bottom of her foot with redness surrounding the wound and lots of drainage. It definitely looked like she may still have part of the nail and even maybe part of her shoe still in her foot. Infection was setting in! Off to the ER she went for x-rays and I scheduled an operating room to clean out the wound.
Her x-rays showed at least 50 small pieces of metal still in her foot. After I performed surgery to clean the wound, spending an hour taking small pieces of rust and metal shavings, as well a piece of sock and shoe out of her foot; Anne’s foot was on it’s way to recovery. Unfortunately, her wallet was $2,000 lighter after paying her deductible. So much for saving money by doing your own yard work!
What have we learned from Anne’s story? Hire yard workers? No, a better lesson is to address puncture wounds immediately! They are often much more contaminated than they look. Puncture wounds are extremely common in the foot. Even though they are extremely common, most people do not treat them adequately. Getting proper treatment within 24 hours is important in decreasing the infections that lead to serious complications.
Foreign bodies embedded in a puncture wound are extremely common. All kinds of things like toothpicks, glass, small pebbles, needles, nails and even wiry pet hair can become stuck in a puncture wound. Even pieces of your own skin, sock and shoe as well as dirt and foliage can be contaminating a puncture wound. Remember that all puncture wounds are considered dirty wounds because they involve penetration of the skin with a non-sterile object. Regardless of the foreign body, anything that remains in a wound can become an abscess and lead to a severe infection.
Treatment of puncture wounds should begin within 24 hours of the wound and start with cleansing of the wound and close monitoring until it is healed. Surgical cleaning with removal of any foreign bodies is often necessary coupled with a week or two of antibiotics, depending on the wound contamination. X-rays may even be needed to evaluate the bone structure for any involvement. A bonus is that metallic foreign bodies can also be detected by x-ray.
Often foreign bodies can be missed in the emergency room, so proper follow up with your podiatrist is important. Infection is a common complication, so your doctor will monitor your wound closely until it heals. Any changes, swelling, redness or discharge should be reported immediately. In diabetics or patients with poor circulation, a puncture wound can lead to an infection so serious that it leads to an amputation. Do not delay treatment! Hindsight is always 20/20, but you don’t want to be the one wishing they had come into the office when they are in the hospital with a severe infection.
Do not play around with puncture wounds, seek medical attention immediately!
Tuesday, April 21, 2009
Bunion Surgery Revealed!
Many patients are very apprehensive about bunion surgery. They have heard horror stories of severe pain and bad outcomes. These are usually not true. Bunion surgery is actually quite successful, in the right patient, done by the right doctor. Most patients have a lot of questions about whether they should have surgery and what to expect during and after surgery. This is an attempt to dispel old wive's tales and help you to make a more informed decision about bunion surgery. It is important to remember that every patient is different and this information is just to help you prepare to discuss your surgery with your doctor.
Who should do your surgery? Podiatrist versus orthopedic surgeon? A board-certified podiatric foot and ankle surgeon usually has much more experience in bunion surgery than the average orthopedic surgeon. Make sure your surgeon, no matter what their credentials (MD, DO, DPM), has passed their board certification and has experience in your type of surgery.
Who should consider bunion surgery? If your foot hurts every day, in every pair of shoes, and you have failed conservative treatment which should include: wider shoes, anti-inflammatories, padding, orthotics, and possibly steroid injection; you are a candidate for bunion surgery.
Bunion surgery involves an incision along the top of the big toe joint and the removal and realignment of soft tissue and bone to restore normal joint alignment and to relieve pain. The first metatarsal bone is often cut, realigned and then stabilized with small screws. There are no guarantees that a bunion surgery will fully relieve your pain because of wear and tear arthritic change to the joint and nerve damage from the deformity. Most patients achieve at least 85% relief of their symptoms.
Anesthesia selection is really patient and procedure specific, but light to moderate sedation, to make you sleepy, coupled with a local anesthetic block, similar to the dentist, is often used during the procedure. Some people do require general anesthesia due to a history of local anesthetic complications or other medical problems.
The procedure usually takes a little more than an hour, depending on the type of surgery. A more complicated bunionectomy can take two hours or more.
Bunion surgeries are usually done on an outpatient basis at a free standing surgery center or outpatient center at a hospital.
The most common types of bunion surgery are:
1. Keller: Removal of part of the metatarsal head (the part of the foot that is bulging out) and the base of the proximal phalanx (removal of part of the toe joint). This procedure is called a Keller bunionectomy. These usually work well in an arthritic joint but do not allow for complete joint function after surgery. Usually these are used in the elderly.
2. Austin or Chevron: Realignment of the soft tissue ligaments around the big toe joint. Removal of the part of the metatarsal head (the bump). Then, the first metatarsal bone is cut in a V-fashion then moved laterally to realign the joint. The cut or osteotomy is then stabilized with a pin or two small screws. This is the most common procedure and is known as an Austin bunionectomy.
3. Lapidus: Realignment of the soft tissue ligaments around the big toe joint. Removal of the part of the metatarsal head (the bump). Then, removal of a wedge of bone from the base of the first metatarsal and the bone adjacent to it (the cuneiform) as well as the cartilage surface of the two bones. The first metatarsal cuneiform joint is then reshaped and stabilized with two large screws or a plate. This increases the stability of the area and decreases recurrence of a bunion deformity. This procedure is known as a Lapidus fusion and is usually performed in adolescents or adults with really flexible foot deformities.
4. Other Procedures: Fusion (arthrodesis) of the big toe joint or Total Joint Implant (arthroplasty) are also common, but usually used when the joint is severely damaged and is not repairable.
