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A newsletter from Ankle & Foot Care Centers.

Second Quarter 2016 Edition:

Ankle Replacement Ends 40 Years of Pain, Swelling

After 40 years of persistent ankle pain and little hope for healing, Lavonne Root now has a replacement ankle that lets her walk as much as she'd like with no pain.

The West Farmington woman credits Dr. Lawrence DiDomenico of Ankle & Foot Care Centers, who installed the new ankle, and Google, the search engine that led her to the accomplished foot and ankle surgeon.

"It's been an amazing difference," said Lavonne, 60. "I was in pain all the time and scared to death that my ankle would lock up and make me fall down the stairs. Now I can walk as much as I'd like and I'm confident I can keep working until it's time to retire."

Total ankle replacement involves placing metal and plastic components that re-create an ankle joint. The replacement surgery can dramatically improve mobility and reduce pain for those confirmed as candidates for it.

Lavonne's ankle problems began when she was in a car accident at age 19. She underwent surgery and had pins installed (and later removed) to secure her ankle.

"But my ankle was always huge and swollen, and it always bothered me," she recalled. "As I got older, I got spurs and cysts, and the problems got worse."

About six years ago, she started working at a flooring factory that required rigid steel-toed shoes. Many of her work days lasted 12 hours and involved walking on a concrete floor.

Although she liked the work, her feet would hurt frequently, so she took over-the-counter pain medication every four hours to deal with it.

A doctor recommended ankle fusion surgery, but Lavonne declined after reading that the procedure could overstress her other joints and eventually limit her mobility.

"I read an article about ankle replacement surgery and did a search on Google to see if anyone around here offered it," she recalled. That search turned up the Ankle & Foot Care Centers website.

She made an appointment with Dr. DiDomenico at the Market Street office and, after some tests, was confirmed as a good candidate for a total ankle replacement. Lavonne underwent the surgery early last year and focused on healing and recovering. Daily work on a seated elliptical helped considerably.

"Now, there's no pain and no swelling and my foot doesn't bother me at all," she said. "It's the best thing I've ever done. It makes a big difference and will for the rest of my life."

Copyright © April 2016 Ankle & Foot Care Centers

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Foot Ulcer Treatment Opens Door for Successful Knee Therapy

In 2012, a large ulcer on Wolfgang Weber's foot threatened to derail the therapy he needed to recover from knee replacement surgery.

But treatment led by Dr. Thomas Groner, a podiatric physician with Ankle & Foot Care Centers, eliminated the 2-inch wound so that Wolfgang's therapy and recovery could proceed.

"Dr. Groner did a skin transplant, and the wound healed beautifully," recalled Wolfgang, now 90. "That made it possible for me to follow through with the therapy."

Wolfgang, a retired photographer and resident of Copeland Oaks in Sebring, developed the ulcer because of excessive pressure on his foot. A loss of feeling likely blocked the pain of shoes that were worn too tight.

Because of its size, the ulcer would have hampered the post-surgical program of exercises and flexes Wolfgang needed to work in his new knee.

So Dr. Groner performed a series of skin grafts to close the wound.

"Once Dr. Groner did the skin transplant, it quickly turned the corner and healed up," Wolfgang recalled.

Copyright © April 2016 Ankle & Foot Care Centers

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Newest A&F Surgeon Trained Early on Advanced Procedures

Unlike most young  physicians and surgeons, the newest doctor at Ankle & Foot Care centers has already performed hundreds of advanced reconstructive surgeries.

In fact, Dr. Ramy Fahim, 35, is already teaching courses on such procedures and is the youngest-ever faculty member for the American Academy of Foot and Ankle Osteosynthesis.

"My training was very specialized from the get-go," said Dr. Fahim, who enjoyed a 12-month fellowship in the Mahoning Valley with Dr. Lawrence DiDomenico, a leading surgeon and author.

"I was fortunate to train with Dr. DiDomenico and be exposed to a lot of pathologies and really dove into those. It's been fantastic and I want to keep accomplishing more."

The academy stages comprehensive training programs twice a year in Memphis, Tenn., for residents across the United States in reconstructive surgeries that address deformities, other severe conditions and unsuccessful surgeries.

Dr. Fahim has been delivering classroom and clinical instruction at these sessions for the past two years.

Dr. Fahim grew up in Toronto, Canada. While playing soccer in high school and college, he sustained several foot and ankle injuries and developed a curiosity about podiatry. And although his studies at the University of Toronto were focused on becoming a chemist, he wound up getting a close look at feet when working on a research project about a new treatment for diabetic foot ulcers.

