Be on the look-out for particularly virulent (toxic) strains of staph and strep.Staphylococcus and streptococcus are two infectious bacteria that can, and more commonly these days, become life and limb threatening.
Largely due to the indiscriminate usage of antibiotics these days where a doctor over prescribes pills to treat “just in case”, massively resistant strains of infectious bacteria have now been turned loose on the public.
Methicillin resistant staph aureus, or MRSA as it’s more commonly referred to is an emergency. Special drugs must be utilized to treat this dangerous infection.
The problem with these virulent bacteria is that can progress quickly, literally eating the flesh from your limbs.
MRSA has become increasingly common in both hospitals and around sports teams.
An alarming trend for sure, and if you notice a cut that starts to turn wicked over a short period of time with fever/chills and pain; be sure to see a doctor right away. Be particularly concerned if you start to see streaking or “cellulitis” advancing up your leg.
It could literally save your life.
Many people may wonder about what doctors think about HIPAA. This very question, or something very similar to it, was asked at Yahoo Answers.
I couldn’t help but put my two cents worth in on it.
I can think of one historical incident where a political figure was compromised because of shock treatments that were uncovered in his medical past. Thomas Eagleton, a VP choice of McGovern, had to beg off the position when the press started to have a field day with what the discovered in his medical records.
Would HIPAA have prevented this? I think not. Most doctors resent further government intervention into their affairs. It’s a common sense thing that we didn’t need reams of regulations for.
The most common way I treat chronic, ingrown toenail pain is with phenol. This chemical induces a chemical burn at the level of nail matrix (where your toenail is made).
Because this becomes a chemical burn, the dead nail cells need an open conduit to drain. This drainage process can take anywhere from one to two weeks.
For this reason, I tell my patients that it is very important that they soak their foot every day after the procedure for 15 minutes. I consider this to be so important that not only do I:
- tell them verbally to do so at the office
- give them a written list of post op instructions
- set up an automatic aWeber email reminder system
I can always tell which patients follow my post-op instructions by the level of “crud” I remove from the nail border when they come in for their post-op check.
Also, the level of redness and pain around the nail border are a dead giveaway as well.
So, be good to yourself, follow your doctor’s advice; and your healing period will process as quickly as possible.
One of the first things I tell my patients who come to see me regarding plantar fasciitis is that it’s going to take some time.
Plantar fasciitis, especially when it gets to the point of forming a heel spur, is a long developing process. The spur you are seeing is literally the bone being pulled away by the tight fascia. As you can imagine, this is not an overnight process.
Plantar Fasciitis Damage
I am setting up my patients on the expectation that this will take a while to heal. And by “heal” I mean relief of symptoms to the point where they feel about 85-90% better than when they first came in.
I don’t want patients to have the false expectation that Dr Schafer has a little magic pill to make heel pain go away overnite.
It doesn’t happen that way.
Anything that takes a long time to develop, stands to reason will take a substantial period to heal. The good news is that heel pain is treatable 85% of the time without surgery.
Patients hear this, and it makes the timeframe seem not so bad.
Morning Walker
In this day and age of fast results, with less work we are introduced to yet another miracle product. The Morning Walker! The Morning Walker is an aerobic exerciser for the entire body, designed by “the principle of a goldfish”, but never goes into detail about what exactly the principles of a goldfish are. Some of its health benefits include: improves digestion, weight loss, improved blood circulation, relieves back and muscle pain, as well as, helping to alleviate various diseases and ailments like Diabetes, Insomnia, Arthritis and Digestive Disorders.
It says that using the Morning Walker for 15 minutes produces the same effect as walking 10,000 steps. It works by moving the entire body, most importantly; it is moving the largest muscle group in the body, your legs. “The swinging motion causes your blood to circulate efficiently in the whole body. Letting every cell absorb oxygen and the toxins are removed. Instead of a 6 mile run kind of workout which makes you sweaty and exhausted, with the Morning Walker you can lie down and relax while working out, and your entire body is rejuvenated within these few minutes of workout.”
I hate to be a cynic, but I just feel “Morning Walker” is the antithesis of healthy. behavior. Basically its saying you can stay in bed and work out. That doesn’t seem very “healthy”. Interaction is healthy! Going outside, taking a walk in the park, or here’s a crazy thought, go to a gym. Sweating is good for you it releases toxins from your body. Though I do believe this product might be beneficial for a certain category of people. Like the disabled, who our bed ridden or wheel chair bound, the Morning Walker movement could be good for their circulation. It’s an otherwise silly product.