The usual recovery period after bunion surgery is 8 weeks to 4 months, depending on the procedure and the health of the patient. Compliance also dictates how fast a patient heals. Swelling after surgery can last for up to a year.
In a Keller or Austin, the patient is usually completely off their feet for just a few days, then in a walking cast or special shoe for 4 to 8 weeks. Normal activity is usually resumed in 2 to 3 months.
In a Lapidus fusion, most patients are in a hard below knee cast completely non-weight bearing for 8 weeks, then a walking cast for 2 weeks, then a sneaker for another month. Normal activity is usually resumed in 4 months.
Every patient is different. Some patients have softer bone and require longer immobilization. Some patients require physical therapy after surgery.
There are risks involved in having any type of surgery. No matter how good your surgeon is, if you do not follow directions you may have a bad outcome. Scarring, prolonged swelling, a stiff joint, numbness, shortening of the big toe, degenerative arthritis, infection and continued pain are the most common complications. More serious complications can include non-healing of bone or a severe infection requiring a second surgery.
After having bunion surgery, most people are happy with the results. A survey by the American College of Foot and Ankle Surgeons revealed 95% of patients with good to excellent outcomes form their bunion surgery. After having surgery, your ability to walk and be active is likely to improve. The big toe joint is usually much less painful and functions better.
Some people are disappointed with their surgery results even though their joint looks and functions better. This is usually due to unrealistic expectations. You will still not be able to wear extremely high heeled shoes after surgery and it is unrealistic to think that your joint will be "perfect" or function like it never had a problem. With realistic expectation, most patients are happy with their bunion surgery.
Who should do your surgery? Podiatrist versus orthopedic surgeon? A board-certified podiatric foot and ankle surgeon usually has much more experience in bunion surgery than the average orthopedic surgeon. Make sure your surgeon, no matter what their credentials (MD, DO, DPM), has passed their board certification and has experience in your type of surgery.
Who should consider bunion surgery? If your foot hurts every day, in every pair of shoes, and you have failed conservative treatment which should include: wider shoes, anti-inflammatories, padding, orthotics, and possibly steroid injection; you are a candidate for bunion surgery.
Bunion surgery involves an incision along the top of the big toe joint and the removal and realignment of soft tissue and bone to restore normal joint alignment and to relieve pain. The first metatarsal bone is often cut, realigned and then stabilized with small screws. There are no guarantees that a bunion surgery will fully relieve your pain because of wear and tear arthritic change to the joint and nerve damage from the deformity. Most patients achieve at least 85% relief of their symptoms.
Anesthesia selection is really patient and procedure specific, but light to moderate sedation, to make you sleepy, coupled with a local anesthetic block, similar to the dentist, is often used during the procedure. Some people do require general anesthesia due to a history of local anesthetic complications or other medical problems.
The procedure usually takes a little more than an hour, depending on the type of surgery. A more complicated bunionectomy can take two hours or more.
Bunion surgeries are usually done on an outpatient basis at a free standing surgery center or outpatient center at a hospital.
The most common types of bunion surgery are:
1. Keller: Removal of part of the metatarsal head (the part of the foot that is bulging out) and the base of the proximal phalanx (removal of part of the toe joint). This procedure is called a Keller bunionectomy. These usually work well in an arthritic joint but do not allow for complete joint function after surgery. Usually these are used in the elderly.
2. Austin or Chevron: Realignment of the soft tissue ligaments around the big toe joint. Removal of the part of the metatarsal head (the bump). Then, the first metatarsal bone is cut in a V-fashion then moved laterally to realign the joint. The cut or osteotomy is then stabilized with a pin or two small screws. This is the most common procedure and is known as an Austin bunionectomy.
3. Lapidus: Realignment of the soft tissue ligaments around the big toe joint. Removal of the part of the metatarsal head (the bump). Then, removal of a wedge of bone from the base of the first metatarsal and the bone adjacent to it (the cuneiform) as well as the cartilage surface of the two bones. The first metatarsal cuneiform joint is then reshaped and stabilized with two large screws or a plate. This increases the stability of the area and decreases recurrence of a bunion deformity. This procedure is known as a Lapidus fusion and is usually performed in adolescents or adults with really flexible foot deformities.
4. Other Procedures: Fusion (arthrodesis) of the big toe joint or Total Joint Implant (arthroplasty) are also common, but usually used when the joint is severely damaged and is not repairable.
The usual recovery period after bunion surgery is 8 weeks to 4 months, depending on the procedure and the health of the patient. Compliance also dictates how fast a patient heals. Swelling after surgery can last for up to a year.
In a Keller or Austin, the patient is usually completely off their feet for just a few days, then in a walking cast or special shoe for 4 to 8 weeks. Normal activity is usually resumed in 2 to 3 months.
In a Lapidus fusion, most patients are in a hard below knee cast completely non-weight bearing for 8 weeks, then a walking cast for 2 weeks, then a sneaker for another month. Normal activity is usually resumed in 4 months.
Every patient is different. Some patients have softer bone and require longer immobilization. Some patients require physical therapy after surgery.
There are risks involved in having any type of surgery. No matter how good your surgeon is, if you do not follow directions you may have a bad outcome. Scarring, prolonged swelling, a stiff joint, numbness, shortening of the big toe, degenerative arthritis, infection and continued pain are the most common complications. More serious complications can include non-healing of bone or a severe infection requiring a second surgery.