"I was able to relate to that and it furthered my interest in podiatry," Dr. Fahim said.

He earned a bachelor of science degree from the University of Toronto and a doctor of podiatric medicine degree from the Ohio College of Podiatric Medicine in Cleveland.

After a three-year residency in Cleveland and his 2012-2013 fellowship with Dr. DiDomenico, Dr. Fahim went to Naples, Fla., to be a foot and ankle surgeon with Family Foot & Leg Center and also served as medical director for a home-health agency.

He joined Ankle & Foot in February and sees patients in the Warren, Niles, Andover and Campbell offices.

"Our physicians and staff share an excellent family atmosphere," Dr. Fahim said. "I am very grateful to my mentor, Dr. DiDomenico, and our additional physicians and staff for their contributions to my work and the opportunity to return to this practice."

Dr. Fahim lives in Warren and has family in other communities in Ohio, as well as in Florida, Virginia and Canada.

In addition to his work with patients, he has authored and co-authored several medical journal articles, including the Journal of Foot and Ankle Surgery, Podiatry Today and more (see the complete list of his publications here).

When he’s not treating patients, Dr. Fahim enjoys mixed martial arts and other fitness activities, especially jujitsu. 

Copyright © April 2016 Ankle & Foot Care Centers

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Medical Journal Articles Explore Bunion Surgery

Dr. Lawrence DiDomenico recently co-authored two articles published in Journal of Foot and Ankle Surgery, a medical journal.

One article examines the use of frontal rotation in fusion surgeries for patients with bunions. It is available here. The other explores the effects of early weight-bearing after certain bunion surgeries (read it here).

Copyright © April 2016 Ankle & Foot Care Centers

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Diagnostic Center Secretary Enjoys Multi-Tasking, Flexibility

Maryellen Ramos, a medical secretary at Ankle & Foot Care Centers for almost 13 years, is the ultimate people person, and that's one reason she loves her job.

"It's the best place to work," said Maryellen, 58, a Campbell resident. "It's like family. They really care about you here and are flexible to your needs."

When Maryellen needed to accompany her mother to a Cleveland hospital for medical testing three years ago, her colleagues at the Boardman diagnostic center readily accommodated her. They've done the same on other occasions.

Maryellen manages patient information to support the magnetic resonance imaging and other diagnostic services ordered by physicians across Ankle & Foot's 20 locations.

She also orders supplies, answers the phone, schedules appointments and works with a team of other medical secretaries to manage a growing level of activity.

The diagnostic center, located behind the Route 224 office, was just an MRI unit when Maryellen started in 2003. Now its technicians assess and fit patients for orthotics, braces and diabetic shoes and conduct vascular and nerve testing.

"I love the multi-tasking," she said. "The best part of working here is that we have a great group of people here who get along. Everyone knows their job and doesn't have to be told to do it."

At home, Maryellen and Fred Ramos, her husband of 34 years, like to entertain and are well equipped for it. In addition to their swimming pool, they have a large garage for gatherings that often include meat cooking on a spit, themed decor and lots of people having a good time.

The garage is full of Ohio State University decor, as the Ramoses are big Buckeye fans. It's the site of an annual Fourth of July celebration that often draws more than 50 people, an annual "Mexican Night" that celebrates Fred's family heritage and other themed events.

Friends from Ankle & Foot are often among Maryellen's guests. In fact, one of her work colleagues, Michelle Tych, met Maryellen's son Freddie and wound up dating him - and marrying him.

Freddie and Michelle live in Boardman, with Maryellen and Fred's two grandchildren, Julianna and Freddie. Maryellen's daughter, Melissa, lives with her husband Seth in Niles. Maryellen and Fred have a dog with a true fan's name: Buckeye.

She also enjoys cross-stitch, crafts and mystery novels.

Copyright © April 2016 Ankle & Foot Care Centers

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Coal Miner Walks Away from Pain After Ankle Replacement

Ankle replacement surgery enabled Ohio coal miner Frank Sadlowski to walk away from the severe pain and mobility limits he sustained when he stepped in a hole at work five years ago.

The Shadyside resident recently went back to work after a therapy program and now says he can walk comfortably for the first time since 2011.

"It's going well," said Frank, 58. "Before it was like walking around with a sprained ankle 24/7. Now I'm walking around with a lace-up brace, just for the confidence, but I really don't need it."

Five years ago Frank stepped in a deep hole and tore a ligament while working at the mine in Cameron, W. Va., then part of Consol Energy.