This young lady has a severe flat foot. Her foot is so severely flat that her heels are everted in stance. What that means is that her heel cannot get to ninety degrees with respect to the ground. A normal heel makes a perpendicular relationship to the ground.
As you can see from this photo, her heels are pointing out or everted.
Flat Feet
This type of foot would require special modifications at the orthotic laboratory. only an experienced podiatrist would catch these sorts of events.
Remember this when you order orthotics from some lay person at a foot store like Foot Solutions.
The subject of this post could be life-changing. It really can be.
One of the few things I remember from my biochemistry days in medical school (I mean who really cares about the Krebs cycle) was when we had a guest lecturer. I think he was a cardiologist.
Anyway, he said that we as podiatrists could alert a patient to something that could truly be life-threatening. All it takes is a simple palpation of a patient’s heel cord. Is there a bulge there?
This could be a tendon xanthoma (from the Greek xanthos meaning yellow).
Achilles Tendon Xanthoma
Your achilles tendon is the most likely site for such a lesion. Such a condition exists 75% of the time in familial hypercholesterolaemia. You’ve heard your doctor say that your 250 cholesterol is too high and you need to cut back. These folks can have cholesterol levels of 600 or more!
Needless to say, this has grave consequences for the condition of your arteries. This would be a plaque generating monster!
So go ahead; feel your achilles tendon. If it has a noticeable bulge, see your doctor right away!
One of the more common presentations to a podiatrist would be that of a plantar wart.
Or is it?
Many such lesions get referred to me by a general practioner as “evaluate wart” when the lesion in question isn’t really a wart at all. I cannot fault them for such; I wouldn’t know the first thing about a heart murmur (well maybe enough to be dangerous).
Medicine has become just that specialized these days. But that is a topic for another day.
What often is confused with a plantar wart is what I call an intractable plantar keratosis, or IPK. These lesions are more pressure related, and are often directly underneath one of your metatarsal heads. These are typically small oval shaped lesions with a clear center.
These used to be dealt with surgically by “raising up” the metatarsal head, and THAT is yet another topic to be covered on yet another day.
What truely makes that lesion a wart is adherence to the following:
Wart
- Warts typically occur in the second and third decade of life.
- Warts are more painful with side to side pressure as opposed to direct pressure.
- Warts have a typical “pinpoint bleeding” effect when cut.
- Warts have an appearance that could be described as “cauliflowering”.
Without at least two of the above present, chances are you have an IPK instead of a wart.
Now aren’t you glad for knowing that?
I’d be curious to know what sorts of treatment you have had for warts, and whether it worked or not. Please comment below.
Another question I hear quite frequently in my office is “what caused my bunion”?
One of the most common misconceptions is that they are caused by shoes. A picture I still remember to this day is that of a happy African native who never wore shoes with bunions the size of Cleveland.
Notice I said a “happy” native. And that brings up an important secondary point. While shoes do not cause bunions, they most definitely exacerbate them.
An easy answer would be to say that they’re heriditary. In other words, look at the feet of your parents and you’ll know how susceptible you could be to forming a bunion.
A more involved answer would be to discuss the actions of the conjoined head of the adductor hallucis muscle. This muscle inserts into the base of your proximal phalanx as shown in this wikipedia article. If the vector of “pull” of this muscle gets altered , it starts to pull the proximal phalanx toward the outside of the foot, thus pushing your metatarsal (that which becomes prominent in a bunion) toward the inside.
I often visualize this for my patients by taking two pens that represent the two bones, and demonstrating the above.
Another post will be to discuss how the adductor halluces gets that abnormal vector pull in the first place.
Until then, be like an African native, and go shoeless. Might help your bunion pain.
Particularly, as it applies to plantar fasciitis and heelpain, Best Website Review Blog does a great job at explaining why orthotics are so vital when foot pain rears its ugly head.
It also shows how common and wide spread the problem of plantar fasciitis really is.
I often tell my patients that you would never go to the grocery store, and buy off the rack one of those reading glasses. In much the same way, why would you buy an arch support when you can get a custom made orthotic? Every foot is different, and thus, requires its own prescription.
Lucky that your foot prescription isn’t known to change as rapidly as your eyes do!
Orthotics are a huge part of the treatment regiment that I give to my patients. Plantar fasciitis is essentially a structural defect; and as such, requires structural bracing. Orthotics go a long way toward relieving the stress that is causing the inflammation and pain often associated with plantar fasciitis.