After having bunion surgery, most people are happy with the results. A survey by the American College of Foot and Ankle Surgeons revealed 95% of patients with good to excellent outcomes form their bunion surgery. After having surgery, your ability to walk and be active is likely to improve. The big toe joint is usually much less painful and functions better.
Some people are disappointed with their surgery results even though their joint looks and functions better. This is usually due to unrealistic expectations. You will still not be able to wear extremely high heeled shoes after surgery and it is unrealistic to think that your joint will be "perfect" or function like it never had a problem. With realistic expectation, most patients are happy with their bunion surgery.
Tuesday, April 14, 2009
Friday, April 10, 2009
Ugg Boots Cause Foot Pain!
Ugg Boots Linked to Foot Pain!!!
Check out this video...first flip flops, then Ugg boots...the fashion world need to embrace better shoes!!
Click here for video from ABC news
Check out this video...first flip flops, then Ugg boots...the fashion world need to embrace better shoes!!
Click here for video from ABC news
Thursday, April 2, 2009
Sound Familiar?
James “Buster” Douglas – Boxer
Gary Hall Jr. - US Olympic Gold Medalist, Swimming
“Smokin’ Joe” Frazier – Boxing
Chris Dudley- NBA/New York Knicks center
Ayden Byle -Runner/First insulin-dependent man to run 6521.5 km across North America.
Sir Steven Redgrave - Rower/Winner of five consecutive Olympic gold medals
Ron Santo - MLB/Chicago Cubs legend
Kendall Simmons - NFL/Pittsburgh Steelers
Scott Coleman - Swimmer/First man with diabetes to swim the English Channel, (August 17th 1996)
Sherri Turner - LPGA golfer
Chuck Heidenrich – Skiing
The names listed above are pretty well known. They are known for there athletic ability, determination and talent to the sport. I bet you can’t guess what the common denominator is can you? Believe it or not, each person listed above has Diabetes. Surprising eh?
For those with Diabetes, you can control this disease. The combination of understanding the disease, consistent care and proper nutrition as per your physician is proof that a person can live a normal lifestyle to excelling at the elite athlete level.
For every goal, there are three times as many excuses not to obtain a goal. For example, – if a person is told to control their weight, the excuses multiply by the minute. Have you ever told yourself :
I don’t have time.
I don’t know how to lose weight.
My feet hurt too much when I exercise.
I just don’t feel like working out.
The list of excuses goes on and on. Ultimately, the decision is yours on how healthy your live can be. Break the mold and make the choice to place health at the forefront. Small changes can do wonders from diet to level of activity. Think about how many sessions you could have with a trainer or nutrition counselor each time you pick up that carton of cigarettes or sugar loaded snack when shopping or that large platter of food you ordered while at a restaurant.
Start each day with the right choice - your life depends on it.
Janet Dixon, C.Ped
Healthy Steps DFW...for your feet, for your life...
Gary Hall Jr. - US Olympic Gold Medalist, Swimming
“Smokin’ Joe” Frazier – Boxing
Chris Dudley- NBA/New York Knicks center
Ayden Byle -Runner/First insulin-dependent man to run 6521.5 km across North America.
Sir Steven Redgrave - Rower/Winner of five consecutive Olympic gold medals
Ron Santo - MLB/Chicago Cubs legend
Kendall Simmons - NFL/Pittsburgh Steelers
Scott Coleman - Swimmer/First man with diabetes to swim the English Channel, (August 17th 1996)
Sherri Turner - LPGA golfer
Chuck Heidenrich – Skiing
The names listed above are pretty well known. They are known for there athletic ability, determination and talent to the sport. I bet you can’t guess what the common denominator is can you? Believe it or not, each person listed above has Diabetes. Surprising eh?
For those with Diabetes, you can control this disease. The combination of understanding the disease, consistent care and proper nutrition as per your physician is proof that a person can live a normal lifestyle to excelling at the elite athlete level.
For every goal, there are three times as many excuses not to obtain a goal. For example, – if a person is told to control their weight, the excuses multiply by the minute. Have you ever told yourself :
I don’t have time.
I don’t know how to lose weight.
My feet hurt too much when I exercise.
I just don’t feel like working out.
The list of excuses goes on and on. Ultimately, the decision is yours on how healthy your live can be. Break the mold and make the choice to place health at the forefront. Small changes can do wonders from diet to level of activity. Think about how many sessions you could have with a trainer or nutrition counselor each time you pick up that carton of cigarettes or sugar loaded snack when shopping or that large platter of food you ordered while at a restaurant.
Start each day with the right choice - your life depends on it.
Janet Dixon, C.Ped
Healthy Steps DFW...for your feet, for your life...
Sunday, March 15, 2009
Got Cold Feet?
And no, I’m not talking about the British TV show or a runaway bride. Are your feet always cold? Is your skin cool, clammy, or extremely dry? Many people experience the symptoms of cold feet on a daily basis, but ignore it thinking that it is a minor complaint. This is a mistake. If your feet are always cold and the symptoms are increasing, you should seek the advice of your podiatrist.
Cold feet can be a symptom of many different disorders including:
1. diabetes
2. hypothyroidism
3. anemia
4. peripheral neuropathy
5. coronary artery disease/aortic dissection
6. peripheral arterial disease
7. raynaud’s phenomenon
8. side effect of heart medications for blood pressure and arrythmias
9. early frostbite
10. restless legs syndrome
11. tarsal tunnel syndrome
12. significant stress
None of these disorders are minor and cold feet can be one of the earliest symptoms.