He got medical attention quickly, but it didn't help much.

"I had a real bad sprain, and a lot of pain, and wound up in a walking cast for six weeks," Frank said. "I had therapy, but the pain didn't go away. I couldn't even walk around unless I stepped sideways."

He missed a lot of work. Two years ago, a Steubenville surgeon recommended by his therapist removed bone spurs from Frank's ankle, and that reduced his severe swelling but didn't change the pain.

Then that doctor recommended Dr. Lawrence DiDomenico of Ankle & Foot Care Centers, a leading foot and ankle surgeon and total ankle replacement specialist.

Frank met with Dr. DiDomenico in late 2014 and was glad to hear he was a good candidate for a total ankle replacement, largely because he was not overweight and stayed active with his work.

After the January 2015 surgery, he dedicated himself to recovery and therapy, including walking and exercising in water, weight-lifting and other physical therapy.

Now he's back to work and able to walk around without pain or limits.

"Sometimes when I get back on my feet after a rest, there's some pain, but once I take about 20 steps, it goes away and I feel fine," Frank said. "It's made a big difference."

In total ankle replacement, a surgeon places metal and plastic components that re-create an ankle joint. The replacement surgery can dramatically improve mobility and reduce pain for those confirmed as candidates for it.

Copyright © April 2016 Ankle & Foot Care Centers

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Orthotics, Stretching Often Recommended for Tendinitis

Winter Achilles tendinitis, an inflammation of the Achilles tendon, is one of the most common causes of foot or ankle pain, and it becomes more common as fair weather arrives. Dr. Mark Smesko of Ankle & Foot Care Centers writes about causes, treatments and prevention in this blog.


Copyright © April 2016 Ankle & Foot Care Centers

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New YSU Scholarship Honors Ankle & Foot Administrator

Winter A new scholarship in the name of Ankle & Foot Care Centers Practice Administrator Michael Vallas (far left in picture) has been established for business students at Youngstown State University.

The Mahoning Valley Hospital Foundation recently established scholarships named for Vallas, who served on the foundation's board of directors, and two others -- Mike Senchak (far right), co-founder of Mahoning Valley Hospital, and Alice Guerra, a former foundation board member and professor emeritus at YSU's Department of Health Professions. 

Vallas holds bachelor's and master's degrees from YSU and has been practice administrator at Ankle & Foot since 1999. More information about the YSU scholarships is available here.

Copyright © April 2016 Ankle & Foot Care Centers

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From the Kitchen: Italian Sausage Frittata

From The Kitchen

(From the Kitchen recipes are provided by the Diabetes Partnership of the Mahoning Valley.)

A frittata -- a thick omelet -- makes a quick supper. It is perfect for a busy weekday meal. All you need are a few vegetables, some sausage or leftover cooked meat and eggs, and you can have your meal ready in a jiffy.

This recipe serves: 2 people
Prep time: 10 minutes
Cook time: 25 minutes
Diabetic friendly? Yes


1/4 lb Italian turkey sausage
2 tsp olive oil
1/2 lb russet or baking potatoes, cut into 1/2-inch cubes (about 1 1/2 cups)
2 cups sliced onion
2 cups washed, ready-to-eat spinach
2 cups sliced baby bella mushrooms
2 tsp minced garlic
2 large eggs
5 large egg whites
1/4 cup nonfat milk
1/2 cup fresh basil
1/4 tsp freshly ground black pepper


From The Kitchen1. Preheat the broiler. Cut the sausage into 1/2-inch slices.

2. Heat the oil in a medium, ovenproof, nonstick skillet over medium-high heat. Add the potatoes and saute 3 minutes. Add the sausage, onion and spinach and saute 3 minutes, stirring several times. Add the mushrooms and garlic. Continue to cook 1 to 2 minutes.

3. Meanwhile, whisk the whole eggs, egg whites and milk together. Tear the basil into small pieces and add to the egg mixture along with the black pepper.

4. Pour egg mixture into the skillet and gently stir vegetables to make sure the egg mixture spreads throughout the pan. Press the sausage and vegetables into the egg mixture. Turn the heat to low and cook 10 minutes. Frittata will be mostly cooked through.

5. Place the frittata under the broiler for 1 to 2 minutes to brown. Watch to make sure the top doesn't brown too much.

6. To serve, loosen frittata around edges, cut in half, and slip each half onto an individual plate.

For more information, including nutritional information, see this link.

From Delicious One-Pot Dishes by Linda Gassenheimer, via

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