A closer look at the symptom of cold feet by your podiatrist may include:
1. non-invasive arterial examination
2. neuropathy screening
3. Blood work including a rheumatoid panel, thyroid levels, and blood counts
More advances screenings are sometime warranted and can include:
1. arteriogram
2. nerve conduction velocities
3. EKG or echocardiogram
The most common reason people have cold feet is poor circulation. This is usually described as peripheral arterial disease or hardening of the arteries. Peripheral arterial disease (PAD) is narrowing or blockage of arteries that results in poor blood flow to your feet. Clogged arteries in the legs and feet increase your risk for having a heart attack or stroke. Plaque buildup in the legs does not always cause significant symptoms, so many people can have severe circulation problems and not know it. People who do experience symptoms, such as cold feet, pain or cramping in the legs, often do not tell their doctos, because they believe they are a natural part of aging or due to another cause.
One in every 20 Americans over the age of 50 has arterial disease and it is estimated that over 8 million are undiagnosed. Early detection of circulation problems has been shown to save limbs and lives, so if you have cold feet or any of the risk factors you should undergo screening by your podiatrist yearly or more often if symptoms occur.
Your podiatrist should be able to address your cold feet and send you down the path to warmer days or at least to understanding why you have cold feet.
If all the screening exams are normal, you may just have genetically colder feet than the average. Wear socks to bed! Or you may be experiencing stress. Cold clammy skin can be explained by the release of the hormones, epinephrine and norepinephrine, and is a sympathetic response to stress. Your body is telling you to calm down!
Bottom line: If you are not impending marriage or haven’t just finished a day of skiing, your cold feet are probably trying to tell you something! Listen to them!
Cold feet can be a symptom of many different disorders including:
1. diabetes
2. hypothyroidism
3. anemia
4. peripheral neuropathy
5. coronary artery disease/aortic dissection
6. peripheral arterial disease
7. raynaud’s phenomenon
8. side effect of heart medications for blood pressure and arrythmias
9. early frostbite
10. restless legs syndrome
11. tarsal tunnel syndrome
12. significant stress
None of these disorders are minor and cold feet can be one of the earliest symptoms.
A closer look at the symptom of cold feet by your podiatrist may include:
1. non-invasive arterial examination
2. neuropathy screening
3. Blood work including a rheumatoid panel, thyroid levels, and blood counts
More advances screenings are sometime warranted and can include:
1. arteriogram
2. nerve conduction velocities
3. EKG or echocardiogram
The most common reason people have cold feet is poor circulation. This is usually described as peripheral arterial disease or hardening of the arteries. Peripheral arterial disease (PAD) is narrowing or blockage of arteries that results in poor blood flow to your feet. Clogged arteries in the legs and feet increase your risk for having a heart attack or stroke. Plaque buildup in the legs does not always cause significant symptoms, so many people can have severe circulation problems and not know it. People who do experience symptoms, such as cold feet, pain or cramping in the legs, often do not tell their doctos, because they believe they are a natural part of aging or due to another cause.
One in every 20 Americans over the age of 50 has arterial disease and it is estimated that over 8 million are undiagnosed. Early detection of circulation problems has been shown to save limbs and lives, so if you have cold feet or any of the risk factors you should undergo screening by your podiatrist yearly or more often if symptoms occur.
Your podiatrist should be able to address your cold feet and send you down the path to warmer days or at least to understanding why you have cold feet.
If all the screening exams are normal, you may just have genetically colder feet than the average. Wear socks to bed! Or you may be experiencing stress. Cold clammy skin can be explained by the release of the hormones, epinephrine and norepinephrine, and is a sympathetic response to stress. Your body is telling you to calm down!
Bottom line: If you are not impending marriage or haven’t just finished a day of skiing, your cold feet are probably trying to tell you something! Listen to them!
Wednesday, March 4, 2009
Pesky Warts, Why Wont They go Away?
Pesky Warts... Why wont they go away??
Warts are a virus that are common in both children and adults. Although kids are more prone to warts, adults can get them too! Most commonly warts appear on the hands and feet. Warts on the hands are much easier to get rid of because the skin is very thin on your hands. Most often your pediatrician or dermatologist will perform cryotherapy (freeze) the warts and they will go away.
Warts on the feet?? That is another story..
The skin on the feet is very thick. It helps protect us so when we walk we dont get hurt. Well warts love the feet. The wart virus is attracted to warm wet places, like sweaty feet!
So how do we get rid of them? There is good and bad news. The bad news is that these pesky warts are difficult to get rid of, and usually will not go away with just freezing them. The good news is that we treat them all the time and have been for many years so we have figured out some great tricks to get rid of these pesky things. There are many different treatment combinations that we have found to help speed up the process of getting rid of these pesky things, for more information you can click here.
Warts are a virus that are common in both children and adults. Although kids are more prone to warts, adults can get them too! Most commonly warts appear on the hands and feet. Warts on the hands are much easier to get rid of because the skin is very thin on your hands. Most often your pediatrician or dermatologist will perform cryotherapy (freeze) the warts and they will go away.
Warts on the feet?? That is another story..
The skin on the feet is very thick. It helps protect us so when we walk we dont get hurt. Well warts love the feet. The wart virus is attracted to warm wet places, like sweaty feet!
So how do we get rid of them? There is good and bad news. The bad news is that these pesky warts are difficult to get rid of, and usually will not go away with just freezing them. The good news is that we treat them all the time and have been for many years so we have figured out some great tricks to get rid of these pesky things. There are many different treatment combinations that we have found to help speed up the process of getting rid of these pesky things, for more information you can click here.
Sunday, February 15, 2009
Toenail Fungus Laser Treatment a Success!
TOENAIL FUNGUS LASER TREATMENT
TREAT YOUR TOENAIL FUNGUS SAFELY AND PAINLESSLY
with the new PinPointe FootLaser
Coming in May to Foot & Ankle Associates of North Texas LLP in Grapevine!
This new patented laser technology kills the pathogens that cause toenail fungus (Onychomycosis)
The gentle laser light works through the nail
No side effects
Does not harm the nail or skin
Painless-no anesthesia needed
Usually only one treatment required
Shoes and nail polish can be worn immediately after treatment
How does the laser work?
This patented laser is specially designed to shine through your toenail and destroy the specific pathogens embedded in and under your nail causing the infection. The FootLaser operates in the very tight spectrum of near infa red light. Unlike CO2 lasers of the past, this laser safely destroys the fungi, molds and bacteria that often cause onychomycosis.
Is this laser painful?
The gentle laser light beam has no effect on healthy tissue. There is no discomfort associated with the treatment during or after. This treatment does not harm or affect your activity in any way.
Does it really work?
In the first clinical study, earlier this year, 88% of the treated patients grew out a normal looking nail after one treatment. After the one treatment, the nail plate should grow out normally in 6-12 months if there is a healthy nail bed. This result is comparable to the success rate for the oral pill, Lamisil, which you take for three or four months with some risk of side effects. Additional information can be found at www.pinpointefootlaser.com
Is this treatment safe?
There are no age or health restrictions or limitations. In clinical studies there have been no adverse reactions, injuries, disabilities or known side effects. As you may know, the use of the medication available today for treatment of fungus toenails, carries with it possible systemic involvement (commonly the liver and kidney). This laser does not!
Does my insurance pay for this?
Because this treatment is considered aesthetic (cosmetic), health insurance plans do not cover this treatment. We accept major credit cards and personal checks or you may use your Flexible Spending Account from work. We also offer an interest free payment plan through Care Credit.
How Much Does It Cost?
The laser treatment is applied to all of the toenails on both feet, even the ones that appear uninfected. This reduces the chance of re-infection and takes about 30 minutes. There is an initial consultation with the doctor, which costs $75, to see if you are a candidate for the treatment. This is credited towards your procedure fee if you proceed with treatment. The treatment fee is $850. If the infection is resistant or has not responded with normal nail growth, the nails may need another laser treatment. This often occurs when all ten nails are severely infected. An additional treatment within the first six months is discounted to $450.
TREAT YOUR TOENAIL FUNGUS SAFELY AND PAINLESSLY
with the new PinPointe FootLaser
Coming in May to Foot & Ankle Associates of North Texas LLP in Grapevine!
This new patented laser technology kills the pathogens that cause toenail fungus (Onychomycosis)
The gentle laser light works through the nail
No side effects
Does not harm the nail or skin
Painless-no anesthesia needed
Usually only one treatment required
Shoes and nail polish can be worn immediately after treatment
How does the laser work?
This patented laser is specially designed to shine through your toenail and destroy the specific pathogens embedded in and under your nail causing the infection. The FootLaser operates in the very tight spectrum of near infa red light. Unlike CO2 lasers of the past, this laser safely destroys the fungi, molds and bacteria that often cause onychomycosis.
Is this laser painful?
The gentle laser light beam has no effect on healthy tissue. There is no discomfort associated with the treatment during or after. This treatment does not harm or affect your activity in any way.
Does it really work?
In the first clinical study, earlier this year, 88% of the treated patients grew out a normal looking nail after one treatment. After the one treatment, the nail plate should grow out normally in 6-12 months if there is a healthy nail bed. This result is comparable to the success rate for the oral pill, Lamisil, which you take for three or four months with some risk of side effects. Additional information can be found at www.pinpointefootlaser.com
Is this treatment safe?
There are no age or health restrictions or limitations. In clinical studies there have been no adverse reactions, injuries, disabilities or known side effects. As you may know, the use of the medication available today for treatment of fungus toenails, carries with it possible systemic involvement (commonly the liver and kidney). This laser does not!
Does my insurance pay for this?
Because this treatment is considered aesthetic (cosmetic), health insurance plans do not cover this treatment. We accept major credit cards and personal checks or you may use your Flexible Spending Account from work. We also offer an interest free payment plan through Care Credit.
How Much Does It Cost?
The laser treatment is applied to all of the toenails on both feet, even the ones that appear uninfected. This reduces the chance of re-infection and takes about 30 minutes. There is an initial consultation with the doctor, which costs $75, to see if you are a candidate for the treatment. This is credited towards your procedure fee if you proceed with treatment. The treatment fee is $850. If the infection is resistant or has not responded with normal nail growth, the nails may need another laser treatment. This often occurs when all ten nails are severely infected. An additional treatment within the first six months is discounted to $450.
or
To make an appointment for your initial consultation, call (817)416-6155 or contactus@faant.com
To make an appointment for your initial consultation, call (817)416-6155 or contactus@faant.com
Friday, February 13, 2009
Bamboo For Who? How about you!
Lately, the new buzz word in environmentally friendly materials is Bamboo. So what’s the deal with Bamboo? Here is the scoop from our friends at Dr. Comfort labs:
Bamboo Charcoal was discovered during the Ming Dynasty in 1486 A.D. Today Molecular Nano Bamboo Charcoal is made when bamboo charcoal powder is refined by temperatures over 700 degrees. Nano Bamboo Charcoal Fiber (NBCF) is able to release FAR Infrared Rays that may promote blood circulation and increase Anion production.
NBCF is also a natural deodorizer which has innumerable hole structures to absorb and decompose benzene, phenol, methanol sulfides, and nitrides. Bamboo also helps reduce odors from NH3 gas, adjust for moisture, release Anions and restrain microbial growth. The ability for NBCF to regulate skin temperature will also assist in thermoregulating your feet more effectively than traditional materials. As a sustainable natural resource over hardwood charcoal due to its rapid growth cycle, NBCF will protect the environment as no chemicals are required for this product.
Healthy Steps is proud to offer our customers the Dr. Comfort brand Bamboo Seamless Diabetic Socks. Just in this week, we are already selling the socks with positive reviews!
Utilized in the management of Diabetes, Arthritis, Edema, Neuropathy and Circulatory issues, the socks are shaped to fit and contain Nano Bamboo Charcoal fibers. The Bamboo fibers help to keep the foot dry featuring an anti-microbial odor control. The non binding construction is also seamless which can help in the prevention of skin irratations and promote healthy skin production. An added feature is the Y Heel and Toe Gore which eliminates bunching in the heel and toe area.
Visit Healthy Steps and learn more about the new line of Dr. Comfort socks and new spring arrivals.
Janet Dixon, C.Ped.
Healthy Steps DFW
For your feet....for your life!
Bamboo Charcoal was discovered during the Ming Dynasty in 1486 A.D. Today Molecular Nano Bamboo Charcoal is made when bamboo charcoal powder is refined by temperatures over 700 degrees. Nano Bamboo Charcoal Fiber (NBCF) is able to release FAR Infrared Rays that may promote blood circulation and increase Anion production.
NBCF is also a natural deodorizer which has innumerable hole structures to absorb and decompose benzene, phenol, methanol sulfides, and nitrides. Bamboo also helps reduce odors from NH3 gas, adjust for moisture, release Anions and restrain microbial growth. The ability for NBCF to regulate skin temperature will also assist in thermoregulating your feet more effectively than traditional materials. As a sustainable natural resource over hardwood charcoal due to its rapid growth cycle, NBCF will protect the environment as no chemicals are required for this product.
Healthy Steps is proud to offer our customers the Dr. Comfort brand Bamboo Seamless Diabetic Socks. Just in this week, we are already selling the socks with positive reviews!
Utilized in the management of Diabetes, Arthritis, Edema, Neuropathy and Circulatory issues, the socks are shaped to fit and contain Nano Bamboo Charcoal fibers. The Bamboo fibers help to keep the foot dry featuring an anti-microbial odor control. The non binding construction is also seamless which can help in the prevention of skin irratations and promote healthy skin production. An added feature is the Y Heel and Toe Gore which eliminates bunching in the heel and toe area.
Visit Healthy Steps and learn more about the new line of Dr. Comfort socks and new spring arrivals.
Janet Dixon, C.Ped.
Healthy Steps DFW
For your feet....for your life!
Monday, February 9, 2009
Vitamin D, the new front runner?
You have probably heard a blip or two on the news about vitamin D.
It turns out; vitamin D has quite the resume of benefits to keep you on the road to good health.
Your muscles and bones are important in maintaining your balance, posture and mobility. As we age, it is crucial to maintain strong muscles and bones to prevent falls especially to persons who are age 65 and over. Vitamin D can assist in maintaining your muscle and bone strength and has been shown to increase certain types of muscle fibers resulting in greater mobility and balance. Bones benefit as vitamin D helps the absorption of calcium.
In an article published by researchers from Loyola University Chicago Marcella Niehoff School of Nursing concluded that adequate intake of vitamin D may prevent or delay the onset of diabetes in addition to reducing complications of previously diagnosed with diabetes.
Millions of Americans with diabetes have low vitamin D levels. Evidence suggests that vitamin D plays an integral role in insulin sensitivity and secretion. Vitamin D deficiency results in part from poor nutrition, which is one of the most challenging issues for people with diabetes. Another culprit is reduced exposure to sunlight, which is common during cold weather months when days are shorter and more time is spent indoors.
Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements such as Cooper Complete Vitamin D supplements offered at Healthy Steps can decrease the risk of diabetes and related health concerns.
With no known side effects, vitamin D can be combined with most medications however, ensure you check with your physician prior to taking any supplements.
Janet Dixon, C.Ped.
Healthy Steps DFW
For your feet...for your life!
It turns out; vitamin D has quite the resume of benefits to keep you on the road to good health.
Your muscles and bones are important in maintaining your balance, posture and mobility. As we age, it is crucial to maintain strong muscles and bones to prevent falls especially to persons who are age 65 and over. Vitamin D can assist in maintaining your muscle and bone strength and has been shown to increase certain types of muscle fibers resulting in greater mobility and balance. Bones benefit as vitamin D helps the absorption of calcium.
In an article published by researchers from Loyola University Chicago Marcella Niehoff School of Nursing concluded that adequate intake of vitamin D may prevent or delay the onset of diabetes in addition to reducing complications of previously diagnosed with diabetes.
Millions of Americans with diabetes have low vitamin D levels. Evidence suggests that vitamin D plays an integral role in insulin sensitivity and secretion. Vitamin D deficiency results in part from poor nutrition, which is one of the most challenging issues for people with diabetes. Another culprit is reduced exposure to sunlight, which is common during cold weather months when days are shorter and more time is spent indoors.
Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements such as Cooper Complete Vitamin D supplements offered at Healthy Steps can decrease the risk of diabetes and related health concerns.
With no known side effects, vitamin D can be combined with most medications however, ensure you check with your physician prior to taking any supplements.
Janet Dixon, C.Ped.
Healthy Steps DFW
For your feet...for your life!
Monday, February 2, 2009
Puncture wounds
Did you know that stepping on something could cause an infection? The infection would most likely occur in two to five days, with redness, swelling and pain to the area on your foot.
Puncture wounds happen very commonly in the feet, especially in the summer when you are going barefoot. Most people would not think about it, but stepping on something can lead to an infection if not treated the correct way.
What is the difference between a "puncture wound" and a "cut" in the skin?
A puncture wound has a small entry hole. It can be caused by a pointed object that you step on, like a nail. In contrast, a cut is an open wound in the skin that does not produce a "hole" but rather it produces a "long tear" in the skin.
What can cause a puncture wound?
Foreign Bodies are the most common cause of puncture wounds, most commonly including:
Nails, Glass, Toothpicks, Sewing Needles, Insulin Needles
The biggest concern with a puncture wound is that the wound is considered a "dirty" wound. The reason these are considered dirty is that they involve a foreign body penetrating the skin that is not sterile.
What can happen if I step on a foreign object? Complications are likely, and depend on the severity of the wound. The deeper the wound the more likely an infection will occur. It is very hard to tell how deep a puncture wound is so if you step on something you should seek medical attention as soon as possible.
What will the doctor do when I seek treatment?
The KEY for treatment of a puncture wound is that it is cleaned properly and debrided. It is very easy for debris to get stuck in this hole that you have created in your foot. If the debris is not removed it can lead to an infection. Also part of the foreign body may be lodged inside your foot and you would not know. A doctor might also take x-rays to evaluate bone damage.
No matter what, it is a good thing to be evaluated by a doctor if you have stepped on someting. Proper and early treatment can lead to a full recovery without infection.
Puncture wounds happen very commonly in the feet, especially in the summer when you are going barefoot. Most people would not think about it, but stepping on something can lead to an infection if not treated the correct way.
What is the difference between a "puncture wound" and a "cut" in the skin?
A puncture wound has a small entry hole. It can be caused by a pointed object that you step on, like a nail. In contrast, a cut is an open wound in the skin that does not produce a "hole" but rather it produces a "long tear" in the skin.
What can cause a puncture wound?
Foreign Bodies are the most common cause of puncture wounds, most commonly including:
Nails, Glass, Toothpicks, Sewing Needles, Insulin Needles
The biggest concern with a puncture wound is that the wound is considered a "dirty" wound. The reason these are considered dirty is that they involve a foreign body penetrating the skin that is not sterile.
What can happen if I step on a foreign object? Complications are likely, and depend on the severity of the wound. The deeper the wound the more likely an infection will occur. It is very hard to tell how deep a puncture wound is so if you step on something you should seek medical attention as soon as possible.
What will the doctor do when I seek treatment?
The KEY for treatment of a puncture wound is that it is cleaned properly and debrided. It is very easy for debris to get stuck in this hole that you have created in your foot. If the debris is not removed it can lead to an infection. Also part of the foreign body may be lodged inside your foot and you would not know. A doctor might also take x-rays to evaluate bone damage.
No matter what, it is a good thing to be evaluated by a doctor if you have stepped on someting. Proper and early treatment can lead to a full recovery without infection.
Saturday, January 17, 2009
What is a Bunion??
Video blog from Dr Giacalone discussing bunions and their treatment.
For more information on Hallux Abducto Valgus deformities, also known as bunions, click here!
For more information on Hallux Abducto Valgus deformities, also known as bunions, click here!
Friday, January 9, 2009
Oh My Aching Toes!
“My toes are hurting every time I put on a pair of shoes! Even my Crocs hurt! I’ve noticed some little red spots on my toes that seem to be growing. What’s going on? I’ve tried to scrub them off but they hurt! I even tried some pads but they just made my shoes hurt more! Help!”
Sounds like she may have corns! Corns: such a simple name for a relatively complex problem. Corns can be extremely painful and actually are caused by several different foot ailments, so finding the root cause can take some detective work.
What is a corn?
The name “corn” came from the appearance of a bump that looks like a corn kernel on or between your toes. Corns are actually your body’s defense against the rubbing of your shoes. They are protective layers of compacted, dead skin cells. Corns can be “soft” or “hard”. Soft corns are usually seen in between the toes and hard corns are on the tops or tips of your toes.
What causes a corn?
These annoying bumps are caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe like a seam. Either your toes are crooked or the shoe just does not fit properly. The friction and pressure can cause painful burning or aching which makes wearing shoes very uncomfortable.
Why do my corns hurt even without shoes?
If you have pain in a corn, even when you do not have shoes on, you have most likely developed bursitis which is inflammation of the joint under the corn. Bursitis is often treated with an injection of anti-inflammatory into the inflamed area. This type of pain should be evaluated by your podiatrist, because the other reason for pain without shoes is an infection in or around the corn. Toe infections can become serious and may even lead to amputation in some patients. Don’t ignore your toe pain!
How are corns treated?
The pain from corns often may be relieved by moleskin or padding on the affected areas. A good moisturizing cream can also help. Your podiatrist can scrape or “debride” the corn to reduce the thickness, but remember never to cut corns with any instrument at home, and never apply home remedies or “corn remover patches”. These invite infection and can make your corns a foot emergency!
There are only two permanent treatments for corns:
1. Surgically correct crooked toes also known as hammertoes.
Or
2. Find the culprit shoe and stop wearing it!
Don’t ignore your toe pain from corns! Relief is simply a visit to the podiatrist away!
Sounds like she may have corns! Corns: such a simple name for a relatively complex problem. Corns can be extremely painful and actually are caused by several different foot ailments, so finding the root cause can take some detective work.
What is a corn?
The name “corn” came from the appearance of a bump that looks like a corn kernel on or between your toes. Corns are actually your body’s defense against the rubbing of your shoes. They are protective layers of compacted, dead skin cells. Corns can be “soft” or “hard”. Soft corns are usually seen in between the toes and hard corns are on the tops or tips of your toes.
What causes a corn?
These annoying bumps are caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe like a seam. Either your toes are crooked or the shoe just does not fit properly. The friction and pressure can cause painful burning or aching which makes wearing shoes very uncomfortable.
Why do my corns hurt even without shoes?
If you have pain in a corn, even when you do not have shoes on, you have most likely developed bursitis which is inflammation of the joint under the corn. Bursitis is often treated with an injection of anti-inflammatory into the inflamed area. This type of pain should be evaluated by your podiatrist, because the other reason for pain without shoes is an infection in or around the corn. Toe infections can become serious and may even lead to amputation in some patients. Don’t ignore your toe pain!
How are corns treated?
The pain from corns often may be relieved by moleskin or padding on the affected areas. A good moisturizing cream can also help. Your podiatrist can scrape or “debride” the corn to reduce the thickness, but remember never to cut corns with any instrument at home, and never apply home remedies or “corn remover patches”. These invite infection and can make your corns a foot emergency!
There are only two permanent treatments for corns:
1. Surgically correct crooked toes also known as hammertoes.
Or
2. Find the culprit shoe and stop wearing it!
Don’t ignore your toe pain from corns! Relief is simply a visit to the podiatrist away!
Tuesday, January 6, 2009
How Long Will it Take to Heal Doc?
This is the age old question isn’t it? “Doc, so how long will it take for this thing to heal?”
Where to begin on this seemingly so easy a question? There are sooooo many factors to take into consideration. This explains why you will hear doctors say “on average…” or “typically…”. We know from experience, and what we’ve read in the mountains of medical literature, when things are suppose to heal. This is the easy part. Here is a very short list of when certain body parts heal:
Bone: 6-8 weeks
Tendons: 3-4 weeks
Ligaments: 3-4 weeks
Stitches: top of foot or leg: 2 weeks, bottom of the foot: 3 weeks
Simple huh! Now for the fun part; we add the human factor to the equation and suddenly, all this simplicity flies out the window! What most patients don’t understand is why they may not fall into these criteria! There is a LAUNDRY list of the reasons why things don’t heal when they should and the number ONE reason things don’t heal when they should is that many patients (yes, I could be talking to you!) say they are listening but they are not doing what they are told to do to get them better! They cheat! Not a lot (though there is that distinguished class of patients who do!), but just a little bit! Yes, that little bit over the weeks it could take sets you back even more weeks! I have heard every excuse in the book as to why people couldn’t follow through with what I asked from them and believe me sometimes there is good reason. But all too often the reason is not all that worthy. A sampling of my favorites so far: “I walked around school in a regular shoe because the boot is ugly, but I was really good at wearing it around the house!” or “I know you told me not to, but I walked on it because I just wanted to see if it was getting better and now it hurts worse!”
Let’s keep it real. There is no guarantee that anything will heal at all much less in the intended time frame. But by not following instructions, you are just plain sabotaging your healing. We are a very small part of the healing equation. YOU MUST DO YOUR PART! Regardless of the reasons why you think you can’t, if you don’t, it will take you longer to get back to doing what you want to do in the first place! Do your part and at least give your body the chance it needs to work the miracle of healing. It really is trying and us “Docs” are really trying too!
Where to begin on this seemingly so easy a question? There are sooooo many factors to take into consideration. This explains why you will hear doctors say “on average…” or “typically…”. We know from experience, and what we’ve read in the mountains of medical literature, when things are suppose to heal. This is the easy part. Here is a very short list of when certain body parts heal:
Bone: 6-8 weeks
Tendons: 3-4 weeks
Ligaments: 3-4 weeks
Stitches: top of foot or leg: 2 weeks, bottom of the foot: 3 weeks
Simple huh! Now for the fun part; we add the human factor to the equation and suddenly, all this simplicity flies out the window! What most patients don’t understand is why they may not fall into these criteria! There is a LAUNDRY list of the reasons why things don’t heal when they should and the number ONE reason things don’t heal when they should is that many patients (yes, I could be talking to you!) say they are listening but they are not doing what they are told to do to get them better! They cheat! Not a lot (though there is that distinguished class of patients who do!), but just a little bit! Yes, that little bit over the weeks it could take sets you back even more weeks! I have heard every excuse in the book as to why people couldn’t follow through with what I asked from them and believe me sometimes there is good reason. But all too often the reason is not all that worthy. A sampling of my favorites so far: “I walked around school in a regular shoe because the boot is ugly, but I was really good at wearing it around the house!” or “I know you told me not to, but I walked on it because I just wanted to see if it was getting better and now it hurts worse!”
Let’s keep it real. There is no guarantee that anything will heal at all much less in the intended time frame. But by not following instructions, you are just plain sabotaging your healing. We are a very small part of the healing equation. YOU MUST DO YOUR PART! Regardless of the reasons why you think you can’t, if you don’t, it will take you longer to get back to doing what you want to do in the first place! Do your part and at least give your body the chance it needs to work the miracle of healing. It really is trying and us “Docs” are really trying too!
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